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From the 10/15/2021 release of VAERS data:

Found 800,916 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 406 out of 8,010

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VAERS ID: 1637020 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: North Dakota  
Vaccinated:2021-02-08
Onset:2021-08-24
   Days after vaccination:197
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 2 - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Blood test, COVID-19, Chest X-ray abnormal, Heart rate decreased, Hypotension, Lung infiltration, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminhphen 650mg PO Q4H PRN, albuterol 0gm INH Q2H PRN per dose instruction, albuterol/ipratropium 3ml NEB QIDRT PRN, amlodipine besylate 5mg PO Daily SCH, artificial tears 0ml eyeboth QID SCH per dose instruction, aspirin 81mg PO daily
Current Illness: unknown
Preexisting Conditions: glaucoma, macular degeneration, high cholesterol, hypertension, COPD, lung nodules, BPH, urinary retention, TIA,
Allergies: azithromycin
Diagnostic Lab Data: 8/24/21-PCR, CXR, Bloodwork
CDC Split Type:

Write-up: patient hospitalized for COVID disease. diagnosis date 8/24/21. Presented to the ED with generalized weakness, low heart rate, low blood pressure over last few days. Chest Xray shows LLL Infiltrate.


VAERS ID: 1637022 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Back pain, Chills, Condition aggravated, Migraine, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Prescriptions - Sertraline 100 mg (Night time) - Famotidine 40 MG (2x a day) - Bupropion HCL XL 150 MG (1 x a day) Vitamins - Natures Made D3 Gummies 2000 UI - Natures Made Multi Vitamin for Women + Omega - 3s Gummies
Current Illness: Gastroenteritis Sinusitus
Preexisting Conditions: Sinusitis Migraines Allergies ADHD Depression Brain issues due to meningitis (Non Infectious) (possibly CSF leak) Neurotrax test confirmed memory issues, organizational issues, cannot multitask
Allergies: Penicillin Ceclor Nexium Prilosec Percocet Darboset
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Uncontrollable chills - couldn''t hold a bottle of water or other Sever Throwing Up Sharp Stabing Pain in upper stomach area to my back - so sever was doubled over for some time Sever Aches Migraine


VAERS ID: 1637066 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA MODERNA002C21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Fatigue, Headache, Heart rate increased, Pain, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 50mcg
Current Illness: None
Preexisting Conditions: Hashimoto thyroiditis. Narcolepsy.
Allergies: None
Diagnostic Lab Data: None. Stayed home.
CDC Split Type:

Write-up: Fever 103.4 for 12 hours. Headache for 8 hours Fainting 2 times approximately 40 hours after shot. Chest pain 28 hours after shot, lasted for 12 hours, intermittently. Rapid heart rate for last 3 days since shot. Body aches and fatigue for 6-48 post shot.


VAERS ID: 1637100 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-10
Onset:2021-08-24
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cardiac tamponade, Pericardial effusion, Pericardial excision
SMQs:, Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions: hypertension
Allergies: none
Diagnostic Lab Data: emergency surgery with pericardial window 8/24/2021
CDC Split Type:

Write-up: Pericardial effusion presenting with cardiac tamponade


VAERS ID: 1637145 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Dyskinesia, Fatigue, Headache, Hypogeusia, Maternal exposure during breast feeding, Pain
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad), Neonatal exposures via breast milk (narrow), 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: Labetalol Sertraline Norlvda Prenatal D3 5000 iu
Current Illness: None
Preexisting Conditions: High blood pressure anxiety Ptsd
Allergies: Codeine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: At 2 am, 14 hours following the shot, I experienced sudden extreme chills, extreme body aches, involuntary jerking movements in my arms and legs, extreme tiredness, a moderate headache and moderate joint aches. These symptoms stayed consistent for approximately 8 hours at which time I had brief periods of feeling ok followed by symptoms resuming. This continued until the folding morning and for the remainder of that day I was sore and tired. In addition to the above at 2am I had a muted sense of taste for approximately 4 hours. I do exclusively nurse my 4 month old and she had no reactions.


VAERS ID: 1637149 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-16
Onset:2021-08-24
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Computerised tomogram abnormal, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: HTN
Allergies: none
Diagnostic Lab Data: CT scan blood test
CDC Split Type:

Write-up: pulmonary embolism


VAERS ID: 1637156 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Diarrhoea, Fatigue, Headache, Hyperhidrosis, Nausea, Pain, Pyrexia, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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:
Other Medications: Metoprolol. Spironolactone. Clonidine. Omeprazole, Calcium, Vitamin D, Reclast infusion 1x year. Eyelea eye injection every 6 to 8 weeks
Current Illness: None
Preexisting Conditions: Hypertension for long time
Allergies: Sulfa, prednisone, morphine, IVP dye
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Uncontrolled shaking, body pain, headache, nausea, mild fever, diarrhea, weakness, extreme fatigue, profusely sweating


VAERS ID: 1637167 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspnoea, Dyspnoea exertional, Flank pain, Hyperhidrosis, Mobility decreased, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (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? Yes
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: Horrific pain in my left side. Trouble breathing. 100DGS fever lasting for multiple days. Winded upon standing. Inability to move from fetal position for 24 hours. Sweats & chills


VAERS ID: 1637171 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This 16 year od received a dose of Janssen vaccine which is not authorized for 16 year olds.


VAERS ID: 1637193 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-01-08
Onset:2021-08-24
   Days after vaccination:228
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / UNK - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / UNK - / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Headache, Increased upper airway secretion, Oropharyngeal pain, Respiratory tract congestion
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: Melatonin, Vitamin B-12, Vitamin B1
Current Illness: N/A
Preexisting Conditions: Neurocognitive Disorder, Benign Neoplasm of Cerebral Meninges, Disorder of Thyroid, Anxiety, Bronchiectasis, Dementia with Behavioral Disturbance, Depression, Psychotic Disorder, HTN, Seasonal Allergic Rhinitis
Allergies: Sulfa Drugs
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt was having a headache and some throat pain and upper airway congestion.


VAERS ID: 1637218 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-17
Onset:2021-08-24
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injection site erythema, Injection site pruritus, Injection site rash, Injection site swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily Women''s Vitamin
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid Arm. It began itching the evening of 8/24 and when I woke up the AM of the 25th, I had a medium sized rash surrounding my injection site. It is puffy, slightly itchy and red. I also have pain in my left elbow, which I believe is related to this.


VAERS ID: 1637245 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 3 RA / IM
VARZOS: ZOSTER (SHINGRIX) / GLAXOSMITHKLINE BIOLOGICALS D4PA4 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products, Underdose, Wrong product administered
SMQs:, Medication errors (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: not known
Current Illness: cardiomyopathy
Preexisting Conditions: cardiomyopathy
Allergies: penicillins, pineapple
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient requested Shingrix, dose 1. Immunizer incorrectly prepared Pfizer''s COVID-19 vaccination, believing it was Dose 1 in the series. Patient was given 0.25ml (87% of normal dose) before the error was discovered. Patient has previously been vaccinated with Dose 1 and Dose 2 of COVID-19 with the Moderna vaccine, Dose 2 being given early February 2021. Patient really wanted Dose 1 of Shingrix and chose to get the Shingrix in addition to the errant dose of COVID-19 that was given.


VAERS ID: 1637250 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: Tylenol
Current Illness: none
Preexisting Conditions: migraine headaches
Allergies: NKA or NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: 3x3 Erythema and swelling 3x3 demarcated area and associated achiness and tender at the injection site No warmth. . The employee states " the swelling is resolving"


VAERS ID: 1637262 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-02-19
Onset:2021-08-24
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Decreased appetite, Mental status changes, Rhinorrhoea, SARS-CoV-2 test positive, Seizure
SMQs:, Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to ED with altered mental status and breakthrough seizure. Incidental finding of COVID -19 with positive test. Patient has had runny nose and decreased appetite for 3 days.


VAERS ID: 1637286 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood pressure increased, Dizziness, Headache, Heart rate irregular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Cardiac arrhythmia terms, nonspecific (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: none at the time although I have been prescribed hydrochlorothiazide 12.5 MG Also, Cyclobenzaprine HCL 10 mg
Current Illness: None
Preexisting Conditions: Degenerative bone disease
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I got a slight headache about an hour after I received the vaccine. The next day I woke up with a headache and when I got up and started to move around my heart felt like it was beating fast and I felt light headed and weak. I also have elevated blood pressure even after taking medication for 2 days. I have been checking my resting heart rate and it has stayed between 98 and 107.


VAERS ID: 1637296 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Feeding disorder, Feeling cold, Hot flush, Hyperhidrosis, Initial insomnia, Injection site erythema, Injection site swelling, Injection site warmth, Malaise, Nausea, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad), 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:
Other Medications: Over the counter meds: Tylenol
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: A few hours after getting the second dose (the one listed), my arm was a bit sore. I went to sleep and woke up in the middle of the night around 4am, extremely cold and my arm was too sore to lay on. I had trouble going back to sleep after waking up. Later in the day, I went to take my temperature due to being unreasonably cold, and I had a fever of 100.1?F. I noticed the injection site was a bit swollen, red, and warm to the touch. I couldn''t eat because I felt too sick to eat anything, it just made me feel nauseated. Later in the day around 6pm or so, I took my temperature again and it was 102.6?F. During the day I was having hot and cold flashes and sweating a lot. Later in the day after waking up from a nap, around 8pm, I started to feel better and my fever went away. My arm was still sore and the injection site is still swollen, red, and warm to the touch. The next day (8/25/21), I felt fine, but my arm was still a bit sore and the injection site was still swollen, red, and warm to the touch.


VAERS ID: 1637304 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: about a 5 inch area around the injection site became swollen, red, itchy, and hot to the touch


VAERS ID: 1637314 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-17
Onset:2021-08-24
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pruritus, Injection site rash
SMQs:, Hypersensitivity (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: zinc, vit C, magnesium, D3, cranberry, ginco biloba, joint health triple action
Current Illness: none
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itching then rash around injection site.


VAERS ID: 1637340 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-14
Onset:2021-08-24
   Days after vaccination:222
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Work       Purchased by: ?
Symptoms: Cough, Occupational exposure to SARS-CoV-2, Oropharyngeal pain
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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: 08/24/21, 4:20 PM,, sore throat and cough started today, last shifts worked 08/23 and 08/20, she states that her manger told her she was exposed at work on 08/19, has no record of that exposure, COVID test ordered to be done per her request.


VAERS ID: 1637360 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none noted
Current Illness: none noted
Preexisting Conditions: none noted
Allergies: none noted
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated she was feeling tightness with itchy throat. STAT RN was called and RN took over patient. Patient cohearnet and able to verbalzie symptoms. agreed to go to UC.


VAERS ID: 1637367 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-21
Onset:2021-08-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angina pectoris, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Other ischaemic heart disease (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: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Got vaccine Saturday night. By Tuesday, he had stabbing heart pain and shortness of breath when running for cross country. I have him IBProfin.


VAERS ID: 1637382 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cellulitis, Induration, Inflammation, Rash, Rash erythematous, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol sulfate Alcohol Prep Pads aspirin Blood Glucose Test cephalexin complete needle collection system FreeStyle Libre 14 Day Sensor ibuprofen metformin NovoFine Plus potassium chloride rosuvastatin telmisartan-hydrochlorothiazid torse
Current Illness: N/A
Preexisting Conditions: diabetes mellitus diverticulosis of colon essential hypertension history of calculus of kidney hyperlipidemia metabolic syndrome X microscopic hematuria type 2 diabetes mellitus
Allergies: ACE Inhibitors COVID-19 vaccine, mRNA, BNT162b2, LNP-S (Pfizer)
Diagnostic Lab Data: N/ A Medical Examinatinon
CDC Split Type:

Write-up: Swelling at first which formed a hard scar tissue lump about the size of a silver dollar. Today pt woke up and the inflammation was much bigger, a red rash covers nearly all of the patients upper bicep. Rash is warm to touch. MD believes this is cellulitis


VAERS ID: 1637383 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Mobility decreased, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (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: Fainted from college shots
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Trouble breathing, severe muscle aches, unable to move arm, dizziness, nausea


VAERS ID: 1637406 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Diarrhoea, Injection site pain, Injection site swelling, Pain, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (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)

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: Family of 4 immunizing together. all same lot all for boosters no previous reaction. Vaccine administered with no negative results. Mother called on 26th seeking advice. Mentioned patient had GI upset a few hours post shot (pain and diarrhea), then after 24 hours swelling and pain at injection site and some hives and rash on body. Mother asking if utilizing antihistamines a good route. stated they had administered Singulair and Zyrtec. I offered maybe to switch to Benedryl if they wanted to be more aggressive. Stated that if no slowing or reversing of uticaria to contact Dr when they feel it would be necessary. Informed mother that I would fill out VAERS on their behalf and if anything progresses to seek medical attention.


VAERS ID: 1637407 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Insomnia, Pain, Taste disorder
SMQs:, Taste and smell disorders (narrow), Dementia (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: COVID arm
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: amoxicillin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 12 hours after vaccination patient states she "does not feel right" with extreme fatigue, changes in taste, body aches, and insomnia


VAERS ID: 1637596 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E2IA / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Decreased appetite, Fatigue, Feeling abnormal, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Eosinophilic pneumonia (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Woke up on Aug 24th with a slight fever, chills, muscle/head ache, extreme fatigue, low appetite, brain fog.


VAERS ID: 1637638 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Loss of consciousness
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), Accidents and injuries (narrow), 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? 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: Patient waited his recommended 15 minutes after receiving the vaccine. Upon getting out of the chair to exit the building, the patient passed out and fell onto his face. EMT''s were immediately called, and pharmacy staff also immediately attended to the patient.


VAERS ID: 1637828 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 2 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Fatigue, Injection site pain, Physical disability
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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: Atenenol, Zolpidiem, Omeprazole,Lomotil, Imodium, Hydrocodone/Acetaminophen, Multi-Vitamin
Current Illness: Chronic Kidney Disease, GERD
Preexisting Conditions: Kidney Disease
Allergies: Benzodiazepines, Statin Drugs, Tramadol
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: On my 3rd vaccine I suffered severe injection site pain, extreme fatigue, dizziness, impairment


VAERS ID: 1637848 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram, Anticoagulant therapy, Anticoagulation drug level, Blood test, Chest X-ray, Dyspnoea, Fibrin D dimer, Full blood count, International normalised ratio, Metabolic function test, Prothrombin time, Troponin
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), 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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol, astelin, alpha lipoic acid, probiotic, cymbalta, Proscar, lasix, glucosamine-chondroitin, magnesium, singulair, protonix, vitamin B-6, aldactone, flomax
Current Illness:
Preexisting Conditions: GERD, CHF, sleep apnea, hx of bladder cancer, kidney disease, arthritis, multiple ortho replacements
Allergies: None
Diagnostic Lab Data: Blood work (CMP, CBC, d-dimer, anti-Xa, pt, INR, High sensitivity troponin), CTA, CXR on 8/26/21
CDC Split Type:

Write-up: presented to ED (sent by UC) w/ SOB, found to have saddle PE, placed on heparin drip and sent emergently to main campus for intervention.


VAERS ID: 1637851 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-16
Onset:2021-08-24
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Injection site pruritus, Injection site rash, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: On the morning of the 8th day after getting my first shot I noticed my deltoid muscle of my left arm (the arm where I received the shot) was swollen and mildly sore. It was also periodically itchy throughout the day. I put ice on the arm but did not use any OTC medications to treat it. The next day the location was still swollen and sore and itchy but there was also a small rectangular rash. The day after that the swelling at the location was gone as was the rash. It is still periodically itchy but infrequently and for shorter periods than initially


VAERS ID: 1638043 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Body temperature increased, Feeling cold
SMQs:, Neuroleptic malignant syndrome (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: NA
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Temperature of 100.1 with chills. Took two acetaminophen. Temperature was my normal 97.7 about 4 hours later.


VAERS ID: 1638064 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest pain, Cough, Dizziness, Electrocardiogram, Exposure during pregnancy, Injection site irritation, Injection site swelling, Malaise, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft, Iron pills, Prenatal vitamins
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 08/26/21 I went to labor and delivery for the symptoms. They did a chest x-ray, EKG, bloodwork, and a COVID swab. Everything came back clear including the COVID test. The baby is also okay.
CDC Split Type:

Write-up: I went in to the clinic for my second dose of the moderna vaccine for COVID-19. I was advised by my OBGYN to get the vaccine as i am 26 weeks pregnant (EDD 12/01/21). Later that day when i got home i got very sick and it followed into the next day. I have a very bad cough, chest pain, and dizzy spells. The injection site is also extremely swollen and irritated.


VAERS ID: 1638244 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Peripheral swelling, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies: Peppermint & red dye #40
Diagnostic Lab Data:
CDC Split Type:

Write-up: Whole left arm swelling and pain, many small bumps all over left arm


VAERS ID: 1638263 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Palpitations, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever started on 8/24 and continued until 8/25. Starting 8/25 pt experienced SOB and heart racing


VAERS ID: 1638427 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-16
Onset:2021-08-24
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: N/A
Current Illness: N/A
Preexisting Conditions: PCOS
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Area around injection site is itchy, red, slightly swollen and firm to the touch.


VAERS ID: 1638452 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Erythema, Feeling hot, Injection site pain, Nausea, Swelling
SMQs:, 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 (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: Levothyroxine
Current Illness:
Preexisting Conditions:
Allergies: Peanuts Grapes Black pepper Almonds
Diagnostic Lab Data:
CDC Split Type:

Write-up: FC3182, I think was the lot number. It was hard to read. Nausea-same day through day 4. Light headedness- day 2-4. Pain at injection site-day1-still going. Redness and swelling; hot to the touch- day 2- still going, although the sWelling is going down a little. Itchiness around the red area; day 3 and still going. The red area is about 3 inches across.


VAERS ID: 1638937 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Alaska  
Vaccinated:0000-00-00
Onset:2021-08-24
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Lip swelling, Pruritus, 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:
Current Illness: Abstains from alcohol; Allergy to nuts (Hives and Itchiness); Autoimmune disorder; Fruit allergy (Hives and Itchiness); Non-smoker
Preexisting Conditions: Comments: The patient did not have any drug abuse/illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210851957

Write-up: SWOLLEN LIPS; BUMPS AND HIVES ON FROM HEAD TO REST OF HER BODY; ITCHY; This spontaneous report received from a patient concerned a 39 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: autoimmune disease, non alcoholic, non smoker, allergy to nuts, and allergy to fruits, and other pre-existing medical conditions included: The patient did not have any drug abuse/illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: UNKNOWN) dose was not reported, administered on 23-AUG-2021 18:00 for prophylactic vaccination. No concomitant medications were reported. On 24-AUG-2021, the patient experienced itchy. On 25-AUG-2021, the patient experienced swollen lips. On 25-AUG-2021, the patient experienced bumps and hives on from head to rest of her body. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from itchy, and bumps and hives on from head to rest of her body, and had not recovered from swollen lips. This report was non-serious.


VAERS ID: 1640674 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-21
Onset:2021-08-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Facial paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (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: no
Current Illness: hep c
Preexisting Conditions: hep c
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: facial paralysis


VAERS ID: 1640947 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Injection site erythema, Injection site pain, Injection site swelling, Pyrexia, Rash, Reaction to previous exposure to any vaccine, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: Flu - anaphylaxis (dates unknown)
Other Medications: Multivitamin, ibuprofen, Benadryl, iron supplements
Current Illness:
Preexisting Conditions:
Allergies: Eggs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain, redness and swelling at injection site $g15cm. Full body rash. Facial swelling. Low-grade fever 100*F. Chills and headache.


VAERS ID: 1640978 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Nausea, Oropharyngeal pain, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro
Current Illness:
Preexisting Conditions: Allergies Depression/anxiety
Allergies: Allergic to most environmental things "everything per her allergist" Azithromycin Cefpodoxime Codeine Hydrocodone Benadryl Oxycodone
Diagnostic Lab Data: none done
CDC Split Type:

Write-up: Throat swelling, nausea, fatigue, sore throat


VAERS ID: 1641015 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-07
Onset:2021-08-24
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, 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:
Allergies:
Diagnostic Lab Data: 8/26/21 COV/SARS2, Positive
CDC Split Type:

Write-up: Covid positive $g14 days post vaccine series.


VAERS ID: 1641016 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-06
Onset:2021-08-24
   Days after vaccination:49
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW00173 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest pain, Diarrhoea, Dyspnoea, Nausea, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), 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: dexamethasone (DECADRON) 4 MG tablet, Take 1 tablet by mouth every 8 hours for 14 doses, Disp: 42 tablet, Rfl: 0 ? diazePAM (VALIUM) 5 MG tablet, Take 1 tablet by mouth every 8 hours as needed for Anxiety for up to 10 doses., Disp: 10 tabl
Current Illness: Cancer remission - glioblastoma
Preexisting Conditions: Hypertension
Allergies: N/A
Diagnostic Lab Data: Nasopharyngeal swab collected 8/24/21
CDC Split Type:

Write-up: Non-Hospitalized Breakthrough, receiving inpatient therapy at the hospital at time of positive test, he remains without SOB, chest pain, nausea, diarrhea, getting his therapies in his room until his 10 days of quarantine have been completed, he remains positive and upbeat, and denied any new complaints today other than continued congestion.


VAERS ID: 1641018 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-24
Onset:2021-08-24
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Nasal congestion, Pain, 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? 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: Rapid antigen COVID 19 test
CDC Split Type:

Write-up: patient has been diagnosed with COVID as of 8/24/21- Cough, body aches, nasal congestion


VAERS ID: 1641038 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-02-10
Onset:2021-08-24
   Days after vaccination:195
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9808 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Dysphonia, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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: Unknown, home meds upon admission on 8/13/21 were Norco, aspirin, ibuprofen, meloxicam, clonazepam, gabapentin, escitalopram, trazodone, diphenhydramine, loratadine, pravastatin, diltiazem, cephalexin, Mucinex D, spironolactone, magnesium h
Current Illness: Unknown
Preexisting Conditions: ? Arthritis ? Atrial fibrillation (HCC) ? Basal cell carcinoma ? Bowel obstruction (HCC) 1/2018, 1/2019 ? CAD (coronary artery disease) ? Cancer (HCC) skin ? Chest pressure ? Confusion and disorientation 10/31/2017 periods of disoreintation and hallucinations ? Fatigue ? FH: CAD (coronary artery disease) ? GERD (gastroesophageal reflux disease) ? Glaucoma 2019 ? HTN (hypertension) ? Hyperlipidemia ? Hypothyroidism ? Macular degeneration Left Eye- Wet and Right Eye- Dry ? Macular degeneration 2014 ? MDRO (multiple drug resistant organisms) resistance MRSA cleared 2015 VRE screen positive 10/8/18 ? MR (mitral regurgitation) ? MRSA (methicillin resistant staph aureus) culture positive cleared 2015 ? Palpitations ? PVD (peripheral vascular disease) (HCC) ? Shingles ? Unspecified cerebral artery occlusion with cerebral infarction TIA
Allergies: Adhesive tape, sulfa antibiotics
Diagnostic Lab Data: Nasopharyngeal swab on 8/24/21, rapid test
CDC Split Type:

Write-up: Non-Hospitalized Breakthrough, patient here for inpatient rehab (admitted 8/13/21) prior to infection. The patient says her sore throat and voice hoarseness remain unimproved. She is still on isolation due to positive rapid COVID test result. She says her husband also tested positive for COVID and has similar symptom. She denies having fever, chill, shortness of breath, cough, sputum production, or chest pain.


VAERS ID: 1641182 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-07
Onset:2021-08-24
   Days after vaccination:109
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, 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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid 19+ 08/25/2021 with onset 08/24/2021


VAERS ID: 1641206 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939901 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: 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: Aripiprazole escitalopram ventolin
Current Illness:
Preexisting Conditions: delayed milestone mild intermittent asthma mix anxiety depression
Allergies: Erythromycin mucinex zithromax
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderna vaccine is not indicated for patients under 18. Patient was 16 at the time the vaccine was administered by nurse


VAERS ID: 1641227 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-11
Onset:2021-08-24
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Joint swelling, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Received Vaccine on 08/11/2021 - began having swelling in shins / ankles / feet as well as forearms and hands - skin feels "tight" on 08/23/2021. Never have had swelling / tight skin feeling before. No change in diet or exercise routine. Knowledge worker with long hours of sitting, with frequent times of standing up and doing some stretching. BP 119/76 HR 68 weight 124 height 5''4"


VAERS ID: 1641288 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Trazodone 100mg - 3 tablets at bedtime, Sertraline 100mg - once daily, Clonidine 0.1mg - every 6 hours as needed, Lamotrigine ER 25mg - 2 tablets in the morning
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient went to the ER Tuesday night after receiving 2nd Moderna COVID-19 vaccination. He was diagnosed with a pulmonary embolism. Doctors could not say if it was directly related to the vaccination, but did occur later in the day after receiving the second dose of his vaccines. Patient has since been discharged on 8/27 on blood thinners. Patient was experiencing chest pain and blood in sputum for 2 weeks prior to receiving second dose (2 weeks after 1st dose had been administered)


VAERS ID: 1641289 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Headache, Pain, Photophobia, Photopsia, Pyrexia, Visual impairment
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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:
Other Medications: I do not take any medication or supplements.
Current Illness: None
Preexisting Conditions: Mitral valve prolapse
Allergies: I am not allergic to anything.
Diagnostic Lab Data:
CDC Split Type:

Write-up: As I was laying with my eyes closed because I had a bad fever, bodyaches , headache and chills, I had very bright rapid flashes of light in my eyes. And now my vision with my reading glasses has gotten worse. I can?t see without my glasses as well as I could before. I could see less than an arms length without having to wear my readers, now I have to hold my arm much further away to see. And the light of my phone bothers my eyes. And I have constant headache.


VAERS ID: 1641311 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Body temperature increased, Chills, Gait inability, Headache, Hyperhidrosis, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hypertension
Allergies: Amlodipine, bee venom.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore arm, temperature off 100.5, weak, unable to walk, severe headaches, chills, sweating, aching in muscles.


VAERS ID: 1641325 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-08
Onset:2021-08-24
   Days after vaccination:228
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Dyspnoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (narrow), 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient tested positive for COVID at nursing facility and was brought to the ED with shortness of breath for the past week. Patient diagnosed with COVID19 pneumonia and currently undergoing inpatient hospital treatment.


VAERS ID: 1641351 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Electric shock sensation, Hypersensitivity, Influenza like illness, Pain in extremity, Paraesthesia, Paraesthesia oral, Peripheral coldness, Skin discolouration, Swelling, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations: MMR
Other Medications: Iron vitamin, baby aspirin, omega 3
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Aug 26 Vital Signs were stable
CDC Split Type:

Write-up: Allergic reaction that had a slow onset, began with tingling in lips, hands and toes. Felt like small electric shocks through arms and legs. By 7am next morning extremities where white and cold, face and neck were swollen and difficulty breathing. Benadryl 25mg was taken, and again at 1100 on Aug 25, symptoms were relieved and returned in evening. Benadryl continued. On Aug 26, went to Urgent care as symptoms not relieved by Benadryl. Received Decadron . Symptoms of flu like symptoms and arm pain were also noted. Continued use of Benadryl. Symptoms still present at time of report.


VAERS ID: 1641382 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-03
Onset:2021-08-24
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient tested positive for covid 4 days prior to presenting to ED with shortness of breath. He was admitted and is currently undergoing inpatient treatment.


VAERS ID: 1641394 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Dizziness
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu vaccine- got Guillan-Barre syndrome
Other Medications: Restylane for left focal cord paralysis, Beovue medication for eye injections to both eye, receives these injections every 8 weeks, Baby aspirin 81mg, Eloquist 5mg BID, Pepcid, Rosuvastatin 20mg, Pantoprazole 40mg, Fluconazole 200mg, Myrbet
Current Illness: stroke 09/2020, and have a pacemaker.
Preexisting Conditions: Mild form of COPD, Beouve eye injections, valley fever in 1987 which resurrected from the flu shot, stroke 09/2020 and that is why I take Fluconazole, A-fib, heart disease, BP will drop occasionally and that is why I take Medrodrine, I''ve had 3 strokes; 2 brain related where I got a staph infection and got endocarditis which I suffered major stroke and I am still in rehab. Leukemia (CLL), prostate cancer but it has been removed and is at stage 0. I also have a pacemaker.
Allergies: Sulfa drugs, Atenolol (causes angina), Flu shot can not be taken
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: After my stroke, I am currently going to rehab and also have had steroid shots in June 2021. I received my third dose on 08-23-2021. When I first woke up on 08-24-2021 I felt very dizzy. I told my wife how I felt. She then told me to sit down in the toilet seat so I would not fall. My BP was taken by my wife and it was 84/62. My wife gave me the Medridine medication and my BP was 117/77, oxygen level was 76. We then sat down at the kitchen table. And I felt dizzy again and my wife got the BP cuff and she took my BP and it was 100/80. My wife then rechecked my BP in 30 minutes and it was 113/77 and it did not drop again. My wife then called the pharmacist since she knows I have these chronic issues and also to tell her how I was feeling and she recommended for my wife to take me to the Clinic where a doctor saw me there and he took my BP and it was 130 over something and my oxygen level was 98. The doctor at the clinic could not say it was an episode of the vaccine or that just his BP was dropping. My wife does not know if this is coincidental or if the vaccine caused my symptoms. On 08-24-21 at about 1:00AM, I experienced severe abdominal pain but by the later morning I felt fine.


VAERS ID: 1641470 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-15
Onset:2021-08-24
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Exposure to SARS-CoV-2, Nasal congestion, SARS-CoV-2 test positive
SMQs:, 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:
Current Illness:
Preexisting Conditions: None.
Allergies: Contrast dye
Diagnostic Lab Data: Covid test-positive.
CDC Split Type:

Write-up: Pt came to ED to be covid tested b/c her grandson recently tested positive. C/O of some nasal congestion.


VAERS ID: 1641476 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-19
Onset:2021-08-24
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0 / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pruritus, Skin warm
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, ibuprofen, Benadryl and hydrocortisone
Current Illness: Headache some days
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Red halo on left arm, swallow, warm and itchy


VAERS ID: 1641481 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Fatigue
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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: throat swelling
Other Medications: vitamin c multi vitamin vitamin d
Current Illness: none
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Shortness of Breath, Extreme Fatigue


VAERS ID: 1641512 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Hyperhidrosis, Nausea, Oropharyngeal pain, Pain, Pyrexia, SARS-CoV-2 test negative, Streptococcus test negative, Swelling face
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: RAPID COVID AND RAPID STREP BOTH NEGATIVE TODAY
CDC Split Type:

Write-up: FATIGUE, BODY ACHES, FEVER, FACIAL SWELLING, CHILLS/FEVER/SWEATS, NAUSEA, SORE THROAT


VAERS ID: 1641581 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-08
Onset:2021-08-24
   Days after vaccination:228
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19
SMQs:, Infective pneumonia (broad), Opportunistic infections (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID-19 positive.


VAERS ID: 1641588 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2020-12-28
Onset:2021-08-24
   Days after vaccination:239
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 AR / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 2 AR / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (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: METOPROLOL FOR MITRAL PROLAPSE
Current Illness: DENIES
Preexisting Conditions: DENIES
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: POSITIVE COVID


VAERS ID: 1641591 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-19
Onset:2021-08-24
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / UNK LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, Diarrhoea, Dyspnoea, Nausea, Pneumonia, Pneumonia viral, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: simvastatin, Eliquis, allopurinol, ondansetron, calcium
Current Illness: Unknown
Preexisting Conditions: non-Hodgkin''s lymphoma, DVT
Allergies: Smoke
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted 8/24/21 for nausea, diarrhea, and shortness of breath. History of non-Hodgkin''s lymphoma and chemotherapy given 8/9. Resulted positive for COVID on 8/24. Diagnosed with COVID 19, bilateral viral pneumonia and acute hypoxi respiratory failure. Patient received Pfizer vaccination on 3/19/21 and 4/10/2021. Patient is still hospitalized. Hospital Name City State


VAERS ID: 1641654 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 066D21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Dyspnoea, Fatigue, Headache, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Pain, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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: Immune response, 52, 07/26/21, Covid-19, Moderna
Other Medications: Venlafaxine 37.5mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA 8/24/21 Arm started getting very sore in evening 8/25/21 Woke up at 3am with chills and body aches. Very bad arm pain with redness, hot and swelling. Out of breath while moving about the house. Tiredness, Headache and Dizziness lasted all day. 8/26/21 Bad arm pain with redness, hot and swelling continued along with Tiredness and Dizziness. 8/27/21 Arm pain lessened but still red, hot and swollen.


VAERS ID: 1641683 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-11
Onset:2021-08-24
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Diarrhoea, Dyspnoea, Fatigue, Headache, Myalgia, Nausea, Oropharyngeal pain, Pain, Pyrexia, SARS-CoV-2 test positive, Taste disorder, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 8/24/21: CORONAVIRUS SARS COV 2 PCR (RESP) - positive
CDC Split Type:

Write-up: Patient presented to hospital on 8/24/2021 with a 3-day history of worsening shortness of breath, wheezing, and fatigue. She is COVID-19 vaccinated but tested positive for COVID-19 in the ED. She also has subjective fevers, chills, headache, and change in taste that also started 3 days ago. Her headache is bifrontal, throbbing which she rates as 10/10, not responsive to acetaminophen. She reports nausea, sore throat, nonproductive cough, diarrhea, and muscle aches that started 3 weeks ago. Patient was admitted to the hospital for management of COVID-19 illness.


VAERS ID: 1641703 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-21
Onset:2021-08-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram ambulatory abnormal, Extra dose administered, Lung adenocarcinoma, Supraventricular tachycardia, Ventricular extrasystoles
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Ventricular tachyarrhythmias (narrow), Medication errors (narrow), Non-haematological malignant tumours (narrow), Hypokalaemia (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient with metastatic lung adenocarcinoma, received 3rd dose of COVID vaccine, was on holter monitor with PSVCs and PVCs, requested to come to emergency center, with nonsustained VTs, cardiology consulted for possible ischemia, prior history of ibrutinib, CARTOX. Patient discharged in stable condition


VAERS ID: 1641711 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Vermont  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Chills, Echocardiogram normal, Myocarditis, Pyrexia, Troponin
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Troponin 24 on 8/27/2021 ECHO normal on 8/27/2021
CDC Split Type:

Write-up: Myocarditis with chest pain, fever, chills


VAERS ID: 1641712 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-21
Onset:2021-08-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Spinal laminectomy
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient with history of no small cell lung cancer with metastatic disease (T8 lesion). Patient received Moderna COVID vaccine from different facility, two days later complained of bilateral leg numbness, admitted to hospital for T8 laminectomy. Remains admit at current time of VAERS report.


VAERS ID: 1641770 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-16
Onset:2021-08-24
   Days after vaccination:130
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Echocardiogram, Electrocardiogram, Pericarditis
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol inhaler
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Tea mushrooms codeine
Diagnostic Lab Data: Ekg.... Heart echo
CDC Split Type:

Write-up: Pericarditis chest tightness... Pain... Weird pulse rates. Cant lie flat when sleeping.


VAERS ID: 1641792 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Cold sweat, Dyspnoea, Pallor
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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: unknown
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: pt experienced cold sweat, pale and felt weak, pt stated he had difficulty breathing , paramedics were called. no epipen was injected at the pharmacy. paramedics walked him out the store


VAERS ID: 1641796 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pruritus, 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? 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 complained itch bumps on torso and extremities that appeared on Tuesday and called pharmacy on Thursday night at 08:50pm. patient was advised to take Benadryl for itchiness and advised not to drive or operate any machineries.


VAERS ID: 1642010 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Headache, Hypoaesthesia, Myalgia, Neurological examination normal, Pain in extremity, Paraesthesia, Pruritus, Rash, Vaccination complication
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (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: No active medications
Current Illness:
Preexisting Conditions: PMH significant for Palpitations, depression. s/p MVA 10/2019.
Allergies: Pt w/ hx of allergy to ASA (muscle spasms) and tomato (hives).
Diagnostic Lab Data:
CDC Split Type:

Write-up: "Pt w/ hx of allergy to ASA (muscle spasms) and tomato (hives). PMH significant for Palpitations, depression. s/p MVA 10/2019. Current Medications: No active medications 15mins post vaccination, pt c/o rash/itching in her arm. Vitals: BP 116/79, HR 74, RR 16, SpO2 100%. Pt given benadryl 25mg PO @ 16:45 and symptoms resolved. Reviewed ER precautions including SOB, throat swelling, or any other concerning symptoms. Pt stable and released from the vaccination site. Within hours of vaccination, pt developed and numbness/tingling in lower legs, back pain, and intermittent headaches. Pt presented to the ED c/o these symptoms on 8/25. Per ED MD, they did not appreciate swelling on exam but does not tenderness over bilateral calves. VSS, neurological exam WNL, intact reflexes. Pt has 5/5 strength in BLE and BUE with normal gait. ED MD concluded that this is likely myalgia secondary to an immune reaction from the Moderna Vaccine. Pt discharged with APAP."


VAERS ID: 1642297 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (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: Unknown
Current Illness: Unknown
Preexisting Conditions: None
Allergies: NONE
Diagnostic Lab Data: N/A advised patient to see his doctor
CDC Split Type:

Write-up: Patient came in today, 8/27, complaining that his right hand was feeling numb from the mid-forearm to the finger tips of the arm that was not vaccinated. Said that the symptoms started about 3 hours after his vaccine was administered and it has not gotten better. He said it felt like it tingled to the touch, but did not hurt, he was having a hard time keeping his wrist upright when holding his arm parallel to the counter. He could move his fingers but felt like it was limited movement. He was able to touch each finger tip to his thumb.


VAERS ID: 1642777 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling hot
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:
Current Illness: Allergic reaction to analgesics (Tramadol); Allergic reaction to analgesics (Nucynta); Behcet''s syndrome; Drug allergy (Methadone); Drug allergy (Buprenorphine); Drug allergy (Allergic to NSAIDS)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: PVIUS2021001203

Write-up: Entire body feels like it''s on fire; This spontaneous case was reported by a consumer and describes the occurrence of FEELING HOT (Entire body feels like it''s on fire) in a 30-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Drug allergy (Allergic to NSAIDS), Drug allergy (Methadone), Allergic reaction to analgesics (Tramadol), Allergic reaction to analgesics (Nucynta), Drug allergy (Buprenorphine) and Behcet''s syndrome. On 23-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Aug-2021, the patient experienced FEELING HOT (Entire body feels like it''s on fire). At the time of the report, FEELING HOT (Entire body feels like it''s on fire) had not resolved. Concomitant product use was not provided by the reporter. No treatment information was provided. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the event, 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 event, a causal relationship cannot be excluded.


VAERS ID: 1642988 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-08-24
Submitted: 0000-00-00
Entered: 2021-08-28
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: Comments: No known allergies
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210854749

Write-up: PUNCTURED VIAL STORED IN REFRIGERATION BEYOND THE RECOMMENDED 6 HOURS; ADMINISTRATION OF A DOSE OF THE VACCINE THAT WAS STORED OUTSIDE OF THE RECOMMENDED STORAGE CONDITIONS; This spontaneous report received from a pharmacist concerned a 38 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: No known allergies. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: 21-SEP-2021) dose was not reported, administered on 24-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 24-AUG-2021, the patient experienced administration of a dose of the vaccine that was stored outside of the recommended storage conditions. On an unspecified date, the patient experienced punctured vial stored in refrigeration beyond the recommended 6 hours. The action taken with covid-19 vaccine was not applicable. The outcome of the administration of a dose of the vaccine that was stored outside of the recommended storage conditions and punctured vial stored in refrigeration beyond the recommended 6 hours was not reported. This report was non-serious. This case, from the same reporter is linked to 20210855201 and 20210855614.


VAERS ID: 1642989 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-08-24
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Eating disorder, Influenza like illness, Paraesthesia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), 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: Alcohol use (Occasionally); Drug allergy (sleeps for 30 minutes and then is climbing the walls); Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: Total knee replacement; Comments: The patient did not have any drug abuse/illicit drug use. The patient sometimes take vitamins.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210854756

Write-up: HAS NOT EATEN; COULD NOT KEEP ANYTHING DOWN; SYMPTOMS LIKE THE FLU/ HEADACHE/ BODY ACHES/ GOT SICK/ FEELS AN ACHY, FLUISH FEELING; SPARKS RUNNING THROUGH JOINTS, HANDS, LOWER LEGS, FEET, TOES, WRISTS, FINGERS/LITTLE SHOCKS/NERVE SHOCKS; This spontaneous report received from a patient concerned a 57 year old female. The patient''s weight was not reported and height was 64 inches. The patient''s past medical history included: bilateral total knee replacement, and concurrent conditions included: alcohol consumer, non smoker, and allergy to pain medicine, and other pre-existing medical conditions included: The patient did not have any drug abuse/illicit drug use. The patient sometimes take vitamins. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 203A21A, expiry: 21-SEP-2021) dose was not reported, administered on 24-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 24-AUG-2021, the patient experienced symptoms like the flu/ headache/ body aches/ got sick/ feels an achy, fluish feeling. On 24-AUG-2021, the patient experienced sparks running through joints, hands, lower legs, feet, toes, wrists, fingers/little shocks/nerve shocks. On 25-AUG-2021, the patient experienced has not eaten. On 25-AUG-2021, the patient experienced could not keep anything down. The action taken with covid-19 vaccine was not applicable. The outcome of the symptoms like the flu/ headache/ body aches/ got sick/ feels an achy, fluish feeling, sparks running through joints, hands, lower legs, feet, toes, wrists, fingers/little shocks/nerve shocks, could not keep anything down and has not eaten was not reported. This report was non-serious.


VAERS ID: 1642991 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-24
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210854781

Write-up: ARM FEELS A BIT OF PAIN; HUGE FEVER; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 24-AUG-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow up will be requested for this case. No concomitant medications were reported. On 24-AUG-2021, the patient experienced arm feels a bit of pain. On 24-AUG-2021, the patient experienced huge fever. The action taken with covid-19 vaccine was not applicable. The outcome of the huge fever and arm feels a bit of pain was not reported. This report was non-serious.


VAERS ID: 1642999 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-24
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Antibody test, Chills, Fatigue, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Date: 202103; Test Name: Antibody test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210855086

Write-up: ACHES; CHILLS; FEVER; FATIGUE; 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 past medical history included: covid-19. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 24-AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On MAR-2021, Laboratory data included: Antibody test (NR: not provided) Positive. On 24-AUG-2021, the patient experienced aches. On 24-AUG-2021, the patient experienced chills. On 24-AUG-2021, the patient experienced fever. On 24-AUG-2021, the patient experienced fatigue. Treatment medications (dates unspecified) included: acetylsalicylic acid, and paracetamol. The action taken with covid-19 vaccine was not applicable. The patient was recovering from fever, aches, chills, and fatigue. This report was non-serious.


VAERS ID: 1645398 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-08-21
Onset:2021-08-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Mass
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: Naproxen (for joint pain) Rhino (herbal dietary supplement for sexual performance)
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have an internal lump in my right armpit. It was disappearing for a few days but came back by the week''s end following the Covid-19 vaccine.


VAERS ID: 1651204 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-01
Onset:2021-08-24
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient was fully vaccinated with moderna as of April. Patient is symptomatic and has tested positive as of 8/24


VAERS ID: 1651222 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-31
Onset:2021-08-24
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Decreased appetite, Fatigue, Full blood count, Heavy menstrual bleeding, Laboratory test, Pain, Postmenopausal haemorrhage, Pyrexia, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: Protonix, Losartan, Tylenol, Tizanidine, Zyrtec, Vitamin D, Vitamin C, Zinc
Current Illness: None
Preexisting Conditions: Hypertension, history asthma (well controlled), rheumatoid arthritis
Allergies: Ibuprofen, Amoxicillin, Metoprolol
Diagnostic Lab Data: Had recent labs to include CBC which was within normal limits. Consulted primary care provider. Await appointment with gynecologist. Last Pap within past two years with normal findings.
CDC Split Type:

Write-up: Originally having fatigue, body aches, chills, fever, and decrease appetite for 1-3 days after vaccine. Now having post menopausal bleeding which is heavy and with cramping and passing blood clots.


VAERS ID: 1651244 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disturbance in attention, Dizziness, Dry eye, Eye irritation, Fatigue, Feeling abnormal, Muscle spasms
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Noninfectious encephalopathy/delirium (broad), Corneal disorders (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Brain Fog, persistent difficulty concentrating/focusing even after sleep within 16 hours of vaccination. Dizziness, Lasting fatigue, burning/dry eyes, strange seemingly random body cramps even with high fluid intake and rest.


VAERS ID: 1651258 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-29
Onset:2021-08-24
   Days after vaccination:238
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Positive for covid 19


VAERS ID: 1651312 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-05-28
Onset:2021-08-24
   Days after vaccination:88
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Drainage, Drug hypersensitivity, Skin lesion, Staphylococcal infection
SMQs:, Angioedema (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
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: Draining lesions on my 12 year old little girl
CDC Split Type:

Write-up: 3 months after vax she has had an aggressive outbreak of serious MRSA. SHE HAS NEVER HAD MRSA BEFORE. She now has an allergy to antibiotics when she has NEVER had an allergy to ANY MEDICATION.


VAERS ID: 1651321 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-10
Onset:2021-08-24
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood cholesterol increased, Blood triglycerides increased, Brain oedema, Cerebral infarction, Computerised tomogram head abnormal, Headache, Low density lipoprotein increased, Visual impairment
SMQs:, Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Lipodystrophy (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aleve Enalapril
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: Sulfa Aspirin Ibuprofen
Diagnostic Lab Data: CT scan of patient''s head on 08/28/2021 Lim results showed triglycerides 156, cholesterol 215, LDL 130
CDC Split Type:

Write-up: Alteration in vision, headaches. Left posterior parietooccipital lobe cortical hypodensity suspicious for acute-subacute infarct showing on CT scan. CT a of head showed Wedge-shaped edema posterior left temporal lobe may represent acute infarction. Attenuated distal branches left posterior cerebral artery in this distribution. No significant change compared to the noncontrast CT brain earlier today. Right lentiform nucleus and thalamic lacunar infarctions. Will obtain MRI of head, echocardiogram, and carotid duplex along with further lab workup These are age indeterminate.


VAERS ID: 1651390 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Bone pain, Fatigue, Heart rate increased, Hot flush, Postmenopausal haemorrhage, Rash, Rash pruritic, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Osteonecrosis (broad), Hypersensitivity (narrow), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Yearly Flu vaccine
Other Medications: Medical Marijuana, Xopenex as needed, Flovent
Current Illness: Breast Cancer, Peripheral Neuropathy, Small cell lung disease, asthma, Hiatal Hernia
Preexisting Conditions: 9/11 survivor, toxic exposure victim, chronic laryngitis GERD,
Allergies: Aspirin, Penicillin, erythromycin, Levaquin, Fentanyl, Dust, Mold
Diagnostic Lab Data: None yet.
CDC Split Type:

Write-up: Itchy, painful Rash/raised hives, bone pain, lower back pain, fatigue, rapid heart rate, rolling hot flashes I went into chemical menopause after my cancer treatment in June of 2018. My period completely stopped. I got my period today.


VAERS ID: 1651393 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / UNK LA / SC

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Computerised tomogram thorax abnormal, Infection, Interstitial lung disease, Lung opacity, Oedema, Pneumonia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Interstitial lung disease (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone, Lasix, Gabapentin, simvastatin, alendronate , Zanaflex, zolpidem, Ruxolitinib
Current Illness: CLL in remission, GVHD, CKD 3a, h/o colon ca, anemia
Preexisting Conditions: as above
Allergies: nkda
Diagnostic Lab Data: CXR done 1 hour prior to vaccination as apart of routine visit with normal results on 08.23.21 chest CT Diffuse extensive bilateral groundglass opacities with multifocal areas of consolidation is nonspecific. Differential considerations are multifocal pneumonia/infection, acute interstitial pneumonia, organizing pneumonia, edema or inflammatory process, neoplastic process unlikely but recommend follow-up to resolution. on 08.25.21
CDC Split Type:

Write-up: admitted next day with Acute respiratory failure


VAERS ID: 1651399 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-20
Onset:2021-08-24
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy
SMQs:, 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: Fish oil, synthroid
Current Illness: None
Preexisting Conditions: Autoimmune thyroiditis
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lymph node under left arm the size of a golf ball


VAERS ID: 1651400 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFJZERFC3181 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Cough, Headache, Lethargy, Oropharyngeal pain, Rhinorrhoea, Somnolence
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (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: HRT, vitamin C, biotin
Current Illness: NA
Preexisting Conditions: NA
Allergies: Codeine, eggs, peanuts
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Lethargy, headache, sore throat, cough, runny nose, achy joints, no energy, couldn?t stay awake


VAERS ID: 1651441 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E214 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head, Fatigue, Migraine, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within 24 hours pt started to experience migraine headaches, extreme fatigue, after 72 hours, pt started experiencing microseizures, at 96 hours, pt sought medical attention to r/o other neurological causes - after CT head, was determined symptoms were the result of reaction to vaccine


VAERS ID: 1651460 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Hypersensitivity, Pyrexia, Vaccination site erythema, Vaccination site swelling
SMQs:, Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: * Mild fever during the night and following night of vaccination, * Fatigue and tiredness for two days from the night of vaccination, * Redness, swelling at the site of vaccine (left arm), * Allergy at different parts of the body--knee, wrist, thigh, foot, == Fever and fatigue went away naturally after two days but allergy remains. I am doing okay so far. ==


VAERS ID: 1651468 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Chest discomfort, Echocardiogram, Ejection fraction decreased, Electrocardiogram ST segment elevation, Intensive care, Magnetic resonance imaging heart, Myocarditis, Nausea, Troponin
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Myocardial infarction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (narrow), 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? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: insect venom
Diagnostic Lab Data: see above
CDC Split Type:

Write-up: He presented to the ER complaining of chest pressure & nausea in the evening the day he received his 2nd dose (received it around 10am that morning). Upon presentation, his initial troponin was 6.5 & his EKG showed ST elevation in I, aVL, V3-V6. He was given aspirin & admitted to the cardiac intensive care unit. Given his age, unremarkable medical history & family history, there was low suspicion for acute coronary syndrome. Initial suspicion was for myocarditis. Transthoracic echocardiogram revealed EF 50-55% with no other acute abnormalities. Cardiac MRI revealed evidence of late gadolinium enhancement (LGE) of the lateral & anterolateral walls extending from basal to apical segments; LGE was predominantly epicardial in distribution with some mid-myocardial enhancement. These findings were suggestive of myocarditis. He was treated with steroid. His troponin peaked at 14.4 then trended down. He remained stable and was discharged home on 8/28/2021.


VAERS ID: 1651501 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-16
Onset:2021-08-24
   Days after vaccination:220
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anosmia, Dry throat, Headache, Nasal congestion
SMQs:, Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Dehydration (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: HA, dry throat, nasal congestion, and lessoning of smell.


VAERS ID: 1652242 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Chills, Dizziness, Fatigue, Hyperhidrosis, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), 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:
Other Medications: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Tree allergies Mold
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pain at injection site immediately. Waited 15 minutes at the site and felt normal enough to drive. About 10 minutes into my drive home I started breaking out into sweats and felt faint to the point where I pulled over on a side street. I called my spouse and laid back my seat and came close but did not lose consciousness. 5 minutes later I continued my drive and had to pull over once more and lay back before continuing my drive home. I attribute this to an anxiety related event. 12 hours after vaccination I developed a fever and chills which subsided by introducing Tylenol. This did break overnight, however I experienced fatigue 24-48 hours post vaccination.


VAERS ID: 1653572 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Headache, Neck pain, Pain, Photophobia, Skin burning sensation, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), 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: AMPHETAM/DEXTROAMP ER 10MG CAP
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, vomiting, body aches, my skin felt like it was burning off, eyes light sensitive, joints hurt, my neck hurts


VAERS ID: 1653717 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-17
Onset:2021-08-24
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 21C13-02 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Feeling cold, Headache, Hypoaesthesia, Pain in extremity, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (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 DONE YET
CDC Split Type:

Write-up: Extreme cold and shivering. Acute stomach pain. Slight headache. Legs pain. Members numbness. Fever . Symptoms lasted at least 24 hrs while others are still present. No reputable , competent clinics in the vicinity of my present location to follow up with evaluation and possible treatment.


VAERS ID: 1653734 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Headache, Menstrual disorder, Vertigo
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (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: Flu vaccines give me a migraine
Other Medications: Lamictal 50 mg Yaz Birth Control
Current Illness: None
Preexisting Conditions: AUTISM spectrum
Allergies: Penicillin Msg Beans Bananas
Diagnostic Lab Data: None. I do not currently have a health care provider and my health insurance is state/ government, so it''s hard to find a doctor. I contacted the vaccine administration site (Walgreens) and they told me to fill out this form and that''s all that could be done
CDC Split Type:

Write-up: -Breakthrough Menstral 1/2 month early while on controled progesterone blocker ( contraceptive ). Very heavy and has lasted one week already. -Dull headache off/on like a vice clamp still a week later -Vertigo & confusion still a week later


VAERS ID: 1653805 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER FC 3184 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ear discomfort, Feeling abnormal, Headache, Heart rate increased, Lymphadenopathy, Paranasal sinus discomfort, Rhinorrhoea, Sensation of foreign body, Sinus congestion, Taste disorder
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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: Last flu shot2020/rapid HR
Other Medications: Advil, HCTZ, Thrive multi vitamin
Current Illness: High Blood Pressure (controlled)
Preexisting Conditions: Migraines , heart murmur
Allergies: Latex, shellfish, milk, egg, cinnamon, basil, cumin cur cumin, nutmeg, gluten
Diagnostic Lab Data: Bp and HR checked until it came down
CDC Split Type:

Write-up: Rapid HR and high BP. Lasted about 5-10 minutes approximately 3-4 minutes after vaccine was administered. Strange lump/feeling /taste in the back of throat. Like a tang. Lymph nodes in throat swelling, build up of mucus and bad taste once secreted. Right ear plugged and sinuses plugged. Lots of sinus pressure and headache. Felt very out of it. My feet were elevated immediately and blood pressure and heart rate monitored. Left approximately 30 minutes later, my head was foggy did not feel ?normal? until approximately 9:15pm . I had taken 1/2 a Benadryl when I left the clinic (in my car) and another once I got home. I live 30 minutes from the doctors office.


VAERS ID: 1653809 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Extra dose administered, Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Medication errors (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: Levothyroxine, Stelara, Cymbalta, Colace, Ducolax, Xiflaxan
Current Illness: Crohn''s Disease
Preexisting Conditions: Crohn''s Disease
Allergies: Pomegranate
Diagnostic Lab Data: Consulted with NP and Physician neighbor. Swollen, reddened, and intensely itchy... benadryl and tylenol taken around the clock for 3 days. Used ice packs for symptom relief, benadryl cream and hydrocortisone cream.
CDC Split Type:

Write-up: Moderna Vaccine- Rx#1217288. Booster shot. Swollen Left Upper Arm, Severe Itching and Redness that started 12+ hours after vaccine and lasted for 3 days.


VAERS ID: 1653874 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Decreased appetite, Diarrhoea, Disorientation, Fatigue, Nasal congestion
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Dehydration (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: Birth control- drospirenone
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Confusion, disorientation- onset approx 2-3 hrs after vaccine, lasted between 9-16 hours. (Went to bed and seemed better the next day) Diarrhea- onset day after vaccine, lasted approx 4-5 days Loss of appetite- onset approx 4 hrs after vaccine, has continued through day 5 post vaccine Stuffy nose- onset 3 days post vaccine Extreme Fatigue- onset approx 6 hrs post vaccine, has continued through day 5


VAERS ID: 1653899 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-08-08
Onset:2021-08-24
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049EZ1A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain upper, Feeling abnormal, Herpes zoster, Injection site paraesthesia, Pain in extremity, Pain of skin, Rash vesicular
SMQs:, Acute pancreatitis (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Spoke to a teladoc doctor via video call 8/29/2021. He reviewed the images and descriptions I sent him, and he said without a doubt it is shingles. He told me that they are seeing lot of cases of shingles developing after the covid vaccines. Funny, that I couldn''t find any reference to this when researching it. I still have shingles and now a lingering distrust in the system. This is why no one trust the vaccines. Shingles is not listed as a side effect! So, trying to follow the science, I am going to go get more opinions in case the guy I spoke to was a total conspiracy theorist. I just hope they can give me a reason not to be one now. My own mind and best guess is that the vaccine caused and inflammatory response in my immune system that triggered a dormant shingles virus. I have a very robust immune system, and never get sick. Perhaps that is what happened.
CDC Split Type:

Write-up: Day of shot and following 2 days: Tingling in arm of injection site for about 15 minutes directly after vaccine, followed by slightly soar arm, and fleeting auto-immune response "cruddiness" the following day. Overall not bad though. Week after shot: Stomach issues and bad cramps one week after the vaccine. Three weeks after shot: Developed skin tenderness around my left rib cage and late area. Followed by a rash with with fluid filled blisters. Ribs are now very tender and skin is raw to the touch. "Diagnosis is SHINGLES!"


VAERS ID: 1653927 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-21
Onset:2021-08-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Chest X-ray, Chest discomfort, Electrocardiogram, Fatigue, Feeling abnormal, Fibrin D dimer, Headache, Hypoaesthesia, Mental fatigue, Nausea, Pain in extremity, Paraesthesia, Troponin
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Tendinopathies and ligament disorders (broad), Sexual dysfunction (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: Aspirin 81, quercetin 250, claritin 10, zinc 50, vitamin d 4000iu, vitamin c 500
Current Illness: None
Preexisting Conditions: NONE
Allergies: Sulfa
Diagnostic Lab Data: See above clinical report
CDC Split Type:

Write-up: Began having tingling in peripheral extremities and brain fog 30 minutes after injection which subsided after an hour. Experienced exhaustion, mental fog, mild arm soreness first night which continued and increased with nausea through hospital visit on 8/23/2021. Began having chest pressure/discomfort and left arm numbness at noon on 8/23/2021 then headache began. Took my vitals at home as follows: 172/106, 142 bpm and afebrile 95% on room air. Took 324 aspirin and rested supine for 45 minutes and drank water- symptoms did not subside. Went to hospital after being evaluated by critical care nurse friend in my home as all symptoms were still present and vitals were still abnormal as they were prior to her arrival. EKG, troponin, dimer, chest X-ray performed. Cardiac enzymes were normal. 3L of fluids administered by EMS and hospital. After fluids ALL symptoms subsided and was discharged with CP diagnosis. I do not have medical history of HTN- BP is normally 120s/70s. My fluid intake and activity had not changed and had not been outside in heat. The only thing that was a change in my life was the Moderna shot on 8/21/2021.


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