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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 409 out of 8,010

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VAERS ID: 1683698 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051E21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Eye swelling, Feeling cold, Head discomfort, Headache, Pain in extremity, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Vestibular disorders (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, zyrtec, Oil of Oregano, fish oil, B12, turmeric, align probiotic
Current Illness: none
Preexisting Conditions: none
Allergies: none known
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Received shot on 8/24/21. Started having headache, pressure/slight swelling of forehead and swelling feeling/cool type sensation around the eyes around 7pm that evening. Headache continued into following day only. Swelling feeling of forehead continued into the following day only. Swelling feeling/cool type sensation around the eyes has continued since then and I am still having that feeling today 9/8/21. Lightheaded on 8/25/21 only lasted 1 day. Slight soreness of arm lasted for approximately 1 day only. No medications were taken after the shot to treat any of the symptoms.


VAERS ID: 1683901 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 LA / IM

Administered by: Unknown       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received Moderna #1 today at 1024 in left deltoid. Pt complaining to RN of left deltoid to left cheek numbness/tingling starting at 1050. Pt sitting in vaccination OBS room, in no distress, shortness of breath/wheezing, no facial edema noted, no redness/rash/hives noted, pt denies throat swelling/difficulty swallowing, O2 sat 98%. Bilateral upper extremity with equal strength, no unilateral weakness noted, no lower extremity involvement. pt evaluated. Pt denies worsening of symptoms since onset, reports numbness/tingling to entire left arm up to left neck and cheek coming and going in waves. Pt discharged, instructed to return for worsening symptoms.


VAERS ID: 1684460 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Aphonia, Back pain, Blister, Diarrhoea, Eczema herpeticum, Fatigue, Furuncle, Headache, Impaired work ability, Menstrual disorder, Pain, Pharyngeal swelling, Pruritus, Skin reaction
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: 1st Vaccine shot - following day major skin reaction. Itchy patches on hands and legs, turned into large patches of fluid-filled blisters/boils. Horrible pain and itchiness, not able to work, lasted 2 weeks. Went to dermatologist, discovered a severe case of "eczema herpticum". Strongly suggested no second dose of vaccine following severe allergic reaction. Other reactions on a large scale include: body aches, fatigue, headache, diarrhea, swollen throat and voice loss, low back aches, changes in menstrual cycle.


VAERS ID: 1684732 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025E21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (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: Daily multivitamin
Current Illness: No other illness
Preexisting Conditions: Previously diagnosed with hypertension, Resolved when lost weight in 2017. Moderate hearing loss.
Allergies: No food allergies. No drug allergies.
Diagnostic Lab Data: None as of yet. Trying to get into see a doctor.
CDC Split Type:

Write-up: Tinnitus - Has been present before and was only observed in ultra quiet environments. Seemed to be exacerbated by physical stress, such as exercise. However it has become significantly worse and remains unabated. It is non-stop and is audible even in loud environments.


VAERS ID: 1684782 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033621A / 1 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Headache, Hot flush, Injection site pain, Injection site pruritus, Injection site rash, Injection site swelling, Injection site warmth, Neck pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: anthrax vaccine 1999 who arm swollen hot to touch for two weeks,influenza vaccine every time fever, throwing up for as week.
Other Medications: Alive Woman''s Multivitamin 50+ gummies.
Current Illness: None
Preexisting Conditions: Costochondritis mid sternum,
Allergies: Environmental, shrimp, Motrin,
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within 2 hours severe headache last three days medication did not ease, since getting headaches off and on. (Took Tylenol) Fever day 2 and 3 (Took Tylenol) since get periods of hot flashes. Sore right arm from elbow to neckline for 7 days. After 7 days right arm area of injection measuring approximately 6 inches by 6 inches swollen hot to touch rash looking mild itch, (Took Tylenol and Benadryl ) lasted 9 days. Today got checked by doctor area only pink not hot to touch, blood pressure 172/92 do not have high blood pressure monitoring for two weeks will treat if does not go back to normal. Advised to wait for second shot which was scheduled for 21 September 2021 maybe at least a week later to report symptoms to this site.


VAERS ID: 1684803 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-22
Onset:2021-08-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Dyspnoea, Fatigue, Loss of personal independence in daily activities
SMQs:, Anaphylactic reaction (broad), Dementia (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:
Other Medications: Carvedilol , Losartan, Xarelto
Current Illness:
Preexisting Conditions: A-Fib
Allergies: ace inhibitors cephalexin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1-2 days after receiving initial dose patient experienced loss of appetite ranging from no consumption to little consumption. Patient was recommended by cardiologist to take vaccination, with her pace maker it made breathing difficult. Patient reported the tiredness making everyday activities, and labor hard. ex. vacuuming, flights of stairs, walking around grocery store etc. Today is 9/9/21 patient is finally able to do semi normal activities like walking around a grocery store.


VAERS ID: 1684839 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid Pantoprazole sodium Hyoscyamine sulfate Amlodine beyslate/benazepril hydrochloride Gemfibrozil Metoprolol succinate
Current Illness: None
Preexisting Conditions: Hypothyroidism High BP
Allergies: Napeosyn Steriod Lipitor
Diagnostic Lab Data:
CDC Split Type:

Write-up: Acquired Shingles the next morning.


VAERS ID: 1685396 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-03-09
Onset:2021-08-24
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 LA / SYR

Administered by: Private       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: Penicillin
Diagnostic Lab Data: Covid test
CDC Split Type:

Write-up: Covid


VAERS ID: 1685432 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-20
Onset:2021-08-24
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arrhythmia, Cardiac monitoring, Dizziness, Pain
SMQs:, Anticholinergic syndrome (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (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: Dexilant, Estradiol, Fluticasone Propionate Nasal Spray, Cetirizine, Montelukast, Vitamin D3-50
Current Illness: No
Preexisting Conditions: No
Allergies: Mushroom Allergy
Diagnostic Lab Data: I visited ENT specialist- adivsed to see neorologist. Neurologist advised me to see cardiologist. Today, 9-9-2021 I visited cardiologist. Fitted with 28 heart monitor. Will have Cv CT scan and EKG
CDC Split Type:

Write-up: Four days after 2nd dose of vaccine I started having "episodes", light head, dizzy, heat arrythemia and pain.


VAERS ID: 1685562 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: 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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall 20xr
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Went to urgent care to get it checked out. They advised to put in a report. No testes done.
CDC Split Type:

Write-up: When I come in contact with cold water my hands will swell and have a rash. Once my skin warms back up the rash goes away. Has been happening since the shot.


VAERS ID: 1685716 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate increased, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

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

Write-up: patient experienced tachycardia within about 5-6 hours after getting vaccine. He went to doctor and doctor told him what symptoms to watch for to determine if he needed to come back. MD said it might take 14 days to get over it. I checked on him on day 14 and he was better. His heart rate about 10 beats above normal at current time. so he is better.


VAERS ID: 1685732 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-28
Onset:2021-08-24
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Exposure to SARS-CoV-2, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/07/21 2nd dose01/28/21 Diagnosed covid positive:08/28/21 Symptom onset:08/24/21 Exposure:community Symptoms:Cough, sorethroat,runnynose


VAERS ID: 1686245 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-22
Onset:2021-08-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA OS2E21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Heart rate increased, Pain in extremity, Palpitations, Panic attack, Paraesthesia, Vision blurred
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (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: I was taking a kirkland multivitamin for the weeks leading up to vaccination and days after. I''ve always been taking another multivitamin before the recent one I switched to every day. Never had any allergic or negative reactions.
Current Illness: None, but I had symptoms of gingivitis probably due to vitamin deficiency. Was on vegan diet for several months. I saw a dentist who confirmed that I didn''t have gingivitis or any negative dental issues and was probably something else. I''m currently taking a multivitamin and changed back my diet and my gingivitis-like symptoms have been reduced for over a month
Preexisting Conditions: None
Allergies: I had an allergic reaction to SLS toothpaste eventually in my life around my mid twenties. Cankersores, gingivitis-like symptoms.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Initially after vaccination I felt fine, typical arm soreness maybe mild immune response. I was able to go to the gym for 2 days straight the following monday and tuesday. But on Tuesday, despite feeling completely fine after the gym (heavy weight lifting) and eating lunch, about an hour of elapsed time, I drank some coffee and noticed my heart beating faster and faster like I was having a panic attack (also shortness of breath). I also took a multivitamin that morning (single dose) and ate another 2-dose multivitamin after lunch since I figured that I might''ve been vitamin deficient that my body would just dispose of the excess vitamins if it couldn''t absorb them. My hands, feet, neck, shoulder, and lower part of my face were buzzing, my vision was felt like it was fuzzy. Since then I''ve had symptoms of a pounding heart that have gotten better through the past 2 weeks but have plateaued somewhat. It only happens when I''m trying to exercise (have since paused), when I eat food past a certain limit, add salt to my meal, or am in a hot room for too long (81-82 degrees), so I think anything that can stimulate the heart. Other than that, as long as I''m conscious of those things I can feel pretty normal, though sometimes I get shortness of breath.


VAERS ID: 1688437 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC381 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Dehydration, Fatigue, Hypoaesthesia, Hypoaesthesia oral, Insomnia, Micturition disorder, Pyrexia, Renal pain
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow), 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: AMITRIPTYLINE; FLURAZEPAM; KEPRA
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cardiovascular disorder (Bad circulation); Epilepsy; Neuropathy; Penicillin allergy (Known allergies: Penicillin); Radiculopathy; Seafood allergy (Known allergies: Seafood); Shellfish allergy (Known allergies: Shellfish)
Allergies:
Diagnostic Lab Data:
CDC Split Type: PRPFIZER INC202101161914

Write-up: Excessive urinating to point of dehydration; Excessive urinating to point of dehydration; Facial numbness; Pain in kidneys; Lips numb; Weakness/ general weakness; Insomnia; Fatigue; Feverish at random moments; This is a spontaneous report from a contactable consumer, the patient. A 61-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC381) via an unspecified route of administration in the left arm on 24Aug2021 at 11:00 (at the age of 61-years-old) as a single dose for COVID-19 immunisation. Medical history included neuropathy, epilepsy, bad circulation and radiculopathy. The patient had known allergies to penicillin, shellfish and seafood. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccine within four weeks prior to the COVID-19 vaccine. Concomitant medications included amitriptyline (MANUFACTURER UNKNOWN), flurazepam (MANUFACTURER UNKNOWN), levetiracetam (KEPRA), and super complex b; all for an unknown indication from an unknown dates and unknown if ongoing. The patient previously received acetylsalicylic acid (ASPIRIN) and ciprofloxacin (CIPRO) and experienced drug allergy. On 24Aug2021 at 16:00, the patient had excessive urinating to point of dehydration, pain in kidneys, facial numbness, lips were also numb, insomnia, weakness/general weakness, fatigue and feverish at random moments. The events resulted in doctor or other healthcare professional office/clinic visit. Since the vaccination, the patient had not been tested for COVID-19. Therapeutic measures were not taken as a result of the reported events. The clinical outcome of the events excessive urinating to point of dehydration, pain in kidneys, facial numbness, lips numb, insomnia, weakness/ general weakness, fatigue and feverish at random moments were not resolved at the time of this report.


VAERS ID: 1688513 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 80777-0273-15 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Lymphadenopathy, Myalgia, Peripheral swelling, Pyrexia, Vaccination site warmth
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug allergy (Prozac); Drug allergy (Minocyclin)
Preexisting Conditions: Comments: No medical history information was reported
Allergies:
Diagnostic Lab Data:
CDC Split Type: PVIUS2021001215

Write-up: muscle pain; Joint pain; fatigue; fever; Swollen arm; Vaccination site warmth; swollen lymph nodes at my shoulder/neck and armpit; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Swollen arm), VACCINATION SITE WARMTH (Vaccination site warmth), LYMPHADENOPATHY (swollen lymph nodes at my shoulder/neck and armpit), MYALGIA (muscle pain) and ARTHRALGIA (Joint pain) in a 32-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 80777-0273-15) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history information was reported. Concurrent medical conditions included Drug allergy (Minocyclin) and Drug allergy (Prozac). On 24-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 milliliter. On 24-Aug-2021, the patient experienced PERIPHERAL SWELLING (Swollen arm), VACCINATION SITE WARMTH (Vaccination site warmth), LYMPHADENOPATHY (swollen lymph nodes at my shoulder/neck and armpit) and PYREXIA (fever). On 25-Aug-2021, the patient experienced MYALGIA (muscle pain) and ARTHRALGIA (Joint pain). 25-Aug-2021, the patient experienced FATIGUE (fatigue). The patient was treated with ACETYLSALICYLIC ACID (ASPIRIN (E.C.)) for Adverse event, at an unspecified dose and frequency. On 26-Aug-2021, PERIPHERAL SWELLING (Swollen arm), VACCINATION SITE WARMTH (Vaccination site warmth), LYMPHADENOPATHY (swollen lymph nodes at my shoulder/neck and armpit), MYALGIA (muscle pain), ARTHRALGIA (Joint pain), FATIGUE (fatigue) and PYREXIA (fever) had resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. Relevant concomitant medications were not reported.


VAERS ID: 1688665 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-27
Onset:2021-08-24
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Hypoxia, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Flomax Synthroid
Current Illness: unknown
Preexisting Conditions: hypertension hypothyroidism
Allergies: none known
Diagnostic Lab Data: SARS-CoV-2 RNA = DETECTED on 9/7/21
CDC Split Type:

Write-up: severe fatigue, cough, fever increasing over 2 weeks, hypoxic at ER presentation requiring oxygen. Admitted for further care and treatment


VAERS ID: 1688973 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-21
Onset:2021-08-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939901 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Reddened skin at injection site for several days, site then turned into an itchy rash a week after injection and persisted as a large area on upper arm of redness and itchiness until 9/12/2021 Pregnant with no health issues or concerns


VAERS ID: 1689023 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-01-08
Onset:2021-08-24
   Days after vaccination:228
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anaesthesia oral, COVID-19, Cerebrovascular accident, Condition aggravated, Discomfort, Facial paralysis, Infarction, Magnetic resonance imaging, Nucleic acid test, SARS-CoV-2 test positive, White matter lesion
SMQs:, Myocardial infarction (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NORCO, meloxicam, prenatal Vit-Fe Fumarate-Fa
Current Illness: N/A
Preexisting Conditions: Osteoid osteoma of femur, cervical spine surgery, Facial droop
Allergies: N/A
Diagnostic Lab Data: Nucleic Acid Amplification (NAA)/Polymerase Chain Reaction (RT-PCR) positive 8/24/2021. Acute infarction involving the right centrum semiovale. Moderate degree of scattered T2 FLAIR signal within the periventricular and subcortical white matter. Given the patient''s age, findings may relate to vasculitis or hypertensive encephalopathy.
CDC Split Type:

Write-up: Onset of left sided facial droop, tongue heaviness / loss of sensation, acute cortical stroke.


VAERS ID: 1689048 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-08-17
Onset:2021-08-24
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deafness, Disorientation, Fatigue, Feeling abnormal, Pain in extremity, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hearing impairment (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (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:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I had a sore arm for about three days, I had fatigue and brain fog for a couple of days. On the morning of August 24 I woke up and realized I was having trouble hearing out of my right ear. I had some hearing loss, accompanied with ringing in my ear. This did not affect my balance or other function, but persisted for three days. At times I felt slightly disoriented. As my hearing recovered over the three days, the ringing in my year was more apparent, and on the fourth day I woke up and could not notice any ringing or hearing loss.


VAERS ID: 1689104 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939839 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Confusional state, Dizziness, Ear discomfort, Fatigue, Headache, Hyperacusis, Pain, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (narrow), Vestibular disorders (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: Asthma
Allergies: hypersensitivity NSAIDS
Diagnostic Lab Data:
CDC Split Type:

Write-up: Ear fullness and tinnitus in both ears. headache, loss of balance, hearing fluctuation, dizziness, exhaustion, confusion, and body aches.


VAERS ID: 1689168 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Back pain, Chest X-ray, Chest discomfort, Chest pain, Computerised tomogram thorax, Diarrhoea, Dyspnoea, Electrocardiogram abnormal, Feeling hot, Fibrin D dimer, Headache, Malaise, Neutrophil count increased, Peripheral coldness, Pulmonary mass, Vomiting, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: unknown
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: ER on 8/29/2021 with negative d-dimer, labs, CXR, and EKG. EKG :ABNORMAL ECG WHEN COMPARED WITH ECG OF 23-APR-2014 16:47, NONSPECIFIC T WAVE ABNORMALITY NOW EVIDENT IN ANTERIOR LEADS only abnormal labs Leukocytes 3.4 - 9.6 x10(9)/L 10.3 High , Neutrophils 1.56 - 6.45 x10(9)/L 7.17 High all other labs normal. 9/1/21 CT ordered: IMPRESSION: 1. Negative for acute pulmonary embolism. 2. Indeterminate small right pulmonary nodules. Consider 6-12 month follow-up.
CDC Split Type:

Write-up: The patient is a 35 year old female patient of Dr. She received her 2nd Pfizer vaccine on 8/24/2021. She notes within 3-4 hour after receiving the vaccine she started feeling weak and short of breath. She notes with simple exertion she feels short of breath and it takes up to a half hour to regain her breath. She was seen in the ER on 8/29/2021 with negative d-dimer, labs, CXR, and EKG. Since being seen in the ER she feels that her symptoms have worsened. She feels OK lying in bed but anytime she exerts herself she feels unwell. She has felt hot at times, has not taken her temperature. She feels like she has a headache, her temples feel sore. She had vomiting yesterday. She briefly had diarrhea yesterday. She also feels like she has stabbing pain in her upper back and left chest. Feels like she has left sided chest pressure. She also feels like her left hand is cold. Patient was called with CT results the evening of 09/01/2021 and given precautions to seek attention if her symptoms persist or worsen. Offered patient round of steroids if not improving


VAERS ID: 1689367 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8440 / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebral infarction, Computerised tomogram head abnormal, Confusional state, Headache, Lethargy
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: plavix, coumadin, amiodarone, lisinispril, proscar, norco, gabapentin, xanax, flomax, prevastatin, ferrous sulfate , stool softener w/stimulant, fiber, vitamin c & d, zyrtec, omeparazole, montelukast, paxil, albuterol sulfate emergency inha
Current Illness: advanced emphysema, copd, asbestosis, asthma, extensive vascular calcifications, anoxic brain injury, afib
Preexisting Conditions: advanced emphysema, copd, asbestosis, asthma, extensive vascular calcifications, anoxic brain injury, afib, cardiac arrest 2013, renal cancer left kidney 2014, non healing vascular ulcer left foot since 2013 from code cool
Allergies: tape, reaction to penicillin when young
Diagnostic Lab Data: 8/23/2021-er visit & ct brain shows infarct around white matter from previous brain injury from previous cardiac arrest in 2013/will be doing a mri in future
CDC Split Type:

Write-up: Severe Headache, confusion(still not at baseline), lethargic


VAERS ID: 1689391 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-03-05
Onset:2021-08-24
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Malaise, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), 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, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Alfuzosin, calcium-vitamin D3, cholecalciferol, cyanocobalamin, dutasteride, esomeprazole, fluticasone propionate, misoprostol, pregabalin, Xtampza ER
Current Illness:
Preexisting Conditions: Benign prostatic hyperplasia, GERD, hepatitis, erectile disorder, diabetes mellitus, psoriasis, vitamin D deficiency
Allergies: Bupropion (hives), penicillins (hives)
Diagnostic Lab Data: COVID-19 Positive (8/19/2021)
CDC Split Type:

Write-up: Patient came to the emergency department with complaints of feeling unwell increased shortness of breath increased cough due to COVID-19. Patient states he was diagnosed with COVID-19 on August 19, 2021. The patient was supposed to be having an outpatient infusion starting today but missed the appointment secondary to being here. States when he takes a deep respiration has significant coughing fit and has had intermittent fevers. The patient was in the hospital for 10 days before being discharged to a skilled nursing facility.


VAERS ID: 1689486 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-31
Onset:2021-08-24
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral, Echocardiogram, Hemiparaesthesia, Ischaemic stroke, Magnetic resonance imaging head, Visual field defect
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Noninfectious encephalitis (broad), Optic nerve disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: levothyroxine, Rosuvastatin, Meloxicam, Tramadol, Cyclobenzaprine, Linopril
Current Illness: None
Preexisting Conditions: HTN, DM, Hypothyroidism, Previous Hashimoto''s Thyroiditis, Partial Pancreatectomy, Speenectomy, Adrenal Adenomas
Allergies: Hydromorphone-Pruitis, Agitation
Diagnostic Lab Data: Brain MRI, Brain CTA, transthoracic echocardiogram
CDC Split Type:

Write-up: Right Ischemic Occipital CVA with Left Sided Paresthesia and visual field deficit


VAERS ID: 1689506 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Burning sensation, Headache, Migraine, Pain in extremity, Pyrexia, SARS-CoV-2 test negative
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (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: No. But mother has had reactions to flu shots before
Other Medications: Prenatal vitamins, progesterone (trying to conceive but not currently pregnant), levothyroxine 500 mcg, 2-3 weeks before the vaccine: was taking letrozol and orbodril for fertility treatments
Current Illness: N/A
Preexisting Conditions: Hypothyroidism,
Allergies: N/A
Diagnostic Lab Data: Blood Work (normal), Covid Test (negative),
CDC Split Type: vsafe

Write-up: 5-6 hours after vaccine dose, began to have extremely high fever (102), searing pain across forehead (like forehead was on fire), usual symptoms of sore arm, etc. The 102 fever lasted about 4 nights. Still had 99-101 for 3 more days. By 9/1/21 no longer had a fever, but still had the burning sensation in the forehead and migraine, which did not dissipate until 9/8/21. Took tylenol, which would temporarily help the fever/burning, but headache would remain. Not enough to fully resolve pain. Doctor wanted to prescribe steroid pack, but did not end up taking the steroids because I am currently in fertility treatment.


VAERS ID: 1689512 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-18
Onset:2021-08-24
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9263 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Cough, Dyspnoea, Intensive care, Positive airway pressure therapy, Pyrexia, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), 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, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: carvedilol, dofetilide, febuxistat, gabapentin, losartan, nifedipine, potassium chloride, simvastatin, warfarin, escitalopram, pantoprazole
Current Illness: unknown
Preexisting Conditions: childhood NHL s/p chemotherapy (age 11-13 including cardiac arrest), IDDM, NICM s/p HM3 2017 in Tampa, CHF, HTN, Sleep Apnea
Allergies: Phenobarbital, Tape, aspartame
Diagnostic Lab Data: 8/24: SARS CoV 2 PCR COVID-19 Positive
CDC Split Type:

Write-up: COVID-19 breakthrough case. 8/22/21: Patient arrived at the ER due to worsening dyspnea and non-productive cough, he noted a fever of 101 at home. As his dyspnea worsened, he states he used his home CPAP and started feeling better. Reports testing positive for COVID on 8/21/21. admitted to ICU on 8/22. Note: Patient previously received Pfizer COVID-19 vaccine, first dose on 2/25/2021 Lot # EL9263 and 2nd dose on 3/18/2021 Lot # EN6198. Diagnosed with acute hypoxic respiratory failure, COVID-19 pneumonia. 8/30/21: Patient discharged home


VAERS ID: 1689571 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-18
Onset:2021-08-24
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Convalescent plasma transfusion, Cough, Fatigue, Lung infiltration, Positive airway pressure therapy, Pyrexia, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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), Acute central respiratory depression (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), 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: albuterol, amlodipine, ascorbic acid, bifidobacterium-lactobac (probiotic formula), budesonide, budesonide-formoterol, cefepime, cholecaciferol, clonidine, dexamethasone, famotidine, fondaparinux, guaifenesin-dextromethorphan, insulin aspar
Current Illness:
Preexisting Conditions: Orthotopic heart transplant 2016, recurrent Cdiff colitis, CKD stage 3, Afib, DM2
Allergies: Aspirin, heparin, ibuprofen, lisinopril, sulfadiazine
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID19 Breakthrough case. History: on 8/22/21 Patient arrived to HCF on 8/17 with cough, fever, & generalized fatigue x 2 days. Tested positive for COVID-19 on 8/17. Admitted on room air but worsening respiratory status & bilateral pulmonary infiltrates. Oxygen requirements escalated to 60% on CPAP & 8/24 pt was transferred here for further management. He received convalescent plasma on 8/18. Remdesivir started 8/23. Transferred from outside facility on 8/24/21. Diagnosed with acute hypoxic respiratory failure secondary to Covid-19 pneumonia. Remains hospitalized as 9/9/21 (day of report submission). Please note: Patient received first dose Pfizer vaccine on 3/28/2021 Lot # EP6955 and the second dose on 4/18/2021 Lot # ER873


VAERS ID: 1689587 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-06
Onset:2021-08-24
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Asthenia, COVID-19, COVID-19 pneumonia, Cough, Decreased appetite, Diarrhoea, Dyspnoea, Myalgia, Oxygen saturation decreased, Pyrexia, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), 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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Crestor 10 mg PO qDay azaTHIOprine 150 mg PO qDay, predniSONE 15 mg PO qDay hydroCHLOROthiazide 12.5 mg PO qDay losartan 100 mg PO qDay Fish Oil oral capsule 1,000 mg PO qDay Vitamin B-12 500 mcg PO qDay Vitamin C 1,000
Current Illness:
Preexisting Conditions: Pulmonary fibrosis, end-stage pulmonary disease
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID-19 Breakthrough case. on 8/24/21: Patient arrived to ER due to generalized weakness. Per EMS, patient tested positive for COVID on 8/19/2021. EMS reports the pt has been experiencing decreased appetite and weakness over the past 5 days. EMS states the patient received Regeneron treatment today at 0930. He is on 4 liters of O2 at baseline and his O2 saturation was 77% when found by EMS. EMS states the pt''s O2 saturation was 100% on 15 liters NC. He reports fever, cough, SOB, myalgias, and diarrhea. Admitted 8/24/21. Diagnosed and treated for covid-19 pneumonia and acute hypoxic respiratory failure. Condition did not improve. Moved to hospice on 8/27/21. Patient received first dose Pfizer vaccine on 2/13/2021 Lot # EN6201 and the second dose on 03/06/2021 Lot # EM9810


VAERS ID: 1689624 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-19
Onset:2021-08-24
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Positive airway pressure therapy, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (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), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), 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, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Celexa, Nuvaring, Flonase, Deseryl
Current Illness:
Preexisting Conditions: Depression, valvular heart disease, cardiomyopathy, iron deficiency, history of gastric bypass, morbid obesity, multiple sclerosis, anxiety
Allergies: NKDA
Diagnostic Lab Data: Positive COVID test on 08/19/21.
CDC Split Type:

Write-up: Fully vaccinated patient admitted through ED for COVID pneumonia and acute hypoxic respiratory failure. Treated with dexamethason, remdesivir, zin, vit C, and vit D. Required HFNC during day and BiPAP at night. Discharged home on 09/02/2021 with supplemental O2.


VAERS ID: 1689693 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-23
Onset:2021-08-24
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Condition aggravated, Dysstasia, Headache, Hypoaesthesia, Neck pain, Pain, Paraesthesia, SARS-CoV-2 test positive, Sensory disturbance, Sitting disability, Vaccine breakthrough infection
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow), 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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: norethindrone-ethinyl estradiol
Current Illness:
Preexisting Conditions: migraine headaches
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID-19 breakthrough case. History: acute severe headach and neck pain especially on sitting and standing. presented to ED day prior with increased numbness and alteration of sensation of lower extremities in setting of recent COVID-19 infection. Covid testing at outside clinic approximately 4 days prior to admission. Admitted 8/24/21. Note: previously received Pfizer Covid-19 vaccine on 4/2/21 & 4/23/21. Diagnosed with Covid infection without respiratory symptoms. No treatment for this. paresethesia of hand/feet likely due to COVID infection. Discharged on 8/27/21.


VAERS ID: 1689702 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-06
Onset:2021-08-24
   Days after vaccination:140
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Asthenia, COVID-19, Confusional state, Fatigue, Pyrexia, SARS-CoV-2 test positive, Sepsis, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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), Dementia (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Sepsis (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, cinacalcet, clonidine, diphenhydramine, docusate, fludrocortisone, gabapentin, levothyroxine, multivitamin, sevelamer
Current Illness:
Preexisting Conditions: ESRD on hemodialysis, hypertension, diastolic heart failure, pulmonary hypertension, hypothyroidism
Allergies: nka
Diagnostic Lab Data: Tested positive for Covid (PCR) on 8/24/21.
CDC Split Type:

Write-up: COVID-19 Breakthrough case. 8/24/21: presented to the ED for evaluation of fever, fatigue, and weakness that started today. Patient went to dialysis today and was able to complete session but on return to nursing home she was noted to have fever and confusion and EMS was called. COVID rapid antigen PCR test run 8/24 was positive. admitted on 8/24/21. Note: previously received Pfizer Covid-19 vaccines on 3/18/21 & 4/6/21. Diagnosed and treated for acute hypoxic respiratory failure, Covid infection and sepsis. Improved and discharged 8/26/21.


VAERS ID: 1689727 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-14
Onset:2021-08-24
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive, Suicidal ideation, Vaccine breakthrough infection
SMQs:, Suicide/self-injury (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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: clonazepam, finasteride, imipramine, lamotrigine, quetiapine, rosuvastatin, terazosin
Current Illness:
Preexisting Conditions: HTN, HLP, BPH, CVA, tremor, parkinson, CTE, multiple concussions, PE, OSA, hepatitis C, depression, anxiety, bipolar disorder, dementia with behavioral disturbance.
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID-19 breakthrough case. HISTORY: This is a 71 year-old male who is a direct admit from the psych unit due to testing positive for COVID-19 and needing a higher level of care. Patient initially seen by ED physician on 7/25/21 for suicidal ideations. Patient seen by neurology and psychiatry and was to be transferred to a HCF but tested positive for COVID so transferred to COVID unit. Admitted 8/24/21. tested positive for covid on 8/24/21. Note: patient previously received J&J COVID-19 vaccine on 3/14/21. No respiratory symptoms or hypoxia. Did receive medication on 8/25. Stable, discharged 8/27/21. Admitted 8/24/21. Covid vaccine on 3/14/21. tested positive for covid on 8/24/21. No respiratory symptoms or hypoxia. Did receive medication. Stable, discharged 8/27/21.


VAERS ID: 1689799 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Dyspnoea, Pallor
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)

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

Write-up: Patient complained of dizziness, slight chest pressure with pallor observed. No itching, redness or hives. Offered to rest on gurney. Ice pack on back of neck and water with some relief. Rechecked after 15min, patient complains of difficulty breath. Head elevated, no wheezing. Audible stridor. EpiPen administered at 1332 and 911 dispatched.


VAERS ID: 1689811 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Hypotension, Immediate post-injection reaction, Pulse abnormal, Tachycardia
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Dehydration (broad), 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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Iodine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer 2nd dose administered at 1030am and immediately patient reported feeling difficulty breathing. 911 was called at 1030am. 0.3mg of Epinephrine was administered on right vastus lateralis and patient expressed slight relief. Patient had tachycardia with weak pulses and hypotension. Second dose of 0.3mg epinephrine given at 1036am. Paramedics arrived at 1037am.


VAERS ID: 1689994 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Dyspnoea, Emotional disorder
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: Celexa, atenelol, simvistatin, armour thyroid, Flovent, abuterol (as needed), estrodial patch, compound progesterone/DHEA, flonase, xanax, marine collagen peptides, multivitamin, D3+K2, CQ10, Tylenol sinus when needed, Started prescription
Current Illness: Thrush in mouth from asthma inhaler.
Preexisting Conditions: Hypothyroidism, mild controlled asthma, high cholesterol, PVC''s - heart. Occasional Migraines.
Allergies: Sensitivity to Epinephrine. No other allergies known.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The following day of the 1st vaccine, I noticed feeling shortness of breath, chest discomfort and feeling emotional, feeling like something is wrong/feelings of doom. I felt that way all that day on 8/24/21 & 8/25/21. On 8/26/21 it started to ease a little in the afternoon and by day 8/27/21, I felt better and shortness of breath was pretty much gone. I didn''t realize that this may be an adverse side effect until my daughter (who works for a hospital) told me to get a hold of my doctor and let her know. I found the paperwork and read the normal possible side effects and more serious symptoms. I was a week away from getting my 2nd vaccine so I called my physician. She advised me that the shortness of breath was an adverse event and recommended that I don''t get the 2nd vaccine and to report it to CDC. I did use my Albuterol during the time I had shortness of breath and chest discomfort. I was going to go to the ER or call my physician if I felt worse but I started feeling better by 4th day. I usually try to ride thru things and not go to the ER or doctor unless it''s serious. I didn''t realize what I was experiencing was not part of "normal" side effects.


VAERS ID: 1690855 (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: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3004734 / UNK - / OT

Administered by: Military       Purchased by: ?
Symptoms: Headache, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: JPMODERNATX, INC.MOD20213

Write-up: Headache; Feeling queasy; Pyrexia; (Reference number: 2021TJP083289) on 29-Aug-2021 and was forwarded to Moderna on 09-Sep-2021. This case was reported by a family member. On 24-Aug-2021, the patient received this vaccine (unknown number of doses). Headache, feeling queasy, and pyrexia developed after the vaccination. A call for an ambulance was made. On 29-Aug-2021, the symptoms resolved. The outcome of headache, feeling queasy, and pyrexia was reported as recovered. No follow-up investigation will be possible due to the reporters non-cooperation. Company Comment: The events developed after the administration of COVID-19 vaccine mRNA (mRNA 1273) and there is temporal relationship.; Reporter''s Comments: The events developed after the administration of COVID-19 vaccine mRNA (mRNA 1273) and there is temporal relationship.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1691293 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Erythema, Heart rate increased, Heart rate irregular, Heart sounds abnormal, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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), Cardiac arrhythmia terms, nonspecific (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Arrhythmia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: swollen arm; red circle; out of breath when she talks; heart is making weird beating noise; heartbeat is faster; skips a beat; chest felt tight; fever; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (swollen arm), ERYTHEMA (red circle), DYSPNOEA (out of breath when she talks), HEART SOUNDS ABNORMAL (heart is making weird beating noise) and HEART RATE INCREASED (heartbeat is faster) in a 24-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Arrhythmia. On 24-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Aug-2021, the patient experienced PERIPHERAL SWELLING (swollen arm), ERYTHEMA (red circle), DYSPNOEA (out of breath when she talks), HEART SOUNDS ABNORMAL (heart is making weird beating noise), HEART RATE INCREASED (heartbeat is faster), HEART RATE IRREGULAR (skips a beat), CHEST DISCOMFORT (chest felt tight) and PYREXIA (fever). At the time of the report, PERIPHERAL SWELLING (swollen arm), ERYTHEMA (red circle), DYSPNOEA (out of breath when she talks), HEART SOUNDS ABNORMAL (heart is making weird beating noise), HEART RATE INCREASED (heartbeat is faster), HEART RATE IRREGULAR (skips a beat), CHEST DISCOMFORT (chest felt tight) and PYREXIA (fever) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 101 (High) fever of 101. No relevant concomitant medications were reported. Treatment medication was not provided by the reporter.


VAERS ID: 1691453 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling abnormal, Myalgia, Nausea, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: felt really terrible; pain all over; nauseated; achy all over/achy arm; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (felt really terrible), PAIN (pain all over), NAUSEA (nauseated) and MYALGIA (achy all over/achy arm) in a 46-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On 23-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Aug-2021, the patient experienced FEELING ABNORMAL (felt really terrible), PAIN (pain all over), NAUSEA (nauseated) and MYALGIA (achy all over/achy arm). At the time of the report, FEELING ABNORMAL (felt really terrible), PAIN (pain all over), NAUSEA (nauseated) and MYALGIA (achy all over/achy arm) outcome was unknown. No Concomitant medications were provided. No treatment medications were provided.


VAERS ID: 1691456 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-08-24
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Product dose omission issue
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Got his first Moderna dose in June. He was unable to get scheduled for second vaccine dose; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (Got his first Moderna dose in June. He was unable to get scheduled for second vaccine dose) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In June 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Aug-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (Got his first Moderna dose in June. He was unable to get scheduled for second vaccine dose). On 24-Aug-2021, PRODUCT DOSE OMISSION ISSUE (Got his first Moderna dose in June. He was unable to get scheduled for second vaccine dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was Not applicable. Concomitant product use was not provided. Treatment information was not provided.


VAERS ID: 1691467 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, Product storage error
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: in the refrigerator for more than 12 hours; Expired vaccine administered to patient; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Expired vaccine administered to patient) and PRODUCT STORAGE ERROR (in the refrigerator for more than 12 hours) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016C21A) for COVID-19 vaccination. No Medical History information was reported. On 24-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Expired vaccine administered to patient). On an unknown date, the patient experienced PRODUCT STORAGE ERROR (in the refrigerator for more than 12 hours). On 24-Aug-2021, EXPIRED PRODUCT ADMINISTERED (Expired vaccine administered to patient) had resolved. At the time of the report, PRODUCT STORAGE ERROR (in the refrigerator for more than 12 hours) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Concomitant medications were reported. No Treatment information was reported.


VAERS ID: 1691478 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, Product storage error
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: She states that they placed 1 punctured vial of Moderna COVID-19 vaccine, which was first opened yesterday 23AUG2021 around 8-10AM, in the refrigerator for more than 12 hours; Expired vaccine administered to patient; This spontaneous case was reported by a nurse (subsequently medically confirmed) and describes the occurrence of PRODUCT STORAGE ERROR (She states that they placed 1 punctured vial of Moderna COVID-19 vaccine, which was first opened yesterday 23AUG2021 around 8-10AM, in the refrigerator for more than 12 hours) and EXPIRED PRODUCT ADMINISTERED (Expired vaccine administered to patient) in a 49-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016C21A) for COVID-19 vaccination. No Medical History information was reported. On 24-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Expired vaccine administered to patient). On an unknown date, the patient experienced PRODUCT STORAGE ERROR (She states that they placed 1 punctured vial of Moderna COVID-19 vaccine, which was first opened yesterday 23AUG2021 around 8-10AM, in the refrigerator for more than 12 hours). On 23-Aug-2021, PRODUCT STORAGE ERROR (She states that they placed 1 punctured vial of Moderna COVID-19 vaccine, which was first opened yesterday 23AUG2021 around 8-10AM, in the refrigerator for more than 12 hours) had resolved. On 24-Aug-2021, EXPIRED PRODUCT ADMINISTERED (Expired vaccine administered to patient) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Treatment medications were provided No Concomitant medications were provided On 24AUG2021, They Injected the expired Moderna COVID-19 vaccine to 7 patients between 8AM - 11:30AM. Number of doses/vials : 7 doses/ 1 vial. Date the vial was initially stored in the refrigerator : 23AUG2021. Total amount of time the vial was exposed to Refrigerator temperature: Greater than 12 hours in the refrigerator. The nurse states that the vial was placed in the sharps container by now.


VAERS ID: 1691494 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-24
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Faeces discoloured
SMQs:, Noninfectious diarrhoea (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: USMODERNATX, INC.MOD20212

Write-up: I got the Moderna shot on Sunday. Today I have green poop. Is that a side effect?; This spontaneous case was reported by a consumer and describes the occurrence of FAECES DISCOLOURED (I got the Moderna shot on Sunday. Today I have green poop. Is that a side effect?) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Aug-2021, the patient experienced FAECES DISCOLOURED (I got the Moderna shot on Sunday. Today I have green poop. Is that a side effect?). At the time of the report, FAECES DISCOLOURED (I got the Moderna shot on Sunday. Today I have green poop. Is that a side effect?) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Concomitant medications were reported. No Treatment information was reported.


VAERS ID: 1691497 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: No adverse event
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Received Moderna vaccine when he wanted Pfizer vaccine; This spontaneous case was reported by a consumer and describes the occurrence of NO ADVERSE EVENT (Received Moderna vaccine when he wanted Pfizer vaccine) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088D21A) for COVID-19 vaccination. No Medical History information was reported. On 24-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Aug-2021, the patient experienced NO ADVERSE EVENT (Received Moderna vaccine when he wanted Pfizer vaccine). At the time of the report, NO ADVERSE EVENT (Received Moderna vaccine when he wanted Pfizer vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided. This spontaneous case was reported by a consumer and describes the occurrence of NO ADVERSE EVENT (Received Moderna vaccine when he wanted Pfizer vaccine) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088D21A) for COVID-19 vaccination. No Medical History information was reported. On 24-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Aug-2021, the patient experienced NO ADVERSE EVENT (Received Moderna vaccine when he wanted Pfizer vaccine). At the time of the report, NO ADVERSE EVENT (Received Moderna vaccine when he wanted Pfizer vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided.


VAERS ID: 1691516 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-29
Onset:2021-08-24
   Days after vaccination:207
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Blood pressure measurement, Chest pain, Dry skin, Electrocardiogram, Headache, Mass, Musculoskeletal pain, Neuralgia, Pain in extremity, Skin discolouration, Skin texture abnormal, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (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:
Other Medications:
Current Illness: COPD
Preexisting Conditions: Medical History/Concurrent Conditions: Back surgery
Allergies:
Diagnostic Lab Data: Test Name: Blood pressure; Result Unstructured Data: Normal; Test Name: EKG; Result Unstructured Data: Normal
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Headache; Pain in the shoulder blade; vision blurs or has blurry in the eye; pain in arm, left arm hurt, was really painful/left arm was really sore; skin on both arms feels like sandpaper; dark spots that look like skin cancer; dryness and crackling in the skin; chest pain, pain in the heart,felt like someone was stabbing him to the chest, chest pain is more extreme; There are lumps or bumps on both arms,The bump or lump in the arm got more severe on the left; Sharp pain in the chest or back; He had chest pain and headache after both shots; Nerves wrapping around, agitated nerve issue from his back surgery; Little bump in the arm and tissue, a bump with spongy dead tissue, lumps or bumps on both arms, The bump or lump in the arm got more severe on the left; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (He had chest pain and headache after both shots), NEURALGIA (Nerves wrapping around, agitated nerve issue from his back surgery), MASS (Little bump in the arm and tissue, a bump with spongy dead tissue, lumps or bumps on both arms, The bump or lump in the arm got more severe on the left), VISION BLURRED (vision blurs or has blurry in the eye) and PAIN IN EXTREMITY (pain in arm, left arm hurt, was really painful/left arm was really sore) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 022M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Back surgery. Concurrent medical conditions included COPD. On 29-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 28-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 24-Aug-2021, the patient experienced VISION BLURRED (vision blurs or has blurry in the eye), PAIN IN EXTREMITY (pain in arm, left arm hurt, was really painful/left arm was really sore), SKIN TEXTURE ABNORMAL (skin on both arms feels like sandpaper), SKIN DISCOLOURATION (dark spots that look like skin cancer), DRY SKIN (dryness and crackling in the skin), CHEST PAIN (chest pain, pain in the heart,felt like someone was stabbing him to the chest, chest pain is more extreme), MASS (There are lumps or bumps on both arms,The bump or lump in the arm got more severe on the left), BACK PAIN (Sharp pain in the chest or back) and ARTHRALGIA (Pain in the shoulder blade). On an unknown date, the patient experienced CHEST PAIN (He had chest pain and headache after both shots), NEURALGIA (Nerves wrapping around, agitated nerve issue from his back surgery), MASS (Little bump in the arm and tissue, a bump with spongy dead tissue, lumps or bumps on both arms, The bump or lump in the arm got more severe on the left) and HEADACHE (Headache). At the time of the report, CHEST PAIN (He had chest pain and headache after both shots), NEURALGIA (Nerves wrapping around, agitated nerve issue from his back surgery), MASS (Little bump in the arm and tissue, a bump with spongy dead tissue, lumps or bumps on both arms, The bump or lump in the arm got more severe on the left) and HEADACHE (Headache) had resolved and VISION BLURRED (vision blurs or has blurry in the eye), PAIN IN EXTREMITY (pain in arm, left arm hurt, was really painful/left arm was really sore), SKIN TEXTURE ABNORMAL (skin on both arms feels like sandpaper), SKIN DISCOLOURATION (dark spots that look like skin cancer), DRY SKIN (dryness and crackling in the skin), CHEST PAIN (chest pain, pain in the heart,felt like someone was stabbing him to the chest, chest pain is more extreme), MASS (There are lumps or bumps on both arms,The bump or lump in the arm got more severe on the left), BACK PAIN (Sharp pain in the chest or back) and ARTHRALGIA (Pain in the shoulder blade) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood pressure measurement: normal (normal) Normal. On an unknown date, Electrocardiogram: normal (normal) Normal. Relevant concomitant medications were not provided by the reporter. Treatment medication was not reported. Patient took high dose Flu shot on 24-AUG-2021. This case was linked to MOD-2021-296305.


VAERS ID: 1691540 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New Mexico  
Vaccinated:2021-03-08
Onset:2021-08-24
   Days after vaccination:169
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029A21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Hypokinesia, Migraine, Swelling, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (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: HUMIRA
Current Illness: Psoriatic arthritis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: swelling; Interfere with motion; Pain under arm pit; Migraine with vomiting; Migraine with vomiting; This spontaneous case was reported by a consumer and describes the occurrence of MIGRAINE (Migraine with vomiting), SWELLING (swelling), HYPOKINESIA (Interfere with motion), VOMITING (Migraine with vomiting) and AXILLARY PAIN (Pain under arm pit) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 004F21A, 016B21A and 029A21A) for COVID-19 vaccination. Concurrent medical conditions included Psoriatic arthritis. Concomitant products included ADALIMUMAB (HUMIRA) for an unknown indication. On 08-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 05-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 23-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 24-Aug-2021, the patient experienced MIGRAINE (Migraine with vomiting) and VOMITING (Migraine with vomiting). On 25-Aug-2021, the patient experienced SWELLING (swelling), HYPOKINESIA (Interfere with motion) and AXILLARY PAIN (Pain under arm pit). At the time of the report, MIGRAINE (Migraine with vomiting), SWELLING (swelling), HYPOKINESIA (Interfere with motion), VOMITING (Migraine with vomiting) and AXILLARY PAIN (Pain under arm pit) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment medication were provided. Patient said that he would provide ultra sound data to Moderna, but Modena would have to follow-up with him.


VAERS ID: 1691557 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-16
Onset:2021-08-24
   Days after vaccination:220
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, Inappropriate schedule of product administration
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: received an expired booster dose; Inappropriate schedule of vaccine administered; This spontaneous case was reported by a consumer and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (received an expired booster dose) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 017621A, 028L20A and 039K20A) for COVID-19 vaccination. No Medical History information was reported. On 16-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 24-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 24-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (received an expired booster dose). 24-Aug-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered). On 24-Aug-2021, EXPIRED PRODUCT ADMINISTERED (received an expired booster dose) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered) had resolved. No concomitant medications were reported. No treatment details were reported.


VAERS ID: 1691573 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: North Carolina  
Vaccinated:2021-08-17
Onset:2021-08-24
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Malaise, Vaccination complication
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: started to experience a lot of side effects; Feeling under the weather.; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (started to experience a lot of side effects) and MALAISE (Feeling under the weather.) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 17-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Aug-2021, the patient experienced VACCINATION COMPLICATION (started to experience a lot of side effects) and MALAISE (Feeling under the weather.). At the time of the report, VACCINATION COMPLICATION (started to experience a lot of side effects) and MALAISE (Feeling under the weather.) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications were not provided. Treatment information was not provided.


VAERS ID: 1691761 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-07-20
Onset:2021-08-24
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Diarrhea; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (Diarrhea) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 20-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 24-Aug-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced DIARRHOEA (Diarrhea). At the time of the report, DIARRHOEA (Diarrhea) was resolving. The consumer stated that he received second dose on 24 Aug 2021 and experienced diarrhea in the night. He compared it to getting a colonoscopy. The consumer stated that his symptoms continued until Saturday 28Aug2021 and on 30Aug2021, it was definitely subsided somewhat. No concomitant product use was provided by the reporter. No treatment medications were reported.


VAERS ID: 1691860 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-01-01
Onset:2021-08-24
   Days after vaccination:235
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Fatigue, Headache, Heart rate, Nausea, Pain in extremity, Palpitations, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: Allergy to antibiotic; Anemia; Autoimmune disorder (autoimmune disease but its not official diagnosis); Drug allergy (muscle relaxant: Baclofen); Drug allergy (most oral antifungals); Dystonia; Neurological disorder NOS; Scoliosis; Sulfonamide allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Fever; Result Unstructured Data: fever of 102; Test Date: 20210824; Test Name: HR; Result Unstructured Data: High; Test Date: 20210825; Test Name: HR; Result Unstructured Data: normal
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Sore arm; Fever; Nausea; Headache; Very very tired; Chest pounding/Heart palpitation; This spontaneous case was reported by a consumer and describes the occurrence of PALPITATIONS (Chest pounding/Heart palpitation), PAIN IN EXTREMITY (Sore arm), PYREXIA (Fever), NAUSEA (Nausea) and HEADACHE (Headache) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 053E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Scoliosis, Neurological disorder NOS, Dystonia, Anemia, Autoimmune disorder (autoimmune disease but its not official diagnosis), Sulfonamide allergy, Allergy to antibiotic, Drug allergy (most oral antifungals) and Drug allergy (muscle relaxant: Baclofen). On 01-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 24-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 24-Aug-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced PALPITATIONS (Chest pounding/Heart palpitation). On an unknown date, the patient experienced PAIN IN EXTREMITY (Sore arm), PYREXIA (Fever), NAUSEA (Nausea), HEADACHE (Headache) and FATIGUE (Very very tired). At the time of the report, PALPITATIONS (Chest pounding/Heart palpitation) had not resolved and PAIN IN EXTREMITY (Sore arm), PYREXIA (Fever), NAUSEA (Nausea), HEADACHE (Headache) and FATIGUE (Very very tired) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 24-Aug-2021, Heart rate: 90-125 (High) High. On 25-Aug-2021, Heart rate: normal (normal) normal. On an unknown date, Body temperature: 102 (High) fever of 102. Patient reported concomitant medication as corticosteroids used for autoimmune disease. No treatment medication was reported by patient. Patient reported that she contacted HCP and she was told to monitor her symptoms and she is scheduled for EKG test. This case was linked to MOD-2021-302231 (Patient Link).


VAERS ID: 1691910 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Asthenia, Confusional state, Dizziness, Feeling abnormal, Head discomfort, Illness, Insomnia, Nausea, Nervousness, Pain in extremity, Paraesthesia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Shaking inside; Nauseous; Vomiting; Got really sick at night; Dizzy; Weak/Feeling very weak; Confusion was high; Lot of stomach sore; Felt like being hit by a truck; Couldn''t sleep; Her head was all over the place; Arms, legs and feet hurt a lot; Tingling sensation on one of her sides/ this sensation was all over her body/Still has tingling sensation on body; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (Got really sick at night), NERVOUSNESS (Shaking inside), DIZZINESS (Dizzy), ASTHENIA (Weak/Feeling very weak) and CONFUSIONAL STATE (Confusion was high) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 053E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 24-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Aug-2021, the patient experienced PARAESTHESIA (Tingling sensation on one of her sides/ this sensation was all over her body/Still has tingling sensation on body). On 29-Aug-2021, the patient experienced ILLNESS (Got really sick at night), DIZZINESS (Dizzy), ASTHENIA (Weak/Feeling very weak), CONFUSIONAL STATE (Confusion was high), ABDOMINAL PAIN UPPER (Lot of stomach sore), FEELING ABNORMAL (Felt like being hit by a truck), INSOMNIA (Couldn''t sleep), HEAD DISCOMFORT (Her head was all over the place), PAIN IN EXTREMITY (Arms, legs and feet hurt a lot) and VOMITING (Vomiting). On 30-Aug-2021, the patient experienced NAUSEA (Nauseous). On 31-Aug-2021, the patient experienced NERVOUSNESS (Shaking inside). On 24-Aug-2021, PARAESTHESIA (Tingling sensation on one of her sides/ this sensation was all over her body/Still has tingling sensation on body) had resolved. On 30-Aug-2021, DIZZINESS (Dizzy), ASTHENIA (Weak/Feeling very weak), CONFUSIONAL STATE (Confusion was high), ABDOMINAL PAIN UPPER (Lot of stomach sore), FEELING ABNORMAL (Felt like being hit by a truck), INSOMNIA (Couldn''t sleep), HEAD DISCOMFORT (Her head was all over the place), PAIN IN EXTREMITY (Arms, legs and feet hurt a lot) and VOMITING (Vomiting) had resolved. At the time of the report, ILLNESS (Got really sick at night), NERVOUSNESS (Shaking inside) and NAUSEA (Nauseous) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported No treatment medications were reported.


VAERS ID: 1691925 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Night sweats, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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:
Current Illness: Blood pressure high
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Tingling sensation on both sides of his body; Sweated at night; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA (Tingling sensation on both sides of his body) and NIGHT SWEATS (Sweated at night) in a 72-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 053E21A) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure high. On 24-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Aug-2021, the patient experienced PARAESTHESIA (Tingling sensation on both sides of his body) and NIGHT SWEATS (Sweated at night). On 25-Aug-2021, PARAESTHESIA (Tingling sensation on both sides of his body) and NIGHT SWEATS (Sweated at night) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product includes High Blood Pressure medication. Treatment information was unknown.


VAERS ID: 1692092 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-21
Onset:2021-08-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Immunoglobulins, Platelet count, Platelet count decreased, SARS-CoV-2 test
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19; Hives; Platelets decreased
Allergies:
Diagnostic Lab Data: Test Name: Blood test; Result Unstructured Data: Test Result:didn''t have COVID; Test Name: IVGG; Test Result: Negative ; Comments: And up until 3 weeks ago he was negative for IVGG; Test Name: Platelets; Result Unstructured Data: Test Result:168; Comments: His level was 168, which was before the COVID vaccine and which is a low normal; Test Name: Platelets; Result Unstructured Data: Test Result:163; Comments: the other lab said it was 163.; Test Name: Platelets; Result Unstructured Data: Test Result:140 to 143; Comments: checked his platelets after he had COVID and everything was fine, it was 140 to 143 which is not that bad but it did drop a little.; Test Date: 20210824; Test Name: Platelets; Result Unstructured Data: Test Result:123; Comments: his platelets dropped 40 points to 123 thousand; Test Name: blood test and a PCR; Test Result: Negative
CDC Split Type: USPFIZER INC202101104171

Write-up: His platelets dropped 40 points to 123 thousand; This is a spontaneous report from contactable nurse. This nurse (patient''s mother) reported for her 22-year-old son (patient). A 22-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration on 21Aug2021 (Batch/Lot number was not reported) as single dose for covid-19 immunisation. Patient age at vaccination was 22-year-old. Medical history included when he was little, like 11-years-old, he had issues with an allergic reaction, it was hives, and his platelets dropped but he had never had any problems with that. He had played contact sports, like hockey, and was fine. He had the disease, COVID, 10 months ago (Oct2020) and it was just like a bad cold, the worst part for him was that he lost his taste and his smell for 3 weeks. She obviously checked his platelets after he had COVID and everything was fine, it was 140 to 143 which was not that bad but it did drop a little. The patient''s concomitant medications were not reported. Due to patient had history of COVID-19, reporter''s husband who was a physician monitored patient''s antibodies because obviously the antibodies were better than the vaccine. And up until 3 weeks ago he was negative for IVGG. They made the choice to get the Pfizer COVID vaccine. The hematologist said to check her son''s platelets before and after he had the COVID vaccine, like 48 hours to 72 hours afterwards because it may drop between that time period. They tested with two different labs. Patient''s level was 168, which was before the COVID vaccine and which was a low normal and the other lab said it was 163. Reporter was fine with that since it was normal. So patient got the COVID vaccine. Also, before her son was tested for COVID with a blood test and a PCR to make sure that he didn''t have COVID. They did his blood work yesterday (24Aug2021) and his platelets dropped 40 points to 123 thousand. Outcome of the event was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1692093 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-01
Onset:2021-08-24
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, COVID-19, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: Fever of 102; Result Unstructured Data: Test Result:102; Test Date: 20210824; Test Name: Covid; Test Result: Positive
CDC Split Type: USPFIZER INC202101104882

Write-up: This is a spontaneous report from a contactable nurse (patient''s wife) from a Pfizer Sponsored Program Regulatory Authority. A 66-year-old male patient received first dose of bnt162b2 (BNT162B2), via an unspecified route of administration on Mar2021 (Batch/Lot number was not reported) as DOSE 1, SINGLE, and second dose via an unspecified route of administration on Mar2021 (Batch/Lot number was not reported) as DOSE 2, SINGLE for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. A 61-year-old registered nurse and her 66-year-old husband (patient) said they received both doses of the Pfizer-BioNTech Covid-19 Vaccine in March 2021. Yesterday, 5 months after their 2nd dose, they both tested positive for Covid. Patient was "pretty darn ill" and has a fever of 102. The outcome of event was unknown. The lot number for the vaccine, bnt162b2, was not provided and will be requested during follow up.; Sender''s Comments: Based on the information provided the lack of efficacy of the vaccine BNT162B2 cannot be completely excluded. The case will be reassessed if there is any new information available.


VAERS ID: 1692118 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Antibody test, Blood pressure increased, Blood pressure measurement, Dizziness, Feeling abnormal, Feeling cold, Heart rate, Hot flush, Hypoaesthesia, Oxygen saturation, Paraesthesia, Throat irritation, Vital capacity
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypertension (narrow), Vestibular disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ATORVASTATIN
Current Illness: High cholesterol
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Name: Antibody test; Result Unstructured Data: Test Result:No antibodies; Test Date: 20210824; Test Name: Blood pressure; Result Unstructured Data: Test Result:143/78; Test Date: 20210824; Test Name: Blood pressure; Result Unstructured Data: Test Result:142/80; Test Date: 20210824; Test Name: Blood pressure; Result Unstructured Data: Test Result:131/78; Test Date: 20210824; Test Name: Blood pressure; Result Unstructured Data: Test Result:127/78; Test Date: 20210824; Test Name: Blood pressure; Result Unstructured Data: Test Result:120/70; Test Name: Pulse/Heart rate; Result Unstructured Data: Test Result:Normal; Comments: Fine; Test Name: sats/O2; Result Unstructured Data: Test Result:Normal %; Comments: Fine; Test Name: Vitals; Result Unstructured Data: Test Result:Unknown result
CDC Split Type: USPFIZER INC202101110311

Write-up: numbness/numbness in arms and legs, like ice in her veins; tingling/tingling in arm and legs and feet; a cold sensation in her arms and feet; blood pressure was high/Blood pressure increased; her throat became itchy; lightheaded/dizzy; hot flash with her head; felt crappy; This is a spontaneous report from a contactable nurse (patient). A 35-year-old female patient received BNT162B2, via an unspecified route of administration, administered in Arm Right on 24Aug2021 10:00 (Lot Number: EW0177; Expiration Date: 14Sep2021), at the age of 35-years-old, as dose 1, single for COVID-19 immunization. Medical history included ongoing High cholesterol and COVID-19 from Oct2020 to an unknown date. Concomitant medications included atorvastatin taken for High cholesterol from Mar2021 and ongoing. The patient previously had Flu shot (her last shot was in Sept or Oct2020) for immunization. The patient experienced numbness/numbness in arms and legs, like ice in her veins, tingling/tingling in arm and legs and feet, a cold sensation in her arms and feet, blood pressure was high/blood pressure increased, her throat became itchy and lightheaded/dizzy on 24Aug2021 10:10; and hot flash with her head and felt crappy on 24Aug2021. The events (''numbness/numbness in arms and legs, like ice in her veins'', ''tingling/tingling in arm and legs and feet'', ''a cold sensation in her arms and feet'' and ''hot flash with her head'') were assessed as serious- medically significant. The events (''blood pressure was high/blood pressure increased'' and ''her throat became itchy'') were assessed as serious- disability. The event (''lightheaded/dizzy'') was assessed as serious- disability, medically significant. The event (''felt crappy'') was assessed as serious- non-serious. The clinical course was reported as follows: She is a registered nurse, but is calling as the patient. She is 35 years old. She received first dose of Pfizer COVID19 vaccine on 24Aug2021. She had a reaction and spoke to her healthcare practitioner. She experienced numbness, tingling, numbness and tingling in arms and legs and feet, states it felt like there was ice in her veins, cold sensation in her arms and in her feet, her throat became itchy, and her blood pressure was high/went up after they measured it. All of this occurred 10 minutes after receiving the injection. She confirmed details provided by transfer agent and wanted to add that within 10 minutes she got lightheaded and dizzy as well. Blood Pressure was High: it was 143/78 and then another time it was 142/80. It started to go down and then it was 131/78 thirty minutes after the vaccine. She had got a hot flash with her head and that is why they took the last blood pressure reading. The hot flash was only in her head and her head got really hot. Throat was Itchy: she has been taking antihistamines and the itchy throat has gone away. This morning without medication her throat was itchy. It felt like it wanted to come back. She was able to drink water and it felt better. The antihistamines were generic Zyrtec 10mg (lot number: PY920025, expiry: Apr2022) and generic Claritin 10mg (lot number is LVE24488 or 1VE24488. Expiry: Jan2021). She clarified that the itchy throat did go away with the medications. This morning she had not taken either one and she felt it a little bit and then the sensation went away after a few hours. Tingling: she has never had that happen before. It was bizarre. The throat being itchy worried her the most. She would say it was disabling because she didn''t know what would happen. She didn''t know if it would get worse or better. She saw her nurse practitioner for an appointment at 11:15 that morning. The vaccine was given at 10AM. Blood pressure was high: she would say disabling because if it went over a certain amount it could have caused a stroke. Outcome of Events: It all has resolved. Later in the day she didn''t feel quite right. She kind of assumed it was normal because she had COVID before. She thought it was a reaction. She had antibody test before the vaccine and it showed no antibodies. She clarified that she had COVID in Oct 2020. She clarified for the events numbness, tingling, cold sensation in her arms and in her feet, blood pressure was high, dizzy, and lightheaded the stop date would have been 25Aug2021. Tuesday she woke up better, but felt crappy. Investigations: they tested her blood pressure and vitals. Her blood pressure was 127/78. Her pulse was fine and her sats were fine. The nurse practitioner did a physical assessment and felt caller''s throat and looked in her throat. It wasn''t growing, so she said unfortunately there was nothing she could do to undo the vaccine. She wants to know if she should get the second dose, and if she should she report to VAERS. States her blood pressure went up to 142/80 which she says is high for her. States she was treated with Benadryl, states she did not take any antihistamines today and she feels fine. She states her blood pressure returned to normal, her symptoms all resolved that same day but the itchy throat lingered, states it is improving today. States she has never had a reaction to anything before. States that during the event her O2 was 100%, her heart rate was normal and her blood pressure came down to 120/70 after about 30 minutes. Caller states she has had Covid before so she anticipated an immune response but had an antibody test and did not show any antibodies which is why she went ahead and felt more comfortable getting the vaccine. The patient underwent lab tests and procedures which included antibody test: no antibodies on an unknown date; blood pressure: 143/78, 142/80, 131/78, 127/78 and 120/70 all on 24Aug2021; Pulse/Heart rate: normal (Fine) on an unknown date, sats/O2: normal (Fine) % on an unknown date; and Vitals: unknown result on an unknown date. Therapeutic measures were taken as a result of tingling/tingling in arm and legs and feet , a cold sensation in her arms and feet, blood pressure was high/blood pressure increased, her throat became itchy, lightheaded/dizzy and hot flash with her head. The outcome of the event ''felt crappy'' was unknown; event ''her throat became itch'' was recovering; events ''a cold sensation in her arms and feet'' and ''hot flash with her head'' was recovered in Aug2021 and outcome of the other events was recovered on 25Aug2021. Relatedness of drug to reactions/events: Reaction assessed: Numbness, Tingling, cold sensation in her arms and in her feet, throat became itchy, blood pressure was high, Dizzy and lightheaded; Source of assessment: Primary Source Reporter, Drug result: Related.; Sender''s Comments: Based on the information currently available,The casual association between the reported events and suspected vaccine BNT162B2 cannot be completely excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1692139 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-08
Onset:2021-08-24
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hepatitis C
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101115420

Write-up: Facial paralysis; This is a spontaneous report received from a contactable consumer or other non-health care professional (patient). A 32-years-old non-pregnant female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot Number: Unknown), via an unspecified route of administration, administered in Arm Right on 08Aug2021 13:30 (at the age of 32-yearsold) as dose 1, single for COVID-19 immunization. Medical history included hepatitis c from an unknown date and unknown if ongoing. The patient concomitant medications were not reported. Patient had no Known allergies. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, was the patient did not diagnose with COVID-19. Since the vaccination, did not patient been tested for COVID-19. In Health Clinic facility patient received vaccine. The patient experienced facial paralysis on 24Aug2021 at 20:00. The events assessed as serious (medically significant). Patient visited Emergency room/department or urgent care. No treatment was received for the event. The outcome of the events was reported as not recovered. The lot number for the vaccine (BNT162B2) was not provided and will be requested during follow-up.


VAERS ID: 1692155 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Feeling abnormal, Headache, Lip pruritus, Lip swelling, Pain in extremity, Pruritus, Rosacea, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CLINDAMYCIN.
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy to nuts (With these she experiences rashes and itching.); Allergy to plants (With these she experiences rashes and itching. she has severe anaphylaxis with those); Angioedema (she had angioedema); Atopic dermatitis; Diabetes; Drug hypersensitivity; Egg allergy (With these she experiences rashes and itching.); Food allergy; Fruit allergy (With these she experiences rashes and itching.); Latex allergy; Peanut allergy (any type of nuts.). With these she experiences rashes and itching.); Penicillin allergy (Reactions: rash hives itching); Ragweed allergy (Verbatim: allergy to rag weeds Seasonal stuff); Seborrheic dermatitis (is not active. It is dormant, she hasn''t had any problems or reactions.); Shellfish allergy (With these she experiences rashes and itching.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101116693

Write-up: itching and swelling of her lips; itching and swelling of her lips; soreness and arm pain; felt the tightness in her lips; itching on her face and cheeks; itching on the lips; rosy cheeks; entire face swollen; Swelling of lips; sore arm; headache; This is a Follow up spontaneous report from a Pfizer sponsored program Support. A contactable nurse (patient) reported that: A 61-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection), via an unspecified route of administration on 24Aug2021 at 11:30 (At the age of 61-year-old, Batch/Lot Number: FC3181; Expiration Date: 31Oct2021) as dose 1, single for COVID-19 immunisation. Medical history included diabetes from an unknown date and unknown if ongoing, atopic dermatitis from an unknown date and unknown if ongoing, seborrhoeic dermatitis from an unknown date and unknown if ongoing (was not active. It was dormant, she has not had any problems or reactions), food allergy from an unknown date and unknown if ongoing, medication allergies from an unknown date and unknown if ongoing, latex allergy from an unknown date and unknown if ongoing, angioedema from an unknown date and unknown if ongoing, rag weeds allergy from an unknown date and unknown if ongoing (seasonal stuff), allergy to nuts, eggs, peanuts, pecans, fresh strawberries, shellfish from an unknown date and unknown if ongoing (with these she experiences rashes and itching). The patient was allergic to penicillin products. Concomitant medications included clindamycin taken for an unspecified indication from an unspecified start date to 21Aug2021. The patient previously took lidocaine and experienced drug allergy (It causes heart palpitations, and she cannot breathe. She cannot take that stuff now. She found out when she went to the dentist. They gave her some Lidocaine to get numb. She felt like an elephant was sitting on her chest and she could not breathe. They had to give her Narcan to reverse it. She could not figure out why it felt like something was sitting on her chest and could not breathe. It was one of the newer ones.), codeine, demerol, verapamil, lisinopril, lortab, ultram and experienced rash, hives, and itching. The patient was taken epipen for previous history allergies. The patient did not receive any other vaccines within four weeks prior to the vaccination. It was reported that first dose on 24Aug2021, it was before 11:00. Her appointment was at 10:00, they gave it to her about 11:30, she had to stay for 30 minutes. The most significant side effect was the soreness and arm pain and headache, but last night, she noticed a sensation and looked at herself in the mirror and discovered swelling and she felt itching around her lips. When she looked in the mirror, it was slight swelling to her upper and lower lip as well. She thought it was nothing and went to sleep, but she felt the tightness in her lips. This morning, her lips are more swollen, and she has itching on her face and cheeks. She took some Loratadine and still has it but, not as bad, it was improving. The only thing she had introduced new to herself was the vaccine. She knows there are delayed reactions like rash after receiving the Pfizer COVID-19 vaccine. She does not have any shortness of breath or anything like that. She has a lot of allergies and there may be something in the vaccine that could have caused her to experience this sensitivity to it. She thinks she was good, and it is all calming down, but the itching in her lip remains. She knows to go to the emergency department if her symptoms worsen or to see her health care professional if things do not improve. The caller was a health care professional reporting that upon getting the first dose of the Pfizer Covid-19 vaccine on 24Aug2021, last Tuesday, she experienced a sore arm. Last night, she experienced itching on her lips, and they got swollen. She took Loratadine and she noticed her face got itchy. Clarified with the caller that she took the Loratadine because of the itchiness and the swelling, that was why she took the Loratadine. It has now been 30 minutes. The reason she took the Loratadine was that she started to feel itching in the cheeks, closer to her nose. That was why she went ahead and took the Loratadine, to calm it down. She did not have any Benadryl in the house. She usually keeps liquid Benadryl but apparently there was none. It was reported that about an hour after the injection on 24Aug2021. It was still sore now, well, it was not sore, but she has pain in that left arm. It was better. She would expect soreness with any other type of vaccine. She feels it a little more now than she did last night. There was swelling too. When she looked this morning, she took a selfie of her lips before she went to bed. When she looked this morning and compared it, it was a little more swollen, just in the upper lips. The upper lip was more, and she could tell it was in the lower lips but not as bad as the upper lip. She can tell more and can also feel underneath and inside the lips. She can tell that it was swollen. She would not say that it was severe but enough that it was significant, no. Put it this way, it was somewhat significant. The sensation was there and in her facial area, like her cheeks and around the nose area and the lips. Noticing it before she took the Loratadine, it was kind of all over her face. It was significant at one point. She took the Loratadine and it kind of calmed down. Now, it was just in the area of the nose, and mouth and under the eyes. It was itching and swelling, and she did not have any shortness of breath. Just the Loratadine. She applied warm compress to the arm. She did take Tylenol as they told her to take after the injection. Caller states she does not have her glasses on. It was hard to see when you get older, and they do not want to give them contacts. She still has to use readers. She wanted to be vaccinated to protect herself and her entire family. They had already been vaccinated. She went to one of the drives through sites and they would not let her get it there. They told her to go a professional site because of all of her allergies. She also has an epi Pen. She agreed with that. She did not want to go through that in a drive through. She would think they would be at this point. She has had nothing new introduced, no new medications and no new anything. That was the only thing she had taken that was different. She did get a headache immediately after and she does not generally get headaches. She had it for a couple of days. It went away but it was not that bad. It was probably a couple of hours later. It was once she got home. She does not have headaches. She thought it was odd to have a headache. She basically had the COVID shot, and everything was good. She was on an antibiotic that she finished taking Saturday. It was before the Pfizer. She thinks it was for an ear infection, or it was the sinuses. No, caller was just wanting to know, she mentioned delayed reactions. She was trying to see if this was one of them. If she was allergic to something, it happens within the first 15 to 20 minutes, or an hour. She had not had a reaction then, last night, when she noticed it, it was still there. This morning, and it was yesterday, she had rosy cheeks and had swelling in her entire face. She took Loratadine and her entire face has calmed down. She is still itching right underneath the nose and around the lip and mouth area. With the Lisinopril, she did have angioedema and it did make her lip swell. She does not take Lisinopril because she was allergic to it. She took the first dose of Lisinopril and went to bed. She woke up that morning and had a reaction that she had when she was sleeping. Being that the onset was almost 48 hours, she was wondering if there was anything else that would be delayed and if she would have any other reactions. The adverse events were not resulted in visit to emergency room and physician office. No, she called their office and left a message. They have not called back yet. The events were reported as non-serious. There was no laboratory tests or diagnostic studies were performed. The outcome of headache was reported as resolved on an unknown date in Aug2021, itching on her face and cheeks was reported as resolving, sore arm, itching on the lips, swelling of lips was reported was not resolved and rest all events was unknown.


VAERS ID: 1692183 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Breast pain, Breast swelling, Lymphadenopathy, Peripheral swelling, Soft tissue swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Lipodystrophy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Abscess (she had had an abscess before in a lymph node when she was much younger and that had been cut open.); Pneumonia (she had pneumonia twice in 3 years)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101119585

Write-up: she had the swelling in her left armpit; HCP said this was soft tissue swelling; she was unable to move her arm up and couldn''t move it because it was so completely swollen; a lot of soft tissue swelling in her left breast and it is very painful.; a lot of soft tissue swelling in her left breast and it is very painful.; This is a spontaneous report from a contactable Nurse (patient). A 39-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot number was not reported) via an unspecified route of administration, administered in Arm Left on 24Aug2021 08:00 (at the age of 39 years old) as dose 2, single for COVID-19 immunisation. Medical history included pneumonia from an unknown date and unknown if ongoing (she had pneumonia twice in 3 years), abscess from an unknown date and unknown if ongoing (she had had an abscess before in a lymph node when she was much younger and that had been cut open). There were no concomitant medications. Patient''s historical vaccine included first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot number was not reported) via an unspecified route of administration on 03Aug2021 08:00 (at the age of 39 years old) as dose 1, single for COVID-19 immunisation and experienced had gelatinous clear and bloody stools every single day for about 5-6 days, was a little achy in her arm, had never had diarrhea in her 39 years of life; Stated she was still eating and drinking and feeling fine and had stomach pains and that was the only thing coming out of her body. Historical vaccine also included pneumonia vaccine on 2017 for immunisation and experienced achy in her arm; flu vaccine on an unspecified date for immunisation and experienced arm soreness with the flu vaccine. Additional Vaccines Administered on Same Date of the Pfizer Suspect was none. The patient experienced she had the swelling in her left armpit, health care professional said this was soft tissue swelling. She received 2nd dose of the vaccine and had reactions to after the 2nd dose that she got on Tuesday 24Aug2021, she had armpit swelling and her lymph nodes was super swollen and a lot of soft tissue swelling in her left breast and it was very painful (on 24Aug2021). Other vaccines she has had in order to prevent the flu or pneumonia but it was not a big deal. Stated after the 2nd dose of the Pfizer COVID Vaccine, she had the swelling in her left armpit and had gotten the 2nd dose at 08:00 and by Tuesday night (24Aug2021), she realized she was unable to move her arm up and couldn''t move it because it was so completely swollen and she went to work and asked the health care professional she worked with to take a look at it to make sure she was not missing anything because she had had an abscess before in a lymph node when she was much younger and that had been cut open; stated the health care professional said this was soft tissue swelling and to contact her primary care physician. She went today (unspecified) to see her primary care physician and he agreed it was a reaction to the Pfizer COVID vaccine and it was a known reaction to have happen and he put her on steroids over the weekend and said to touch base on Monday or Tuesday and she started taking the steroid Prednisone this morning and it was 20mg and she had to take one tablet twice per day for 5 days. She had arm soreness last year and had pneumonia but did not received the pneumonia shot then and in 2017 she had pneumonia so bad that she was in the hospital for two weeks and when she recovered at 100 percent the health care professional recommended she get the pneumonia vaccine so she got the pneumonia vaccine at that point in 2017 or 2018 and has no lots, expiry dates or NDC or name of the vaccine to provided. Adverse event resulted in physician office visit. Therapeutic measures were taken as a result of she had the swelling in her left armpit, soft tissue swelling. Outcome of the events were unknown. Information on the Lot/Batch number has been requested.


VAERS ID: 1692353 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-17
Onset:2021-08-24
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia
SMQs:, Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VITAMIN D NOS; ZINC
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None, Comment: No chronic diseases, no significant medical history
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101170473

Write-up: Bilateral pain in both wrists developed out of the blue which progressively worsened with both hurting.; This is a spontaneous report from a contactable pharmacist, the patient. A 46-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0171) via an unspecified route of administration in the left arm on 17Aug2021 at 11:30 (at the age of 46-years-old) as a single dose for COVID-19 immunisation. The patient had no chronic diseases, no significant medical history and had no history of wrist problems or arthritis. . The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications included vitamin d nos (VITAMIN D) and zinc (MANUFACTURER UNKNOWN); both taken for unknown indications from unknown dates and unknown if ongoing. On 24Aug2021 at 08:00, the patient experienced bilateral pain in both wrists that developed out of the blue which was followed by the vaccine shot. It had progressively worsened with both wrists hurting. On 04Sep2021, the patient wrapped right wrist with bandage and then bought wrist brace at store on 07Sep2021 for right wrist since the patient was right-handed and complete rest for that wrist was not possible. The event resulted in doctor or other healthcare professional office/clinic visit. Since the vaccination, the patient had not been tested for COVID-19. Therapeutic measures taken as a result of the event included treatment with wrapping of ace type bandage on the right wrist from 04Sep2021 and wrist braces which was used from 07Sep2021. The clinical outcome of the event bilateral pain in both wrists was not resolved at the time of this report.


VAERS ID: 1693002 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-16
Onset:2021-08-24
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Psoriasis
SMQs:, Medication errors (narrow), Immune-mediated/autoimmune disorders (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: Clobatesol 0.05%, carvedilol 25mg, levothyroxine 50mcg, entresto 97/103, aspirin 81mg, furosemide 60mg (am) & 40 mg (pm), omeprazole 40 mg, duloxetine 30 mg, atorvastatin 20 mg, clonazepam 0.5mg, oxycodone 5mg, spironolactone 25mg,
Current Illness: Recurrent gout, psoriasis, heart failure, hypothyroidism, stroke, AFIB
Preexisting Conditions: Recurrent gout, psoriasis, heart failure, hypothyroidism, stroke, AFIB
Allergies: IV Contrast
Diagnostic Lab Data: None,
CDC Split Type:

Write-up: Patient received his 3rd dose. About a week later his psoriasis exploded all of his body. He had sores literally from the top of his head to the soles of his feet. It had never been this bad. This lasted about 2 weeks then subsided without medical intervention. We think the dose sent his immune system into overdrive while it created antibodies and resulted in a severe psoriasis flare.


VAERS ID: 1693038 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-19
Onset:2021-08-24
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Brain natriuretic peptide, Catheter placement, Chest X-ray, Chest pain, Dyspnoea, Electrocardiogram, Fibrin D dimer, Laboratory test, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: I was taken Lexapro 20 mg.
Current Illness: No
Preexisting Conditions: Anxiety
Allergies: Shrimp
Diagnostic Lab Data: CVC, BNP, D Dimer, Lab work, Chest X-Ray and EKG. My PCP repeated those test as well. I am getting a CT Scan of my chest on 09/13/2021.
CDC Split Type: vsafe

Write-up: I had to go to the ER on 8/24/2021 because I started having shortness breath, heart beating really fast and chest pain. Am then about a week after that I started having them again along with severe back pain. I am now seeing my PCP for all the complications. She also started me on 81 mg Aspirin and Albuterol.


VAERS ID: 1693437 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-06
Onset:2021-08-24
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: C-reactive protein increased, Dyspnoea, Pericarditis
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood test showed Sero reative protein level was 36. Blood test 8/26/2021
CDC Split Type:

Write-up: Pericarditis. Could not breathe correctly.


VAERS ID: 1693552 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-19
Onset:2021-08-24
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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 developed a rash that lasted 2 weeks.


VAERS ID: 1694064 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Injection site pain, Productive cough, Rhinorrhoea, SARS-CoV-2 test negative, Upper respiratory tract infection
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Infective pneumonia (broad), COVID-19 (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: Mycophenolate, amlodipine, losartan
Current Illness: none
Preexisting Conditions: Renal transplant (01/05/1998)
Allergies: penicillin
Diagnostic Lab Data: COVID-19 test--results negative
CDC Split Type:

Write-up: The morning after receiving the booster shot I felt quite a bit of soreness at the injection site and began felling tightness in my upper chest along with a runny nose. Over the next two weeks it developed into what I believe was an upper respiratory infection with a productive cough and runny nose. I saw my local physician who ordered a covid test and upon learning it was negative saw me in his office. He indicated my lungs were clear of infection.


VAERS ID: 1694146 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Injection site pain, Neck pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atorvastatin, omeprazole,baby asprin diazepam multi vit vit b vit d ared eye vit
Current Illness: in er at time with vomiting and diaharea suspected food poisioning
Preexisting Conditions: auto immunne scloderma,,, exzema, macular degeneration, vertigo
Allergies: sulfa, iodine shrimp, aleve,
Diagnostic Lab Data:
CDC Split Type:

Write-up: vaccine site pain within a day radiated to neck and shoulder pain progressed with extreme pain and still experiencing sought help at physician office put on prednisone and taking tylenol for pain


VAERS ID: 1694200 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atorvastatin, diazepam, omeprazole, baby asprin, multi vit, vit b, vit d,,,areds eye vit
Current Illness: possible food poisoning
Preexisting Conditions: vertigo, macular degeneration, ecxema, auto immune scleroderma
Allergies: sulfa, iodine,, aleve, shrimp,
Diagnostic Lab Data:
CDC Split Type:

Write-up: right arm injection pain within 1 day pain radiating up arm to neck and shoulder pain increased since saw dr office 9/9 21 prescribed prednisone and tylenol for pain Still in pain will follow up with dr


VAERS ID: 1694226 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Injection site pain, Neck pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

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

Write-up: within 24 hours pain at injection site radiating up arm to neck and shoulder continual and extreme pain STILL


VAERS ID: 1694438 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 1 LA / 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: patient refers not taking medications at the moment
Current Illness: PATIENT REFERS NOT HAVING ANY DISEASES
Preexisting Conditions: ASTHMA
Allergies: PATIENT REFERS NOT HAVING ALLERGIES TO MEDICATIONS, FOOD OR OTHER PRODUCTS
Diagnostic Lab Data:
CDC Split Type:

Write-up: ADMINISTRATION ERROR: CONSENT REFLECTS INFORMATION FROM MODERNA VACCINE ADMINISTERE TO A MINOR 17 YEAR OLD.


VAERS ID: 1694549 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Paraesthesia, Pharyngeal swelling, Pruritus
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), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: SWELLING OF THROAT, ITCHY, TROUBLE OF BREATHS, TINGLING IN FINGERS


VAERS ID: 1694575 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye pain, Headache
SMQs:, Glaucoma (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: Severe reoccurring ocular pain in right orbital. Leading to headache.


VAERS ID: 1694594 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Body temperature fluctuation, Chills, Night sweats, 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: Acyclovir, cenadoctuate, pantoprazole, trimethoprim, and D3 vitamin. Started five days of prednisone on 8/26, the start date of my 6th and final chemo session. On 8/26 I was infused with RCHOP chemo drugs.
Current Illness: Being treated for Lymphoma. Completed 5 of 6 chemo sessions at time of booster shot. Chemo sessions were uneventful.
Preexisting Conditions: None. My chills and fevers started 6 hours after the booster and haven?t stopped to date. Fevers spike to 102 and drop to 95.
Allergies: Blackberries, raspberries etc
Diagnostic Lab Data: Just normal blood draws for Chemo evaluation. Dr advised taking Tylenol to control fevers.
CDC Split Type:

Write-up: Wild temperature swings from 95 to 102 starting 6 hours after shot. Temperature swings are now in the evenings and nights. Massive night sweats. Temperature swings continue to date. I try to control with Tylenol. Very minimal impact on fevers.


VAERS ID: 1694596 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-24
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Injection site erythema, Injection site swelling, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: Losartin, Zoloft
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: Linsinopril
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 6 days after my injection the site was very swollen, red, hot to the touch and I had a low grade fever and chills.


VAERS ID: 1694643 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-16
Onset:2021-08-24
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 00388 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Rash, Rash erythematous, Rash pruritic, Skin swelling, Somnolence
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartin,, Vitamin D, multi vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Oreomycin, Zithromax
Diagnostic Lab Data: .-
CDC Split Type:

Write-up: Full body rash, puffy, red, extremely itchy Atarax has helped to a degree, but I am totally groggy and dizzy.. Please help!


VAERS ID: 1694674 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-11
Onset:2021-08-24
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 2 LA / SYR

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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: COVID Dose 1 -3/11/2021 - Had mild cellulitis at the injection site - 10 days of Augmentin was the treatment - saw doctor on th
Other Medications: Lisinopril - 20 mg for hypertension; one a day vitamin; B12 vitamin; Krill Oil; Vit E; Vit C; Loratadine; Fluticasone - nasal spray for allergies
Current Illness: no - just seasonal allergies
Preexisting Conditions: Hypertension - mild and well controlled
Allergies: Shellfish; iodine - doctors say but can use it on my skin and I take iodized table salt
Diagnostic Lab Data: no - physical exam and wait a couple of weeks and see if it changes. Will do an ultrasound after that.
CDC Split Type: vsafe

Write-up: I noticed a swollen lymph node under my right side jaw and I saw the doctor. I can''t tell that it is changed any yet.


VAERS ID: 1694943 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-04
Onset:2021-08-24
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest pain, Gastric haemorrhage, Malaise
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prozac, serequil, gabapentin, percocet, crestor, amlodipine, estradiol, hydroxcazine vitamin D,B,C
Current Illness:
Preexisting Conditions: Chronic back pain
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chest pains, stomach bleeding, sick, no energy


VAERS ID: 1695027 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-11
Onset:2021-08-24
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID test, positive.
CDC Split Type: vsafe

Write-up: On 8/24/2021, I went on vacation on 8/12/2021 and tested positive for COVID while there. I had moderate to severe symptoms: fever, cough, fatigue, body aches, chest pressure, headaches, loss of taste, congestion and runny nose. I am now fully recovered.


VAERS ID: 1695243 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-16
Onset:2021-08-24
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone, Condition aggravated, Full blood count, Hypoaesthesia, Laboratory test, Metabolic function test, Paraesthesia, Rheumatoid factor, Urge incontinence
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: levonorgestrel ethinyl estradiol.
Current Illness: none
Preexisting Conditions: none
Allergies: amoxicillin hives
Diagnostic Lab Data: R20.2 Paresthesia of both feet (primary encounter diagnosis) Plan : ? ASSAY OF THYROID STIMULATING HORMONE TSH (Future) ? CBC WITH AUTO DIFF (Future) ? COMPREHENSIVE METABOLIC PANEL (Future) ? CYANOCOBALAMIN (VITAMIN B-12) (Future) ? MISC - REFERENCE TEST (Future) ? ANTINUCLEAR ANTIBODIES (ANA) (Future) ? RHEUMATOID FACTOR; QUANTITATIVE (Future) ? REFERRAL TO NEUROLOGY R20.2 Paresthesia of both hands Plan : ? ASSAY OF THYROID STIMULATING HORMONE TSH (Future) ? CBC WITH AUTO DIFF (Future) ? COMPREHENSIVE METABOLIC PANEL (Future) ? CYANOCOBALAMIN (VITAMIN B-12) (Future) ? MISC - REFERENCE TEST (Future) ? ANTINUCLEAR ANTIBODIES (ANA) (Future) ? RHEUMATOID FACTOR; QUANTITATIVE (Future) ? REFERRAL TO NEUROLOGY Nerve conduction studies ordered all results pending.
CDC Split Type:

Write-up: Pt reports that 8 days after receiving Pfizer number one she developed "numbness" of both feet and her arms. She describes numbness as "a tight feeling like my toes are full of water" she reports she cannot feel the tops of her feet. She states that she does cannot feel her toes on plantar aspect. She reports that this is worse with sitting. Symptoms plateaued around 2 weeks and has noticed an improvement over the last two days. She describes arm problem as "tingling sensation on antecubital fossa radiating distally with movement of arms." only present with movement of arms. Denies weakness. No other neurologic symptoms. She reports that she has had urge incontinence since giving birth to her two year old son that became worse after receiving vaccine. Physical exam shows normal appearing female, well developed, in no acute distress. Weight normal. Neuro: Pt is alert to person, place and time. CN nerves 1-12 intact. Olfactory tested with alcohol swab. Visual fields tested with confrontation. Fine visual acuity not tested. PERRLA . EOM intact normal. No ptosis and no nystagmus. Trigeminal nerve normal, muscles of mastication normal and sensation in V1, V2, V3 normal. Corneal reflex not tested. Facial nerve normal in both upper and lower motor distributions. Cranial nerve 8 intact, hearing grossly intact. Cranial 9 and 10 normal no uvula deviation, Palatal articulation "KA" normal, Guttural articulation "GO? normal. Accessory nerve normal. Hypoglossal function normal. Sensation to soft touch is normal in upper extremities bilaterally. Sensation to soft touch is normal in lower extremities bilaterally. this was tested with 10g monofilament and she was able to detect this sensation in hands and feet equally at site of concern. Strength to large muscle groups of upper extremity is 5/5 bilaterally. Strength to large muscle groups of lower extremity is 5/5 bilaterally. In the extremities Muscle tone is normal, no rigidity, no fasciculation. Biceps tendon reflex is 1+ bilaterally. Patellar tendon reflex is 2+ bilaterally, achilles tendon reflex 1+ bilaterally. Coordination- finger to nose normal, pt able to perform rapid alternating movements, heel to shin normal bilaterally, Romberg negative, no pronator drift. Gait- normal


VAERS ID: 1695439 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-12
Onset:2021-08-24
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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? 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: USMODERNATX, INC.MOD20213

Write-up: contracted Covid-19; This spontaneous case was reported by a nurse and describes the occurrence of COVID-19 (contracted Covid-19) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 12-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Aug-2021, the patient experienced COVID-19 (contracted Covid-19). At the time of the report, COVID-19 (contracted Covid-19) was resolving. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication were reported. No treatment information was provided by the reporter.


VAERS ID: 1695805 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Hypotension, Injection site pain, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad), Hypokalaemia (broad), Sexual dysfunction (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: Tdap (unknown brand) caused severe inflammation at injection site; approximately August 2017
Other Medications: Atorvastatin, Bisoprolol, Aspirin, Folic Acid, Niacin
Current Illness:
Preexisting Conditions: History of Heart Failure, History of Myocarditis
Allergies: Ketotifen, Nimesulide
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left arm had severe soreness and pain at injection site beginning 30 minutes after administration. After approximately two hours of administration, I observed increasing numbness of extremities that did not subside for three days. Acute hypotension observed; blood pressure measured at home never exceeded 100/60


VAERS ID: 1696068 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Migraine
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Migraine/headache in AM and PM for 6 days straight post vaccine, treated with Advil as needed. Cough that has continued from date of vaccine administration until today (still active) and I was not coughing prior to vaccine. Very painful arm at location of vaccine for 4 days post injection.


VAERS ID: 1696149 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Chest pain, Computerised tomogram head, Computerised tomogram thorax, Dyspnoea, Echocardiogram, Electrocardiogram, Fatigue, Hypoxia, Pericarditis
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hearing impairment (broad), Chronic kidney disease (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: PARoxetine HCl (20MG Tablet, 1 (one) Oral daily Vitamin D (1000UNIT Tablet, 2 tablets Oral daily clonazePAM (1MG Tablet, 1 (one) Oral two times daily, as needed,
Current Illness: Shingles
Preexisting Conditions: OBESITY (BMI 30.0-34.9) (E66.9) HYPERLIPIDEMIA (E78.5) DYSMETABOLIC SYNDROME (E88.81) SYMPTOMATIC PREMATURE MENOPAUSE (E28.310) SOMATIC DYSFUNCTION OF BACK (M99.09) ANXIETY AND DEPRESSION (F41.9, F32.9) MULTINODULAR GOITER (NONTOXIC) (E04.2) VITAMIN D DEFICIENCY (E55.9) BENIGN ESSENTIAL HTN (I10) DERMOID CYST OF RIGHT OVARY (D27.0)
Allergies: Mefoxin *CEPHALOSPORINS* Gave pt. C.diff Luvox *ANTIDEPRESSANTS* Rash.
Diagnostic Lab Data: CT chest CT head Echocardiogram EKG Blood tests 6 min walk
CDC Split Type:

Write-up: Sx initially of fatigue then SOB chest pains Dx Pericarditis with Hypoxia and Bells Palsy developed on next 2 weeks.


VAERS ID: 1696229 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Fatigue, Herpes zoster, Immune system disorder, Malaise, Mobility decreased, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Rheumatoid Arthritis
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Like the second shot, the 3rd shot made me bed-sick for 3 days with fever, body aches, fatigue, sick to stomach. However, this time I also broke out with Shingles, even though I had the first Shingles shot in my 50''s and Shringrex in late 60''s. Clearly, this 3rd shot weakened my immune system to the maz.


VAERS ID: 1696272 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-11
Onset:2021-08-24
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205AZ1A / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Abortion spontaneous, Amniocentesis normal, Arthralgia, Blood urea normal, Diarrhoea, Drug screen negative, Exposure during pregnancy, Nausea, Pain in extremity, Premature separation of placenta, SARS-CoV-2 test negative, Vomiting, White blood cell count increased
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: labetalol HCL 100MG 2 times daily Loperamide 2MG once daily as needed Ondansetron 4MG every 8 hours PRN for nausea Ferrous Gluconate 324MG 3 times daily iron supplement
Current Illness: Prenatal Hypertension
Preexisting Conditions: previous history of spontaneous miscarriage
Allergies: Codeine causing rash
Diagnostic Lab Data: Amniocentesis performed due to FOB family history of hemifacial microsomia on 8/10 prior to vaccine date. 8/16 Down''s screening negative, but elevated WBCs (16.28) on this date and urea nitrogen normal 8/19 clear urine sample but WBCs 17.92, COVID test performed and resulted negative, drug screen cleared and negative
CDC Split Type:

Write-up: Vaccine received after recommended by perinatal specialist on 8/11/2021 at the Pharmacy, Normal ultrasound 8/12/2021 8/19/2021 patient developed nausea/vomiting/diarrhea 8/24/2021 patient presents with severe abdominal pain running from hips to center of abdomen and down legs. She is seen and discharged. Patient then presents to the facility and diagnosed with small abruption at 22 weeks. On 8/26 she spontaneously delivers at 22 weeks. Infant was peri-viable and intubation was attempted but ultimately did not survive


VAERS ID: 1696700 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-10
Onset:2021-08-24
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Joint effusion, Joint stabilisation, Joint swelling, Joint warmth, Magnetic resonance imaging, X-ray
SMQs:, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Allergies: none
Diagnostic Lab Data: MRI x-ray
CDC Split Type: vsafe

Write-up: On 08/24/2021, I could not bend my knee all the way, it was swollen more than pain. I could not go down the stairs, could not tolerate sitting , I could not have it straight. and there was a lot of heat coming from it. No redness just hot and swollen. The swelling was significant he did an MRI and an x-ray. I saw Dr. on 08/30/2021, Diagnosed it as joint a fusion . It could be a virus, or an immune response to have that much inflammation. It is getting better, I am walking without crutches, but I am not 100% back to where it was. It is getting better. I had never had any swelling on my knees.


VAERS ID: 1696851 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-20
Onset:2021-08-24
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest discomfort, Dizziness, Echocardiogram, Electrocardiogram
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), 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:
Other Medications: none
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: EKG on 8/27/21 - Normal Echocardiogram on 9/2/21 - Normal Bloodwork on 9/10/21 - Normal PCP Doctor referring me on to ENT as of 9/14/21
CDC Split Type:

Write-up: Four days after Shot 8/24/21 - Started feeling dizzy and lightheaded. Felt a pressure in left side of chest and around left shoulder blade area on 8/26/21 that evening of 8/26/21 felt like heart was racing and very dizzy. 8/24/21 was the peak of all my symptoms. Felt dizzy 8/24/21 through 8/28/21 and did not exercise during this time and tried to rest and drink more fluids. On 8/29 the daily feeling of dizziness and lightheaded went away and was able to get back to normal daily activity. Still feeling the chest pressure at times but intermittently and not every day. 8/30/21 - Tried to start my daily walks again but became dizzy and had to stop. Felt dizzy upon waking up again on 8/31/21. Started feeling good and no more dizziness with normal daily activity but still feel the pressure in chest at times. Tried to start walking again on 9/13/21. Was able to walk my normal distance but felt lightheaded and still feel off but not dizzy like have been feeling. 9/14/21 - in the morning feeling lightheaded again but able to complete normal daily activities without feeling dizzy.


VAERS ID: 1696884 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: patient is still having muscle achiness and joint pain and he is getting tingling down his legs. Told patient to consult his physician.


VAERS ID: 1696987 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Intermenstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Armor Thyroid
Current Illness: no
Preexisting Conditions: none
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: The same day I received my first dose of the Pfizer covid 19 vaccine, I began menstrual spotting and it continued for 8 days. My period is very regular and I do not spot at any point other than during my menstrual phase which only lasts for four days.


VAERS ID: 1700208 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Breast pain, Chest pain, Pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Lipodystrophy (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: Adderall and Otc vitamins
Current Illness: None
Preexisting Conditions: None..I have had Thrombocytopenia in my past and low platelets issues. Also have had kidney stones in the past nothing currently.
Allergies: None
Diagnostic Lab Data: Na
CDC Split Type:

Write-up: About 24 hours after my first Pfizer Covid injection I had a throbbing pain in my armpit..it radiated into my chest and breast area. The pain was almost unbearable for the first 12 hours and continued to throb for approximately 48 hours after it began on 8/24/21..it slowly subsided over time.


VAERS ID: 1700335 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Florida  
Vaccinated:2020-12-23
Onset:2021-08-24
   Days after vaccination:244
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Aggression, Confusional state, Mental status changes, SARS-CoV-2 test
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (narrow), Cardiomyopathy (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lasix, Insulin Detemir,Tamsulosin, K-Dur, Coumadin, Flovent, Iron, MOM, Proscar, Multivitamin, Allopurinol, Vit C, ASA, CHolecalciferol Dulcolax, Sodium biphophate, Hydrocortisone topical, Albuterol
Current Illness: Unknown
Preexisting Conditions: Afib, Pacer, HTN, COPD, DM, Asthma, BPD, ASHD, Gout, GERD, Hyperlipidemia, Sleep apnea
Allergies: No known allergies
Diagnostic Lab Data: SARS COV2 COVID 19 PCR 08/24/21
CDC Split Type:

Write-up: The patient presents with Altered mental status xPTA. Per EMS, pt who comes form Lake Eustis was combative with EMS by biting and kicking. Pt also has a DNR in place and although confused pt knows their whereabouts. Pt voices no complaints or pain. Risk factors consist of nursing home resident. 86-year-old male presents to ED via EMS from Lake Eustis Health Care Center for evaluation altered mental status with associated combative behavior, onset prior to arrival. PMHx atrial fibrillation, paced rhythm, HTN, COPD, DM. Per EMS report, patient was kicking and biting. Unclear baseline mentation. Further history/ROS limited secondary to patient''s current clinical condition


VAERS ID: 1700429 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-20
Onset:2021-08-24
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Muscle spasms, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (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: None
Preexisting Conditions: Sjogren''s
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 6 weeks pregnant at the time of vaccination. Estimated due date 04/15/2022. 4 days after vaccination bleeding and cramping began and lasted 10 days, resulting in a miscarriage. 2 normal and healthy pregnancies in 2012 and 2014.


VAERS ID: 1700449 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-22
Onset:2021-08-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Thrombosis, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C gummies Vitamin D periodically unknown dose
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: Ultrasound of left lower leg
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA. 09/14/2021: The patient called Health Dept. to report a blood clot developed following receipt of one dose of Moderna COVID-19 vaccine. The patient was diagnosed on September 9, 2021, and physician instructed the patient to report the adverse side effect. 08/22/21: Patient received the first dose of Moderna COVID-19 vaccination at approximately 10:00. 08/24/21, a.m.: Patient reported he noticed pain in the back of his left leg, thought he had pulled a muscle, and the pain improved after walking. 08/25-08/27/21: The pain continued in the left leg, and swelling observed on august 27, 2021. 09/09/21: The patient was evaluated by his physician, an ultrasound was ordered, and a blood clot was found in the left posterior leg, behind the knee area. The physician prescribed Zoloft, patient unsure of the dose, and is currently taking the medication twice per days for 21 days, then one dose per day for 7 days. A follow-up appointment with the physician is to be scheduled in 5 weeks. No additional symptoms or adverse side effects reported by the patient as of this date.


VAERS ID: 1700540 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-11
Onset:2021-08-24
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adenovirus test, Angiogram pulmonary abnormal, Aortic disorder, Arteriosclerosis coronary artery, Asthenia, Bordetella test negative, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chlamydia test negative, Coronavirus test negative, Cough, Dyspnoea, Enterovirus test negative, Fibrin D dimer increased, Hepatic steatosis, Hepatomegaly, Hiatus hernia, Human metapneumovirus test, Human rhinovirus test, Inflammatory marker test, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Interstitial lung disease, Lung opacity, Mycoplasma test negative, Osteopenia, Paratracheal lymphadenopathy, Patient isolation, Respiratory failure, Respiratory syncytial virus test negative, Respiratory viral panel, SARS-CoV-2 test positive, Scan with contrast abnormal, Spinal osteoarthritis, Viral test negative
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Haemorrhage laboratory terms (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), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (narrow), Osteoporosis/osteopenia (narrow), Hypersensitivity (broad), Arthritis (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Hypokalaemia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ALPRAZolam (XANAX) 0.5 mg tablet aspirin 81 mg tablet budesonide (RINOCORT AQUA) 32 mcg/actuation nasal spray bupivacaine HCl/0.9 % NaCl/PF (BUPIVACAINE IN NACL,PF,) 0.125 % 750 mL elastomeric pump,hi var rate buPROPion SR (WELLBUTRIN S
Current Illness:
Preexisting Conditions: Nervous Migraine Pain, foot, right, chronic Carpal tunnel syndrome Pain in thumb joint with movement Pain in joint of left shoulder Acute pain of both shoulders Respiratory Asthma CAP (community acquired pneumonia) Reactive airway disease Pneumonia of right lung due to infectious organism, unspecified part of lung Pneumonia due to COVID-19 virus Circulatory Transient cerebral ischemia Digestive Gastritis Obese Vitamin D deficiency Musculoskeletal Osteoarthritis of midfoot, left Hammer toe of left foot Closed fracture of distal end of left fibula with routine healing DDD (degenerative disc disease), cervical Ischial bursitis Osteoarthritis of ankle or foot Osteoarthritis of knee Spondylosis Arthritis of midfoot Dysfunction of rotator cuff of both shoulders Endocrine/Metabolic Hypothyroidism Immune Rheumatoid arthritis Sjogren''s disease Immunosuppressed status Other Anxiety Failure of joint fusion, subsequent encounter Failure of joint fusion, initial encounter On long term drug therapy Counseling and coordination of care
Allergies: Allergies PhenobarbitalHypotension Erythromycin BaseOther (document details in comments)
Diagnostic Lab Data: Updated Procedure 09/07/21 0343 Respiratory virus detection panel Collected: 09/07/21 0216 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected XR CHEST 1 VW PORT IMPRESSION: Bilateral patchy airspace disease, right greater than left concerning for pneumonia/atelectasis. END OF IMPRESSION: INDICATION: shortness of breath. TECHNIQUE: AP upright portable projection of the chest is acquired. COMPARISON: 3/26/2019 FINDINGS: The heart size is normal. The vascular distribution is normal. The aorta is mildly tortuous. There are bilateral patchy airspace disease, right greater than left. Increased interstitial lung marking is again noted. No pleural effusion is identified. There is no evidence of pneumothorax. There is osteopenia. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. CT angiogram chest pulmonary embolism with and without contrast [3301556638] (Abnormal) Resulted: 09/07/21 0526 Order Status: Completed Updated: 09/07/21 0526 Narrative: PROCEDURE INFORMATION: Exam: CTA Chest With Contrast Exam date and time: 9/7/2021 3:58 AM Age: 69 years old Clinical indication: Cough and dyspnea; Patient HX: Covid+; Additional info: Rule out pe, elevated d-dimer TECHNIQUE: Imaging protocol: Computed tomographic angiography of the chest with contrast. 3D rendering (Not supervised by radiologist): MIP and/or 3D reconstructed images were created by the technologist. Radiation optimization: All CT scans at this facility use at least one of these dose optimization techniques: automated exposure control; mA and/or kV adjustment per patient size (includes targeted exams where dose is matched to clinical indication); or iterative reconstruction. Contrast material: OMNIPAQUE 350; Contrast volume: 80 ml; Contrast route: INTRAVENOUS (IV); COMPARISON: DX XR CHEST 1 VW 9/6/2021 11:54 PM FINDINGS: Pulmonary arteries: Normal. No pulmonary emboli. Aorta: Unremarkable. No aortic aneurysm. No aortic dissection. Lungs: Extensive patchy bilateral airspace and ground-glass opacities. Pleural spaces: Unremarkable. No pneumothorax. No pleural effusion. Heart: Atherosclerotic disease of the coronary arteries. Mediastinal space: Small hiatal hernia. Lymph nodes: Mild paratracheal adenopathy. Liver: Mild hepatomegaly and steatosis. Bones/joints: Multilevel degenerative disease of the thoracic spine. Soft tissues: Unremarkable. IMPRESSION: Extensive patchy bilateral airspace and ground-glass opacities. No acute pulmonary embolic disease.
CDC Split Type:

Write-up: ED to Hosp-Admission Discharged 9/6/2021 - 9/9/2021 (3 days) Pneumonia due to COVID-19 virus DETAILS OF HOSPITAL STAY Presenting Problem/History of Present Illness/Reason for Admission Shortness of breath [R06.02] Pneumonia due to COVID-19 virus [U07.1, J12.82] COVID-19 [U07.1] Hospital Course Pleasant 69-year-old female admitted to the hospital with generalized weakness, shortness of breath, cough, respiratory insufficiency related to COVID-19 pneumonia. She is nearing 14 days out from initial diagnosis, she reports ongoing symptoms throughout that time. She was started on Decadron, remdesivir but was not requiring supplemental oxygen. She did however have oxygen saturations in the low 90s on room air. With Decadron and remdesivir she slowly improved over the course of 2 days. By the final day of admission she was averaging sats in the high 90s on room air. I felt she was appropriate for discharge home. Inflammatory markers are rather benign. She will continue a course of prednisone taper at discharge. She is to follow-up with PCP within 7 to 10 days. I advised her to continue isolation until the 14th day from initial diagnosis. The remainder of her stay was unremarkable.


VAERS ID: 1700649 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-12
Onset:2021-08-24
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / 2 LA / IM

Administered by: Public       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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I was diagnosed with Covid-19. I am fully vaccinated.


VAERS ID: 1700665 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Dizziness, fatigue, and malaise after first COVID vaccine, received on 7/27/21.
Other Medications: Unknown
Current Illness: None disclosed
Preexisting Conditions: Non disclosed
Allergies: None disclosed
Diagnostic Lab Data: None required.
CDC Split Type:

Write-up: 8/30/2021 3:19:02 PM Spoke with Pt about adverse effects from his most recent COVID vaccine on 8/24/2021. He felt dizzy and weak after the shot. He didn''t contact our office until 8/30/2021 at 3:15 PM and didn''t contact his doctor.


VAERS ID: 1700865 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-03-10
Onset:2021-08-24
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / N/A LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Influenza, Nasopharyngitis, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: losartan potassium, florastor probiotic , claritin, vit e, Vit d,
Current Illness:
Preexisting Conditions: high blood pressure,
Allergies:
Diagnostic Lab Data: Covid test positive both a rapid and PCR
CDC Split Type: vsafe

Write-up: I started off with cold and flu symptoms and first few days I really believed it was a cold then I started having a fever so I went in got a covid test it came back positive, I kept running fevers at 102.5 . I went in for a chest x-ray, they put me on antibiotic for double pneumonia, Then I went in for monoclonal antibodies, I had covid Pneumonia from the 24th to the 5th . I feel like I''m about 85% back, I definitely still have chest congestion.


VAERS ID: 1701134 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-24
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Exposure during pregnancy, Pruritus, Rash, Rash morbilliform
SMQs:, Anaphylactic reaction (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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: none
Current Illness: Hypothyroidism Gestational Diabetes Atopic dermatitis
Preexisting Conditions: None
Allergies: Banana
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 1 week after vaccine, patient developed a diffuse morbilliform eruption associated with itch and rash


VAERS ID: 1701722 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chills, Headache, Pain
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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pristiq, Abilify, Norvasc, lisinopril, rosuvastatin
Current Illness: None
Preexisting Conditions: HTN, depression anxiety fibromyalgia
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills, body aches, temp, headache


VAERS ID: 1701912 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-14
Onset:2021-08-24
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Blood test, Electrocardiogram, Fatigue, Heart rate increased, Laboratory test, Muscular weakness, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (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: Advair; Nasacort; Loratadine; Albuterol
Current Illness: None
Preexisting Conditions: Triad Asthma
Allergies: Aspirin
Diagnostic Lab Data: Visit to Nurse Practitioner to diagnose/treat symptoms on 8/31/2021 EKG - 8/31/2021 Lab/blood workup 8/31/2021
CDC Split Type:

Write-up: Leg pain/weakness; constant accelerated heart rate; fatigue; general weakness


VAERS ID: 1704092 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-24
Onset:2021-08-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (broad)

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

Write-up: Patient received first Pfizer covid vaccine from our vaccine clinic on 8/24/21. We later determined that she had received one Moderna dose on 5/5/21.


VAERS ID: 1704109 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-18
Onset:2021-08-24
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Platelet count decreased, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amlodipine, lisinopril, HCTZ, flonase.
Current Illness: no
Preexisting Conditions: WPW
Allergies: ibuprofen and zyrtec.
Diagnostic Lab Data: Platelet Counts: 8/24 183 THO/uL. 9/7 73 THO/uL. 9/16 149 THO/uL.
CDC Split Type:

Write-up: My platelet count has been trending downward with each shot. My 1st result was on 8/24 was 183 THO/uL. On 9/7, it was 173 THO/uL. This morning , 9/16 the result returned 149 THO/uL. This places me at thrombocytopenia technically. I am waiting for direction from Hematology and my PCP.


VAERS ID: 1704178 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-23
Onset:2021-08-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest X-ray, Chills, Electrocardiogram, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I take Metformin, Rosatatin,
Current Illness: no
Preexisting Conditions: allergies
Allergies: no
Diagnostic Lab Data: Unknown date-just about a week after the onset of symptoms EKG-normal Chest x-ray-normal
CDC Split Type: vsafe

Write-up: 08/24/2021 around midnight woke up with high fever, headache, chills and body aches. The fever ended after about 24 hours, the headache and body aches lasted for three days. Still having a lingering pain on the right side below shoulder area.


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