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From the 7/16/2021 release of VAERS data:

Found 479,813 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 40 out of 4,799

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VAERS ID: 1462069 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood pressure increased, Disturbance in attention, Fatigue, Headache, Heart rate irregular, Inflammation, Neck pain
SMQs:, Neuroleptic malignant syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Cardiac arrhythmia terms, nonspecific (narrow), Depression (excl suicide and self injury) (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metoprolol
Current Illness:
Preexisting Conditions: hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rather intense headache and fatigue night of vaccination, but that was expected. Since then (from day 2 up till now), persistent headache (dull at the back of the head), neck and shoulder ache. Very annoying and makes it difficult to think and/or concentrate. Also having strange inflammation (both in the head and cardiac) and erratic heartbeat, likely contributing to increased blood pressure.


VAERS ID: 1462072 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-08
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / UNK RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Immunisation, Product preparation issue
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Vial of vaccine improperly reconstituted and administered on 07/08/2021. Patient contacted on 07/09/2021. Home visit conducted on 07/10/2021 and correct dose of 0.3ml administered.


VAERS ID: 1462076 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-08
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / UNK RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Immunisation, Product preparation issue
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Vial of vaccine improperly reconstituted and administered on 07/08/2021. Patient contacted on 07/09/2021. Home visit conducted on 07/10/2021 and correct dose of 0.3ml administered.


VAERS ID: 1462079 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Pallor, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: no illnesses day of or up to one month prior
Preexisting Conditions: no long-standing conditions
Allergies: no allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient became lightheaded, pale, and dizzy several minutes after vaccine. She vomited into a trash can and had fainted into her chair during the minutes following the husband alerting the pharmacy team she was having a reaction (we were there to witness and aid the patient.) After vomiting and having water, the patient recovered quickly. We monitored her one on one in the vaccine room for about 10 to 15 additional minutes and also took her blood pressure and temperature (both normal.) Patient remarked that she felt completely fine thereafter.


VAERS ID: 1462151 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-18
Onset:2021-07-01
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW01818/21 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Dyskinesia, Insomnia, Loss of personal independence in daily activities, Panic attack, SARS-CoV-2 antibody test negative, Self-injurious ideation, Soliloquy, Suicidal ideation, Tachyphrenia
SMQs:, Suicide/self-injury (narrow), Neuroleptic malignant syndrome (broad), Dementia (broad), Dyskinesia (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Teen girl vitamins - 1 a day
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: On July 4th, Hospital gave her COVID antibody test. They reported it came back negative. What happened? Is it all attacking her brain?
CDC Split Type:

Write-up: 3 days after dose 1, which was given on 05/28/21, PT reported feeling not herself. She was experiencing brain fog and not able to focus on her school work. She was worried about not being able to finish up the school year. We figured it was just "burnout", but knew this was strange behavior for PT who is usually very focused and has no problem getting good grades. We let her get the 2nd vaccine on June 18th. About 10 days later, PT reported feeling like her mind was racing and she could not sleep for 5 nights. She was very anxious and having panic attacks. On July 4th, PT came to us and told us, "the only way to stop the thoughts is to hurt myself." We immediately took PT to the Hospital ER. We have NEVER seen PT like this and she has NEVER had thoughts like this. She was talking to herself, making strange body movements and this frightening behavior came out of nowhere. They kept her overnight and sent her home with referrals to other doctors. She is still having suicidal thoughts and cannot function. We have had to cancel all trips, summer camps and check her out of soccer for the next month. There is no way she is going to be able to go to anything.


VAERS ID: 1463013 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821287 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Decreased appetite, Hyperhidrosis, Nausea, Pain of skin
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Arthritic pains
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210709209

Write-up: SWEATING; STOMACH ACHE; STING ON THE RIGHT SIDE OF FACE; NAUSEA PREVENTED FROM EATING ANYTHING; NAUSEA; This spontaneous report received from a patient concerned a 64 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included aches every day due to history of arthritis.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821287, expiry: UNKNOWN) dose was not reported, administered on 30-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-JUL-2021, the subject experienced sweating. On 01-JUL-2021, the subject experienced stomach ache. On 01-JUL-2021, the subject experienced sting on the right side of face. On 01-JUL-2021, the subject experienced nausea prevented from eating anything. On 01-JUL-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sting on the right side of face on 01-JUL-2021, was recovering from sweating, nausea, and stomach ache, and the outcome of nausea prevented from eating anything was not reported. This report was non-serious.


VAERS ID: 1463032 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Abdominal pain upper, Injection site bruising
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Diabetes; Spider bite
Preexisting Conditions: Medical History/Concurrent Conditions: Liver transplant
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210717625

Write-up: STARTED TO FEEL LIKE SOMEONE IS STANDING ON MY STOMACH IN THE MORNING/HE THOUGHT HE WAS CONSTIPATED/ PAIN THEN STARTED TO MOVE FROM THE LEFT SIDE THEN IN HIS BACK; BLACK AND BLUE AT THE INJECTION SITE; This spontaneous report received from a patient concerned a 71 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included liver transplant, and concurrent conditions included diabetes, and spider bite. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A, expiry: 05-AUG-2021) dose was not reported, administered on 01-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-JUL-2021, the subject experienced black and blue at the injection site. On 06-JUL-2021, the subject experienced started to feel like someone is standing on my stomach in the morning/he thought he was constipated/ pain then started to move from the left side then in his back. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from black and blue at the injection site on JUL-2021, and had not recovered from started to feel like someone is standing on my stomach in the morning/he thought he was constipated/ pain then started to move from the left side then in his back. This report was non-serious.


VAERS ID: 1463342 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-29
Onset:2021-07-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Hypersensitivity, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021828873

Write-up: Severe Allergic Reaction; Developed a Severe Rash; Severe Allergic Reaction; Developed a Severe Rash; This is a spontaneous report from a contactable consumer (patient). A 58-year-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection; Lot number: FA6780) via an unspecified route of administration in left arm on 29Jun2021 as dose 2 single for COVID-19 immunization. Patient had no medical history and was not taking any other Products. Concomitant medications of the patient were not reported. Patient previously received historical first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection; Lot number: ER8735) via an unspecified route of administration on 08Jun2021 as dose 1st single for COVID-19 immunization. On 01Jul2021, 48 hours after receiving second dose of vaccination, patient experienced severe allergic reaction; developed a severe rash. Patient received treatment with Antihistamine. Outcome of the event not recovered/not resolved. Follow-up attempts are needed. Further information is expected.


VAERS ID: 1463490 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Ageusia, Nausea, Pain, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: melatonin, depakote, sedalia
Current Illness: epilepsy, TBCK gene carrier
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: rash, stomach pain, fever, body aches, nausea, loss of taste.


VAERS ID: 1463561 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-01-01
Onset:2021-07-01
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Muscular weakness, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tetnus
Other Medications: Several, took all for years before vaccination
Current Illness: No
Preexisting Conditions: Hypothyroid, increased BP
Allergies: Tetnus, morphine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pain and muscle weakness in opposite arm from 2nd vaccination until now


VAERS ID: 1463626 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-23
Onset:2021-07-01
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Dizziness, Erythema, Injection site rash, Peripheral swelling, Rash, Rash papular, Rash pruritic
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Venlafaxine Adderal
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: On June 23, my arm was swollen; very red and i could see tiny raised bumps around the injection site and i felt dizzy now and again. When i woke on july 1st i noticed a rash with raised very itchy bumps on my chest, neck and face including my eyelid, and they were extremely itchy. The next few days i continued finding more red itchy bumps my shoulds all around my neck my left arm mostly my wrist, my stomach on the left side and my left thigh. This is a servere very inflamed rash. I am still dizzy and the rashes are huge. Ans my left side stomach just started hurting today


VAERS ID: 1463634 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Cough, Decreased appetite, Dizziness, Headache, Hypotension, Malaise, Nausea, Oropharyngeal pain, Pain, Rhinorrhoea, Vertigo
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I was taking an antibiotic for bacterial vaginosis and previous to that I took antibiotic for a bladder infection. I was not taking vitamins
Current Illness: I was just passing some bladder stones and was given antibiotic and than the week I got the vaccine I was taking the other antibiotic for bacteria vaginosis. I took the antibiotic that morning and had the vaccine at 2 pm but than I didn?t want to continue with antibiotic
Preexisting Conditions: No
Allergies: No I am not allergic to any medication
Diagnostic Lab Data: No I didn?t go to see a dr.
CDC Split Type:

Write-up: The following day in the morning, I felt weak and my blood pressure was low, than same day I felt nauseated and felt like my head was spinning inside. It was like that all day. 2nd day I felt nauseated and also my head was like spinning inside and than had a very terrible headache later in the day &I was not hungry. I was just in bed. 3rd day, all my body felt sick, had mild running nose, mild cough, mild soar throat and just felt ache, I felt like that all day and till the 4th day. I started feeling myself in the evening of the 4th day. 5 th & 6th day, I just felt on and of light headed and nauseated. It was the most miserable days I?ve had.


VAERS ID: 1463696 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-28
Onset:2021-07-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure measurement, Blood test, Echocardiogram, Electrocardiogram, Myocarditis, Ultrasound scan
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ibuprofen
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: 7/2/2021 - EKG, Ultra sound, echocardiogram, blood pressure, blood tests, oxygen level 7/3/2021 - EKG, echocardiogram, blood pressure, blood tests, oxygen level 7/2/2021 - EKG, echocardiogram, blood pressure, blood tests, oxygen level 7/2/2021 - EKG, echocardiogram, blood pressure, blood tests, oxygen level 7/2/2021 - EKG, echocardiogram, blood pressure, blood tests, oxygen level
CDC Split Type:

Write-up: PT had myocarditis as a result of the second dose of the vaccine. He spent 5 days at Hospital.


VAERS ID: 1463715 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood bilirubin increased, Dizziness, Dyspnoea, Haematocrit normal, Haemoglobin normal, Headache, Heart rate increased, Pain in extremity, Peripheral swelling, Pyrexia, Rash, Red blood cell count normal, Tinnitus, Vertigo, Vision blurred
SMQs:, Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (narrow), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Breo 200mg Zyrtec-D Flonase
Current Illness: None
Preexisting Conditions: Cerebellar Pilocytic Astrocytoma - Successfully Removed Spontaneous Pneumo Thorax - Successfully repaired Chronic Allergies
Allergies: Levoquin Vicodine Codine
Diagnostic Lab Data: July 7th High RBC - 5.7m Hemoglobin - 17.5 HEMATOCRIT - 50.8 Bilirubin - 2.2mg
CDC Split Type:

Write-up: Rapid Heart Beat Blurry Vision High Fever - Approaching 2 weeks Strong Dizziness/Vertigo Rashes Week long Headaches Hard to breath Ringing in ears Deep ache/pain in leg & arm with leg swelling


VAERS ID: 1463719 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-01-18
Onset:2021-07-01
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Fatigue, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nauseous, dizzy, tired


VAERS ID: 1463747 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW018S / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram normal, Myocarditis
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Autism
Allergies:
Diagnostic Lab Data: EKG - 7/2/21 - NSR
CDC Split Type:

Write-up: Chest pain, Myocarditis, seen in ED on 7/2/21 (2 days after vaccine) with diagnosis confirmed. no EKG changes, treated with toradol and ibuprofen 600mg TID x 5 days, symptoms resolved by 7/9/21


VAERS ID: 1463924 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-vitamin
Current Illness: none
Preexisting Conditions: none
Allergies: Penicillin, Titanium Dioxide
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bell''s Palsy that lasted for 28 hours


VAERS ID: 1463966 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-31
Onset:2021-07-01
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-vitamins
Current Illness:
Preexisting Conditions: Anxiety
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Numbness and tingling of right side arm, hand, leg, foot


VAERS ID: 1463986 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-15
Onset:2021-07-01
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoxia, Pneumonia, Pyelonephritis, SARS-CoV-2 test negative, Sepsis
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID19 Negative test 6/30/21
CDC Split Type:

Write-up: Patient admitted for sepsis/pyelonephritis/pneumonia/hypoxemia. COVID 19 negative.


VAERS ID: 1464003 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-01-11
Onset:2021-07-01
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1253 / 2 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Back pain, COVID-19, Headache, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: na
Current Illness: none known
Preexisting Conditions: none
Allergies: none known
Diagnostic Lab Data: COVID- 19 rapid 7/5 positive COVID-19 PCR 7/6 saliva - positive
CDC Split Type:

Write-up: On July 1 traveling back from another state, developed headache and back ache on 7/3 developed fever 102. + test for COVID-19. Symptoms resolved by Mon 7/5


VAERS ID: 1464026 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-06-01
Onset:2021-07-01
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Neck pain
SMQs:, Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan 50ng, Ibuprofen
Current Illness:
Preexisting Conditions: Hypertension, osteoarthritis
Allergies: Iodine dye
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 2 weeks after vaccination and still continuing, head and neck pain. Running up neck to the back of head all the way to the top of head in the back.


VAERS ID: 1464106 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia, Skin irritation
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Since getting the vaccine continuous arms/legs falling asleep/numb/pins and needles/feeling like sharp pricks and irritation


VAERS ID: 1464168 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-17
Onset:2021-07-01
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Parosmia, SARS-CoV-2 test negative
SMQs:, Taste and smell disorders (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Plantival (Melissa and Valerian extract) Ginseng Ginkgo Biloba Vitamin C and D
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: On Thursday 8th I consulted with an otolaryngologist, he asked me for a PCR COVID-19 test, which was negative. As a result of the above, he suggested me to contact you and inform of this. As a treatment, he asked me to do olfactory retraining smelling lemon, rose water, cloves and eucalyptus in series, 4 times a day for 2 weeks.
CDC Split Type:

Write-up: From the second week of the vaccination I began to perceive a smell of burning or smoke. It started gradually on Thursday July 1st with low intensity of the odor and few events per day. AS of Sunday July 4 the smell reached its maximum and the events per day were prolonged. On Monday July 5 and Wednesday July 7 the events were similar to that of July 4. On Tuesday 6 and Thursday 8, the intensity of the odor remained but the events decreased. As of Friday the 9th the events have been few (1 to 3 a day) with less odor intensity than past events, and the duration periods have decreased. On Thursday 8th I consulted with an otolaryngologist, he asked me for a PCR COVID 19 test, which was negative. As a result of the above, he suggested me to contact you and inform of this. As a treatment, he asked me to do olfactory retraining smelling lemon, rose water, cloves and eucalyptus in series, 4 times a day for 2 weeks.


VAERS ID: 1464186 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-02-10
Onset:2021-07-01
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Decreased appetite, Dyspnoea, Nasal congestion, Pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Kenalog (local), Amlodipine, Wixela, Albuterol, Gabapentin, Meloxicam, Spiriva, Duloxetine
Current Illness: None
Preexisting Conditions: ADHD, Osteoarthritis, HTN, Allergic Rhinitis, moderate depression, neuropathy, COPD, bilateral hearing loss, bilateral knee pain
Allergies: Animal hair, Trees
Diagnostic Lab Data: 07/01/21: Positive SARS-COV-2-RNA
CDC Split Type:

Write-up: 07/01/21: cough, fever, runny nose, nasal congestion, shortness of breath, body aches, loss of taste and smell, loss of appetite


VAERS ID: 1464313 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: CSF protein increased, Discomfort, Fibrin D dimer, Gait disturbance, Hypoaesthesia, Immunoglobulin therapy, Impaired driving ability, Laboratory test, Lumbar puncture abnormal, Magnetic resonance imaging head normal, Magnetic resonance imaging neck, Magnetic resonance imaging thoracic normal, Mobility decreased, Muscular weakness, Orthosis user, Paraesthesia, Peripheral swelling, Platelet count normal, Sitting disability, Spinal X-ray, Ultrasound Doppler normal, Walking aid user
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: multivitamin, Vit D, Vit B, MTHF, Neuro-Mag, NAC
Current Illness: none
Preexisting Conditions: none
Allergies: Amoxicillan
Diagnostic Lab Data: June 22: labwork per doctor''s order -- Vit B looked good, platlettes looked good; negative for DIMMER (blood clot) June 24: unable to sit in chair; spending most of the day horizontal on bed or sofa; visited Dr. x-rays on lumbar spine (negative for tumors and cysts); given crutches and ankle brace and prednisone prescription June 24: visited for Doppler on leg (negative for blood clot) June 25: started taking prednisone, which alleviated discomfort/swelling, although leg still numb with limited mobility and circulation and still unable to sit in chair or walk well June 25: visited for MRI of lumbar (negative for pinched nerve and herniated disc) June 29: consultation at Neurology June 30: weakness/tingly in both hands, both feet; right leg getting weaker; not able to drive safely July 1: visited Wake med ER and admitted to hospital July 2: MRIs of brain, cervical, and thoracic spine (all looked good) July 2: lumbar puncture, revealing elevated proteins (77); started IVIG treatment in hospital July 6: finished IVIG treatment; discharged from hospital July 12: awaiting follow-up appts with out-patient PT and Neurology
CDC Split Type:

Write-up: May: tingly/pins-and-needles in hands June: loss of feeling/numbness in left lower leg; quickly followed by acute weakness and loss of feeling/mobility in right leg and both hands and forearms


VAERS ID: 1464445 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-22
Onset:2021-07-01
   Days after vaccination:129
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray normal, Cough, Electrocardiogram, Hyperhidrosis, Night sweats, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: cetirizine (ZyrTEC) 10 mg tablet irbesartan-hydroCHLOROthiazide (AVALIDE) 150-12.5 mg per tablet
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Updated Procedure 07/08/21 1148 POCT COVID-19 PCR Collected: 07/08/21 1148 | Final result | Specimen: Swab from Nares POC COVID-19 PCR DetectedAbnormal Lot # 1000265155 Point of Care COVID-19 PCR Testing Method Cepheid Lot Expiration Date 05/15/22 Study Result Narrative & Impression XR CHEST 2 VW IMPRESSION: No acute findings or significant interval change. END OF IMPRESSION: INDICATION: Cough. Exposure to Covid. TECHNIQUE: Upright PA and lateral chest COMPARISON: 4/23/2012 FINDINGS: No diffuse or focal airspace disease, pleural effusion or pneumothorax. Heart, mediastinum and bones are within baseline normal limits. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. Result History X-ray chest 2 views on 7/8/2021 - Order Result History Report
CDC Split Type:

Write-up: Office Visit 7/8/2021 Family Medicine COVID-19 virus infection +2 more Dx Covid-19 Screening Reason for Visit Progress Notes (Nurse Practitioner) ? ? Family Medicine ? ? Encounter Date: 7/8/2021 ? ? Addendum Nontoxic 65 y.o. male presenting with viral symptoms for a week with known exposure to COVID-19 household member. Reports periods of diaphoresis without chest pain or palpitations. On exam hemodynamically stable without respiratory distress or hypoxia. Appears well-hydrated with clear breath sounds. Chest x-ray-no acute process. EKG sinus rhythm ventricular rate 75 bpm. No ischemic changes. COVID-19 testing completed. Instructed to quarantine at home according to Department of Health guidelines. Symptomatic treatments reviewed. Red flag symptoms for follow-up reviewed. Addendum: Covid 19 result positive. Patient was contacted with test results. Again encouraged symptomatic management with over-the-counter cough and cold medication, Tylenol or ibuprofen, stay hydrated. Follow-up with PCP for shortness of breath, uncontrolled fever, uncontrolled vomiting. Symptoms began July 6. Last day of isolation is July 16th 2021. Monoclonal antibody infusion discussed with patient but he feels that his symptoms are not severe enough at this point. States he will call back if symptoms worsen. 1. COVID-19 virus infection 2. Night sweat 3. Cough Patient was seen today for covid-19 screening. Diagnoses and all orders for this visit: COVID-19 virus infection - X-ray chest 2 views; Future - POCT COVID-19 PCR Night sweat - ECG 12-lead: URGENT CARE - POCT COVID-19 PCR Cough - X-ray chest 2 views; Future - POCT COVID-19 PCR


VAERS ID: 1464519 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-08
Onset:2021-07-01
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Echocardiogram, Electrocardiogram, Laboratory test, Myocarditis
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: none
Allergies: No known allergies
Diagnostic Lab Data: Multiple lab tests completed at hospital on 7/2. He also had chest x-ray, echocardiogram and ECG.
CDC Split Type:

Write-up: This patient had his first mRNA vaccines when he was under 12 years old from a pharmacy outside of hospital. . He had his second mRNA vaccine on 6/30/21 also from an outside pharmacy. He had post-vaccine myocarditis and was treated at hospital.


VAERS ID: 1464530 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 122128 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Heavy menstrual bleeding, Pelvic pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I got the shot on the first day of my menstrual cycle. About two hours after getting the shot, I experienced excessive bleeding for the next seven hours. For four of those hours I bled through a Tampon every half hour. In addition, to the bleeding, there was a lot of lower back pain, pain in the hips and general pelvic region.


VAERS ID: 1464710 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose normal, Cold sweat, Dizziness, Hyperhidrosis, Pallor, Retching
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BG 116
CDC Split Type:

Write-up: Pt received his Covid vaccine and as was scheduling his second dose, pt stated he started to feel dizzy. patient was reclined and gavin juice and called for assistance from the LVN . Pt was pale, clammy/sweaty, and dry heaving.; call for Rapid Response. They were in the pt''s room within the minute and proceeded to take vitals and treated the pt with a bag of IV fluid while having the pt be observed by an RN for an additional amount of time. After the nurse observed the pt walking on his own, she gave pt permission to leave. Patient was discharged 1601 after receiving a liter of NS IV.


VAERS ID: 1464748 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-08
Onset:2021-07-01
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I took 20mg Simvastatin taken daily for high cholesterol.
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Not applicable
CDC Split Type: vsafe

Write-up: I experienced high blood pressure reading and made an appointment with my doctor one week later because it continued to be extremely high. He stated that my blood pressure swings erratically often and that he was not concerned because of my age and the foods, caffeine, and alcohol could have attributed to the elevation in blood pressure. He also asked me to continue tracking it and to contact him if I experienced any headaches, light headedness or if my blood pressure became too erratically high again.


VAERS ID: 1464804 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-12
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: About 5 minutes after receiving the vaccination patient fainted and was unconscious for about a minute. Patient''s eyes remained open even though he was not conscious. Patient was transported by paramedic to the emergency room


VAERS ID: 1464839 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-15
Onset:2021-07-01
   Days after vaccination:47
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Amenorrhoea
SMQs:, Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, topimax, wellbutrin , fish oil, vitamin d, probiotic
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Missed period, period stopped. Pregnancy tests all negative. Have had 28 day cycle of 3-5 days until now.


VAERS ID: 1465351 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-14
Onset:2021-07-01
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Lethargy, Neuralgia
SMQs:, Peripheral neuropathy (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Promethazine, Protonix, Lexapro, Klonopin, Flexiril, Dycyclomine
Current Illness: Gallbladder Sludge, Cysts on Liver
Preexisting Conditions: Back pain, depression, anxiety
Allergies: Levoquin, Ceftin
Diagnostic Lab Data: CT scan - 7/12/2021 Blood work- 7/12/2021
CDC Split Type:

Write-up: I?ve had extreme lethargy and most recently excruciating nerve pain for over two weeks.


VAERS ID: 1465379 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-15
Onset:2021-07-01
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Herpes zoster, Rash vesicular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroxine 75ug, Vitamin B Complex
Current Illness:
Preexisting Conditions: Hypothyroid
Allergies: Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA Moderate case of shingles, left flank. Vesicular rash appeared July 1, visited urgent care to confirm and was treated with antivirals.


VAERS ID: 1465594 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-01
Onset:2021-07-01
   Days after vaccination:91
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Computerised tomogram, Hypoaesthesia, Magnetic resonance imaging, Neurological symptom, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Propanolol,
Current Illness: none
Preexisting Conditions: treated for high blood pressure
Allergies: none
Diagnostic Lab Data: Initial concern was symptoms due to stroke. three days hospitalization, and multiple tests showed no evidence of stroke, MRI, Multiple CT scans, but Guillian-Barre was never mentioned. Still not confirmed.
CDC Split Type:

Write-up: Severe symptoms of Guillain-Barre syndrome. Began July 1. Admitted to hospital July 2, Numbness on left side began as tingling in both legs. Outcome still in doubt this is ongoing.


VAERS ID: 1465599 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-09
Onset:2021-07-01
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site abscess
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported an abscess at the injection site occurring one month after his second dose. Patient reported having to go to the hospital to have it drained and is currently on antibiotics for it.


VAERS ID: 1465669 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Headache, Heart rate, Heart rate increased, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202107; Test Name: Body temperature; Result Unstructured Data: not reported; Test Date: 202107; Test Name: Heart rate; Result Unstructured Data: rapid
CDC Split Type: USJNJFOC20210713243

Write-up: RAPID HEARTBEAT; SORE ARM; HEADACHE; FEVER; This spontaneous report received from a patient concerned a 20 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 203A21A expiry: UNKNOWN) dose was not reported, administered on 02-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On JUL-2021, the subject experienced rapid heartbeat. On JUL-2021, the subject experienced sore arm. On JUL-2021, the subject experienced headache. On JUL-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) not reported, and Heart rate (NR: not provided) rapid. Treatment medications (dates unspecified) included: acetylsalicylic acid. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from rapid heartbeat, headache, and fever on JUL-2021, and had not recovered from sore arm. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure as the case assessed as non-serious.


VAERS ID: 1465672 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210716868

Write-up: VACCINE ADMINISTERED TO TWO PATIENTS WAS AT ROOM TEMPERATURE FOR FOUR HOURS; INCORRECT PRODUCT STORAGE; This spontaneous report received from a health care professional concerned multiple patients. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and expiry: 04-AUG-2021) dose was not reported, administered on 01-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-JUL-2021, the subject experienced vaccine administered to two subjects was at room temperature for four hours. On 01-JUL-2021, the subject experienced incorrect product storage. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vaccine administered to two patients was at room temperature for four hours and incorrect product storage was not reported. This report was non-serious.


VAERS ID: 1466453 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-07-13
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002B21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, CSF protein increased, Condition aggravated, Demyelination, Electromyogram abnormal, Gait disturbance, Guillain-Barre syndrome, Hypoaesthesia, Immediate post-injection reaction, Immunoglobulin therapy, Limb discomfort, Lumbar puncture abnormal, Nerve conduction studies abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Optic nerve disorders (broad), Demyelination (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Simvasatin Levothyroxin Losartan
Current Illness: None. Was totally well before and immediately after vaccination. Guillian Barre began suddenly in early April.
Preexisting Conditions: High blood pressure (treated)
Allergies: None.
Diagnostic Lab Data: EMG Nerve Conduction Study Lumbar Puncture Full range of blood tests
CDC Split Type:

Write-up: Immediately after injection, my arm was numb for more than 15 minutes. I waited 30 minutes before leaving. After that, all seemed good. In early April, my legs seemed heavy for a day. The next morning, I would barely walk. After visiting an orthopedic surgeon, I was sent to have an EMG and nerve conduction study which showed demylinatization in my legs and somewhat in my arms, especially my right arm. I visited a neurologist who completed extensive blood work and a lumbar puncture. The EMG, nerve conduction study, and very elevated protein in my spinal fluid confirmed Guillian Barre. I had to undergo IVIG treatments, which helped. I continue to suffer from effects today (July 2021), but am now able to walk better. I support the vaccine still. It appears to be saving millions. I just "hate" that I was adversely impacted by the vaccine personally.


VAERS ID: 1466515 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-21
Onset:2021-07-01
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chest pain


VAERS ID: 1466662 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-06-23
Onset:2021-07-01
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have been very fatigued since getting the shot. Far more than normal and it has been over 3 weeks.


VAERS ID: 1466781 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BCP
Current Illness:
Preexisting Conditions: asthma, eczema, Allergic Rhinitis
Allergies: unk
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt states she has burning in her chest substernal about 24 hrs after getting the vaccine. Pt states the pain was about 7/10 and subsides about an hour or so later. Pt denies sob, radiating pain, n/v, fever, chills, GI upset, vision change, skin reaction, h/a, acid taste in mouth. Pt says she has been fine ever since without any residual symptoms. Symptoms: CHEST PAIN, UNSPECIFIED(R079).


VAERS ID: 1466824 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-29
Onset:2021-07-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Rash, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lasix 40 mg, Losartan 25mg, Wellbutrin 300mg
Current Illness: poison ivy rash on right wrist
Preexisting Conditions: Stage 3 Renal Dx
Allergies: PNC, Erythromycin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Itchy rash started by July 1 on inside elbow of right arm. Then surfaced on left arm and right groin area. There is a small patch on her back and between her breast. Ice packs help with itching. Seen in UC and at primary care. Taken Hydroxyzine 25mg and Methyprednisone 4 mg. Zanfel ointment - no help. Oatmeal baths - help some. Benadryl cream makes it worse.


VAERS ID: 1467195 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-01
Onset:2021-07-01
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 5521 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Problems with breathing


VAERS ID: 1467237 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-29
Onset:2021-07-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Aphthous ulcer, Candida test negative, Genital discolouration, Genital discomfort, Genital rash, Sexually transmitted disease test, Urinary tract infection, Urine analysis abnormal, Vulval disorder, Vulvovaginal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: none
Preexisting Conditions: none
Allergies: Sensitivity to omnicef antibiotics
Diagnostic Lab Data: UTI and yeast infection test. 7/1 - positive for UTI, negative for yeast 7/5 STD test - negative on all STDs.
CDC Split Type:

Write-up: She woke up in pain around 6am thinking maybe she had scratched her Labia major. She went back to bed. Throughout the day the pain and discomfort grew. Around 5pm she told me that she was hurting a lot and she needed help. I examined her and it looked like a bruise about the size of a dime but long. I asked if she fell or hurt herself, no. I called the pediatrician and informed them and they suggested seeing them the following day. Took her to the ER later that night due to significant pain. They thought she might have yeast infection or herpes. Gave her some antibiotics and sent her home her pain level was a 7 and she now looked like she chemical burn. The next day I took her to pediatrician. She felt like it could be herpes or something else. Prescribed different meds and sent us home. Nothing for pain. The antibiotics worked a little, but by Monday everything was horrible. She was covered in sores from the labia major to her vulva. Took her to ER where they felt like it was herpes. She was asked about her sexual experience or being molested. They immediately admitted her to the hospital where we stayed for 4 days. With antibiotics, steroids and pain meds. She saw her Gynecologist Tuesday morning where she determined PT was suffering from aphthous ulcers, a side effect that she was aware of from the covid19 vaccine.


VAERS ID: 1467277 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-10
Onset:2021-07-01
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Arthralgia, Blood test, Ear congestion, Ear pain, Fatigue, Feeling abnormal, Feeling cold, Headache, Hyperhidrosis, Influenza like illness, Lymph node pain, Lymphadenopathy, Malaise, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lysine pro; Lantus insulin; Glimepiride; Lexapro; Wellbutrin; Vitamin C; Goli Apple Cider Vinegar gummy supplements
Current Illness: None
Preexisting Conditions: Diabetic; Blood Pressure; Hypertension; PTSD
Allergies: Sulfa; Penicillin; Gluten
Diagnostic Lab Data: Standard blood panel 07/06/2021. Standard blood panel 07/12/2021.
CDC Split Type: vsafe

Write-up: So, I had flue like symptoms chills, body, sweats, join, paint, headaches, nausea and fatigue like crazy. Like feeling overall awful and that was the start as soon as I got it within the next 48 hours. The issue I''ve had since then that sent me to the UC was that I felt like I had a left ear infection. My left ear hurt which was on the same side that I had my shot on. Throbbing and painful and clogged left ear. I felt like I had an ear infection. A few days after that I found right behind my ear, I had a big swelling lymph node and that was before 07/01 and it is still there. I also have a large lymph node under my left armpit. They''ve swollen and they''re painful and that''s ultimately why I went in because I was feeling sick with a lot of fatigue and not feeling good. Because of the ear and lymph nodes behind the ear I wanted to make sure nothing was wrong. When I went to the UC I let them know that I didn''t know if it was because of the vaccine. They tested and said I had some kind of infection and they put me on Augmentin it was a 10-day dose twice a day and that''s what I began to become allergic to since I was prescribed that. I''ve had every side effect from Augmentin that you can have. I''ve had extreme diarrhea, bloating, stomach cramps, joint pains, nausea, lack of appetite and lack of sleep. As of yesterday, the doctor said, "oh yeah you''re having reaction to that", and she switched me to Keflex 4 times a day for 10 days. Six days after my follow, my white blood cell count actually went up. Even though I was on antibiotics my infection increased instead of getting better.


VAERS ID: 1467321 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Wrong product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: pt is not currently on any medications
Current Illness: URI Symptoms
Preexisting Conditions:
Allergies: Non listed
Diagnostic Lab Data:
CDC Split Type:

Write-up: The pt was supposed to receive dexamethasone, however was administered Moderna in error.


VAERS ID: 1468358 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-06
Onset:2021-07-01
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH CVS 03569 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Antinuclear antibody negative, Arthralgia, C-reactive protein normal, Fatigue, Hypoaesthesia, Inflammation, Musculoskeletal pain, Paraesthesia, Rheumatoid factor negative, Tryptase
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamictal, luvox, Lisinopril
Current Illness: None
Preexisting Conditions: Hypertension and depression
Allergies: Bactrim
Diagnostic Lab Data: Labwork for ANA, RF, CRP and tryptase done and WNL. Started on prednisone to calm inflammatory process but still with butt tingling and numbness and joint pain.
CDC Split Type:

Write-up: I began allergy shots for fire ants and on the second shot, I started developing rare tingling and numbness in the buttocks and severe musculoskeletal pain as well as extreme fatigue. Allergist said they have never seen this. Could Covid Vaccine make immune system overrespond to antigens?


VAERS ID: 1468973 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oropharyngeal pain, Tonsillar hypertrophy
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Allergies
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Sore throat and englarged tonsils both sides. Feels like strep.


VAERS ID: 1469617 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Chronic obstructive pulmonary disease
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210715832

Write-up: NOT BEING ABLE TO BREATH; RIGHT LEG AND FOOT VERY SWOLLEN; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. The patient''s concurrent conditions included chronic obstructive pulmonary disease. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose was not reported, administered on 05-JUL-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On JUL-2021, the subject experienced not being able to breath. On JUL-2021, the subject experienced right leg and foot very swollen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from not being able to breath, and right leg and foot very swollen. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard operating procedure as the case is assessed as Non-serious.


VAERS ID: 1469627 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210722862

Write-up: ONE DOSE WAS INADVERTENTLY ADMINISTERED THIS MORNING FROM PUNCTURED VIAL THAT WAS LEFT IN REFRIGERATOR YESTERDAY; THE VIAL WAS LEFT IN THE FRIDGE PUNCTURED FOR AROUND 12 HOURS; This spontaneous report received from a pharmacist concerned a 30 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821286 expiry: 06-SEP-2021) dose was not reported, administered on 09-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On JUL-2021, the subject experienced the vial was left in the fridge punctured for around 12 hours. On 09-JUL-2021, the subject experienced one dose was inadvertently administered this morning from punctured vial that was left in refrigerator yesterday. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the the vial was left in the fridge punctured for around 12 hours and one dose was inadvertently administered this morning from punctured vial that was left in refrigerator yesterday was not reported. This report was non-serious.


VAERS ID: 1469629 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Pain, Poor quality sleep, Venous injury
SMQs:, Accidents and injuries (narrow), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient was healthy and had no previous conditions.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210722944

Write-up: SAFENA VEIN DAMAGED; CONSTANT PAIN; VERY LITTLE SLEEP FOR FEW DAYS; This spontaneous report received from a patient concerned a 39 year old female. The patient''s height, and weight were not reported. The patient was healthy and had no previous conditions. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported, expiry: UNKNOWN) dose was not reported, 1 total administered on 10-JUL-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 10-JUL-2021 immediately after vaccination, the patient felt pain in the left leg and her veins began to feel inflamed, the inflammation began to show in the foot and developed upwards. On an unspecified date in JUL-2021, the patient experienced constant pain and very little sleep for few days until then the patient visited the physician''s office and was told that the patient had her safena vein damaged for which she had to undergo unspecified treatment and potentially surgery. The patient reported that her leg was just fine prior to the vaccine and that the treatment would last for 3 months. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the very little sleep for few days, safena vein damaged and constant pain was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0:20210722944-JANSSEN COVID-19 VACCINE Ad26.COV2.S- venous injury-This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1469651 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Contusion, Diarrhoea, Dyspepsia, Fatigue, Headache, Oedema peripheral
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Gastrointestinal disorder
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210725253

Write-up: STOMACH PAIN; DIARRHEA; BURNING FEELING IN STOMACH; HEADACHE; FATIGUE; MILD REDDISH BRUISE ON RIGHT HAND; RIGHT CALF A LITTLE SWOLLEN VERY MINUTE; This spontaneous report received from a patient concerned a 31 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included previous gastric issues. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821288, and expiry: UNKNOWN) dose was not reported, administered on 05-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On JUL-2021, the subject experienced right calf a little swollen very minute. On 06-JUL-2021, the subject experienced mild reddish bruise on right hand. On 06-JUL-2021, the subject experienced fatigue. On 07-JUL-2021, the subject experienced stomach pain. On 07-JUL-2021, the subject experienced diarrhea. On 07-JUL-2021, the subject experienced burning feeling in stomach. On 07-JUL-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from mild reddish bruise on right hand, and fatigue, and had not recovered from right calf a little swollen very minute, stomach pain, diarrhea, burning feeling in stomach, and headache. This report was non-serious.


VAERS ID: 1469658 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use; Non-smoker
Preexisting Conditions: Comments: The patient had no known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210725476

Write-up: NUMBNESS IN THE ARMS AND LEGS; TINGLING OF LEFT ARM; This spontaneous report received from a patient concerned a 36 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included alcohol use, and non-smoker, and other pre-existing medical conditions included the patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808982 expiry: 07-AUG-2021) dose was not reported, administered on 06-JUL-2021 15:15 for prophylactic vaccination. No concomitant medications were reported. On JUL-2021, the subject experienced tingling of left arm. On 06-JUL-2021, the subject experienced numbness in the arms and legs. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from numbness in the arms and legs, and the outcome of tingling of left arm was not reported. This report was non-serious.


VAERS ID: 1470213 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-03-11
Onset:2021-07-01
   Days after vaccination:112
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Musculoskeletal stiffness, Neck pain, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Rx: lisinopril/hctz tabs 10/12/.5 1 p/day ; atenolol 50 mg 1 p/day ; simvistatin 40 mg 1 p/day; folic acid 1 mg 1 p/day; sulfasalazine 500mg 4 p/day. otc: calcium+D ; multivitamin; turmeric ; fish oil; D3 1000mg; probiotoc ( all are 1 p/da
Current Illness: No
Preexisting Conditions: High Blood pressure High cholesterol Psoriatic Arthritis
Allergies: Tylenol and Keflex
Diagnostic Lab Data: None so far. Have been seeing chiropractor almost every day since July 14 for what I thought was vertabrae out of whack. So far minimul relief. Went to Urgent Care July 10 for prescription anti-inflammatory and muscle relaxer.
CDC Split Type:

Write-up: Began with rash on torso that still keeps spreading to more spots. Within 2-3 days of rash beginning, started with a stiff neck. Within 24 hours stiff neck became extremely painful. Swelling of neck on right side.


VAERS ID: 1470291 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-15
Onset:2021-07-01
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Limb discomfort, X-ray
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trazodone 200mg, Hydrohybamoate 50mg, Tamsulosin 0.4mg, Adderall, Mirtazapine 45mg, Atorvastatin 20mg, Aripiprazole 5mg, aspirin tabs 81mg, Doxepin 100mg,
Current Illness: no
Preexisting Conditions: COPD, Bronchitis, Emphysema
Allergies: no
Diagnostic Lab Data: yes, x rays at hospital
CDC Split Type:

Write-up: numbness from top of head all the way to the bottom of feet, heavy feeling in foot and arm on the left side, on right big toe numbness


VAERS ID: 1470329 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Vaccine positive rechallenge
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: had same reaction with pfizer first dose, persistent headache as well.
Other Medications: unknown
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: unknown
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: persistent headache since day after administration of second vaccine.


VAERS ID: 1470343 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Cough, Dyspnoea, Headache, Muscular weakness, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Dupixent
Current Illness: Mycobacterium Adium intracellulare. Eczema
Preexisting Conditions: MAI lung infection. Eczema
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Previous history covid in March 2021. After first shot reactivating of covid symptoms. Fatigue,fever,sever back pain,muscle aches,severe lethargy and headache. After second shot, shortness of breath,cough,headache,back pain and muscle weakness reactivated, cough, severe facial rash.


VAERS ID: 1470495 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-17
Onset:2021-07-01
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Public       Purchased by: ?
Symptoms: Echocardiogram normal, Electrocardiogram normal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin 200mg daily
Current Illness: None
Preexisting Conditions: Bicuspid Aortic Valve
Allergies: None
Diagnostic Lab Data: EKG, 2D echo performed on: 7/9/21
CDC Split Type:

Write-up: Unknown lot #. Syncope s/p 2 weeks from vaccination


VAERS ID: 1470546 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Nausea, Pain in extremity, Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 50mg, Xulane (Birth control patch), Vitamin D2.
Current Illness: None.
Preexisting Conditions: Asthma.
Allergies: Lactose
Diagnostic Lab Data:
CDC Split Type:

Write-up: After second vaccination became very nausea, arm is swollen. Arm currently still swollen, bruised, itchy and painful.


VAERS ID: 1470585 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2020-12-31
Onset:2021-07-01
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: Diabetes, HTN, Sleep apnea
Allergies: None
Diagnostic Lab Data: Covid swab positive 7/2/2021
CDC Split Type:

Write-up: Developed cough, fatigue, congestion 7/1/21. Symptoms fully resolved by 7/12/21.


VAERS ID: 1470612 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-01
Onset:2021-07-01
   Days after vaccination:122
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Fatigue, Headache, Myalgia, Nasal congestion, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccinated by Pfizer on 3/1/20 and 3/22/21. Symptom onset 7/1/21 with cough, runny nose, muscle aches, loss of smell, loss of taste, sore throat, nasal congestion, headache,, fatigue. Tested positive for Covid-19.


VAERS ID: 1470621 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-22
Onset:2021-07-01
   Days after vaccination:101
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Fatigue, Headache, Myalgia, Nasal congestion, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccinated with Pfizer on 3/1/21 and 3/22/21. Symptom onset 7/1/21 - cough, runny nose, muscle aches, loss of smell and taste, sore throat, nasal congestion headache and fatigue. Tested positive for Covid19 on 7/13/21.


VAERS ID: 1470673 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-15
Onset:2021-07-01
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injected limb mobility decreased, Injection site discomfort, Injection site hypoaesthesia, Injection site muscle weakness, Injection site pain, Injection site paraesthesia
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Linsinpril Amlodipine Azathoriprin Hydroxychroquine Metoprolol
Current Illness:
Preexisting Conditions: Lupus Osteoarthritis
Allergies: Demorol ibuprofen
Diagnostic Lab Data:
CDC Split Type:

Write-up: I am experiencing a strong tingling in my left arm where I got the JJ vaccination. While its tingling my upper arm feels as if its being squeezed and I feel pain when it happens. Also it becomes numb to the point my arm is weak, and hard to lift. This happens through out my day, for the last 2wks.


VAERS ID: 1470756 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-06-25
Onset:2021-07-01
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Dizziness, Dyspnoea, Fatigue, Heart rate increased, Hypertension, Muscle tightness, Nausea, Presyncope
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Klonopin
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin, omnicef, sulfa based antibiotics
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rapid heart rate, chest pain, shortness of breath, fatigue, high blood pressure, tight muscles, dizziness, feeling like passing out, nausea, joint pain


VAERS ID: 1470783 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-17
Onset:2021-07-01
   Days after vaccination:106
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest pain, Electrocardiogram, Headache
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multivitamin, zoloft, digestive enzymes, omeprazole
Current Illness: None
Preexisting Conditions: Borderline high cholesterol, heartburn
Allergies: Penicillin, soy
Diagnostic Lab Data: Chest xray, blood work, EKG, (all done 7/3/21 at Emergency room)
CDC Split Type:

Write-up: 7/1/2021: Headache, chest pain (felt like heartburn).


VAERS ID: 1474031 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dysphagia, Rash
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ventolin, apixaban, klonipin, lamictal,zoloft
Current Illness: none
Preexisting Conditions: bipolar, migranes, asthma low back pain.
Allergies: Compazine, reglan, latex, iodinated products, shrimp
Diagnostic Lab Data: none
CDC Split Type:

Write-up: cough difficulty swallowing and chest rash 2 does of Epi given


VAERS ID: 1474361 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-06-21
Onset:2021-07-01
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Balance disorder, Blood test, Dizziness, Fatigue
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood work July 14th 2021
CDC Split Type:

Write-up: A week after vaccine. Felling extremely tired, unbalance, dizzy


VAERS ID: 1474364 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Muscle spasms
SMQs:, Retroperitoneal fibrosis (broad), Dystonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu vaccine, November of 2020, congestion, leg edema, fever, high blood pressure Flu vaccine 2012 or 2013 - hives
Other Medications: Nexium, vitamin d, xyzal, Flonase sensimist all taken within 24 hours of vaccine
Current Illness: Nasal congestion
Preexisting Conditions:
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: I am experiencing lower back pain and muscle spasms she. Standing for longer than 10-15 minutes. I did not include it in my vsafe check in because it wasn?t constant and I didnt think it was related to the vaccine. It wasn?t until I was making a note of when it started to make an appointment with my doctor that I realized that the first instance was within hours of me getting the vaccine.


VAERS ID: 1474381 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-13
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No medications prescriptive or otherwise taken.
Current Illness: None reported.
Preexisting Conditions: None reported
Allergies: no known allergies
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: No symptoms reported, but pt is 11yr and 9 months old.


VAERS ID: 1474441 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-06-03
Onset:2021-07-01
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acne, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metformin, amlodipene, atoravastatin, januvia, jardiance, lisinopril,
Current Illness:
Preexisting Conditions: Type 2 diabetes, hypertension
Allergies: Medication : sulfamethoxazole Foods: Peanuts, almonds, seasonal allergies- pollen, cherries, peaches, plums, apples, pears, raw carrots, raw celery,.....
Diagnostic Lab Data: none saught
CDC Split Type:

Write-up: Rash, cluster of tiny pimples on right shoulder approximately 2inch circumference


VAERS ID: 1474585 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, No adverse event
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NO
Current Illness: NO
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient got 1st dose on 05/20/21 and 2rd dose of vaccine on 07/13/21 53 days after 1st dose. No adverse effect was noticed


VAERS ID: 1474610 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Inflammation, Injection site pain, Joint range of motion decreased, Limb injury, Loss of personal independence in daily activities, Product administered at inappropriate site, Shoulder injury related to vaccine administration, X-ray
SMQs:, Dementia (broad), Drug abuse and dependence (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol 200 mg once daily Lisinopril 10 mg once daily Pantoprazole 10 mg once daily Montelukast 10 mg once daily Methimazole 10 mg once daily Trazadone 50 mg as needed for sleep Vitamin D3 5000 IU 3x week Lutein 25 mg once daily
Current Illness: None
Preexisting Conditions: Cardio myopathy (rapid heartbeat) hyper-thyroid
Allergies: None
Diagnostic Lab Data: Had an appointment on July 15, 2021 with my primary care provider. I was diagnosed with Shoulder Injury Related to Vaccine Administration (SIRVA). They did an X-Ray (no results yet), and prescribed a short-term dose of steroids. Will have follow-up appointment in mid-August, and may possibly need an MRI and/or Physical Therapy.
CDC Split Type:

Write-up: The injection was given into the shoulder joint rather than the deltoid muscle. This has resulted in an inflammatory process that has caused pain and injury to my left shoulder (e.g., tendons, ligaments, bursae, nerves). I now have persistent shoulder and upper arm pain, weakness, and limited range of motion that has worsened in the two weeks following the injection. I am dealing with chronic shoulder and upper arm pain, and am unable to carry out daily activities that were not an issue prior to vaccination. When the symptoms did not subside, I sought medical treatment from my primary care provider on July 15, 2021.


VAERS ID: 1474682 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Injection site pain, Lip swelling, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Swollen lip and rash around mouth that developed on the evening that 2nd dose of Covid vaccine was given (i.e on evening of 07/01/2021). Rash and swelling of lips and mouth initially seemed to improve, then worsened again by 07/06/21, at which time medical provider (this writer) was contacted. Rash was itchy. Other symptoms included chills, body ache, headache, and soreness at the injection site. Treated with oral Cetirizine with full resolution of symptoms. These symptoms were reported by parent via online messaging system to patient''s pediatrician (this writer).


VAERS ID: 1474754 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-07-01
   Days after vaccination:85
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood cholesterol, Blood test, Dizziness, Feeling abnormal, Head discomfort, Narcolepsy, Nausea, Pain, Petit mal epilepsy
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, Atorvastatin, Metoprolol, Clopidogrel, Pantoprazole, Tylenol, Meloxicam, Aspirin, SpectoVite Womens
Current Illness: None
Preexisting Conditions: Seasonal Allergies, Stint, Artery clogged, Hypertension, prolapse mitral valve.
Allergies: Sulfa
Diagnostic Lab Data: Ordered MRI for 07/21/2021, Recent blood work showed no issues other than cholesterol.
CDC Split Type: vsafe

Write-up: Lightheaded with pressue and dizzy, nausea, brain fog, Shooting pains across cranium between temple but smaller pains across whole head, changed heart meds for low heart rate. Increasing issue since onset. Narcolepsy; petit mal.


VAERS ID: 1474999 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Shoulder injury related to vaccine administration, X-ray limb
SMQs:, Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trazodone, Pantoprazole, Lisinopril, Montelukast, Metoprolol ER, and Methimazole
Current Illness: No known illnesses
Preexisting Conditions: No known health conditions
Allergies: No known allergies
Diagnostic Lab Data: The patient received an x-ray on 7/15/21, which the results are unknown as of now.
CDC Split Type:

Write-up: The patient was given the Janssen Covid vaccine on 7/1/21 and she called in on 7/15/21 to report her adverse event. She said she had been having awful shoulder pain ever since receiving the vaccine and it continued to get worse. She went to see her Doctor on 7/15/21 and received and x-ray and prescriptions for oral steroids and an NSAID gel. She said her Doctor diagnosed her with a vaccine related shoulder injury. The results of the x-ray are unknown as of now and the medication was just started today. I told her I would be filling out reports on the incident and that I would check back with her in a few days to see if the medication was helping.


VAERS ID: 1475011 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-05
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ciclopirox cream, lorazepam, escitalopram, risperidone
Current Illness:
Preexisting Conditions:
Allergies: keflex
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient reports developing shingles shortly after receiving the dose of Pfizer vaccine


VAERS ID: 1477739 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-02-11
Onset:2021-07-01
   Days after vaccination:140
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrochlorothiazide, Lovastatin, Levothyroxine, Centrum multi-vitamins
Current Illness: None
Preexisting Conditions: Controlled hypertension, Controlled hypothyroidism, Controlled hypercholesterolemia
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Developed shingles on 07/12/2021. Never had shingles before. Started at skin area around T-12 and followed rib cage all the way around to midline on stomach. Doctor ordered acyclovir.


VAERS ID: 1440599 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Headache, Pain
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizzy headache aches in body


VAERS ID: 1444740 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Enzimatik (multienzymes) and Hyosymol (paracetamol and hyoscine) Both due to a gas accumulation issue
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I haven''t been to the doctor yet.
CDC Split Type: PID - 03543689

Write-up: Hives or rash on two points: Tummy at the level of the liver and on the climb in the lower part of the right lung. Permanent thickness.


VAERS ID: 1450241 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient came in to Vaccine pod and stated he was there for first vaccine. Patient given Pfizer. After vaccine given he states that it was his first vaccine of Pfizer but that he had received different vaccine. Patient was given follow up phone call and states he has had no side effects from the vaccine.


VAERS ID: 1473614 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3002615 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Headache, Migraine, Migraine with aura, Nausea, Peripheral swelling, Rash erythematous, SARS-CoV-2 test, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: FEXOFENADINE HYDROCHLORIDE; IBUPROFEN; PARACETAMOL; PENICILLIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: No - Negative COVID-19 test
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Red rash; Headache; Vomiting; Nausea; Diarrhea; Migraine aura; Migraine; Swelling arm; Tiredness; This regulatory authority case was reported by a consumer and describes the occurrence of MIGRAINE WITH AURA (Migraine aura), MIGRAINE (Migraine), PERIPHERAL SWELLING (Swelling arm), RASH ERYTHEMATOUS (Red rash), DIARRHOEA (Diarrhea), HEADACHE (Headache), VOMITING (Vomiting), NAUSEA (Nausea) and FATIGUE (Tiredness) in an 18-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3002615) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased. Concomitant products included FEXOFENADINE HYDROCHLORIDE from June 2018 to an unknown date for Hay fever, PARACETAMOL for Migraine, IBUPROFEN for Period pains, PENICILLIN from 18-May-2021 to 27-Jun-2021 for Tonsillitis and Acute kidney infection. On 01-Jul-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 01-Jul-2021, the patient experienced FATIGUE (Tiredness) (seriousness criterion hospitalization). On 02-Jul-2021, the patient experienced PERIPHERAL SWELLING (Swelling arm) (seriousness criterion hospitalization). On 04-Jul-2021, the patient experienced MIGRAINE WITH AURA (Migraine aura) (seriousness criterion hospitalization), MIGRAINE (Migraine) (seriousness criterion hospitalization), DIARRHOEA (Diarrhea) (seriousness criterion hospitalization) and NAUSEA (Nausea) (seriousness criterion hospitalization). On 05-Jul-2021, the patient experienced RASH ERYTHEMATOUS (Red rash) (seriousness criterion hospitalization), HEADACHE (Headache) (seriousness criterion hospitalization) and VOMITING (Vomiting) (seriousness criterion hospitalization). The patient was hospitalized from 07-May-2021 to 07-May-2021 due to DIARRHOEA, FATIGUE, HEADACHE, MIGRAINE, MIGRAINE WITH AURA, NAUSEA, PERIPHERAL SWELLING, RASH ERYTHEMATOUS and VOMITING. On 04-Jul-2021, MIGRAINE WITH AURA (Migraine aura) and PERIPHERAL SWELLING (Swelling arm) had resolved. On 05-Jul-2021, RASH ERYTHEMATOUS (Red rash), DIARRHOEA (Diarrhea), VOMITING (Vomiting) and NAUSEA (Nausea) had resolved. On 07-Jul-2021, FATIGUE (Tiredness) had resolved. At the time of the report, MIGRAINE (Migraine) and HEADACHE (Headache) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: negative (Negative) No - Negative COVID-19 test. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. Laboratory details was mentioned as blood taken for tests. Treatment information was mentioned as patient was given intravenous anti sickness to stop vomiting and was discharged around 9:30am the same day. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1473896 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Pyrexia, SARS-CoV-2 test, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased; Suspected COVID-19 (Unsure when symptoms started; Unsure when symptoms stopped)
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Covid-19 test positive; Fever; Fever; Headache; This regulatory authority case was reported by a consumer and describes the occurrence of the first episode of PYREXIA (Fever) and HEADACHE (Headache) in an 18-year-old female patient who received mRNA-1273 (COVID-19 Vaccine Moderna) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Lactation decreased and Suspected COVID-19 (Unsure when symptoms started; Unsure when symptoms stopped). On 01-Jul-2021, the patient received first dose of mRNA-1273 (COVID-19 Vaccine Moderna) (Intramuscular) 1 dosage form. On 01-Jul-2021, the patient experienced the first episode of PYREXIA (Fever) (seriousness criterion medically significant), HEADACHE (Headache) (seriousness criterion medically significant) and the second episode of PYREXIA (Fever). On an unknown date, the patient experienced SARS-COV-2 TEST POSITIVE (Covid-19 test positive). At the time of the report, HEADACHE (Headache) and the last episode of PYREXIA (Fever) had not resolved and SARS-COV-2 TEST POSITIVE (Covid-19 test positive) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (COVID-19 Vaccine Moderna) (Intramuscular) was unknown. No concomitant medications were reported. Treatment information was not provided. Based on the current available information and temporal association between the use of the product and the start date of the events fever and headache, a causal relationship cannot be excluded. Events seriousness was assessed as per source document by regulatory authority. Based on the mechanism of action of mRNA-1273 causal association between the event of SARS-CoV-2 test positive and mRNA-1273 is assessed as not applicable; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events fever and headache, a causal relationship cannot be excluded. Events seriousness was assessed as per source document by regulatory authority. Based on the mechanism of action of mRNA-1273 causal association between the event of SARS-CoV-2 test positive and mRNA-1273 is assessed as not applicable


VAERS ID: 1434520 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-30
Onset:2021-06-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Dizziness, Hypertension, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 0917 am anxiety, n/v, dizziness, feeling faint, hypertension


VAERS ID: 1434913 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-30
Onset:2021-06-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: None
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Pt began to feel light headed and began to vomit. Pt was taken back to a pt room were vital were taken which were normal. Pt began to feel normal again after about 15 minutes.


VAERS ID: 1437276 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-30
Onset:2021-06-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram, Computerised tomogram thorax abnormal, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ASA 81 mg daily, DuoNeb nebulizer QID, amlodipine 5 mg daily, Ambien 10 mg QHS, Xanax 0.5 mg daily PRN, pravastatin 40 mg daily, Zoloft 100 mg daily, Lopressor 50 mg daily
Current Illness: No acute illnesses
Preexisting Conditions: Severe COPD, pulmonary fibrosis/ILD, current smoker, insomnia, HTN, dyslipidemia, CAD, sp PTCA and CABG, RLS, depression/anxiety
Allergies: NKA
Diagnostic Lab Data: Confirmed by CTA chest6/14/2021
CDC Split Type:

Write-up: Pulmonary embolism, with symptoms starting one week following administration of vaccine.


VAERS ID: 1437344 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-24
Onset:2021-06-30
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA8721 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA9091 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Loestrin
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Red dots all over the body including face, arms, neck, legs. Also a big rash at the place of injection


VAERS ID: 1437353 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-06-30
Onset:2021-06-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect dose administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is currently being monitored for side effects. She was given the vaccine without the vial having the diluent added. This resulted in the patient having too high of a dose given.


VAERS ID: 1437369 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-06-29
Onset:2021-06-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: NKDA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Fatigue, lightheadedness and dizziness


VAERS ID: 1437374 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-06-30
Onset:2021-06-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Was given the vaccine in the right arm and about 5-10 mins after being vaccinated as the patient was walking out of the consultation room the patient became lightheaded Patient sat down for about 15 mins and given 2 small cups of water to sip


VAERS ID: 1437384 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-30
Onset:2021-06-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Vertigo
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: dizziness, vertigo


VAERS ID: 1437385 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-30
Onset:2021-06-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood glucose normal, Blood pressure increased, Loss of consciousness, Swollen tongue, Urinary incontinence
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: per pt chart- 1/7/2015 (22years of age at time of vaccination) pt had a seizure after receiving flu, Tdap, and HPV vaccines
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediately after receiving Pfizer vaccine, pt experienced loss of consciousness for approximately 3 minutes, tongue swelling, incontinence of urine. Epi pen given x1, pt regained consciousness immediately after receiving epi. Vital signs as follows: BP 144/69, HR 63, O2 100% then approx 8 minutes later BP 113/63, HR 74, O2 99%, blood sugar 101. Provider assessed pt and recommended to call an ambulance for possible seizure. Pt refused to go to hospital. After incident occurred, pt stated that he has had a reaction to vaccines in the past but was unsure which ones. Pt chart stated that patient had an adverse reaction (seizure) after receiving flu, Tdap, and HPV vaccines in 2015.


VAERS ID: 1437409 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-28
Onset:2021-06-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary mass, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tamsulosin 0.8mg daily, Meloxicam 15mg daily as needed, donepezil 5mg at bedtime, Albuterol HFA 1 puff as needed for wheezing, Eliquis 5mg twice daily, Fluticasone Nasal spray 2 sprays each nostril daily, Atorvastatin 40mg daily, Amlodipine
Current Illness:
Preexisting Conditions: Arthritis, Asthma, Chest pain, Depression, Enlarged prostate, High blood pressure, Hypercholesterolemia, Dementia (early stages), Schizophrenia, Seizures, Pain
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient''s wife called around 10:30a on 06/30/2021 and said he had a knot under his left arm. She stated his arm was sore in addition to knot. It was recommended by pharmacist that he could take acetaminophen for the soreness and apply a cool compress for the swelling. I asked her to call us if anything changes or if she notices any new symptoms. We will follow up with patient in 24 hours to assess how he is doing.


VAERS ID: 1437466 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-26
Onset:2021-06-30
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphagia, Facial paralysis, Tenderness
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HBP, DYSLIPIDEMIA
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: PT CALLED SAYING SYMPTOMS STARTED TODAY 6/30: DROOPING ON ONE SIDE OF FACE, REPORTS TENDERNESS, TROUBLE SWALLOWING; DENIES TROUBLE BREATHING OR SIGNIFICANT PAIN IN AREA. EXPLAINED IT MAY BE BELLS PALSY. PT WILL BE GOING TO ER TO BE FURTHER EVALULATED.


VAERS ID: 1437475 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-29
Onset:2021-06-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Headache, Oropharyngeal pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenate mini, hair, skin and nails supplement
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever 101, chills, sore throat and extremely severe body aches, headache, weakness and dizziness. Treatment: Tylenol 325 mg Ibuprofen 600mg No improvement in symptoms


VAERS ID: 1437483 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-06-30
Onset:2021-06-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0011D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None in the system
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient got her 1st shot of COVID Moderna Vaccine at the pharmacy on 06/30 @ 11:40 AM. After 15 minutes of sitting in the waiting area, patient reports that she is feeling a general mild itchy feeling all over her body that comes and goes in phases. Patient did not report swelling, throat tightening, injection site pain, or injection site itching. Injection site redness or swelling was not observed. Pharmacist decided to administer one dose of diphenhydramine 25mg, gave one more capsule for patient to take home, and counseled on the sign and symptoms of anaphylaxis allergic reaction. Patient feels fine after another 15 minutes observation.


VAERS ID: 1437484 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-28
Onset:2021-06-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Brain natriuretic peptide, C-reactive protein increased, Chest pain, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Pericarditis, Red blood cell sedimentation rate normal, Troponin normal
SMQs:, Systemic lupus erythematosus (broad), Myocardial infarction (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG with diffuse ST elevation CRP 1.2, ESR nml, troponin <0.012, BNP <15
CDC Split Type:

Write-up: Chest pain with evidence of pericarditis on EKG discharged with close PMD follow-up and NSAIDs


VAERS ID: 1437497 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-26
Onset:2021-06-30
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Injection site pain, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NO
Current Illness: NO
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient experienced fatigue and soreness at the site that improved. This morning developed uticaria - all over .


VAERS ID: 1437498 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-30
Onset:2021-06-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro
Current Illness: no
Preexisting Conditions: no
Allergies: none
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Right arm and hand become numb within 5 minutes after vaccination. Can feel only pressure in R upper extremity. Patient will follow up with urgent care if symptoms persist.


VAERS ID: 1437512 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-24
Onset:2021-06-30
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821281 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No known meds
Current Illness: No known illnesses
Preexisting Conditions: No known medical conditions
Allergies: No known allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Floris experienced two welts on her back, almost a week after receiving the shot.


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