National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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 418 out of 8,010

Result pages: prev   319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517   next


VAERS ID: 1628243 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD 8448 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Heart rate increased, Hypoaesthesia oral, Paraesthesia oral, Sensation of foreign body
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: celebrex , lasix, potassium chloride,, Premarin daily, D3 4,000 units, 750 mg Vitamin E, Tumeric/Curcumin, Aleve as needed., Losartan, and unknown cholesterol med
Current Illness: fatty liver, pre diabetic , swelling to lower extremites
Preexisting Conditions: fatty liver, pre diabetic, edema
Allergies: Gabapentin, Penicilln
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: pt reports having what felt like a lump in her throat, my tongue was tingling, and lips were numb. Heart rate was 126." I went to the clinic at Hytrol and was given a Benadryl ."


VAERS ID: 1628247 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-03
Onset:2021-08-23
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Dizziness, Dyspnoea, Fatigue
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: dyspnea, fatigue, cough, and light headed


VAERS ID: 1628251 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 08802A1 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Hypoaesthesia oral, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE LISTED
Current Illness: NONE LISTED
Preexisting Conditions: NONE LISTED
Allergies: NONE LISTED
Diagnostic Lab Data: I TOOK HIS BLOOD PRESSURE, IT WAS 151/101
CDC Split Type:

Write-up: THE PATIENT FELT PALPITATIONS, A PAIN IN HIS RIGHT TEMPLE, SOME NUMBNESS IN HIS TONGUE


VAERS ID: 1628261 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: California  
Vaccinated:2021-02-19
Onset:2021-08-23
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NA / N/A UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Blood sodium decreased, COVID-19, Hyponatraemia, SARS-CoV-2 test positive
SMQs:, Hyponatraemia/SIADH (narrow), Chronic kidney disease (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: zofran, lipitor, megace, prednisone, B6, metformin, leuprolide, ASA
Current Illness: NA
Preexisting Conditions: metastatic prostate CA, HTN, DM2
Allergies: NKDA
Diagnostic Lab Data: 8/23 NA 119 8/23 COVID PCR+
CDC Split Type:

Write-up: Admitted to hospital with COVID 8/23, labs notable for hyponatremia


VAERS ID: 1628269 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-12
Onset:2021-08-23
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray abnormal, Pneumonia
SMQs:, Cardiomyopathy (broad), Eosinophilic pneumonia (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? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Osteoarthritis; Rheumatoid arthritis; CKD
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID/PNA confirmed via Xray. Still receiving inpatient hospital treatment.


VAERS ID: 1628297 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-21
Onset:2021-08-23
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asymptomatic COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARS-CoV-2 (COVID-19) by NAA, Micro detected, 8/23/2021
CDC Split Type:

Write-up: While in hospital to deliver baby, patient was routinely tested for covid and tested positive. She is asymptomatic. Baby was delivered by C section for breech presentation. Mom and baby doing well.


VAERS ID: 1628299 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-07
Onset:2021-08-23
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Oxygen saturation decreased, SARS-CoV-2 test positive
SMQs:, Acute central respiratory depression (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol-ipratropium 2.5 mg-0.5 mg/3 mL inhalation solution 3 mL, NEB, 4 times a day Alphagan P 0.1% ophthalmic solution 1 Drop, Both Eyes, TID (3 times a day) bumetanide 1 mg oral tablet 1 mg = 1 TAB, PO, Daily Eliquis 2.5 mg oral tabl
Current Illness:
Preexisting Conditions: Contusion of pelvic region AAA - Abdominal aortic aneurysm Aortic stent Benign prostatic hypertrophy COPD Cataract Cholecystectomy Hip replacement Hypertension Implantation of cardiac pacemaker Knee replacement Osteoarthritis
Allergies: NKA
Diagnostic Lab Data: POSITIVE COVID TEST 08/23/2021 @ 1852
CDC Split Type:

Write-up: BROUGHT BY EMS FROM THE FACILITY FOR LOW O2 SATURATION. COVID POSITIVE. PER EMS PT O2 SAT WAS 99% ON 4L. PT NORMALLY ON 2L. PREVIOUS HX OF COPD. PT A&OX2


VAERS ID: 1628308 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: not listed
Preexisting Conditions:
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received first dose of Moderna on 8/23/21 at 12:30pm. She was observed for 30 minutes due to a medication allergic reaction in the past for throat swelling while taking penicillin. Pt did not show any signs or symptoms at the end of the 30 minute observation and left the pharmacy. The patient called the next morning stating that on her drive home she started to experience numbness in her face from under her eyes to her neck. She called her primary care physician. The patient states the nurse she spoke to checked with her physician and which point they asked if she had any issues breathing and she should go to the emergency department if so. Pt states she did not have any issues breathing so she decided to take Benadryl. The following day on 8/24 in the morning she contacted the pharmacy to let me know what happened. She reported the event to VEARS through the online process the pharmacy showed her to report to in the event of an adverse issue. While speaking with the patient she stated the numbness in her face has been slowly going down since yesterday.


VAERS ID: 1628326 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 2 RA / SYR

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

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

Write-up: Severe body aches 12 hours after vaccine. 102 fever 24 hours after. Rash on stomach, neck, chest, back and legs 24 hours later. Severe body aches continued after 24 hours. Severe headache 6 hours later and continued 24 hours later. Taking Tylenol OTC


VAERS ID: 1628337 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939676 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Decreased appetite, Fatigue, Headache, Nausea, Oropharyngeal pain, Pain, Pain in extremity, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Buproprion, Escitalopram, multivitamin, Vitamin c
Current Illness:
Preexisting Conditions: Depression, anxiety, and migraines
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Felt feverish/chills, body aches, cough, fatigue, generalized headache, nausea, vomiting, sore throat, decreased appetite, arm is sore.


VAERS ID: 1628356 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)

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

Write-up: This is the 2nd dose of Pfizer COVID vaccine. Patient is allergic to tree nuts but ok on the first shot. Patient complained of throat tightness 10 minutes after the injection. She was given water and monitored in front of the pharmacy. She still complained of throat tightness and asked for Epi-pen injection which she had used before. She immediately felt relief after she injected 1 Epi-pen into her right thigh. After confirming that she has non-expired Epi-pen at home and she felt good enough, she was discharged home.


VAERS ID: 1628357 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Condition aggravated, Gaze palsy, Muscle contractions involuntary, Seizure, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: pt stated he was prescribed seizure medication
Current Illness: unknown
Preexisting Conditions: seizure disorder
Allergies: unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: approx 15 mins after pt received first dose of Pfizer COVID-19 vaccination pt had a seizure. He was initially observed slumped in chair with eyes rolling back and then began to seize and contract, he was lowered to the floor and 911 called. Pt remained unresponsive until EMS arrived, at which point he stated he has a history of seizures and has not taken his prescribed seizure medication for the past week. He was transported to the hospital with EMS.


VAERS ID: 1628385 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstruation irregular
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)

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

Write-up: Onset of early period and heaviest period I?ve experienced


VAERS ID: 1628418 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site haemorrhage, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (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: crestor 20mg, enalapril 5mg, brilinta 90mg, felodipine er 10mg, isosorbid din 5mg, metoprolol xl 25mg
Current Illness: hypertension
Preexisting Conditions: stent placment
Allergies: none
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient injection site would not stop bleeding over night. Patient came to pharmacy I applied pressure with a cotton ball and changed the Band-Aid bleeding stopped.


VAERS ID: 1628421 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Dysphagia, Dyspnoea, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Allergic: Anaphylaxis-Medium, Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Additional Details: taken to ER by paramedics, treated with 3-4 more doses of epi. discharged several hours later


VAERS ID: 1628439 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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:

Write-up: Error: Booster Given Too Early-


VAERS ID: 1628458 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Patient representative called to let us know patient was violently vomiting throughout the night after receiving the vaccine. Today, he is tired and sore. Recommended he call primary care provider


VAERS ID: 1628478 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Wrong product administered
SMQs:, Medication errors (narrow)

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

Write-up: Patient''s father told staff that he was 18. He was inadvertently given the Janssen vaccine instead of Pfizer. Birth date was not correctly verified prior to injection. Patient is not having any adverse reaction or symptoms.


VAERS ID: 1628479 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

Administered by: Private       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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allopurinol, Eliquis, Atorvastatin, Calcium Acetate 667, Carvedilol, Erocalciferol, Humulin N, Humulin R, Isosorbide, Losartan, Tamsulosin, Torsemide, Vitamin C, Folic Acid, Zinc, Multi-Vitamin and Vitamin B Complex.
Current Illness: None
Preexisting Conditions: Heart Bypass (18 years ago), Dialysis (Peritoneal Dialysis), Type 2 diabetic , Congestive Heart Failure
Allergies: Zantac
Diagnostic Lab Data:
CDC Split Type:

Write-up: Broke out in a rash that won''t go away.


VAERS ID: 1628489 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Unevaluable 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:

Write-up: None stated.


VAERS ID: 1628497 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

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

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

Write-up: Patient''s father told clinical staff that child was 18. Patient inadvertently received the Janssen vaccine instead of the Pfizer vaccine. The birthdate was verified prior to the injection being given. No adverse symptoms are noted. Phone message has been left for the parent to call our office to notify them of the error. The call has not been returned yet.


VAERS ID: 1628535 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-19
Onset:2021-08-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Eosinophilic pneumonia (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: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: severe lower back pain started 2 days after recieving 2nd shot. General muscle soreness/pain everywhere but primarily lower back pain. Called Dr. He told me to give him advil.


VAERS ID: 1628540 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / SYR

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

Write-up: Passed out for a couple minutes


VAERS ID: 1628563 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

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

Write-up: Chest pains for 10-15 minutes.


VAERS ID: 1628581 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Oropharyngeal pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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 Vitamins
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore Throat, fever of 103.8, body aches, headache, body chills, fatigue


VAERS ID: 1628589 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-01-29
Onset:2021-08-23
   Days after vaccination:206
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW5318 / 1 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 AR / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: COVID-19, Ocular hyperaemia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Glaucoma (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine, ammonium lactate, aspirin 81mg, atorvastatin, basaglar kwikpen, carvedilol, cyclosporine, donepezil, daily vite, januvia, melatonin, memantine, milk of magnesia, mycophenolic acid, potassium chloride, repaglinide
Current Illness: NA
Preexisting Conditions: dementia, hypomagnesemia, DMII, IBS, HTN, MDD
Allergies: NA
Diagnostic Lab Data: Positive rapid test on 8.23.21
CDC Split Type:

Write-up: On 8.23.21 approximately mid morning patient presented with a clear runny nose and red eyes. Pt does not have allergies, so a Covid rapid test was obtained with a positive result.


VAERS ID: 1628625 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-18
Onset:2021-08-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none known to pharmacy
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none up to this point in time.
CDC Split Type:

Write-up: Patient returned to pharmacy today with a very large red, itchy, raised area on his left upper arm at the vaccine location for Moderna vaccine, dose #2. He said he noticed it last night, 8/23. He was immunized on 8/18. I informed him to take antihistamines/ use an ice pack/ treat with tylenol and advil. Also advised him to take a photo or trace around the area to track if it worsens and to contact his PCP if it worsens at all. Calling his PCP today.


VAERS ID: 1628630 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 RA / IM

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

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

Write-up: Two to five minutes following vaccination, patient''s significant other reported to pharmacist he was not feeling well. Pharmacist immediately went to patient to find him unconscious on the floor. Patient was having no trouble breathing. Could not get reading of blood pressure or pulse. Patient was in and out of consciousness and very determined to stand back up despite wavering consciousness. Patient was monitored and kept in a safe location until EMS could arrive. Patient was loaded onto stretcher and taken out of the store by EMS. It is unknown if the patient left with EMS to the Emergency Room.


VAERS ID: 1628633 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-14
Onset:2021-08-23
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
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: Unknown
Current Illness: None reported
Preexisting Conditions: High blood pressure, hypercholesterolemia, On blood thinner, Depression
Allergies: None reported
Diagnostic Lab Data: None. Patient was to consult primary care provider.
CDC Split Type:

Write-up: Patient contacted pharmacy to report that the site of injection was red and warm to touch. Inflamed area was "about the size of a quarter". She also indicated that area was sore.


VAERS ID: 1628636 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-21
Onset:2021-08-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Echocardiogram normal, Electrocardiogram normal, N-terminal prohormone brain natriuretic peptide increased, Troponin I increased
SMQs:, Cardiac failure (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Pro-BNP elevated Troponin I 1.5 (upper limit of normal 0.08) ECG Normal findings Echocardiogram normal function Cardiac MRI pending
CDC Split Type:

Write-up: Patient was admitted for chest pain 2-3 days following second dose of vaccine. No symptoms or close contacts that have been ill. Currently stable but admitted for elevated troponin and monitoring. Awaiting further imaging to confirm myocarditis. Chest pain resolving after ibuprofen x1.


VAERS ID: 1628657 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Injection site pain, Lethargy, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Supplemental Oxygen 3 liters at night Fasenra every 2 months injection started Feb 23 2021 Nebulizers Budesonide 0.5 mg Perforomist 20MCg Yupelri 175MCg/3Ml Azithromycin 250mg Mon, Wed & Fri Singulair p.m Gabapentin 300 mg a.m
Current Illness: COPD, Diabetes, peripheral neuropathy, Carotid stenosis right
Preexisting Conditions: COPD, Diabetes, peripheral neuropathy
Allergies: Levaquin Vancomyacin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Chills, lethargy, sore arm at int. site muscle stiffness. Felt better this a.m. 8/24/2021. Improving


VAERS ID: 1628705 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Peripheral swelling, Pruritus, Rash, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra 24 taken 1 hour prior to second Pfizer shot per allergist instructions.
Current Illness: none
Preexisting Conditions: Autoimmune disease sjogren''s syndrom, former triple negative breast cancer 2009 chemotherapy only, no radiation.
Allergies: Dilantin, Compazine, Norco, Percocet, Ansef, Keflex, Keppra,
Diagnostic Lab Data: Nothing as of yet. Have not been into the doctor''s office for the rash as of 8-23-21
CDC Split Type:

Write-up: After the second shot, roughly within a 10 minute period I felt my body starting to want to be itchy. I had what looked like little pale goosebumps on my arms and torso area. I Wasn''t expecting anything, as after my first vaccination FA7484 lot on 7/30/21, I had minor body aches approximately 6 hours post shot and no other adverse side effects. After second dose 3 days post shot, Monday 8-23-21 woke up to very itchy forearms, back of hands and slightly swollen fingers. Both arms have fine light pink rash, and lower legs below knee area. I emailed the Allergist who monitored my first shot and suggested onboarding with Allegra 24 1 hour prior to my shots. I let the doctor know of the rash and that I was taking .50 doses of Benadryl every 6 hours. The rash was warm to touch but today 8-24-21 isn''t as warm, but present. Continuing to monitor body area and see if any other areas are itching. Rash very itchy, only darker pink if I scratch, followed with a burning sensation. Notified my GP as well, but out of town. I will continue to monitor. No breathing issues or other problems, except the very itchy inner forearms and sometimes back of forearms. Nothing where shot was given.


VAERS ID: 1628714 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032H20A / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 6023844 / 2 LA / IM

Administered by: Pharmacy       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: Unknown
Current Illness: none
Preexisting Conditions: none
Allergies: not allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: None


VAERS ID: 1628718 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pharyngeal swelling, Rash, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None taken day of vaccination. Xyzal taken regularly otherwise.
Current Illness: no known
Preexisting Conditions: eosinophilic gastroenteritis
Allergies: Severe grass and weed allergy Suspected penicillin allergy
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Mild tongue and throat swelling which subsided by day 2. Mild skin rash on both forearms.


VAERS ID: 1628726 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: Moderna 2nd shot. Body aches but no fever
Other Medications: Multivitamin D3 Vitamins B12 Vitamins Entyvio
Current Illness: Crohn''s Disease GERD
Preexisting Conditions: Crohn''s Disease
Allergies: Some pain medications
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Persistent Fever around 100 degrees, extreme body aches, chest pain last night only feber and extreme body aches persist)


VAERS ID: 1628758 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003F21A / 3 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Extra dose administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Magnesium oxide, acetaminophen, buspirone, Vitamin D3, Vitamin B12, Sennosides with docusate sodium, fludrocortisone, folic acid, gabapentin, midodrine, multivitamin with minerals, naltrexone, omeprazole, quetiapine, tetrahydrolozine, trazo
Current Illness: Urinary tract infection
Preexisting Conditions: Drug induced autonomic dysfunction, Elevated transaminase, alcohol dependence, polyneuropathy, schizoaffective disorder, anemia, chronic gastritis
Allergies: Codeine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient denied previous Covid vaccines during screening and consent review. After dose administered, informed administering clinician that she had already received 2 doses of Moderna Covid vaccine. After discussion with PCP and state epi, determine that patient does not meet guidelines for immunocompromised although is taking long-term corticosteroids.


VAERS ID: 1628770 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site pain, Injection site swelling, Loss of personal independence in daily activities, Nausea, Pain, Tinnitus
SMQs:, Acute pancreatitis (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), 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: Nitrofurantion(preventative antibiotic for UTI) Divigel and Progesterone
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: none taken at this point.
CDC Split Type:

Write-up: I was fine until I woke up at 2am the next morning with a sever headache, body aches, injection site swollen and extremely sore. I was very nauseous. I slept most of the day the next day and was not functional. On Day 2 now and I have started to feel better but I have ringing in my ears, a slight headache and some body aches. I can function at least, but still tired. FYI - I did have covid in late october of 2020.


VAERS ID: 1628779 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

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

Write-up: Swollen lymph nodes in neck


VAERS ID: 1628821 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Headache, Nausea, Pain, 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? No
Previous Vaccinations: Headache, fatigue, fever, sore arm
Other Medications:
Current Illness:
Preexisting Conditions: Chronic back pain
Allergies: Augmentin, zophran, toroidal
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heart beating hard, normal heart rate, just felt it was beating hard.(4 hrs after receiving shot). 16 hours after receiving 2nd vaccine shot: Fatigue Severe headache Fever Body aches Sore arm (left arm received vaccine in). Nausea Loss of appetite


VAERS ID: 1628843 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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: NO KNOWN
Current Illness: NO KNOWN ILLNESS
Preexisting Conditions: NO KNOWN CHRONIC CONDITIONS
Allergies: NO KNOWN ALLERGY
Diagnostic Lab Data: NONE REQUIRED
CDC Split Type:

Write-up: ON 08/23/2021, PATIENT REQUESTED JANSSEN COVID-19 VACCINE. PATIENT WILLINGLY FILLED OUT CONSENT FORM AND SIGNED AND DATED, THEN PROCEEDED TO WAIT UNTIL ADMINISTERING STAFF PREPARED VACCINATION FOR PATIENT. PATIENT ASKED IF WE "PLUNGED" THE VACCINE WHILE ADMINISTERING VIA INTRAMUSCULAR ROUTE. ADMINISTERING TECHNICIAN EXPLAINED THE TECHNIQUE THAT WAS TAUGHT DURING COMPANY CERTIFICATION TRAINING VIDEO THROUGH STATE UNIVERSITY AND SKILLS CHECK, BEING THE Z-TRACK METHOD, AND DEMONSTRATED TECHNIQUE BEFORE ADMINISTERING TO ENSURE PATIENT WAS COMFORTABLE AND INFORMED. ADMINISTERING TECHNICIAN ASKED IF PATIENT WAS COMFORTABLE PROCEEDING, WHICH THE PATIENT SAID "YES". ADMINISTERING TECHNICIAN PROCEEDED TO VACCINATE AND APPLY BANDAID (PATIENT DID NOT BLEED DURING OR AFTER ADMINISTRATION). PATIENT THEN WAS ADVISED TO WAIT IN THE WAITING AREA AFTER VACCINATION FOR 15 MINUTES OF MONITORING AS ADVISED BY THE CDC. UPON LEAVING, PATIENT WAVED GOODBYE AND SAID HE "FELT FINE" AND PROCEEDED TO LEAVE THE PHARMACY AREA. WHILE WALKING TO THE FRONT DOOR, PATIENT STOPPED THE FRONT STORE STAFF AND ASKED IF PHARMACY WAS AFFILIATED COMPANY AND FURTHER ASKED FOR OUR CORPORATE PHONE NUMBER. THE FRONT STORE STAFF PROCEEDED TO GIVE PATIENT THE COMPANY PHONE NUMBER AS REQUESTED. NO FURTHER CONTACT WAS MADE TO THE PHARMACY STAFF AFTER THE PATIENT LEFT THE PHARMACY ON 08/23/2021. NO ERROR WAS MADE BY PHARMACY STAFF, HOWEVER, DOCUMENTATION WAS REQUESTED BY CORPORATION ON OUR BEHALF.


VAERS ID: 1628878 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 988P21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthma, Impaired work ability, Scratch
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Accidents and injuries (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

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

Write-up: Scratchy throughout, heightens allergies leading to severe asthma ataccks that have lasted 2 days keeping me out of work. I used my inhalers and stay inside and I don''t have attacks. It''s still hard to breathe in air-conditioning. If I go out side I have an asthma attack. I also work in a metal shop Wich makes it so I can''t go to work cause I would be in a load of polutents


VAERS ID: 1629060 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Chest pain
SMQs:, Anaphylactic reaction (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: vaccine given 8/22/21, chest pain/pressure started 8/23 night, chest pressure continued into 8/24. no other sx and pt stable. parent monitoring at home.


VAERS ID: 1629062 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Gait disturbance, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: An actual documented case of the measles following the mmr - my 2nd in college.
Other Medications: Diamox, Propranolol, Topiramate, Wellbutrin, Abilify, Adderall, Lyrica, gabapentin, Tysabri
Current Illness: Multiple Sclerosis
Preexisting Conditions: Multiple Sclerosis
Allergies: Bees, IV Contrast, Depakote, Copaxone, Cephalosporins
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Due to my MS I have numbness, and a ?pins and needles? feeling in my lower legs, bilaterally, below the knee. About 30 minutes following the 3rd shot I began to have a feeling of numbness (new) in both legs extending up to my mid-thighs - not completely numb, I can still feel everything, the feeling is just diminished. More on the left than the right. It has made walking more challenging than usual. If not improved in the am then I was going to go to the doctor.


VAERS ID: 1629065 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER ERRO185 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chest discomfort, Chills, Cold sweat, Cough, Decreased appetite, Dysphonia, Fatigue, Flushing, Heart rate increased, Hyperhidrosis, Injection site bruising, Injection site pain, Myalgia, Nasal pruritus, Pain, Paraesthesia, Pyrexia, Restlessness, Sinus operation, Thirst, Urticaria, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Akathisia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyloft, zyrtec, Singulair, gabapentin, omeprazole, calcium, vitamin d, magnesium
Current Illness: erosions of spine, easy bruising,
Preexisting Conditions: Asthma, hay fever, erosions of spine, easy bruising, osteopena, IBS
Allergies: Omnicef, ceftin, augmentin, trazadone, pantoprazole Peanuts, shellfish, corn, all corn containing products, wheat (gluten), mustard, watermelon, eggs
Diagnostic Lab Data: No tests or labs have been taken between covid19 vaccine injection on 8/23/21 @1pm and 8/24/21@6:23pm. I carry an epi pen and continue to monitor.
CDC Split Type:

Write-up: 1:12pm Fast heartbeat, clamy hands, chills, sinus drainage, 1:26pm coughing, chest tightness, raspy voice, tingling/itchy nose, flush cheeks, chills 2:30pm slight fever, extremely tired 6:00pm sweating, loss of appetite, coughing, drainage, and tightness continued through night 9:00pm severe back ache (all over), injection site, bruised, tender, and throbbing 8/24/21 @6:30am after a restless evening woke up with a cough, extended hoarse voice, extreme thirst, and complete body aches. As of 6:20pm (8/24/21) complete body muscle/ joints ache, tired, sinus drainage continues, chest is tight with light wheezing periodically, voice remains raspy, and dry coughing continies, small hives appear on face and back,


VAERS ID: 1629074 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Headache, Insomnia, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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: Pepcid
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever 101-102 Headache Aches and pains Brain fog Insomnia Sore arm


VAERS ID: 1629081 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-21
Onset:2021-08-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anion gap, Blood calcium decreased, Blood creatinine normal, Blood culture, Blood glucose increased, Blood lactic acid, Blood sodium decreased, Blood urea increased, Carbon dioxide decreased, Colitis, Computerised tomogram thorax abnormal, Haemoglobin decreased, Hypotension, Intensive care, Legionella test, Lung opacity, Malaise, Mental status changes, Metabolic acidosis, Pneumonia, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Lactic acidosis (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific inflammation (narrow), Hyponatraemia/SIADH (narrow), Ischaemic colitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Noninfectious diarrhoea (broad), Tumour lysis syndrome (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (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: amlodipine, aspirin, atorvastatin, duloxetine, hydrochlorothiazide, hydroxyzine, Creon, Dulera, multivitamin, pantoprazole, topiramate
Current Illness:
Preexisting Conditions: Bipolar 2 disorder, COPD, multiple sclerosis, CKD, alcohol abuse, fibromyalgia, anxiety, hypertension, migraines, hepatic steatosis, history of CVA
Allergies: ceftriaxone, sumatriptan, bee venom, peanut butter, adhesive tape, erythromycin, lisinopril, ketorloac
Diagnostic Lab Data: 8/23/21 COVID-19 - negative Lactic acid - 3.5 Creatinine - 0.95; BUN - 25; sodium - 125; glucose - 286; calcium - 6.4; CO2 - 12; Anion gap - 32 CT chest PE - no evidence of PE; bilateral ground glass opacities Hemoglobin - 10.9
CDC Split Type:

Write-up: Patient presented to ED with altered mental status, unable to provide much history beyond feeling unwell for the past few days. She was found to have metabolic anion gap acidosis, with no osmolar gap. Patient was found to have pneumonia and pancolitis. She was treated with vancomycin and meropenem in ED and transitioned to levofloxacin and metronidazole as an inpatient. She was started on norepinephrine due to low blood pressure. She is COVID-19 negative and legionella negative. Blood cultures are pending. Patient currently in ICU.


VAERS ID: 1629276 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
SMQs:, Medication errors (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: None
Current Illness: none
Preexisting Conditions: none
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dose 2 given at 21 days instead of 28 days.


VAERS ID: 1629277 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Anaphylactic reaction, Dizziness, Dyspnoea, Insomnia, Pharyngeal swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/a
Current Illness: N/a
Preexisting Conditions: Asthma
Allergies: Fish, shellfish ,nuts, sesame, kiwi, strawberry, pears, apples, cherries, plums, peaches
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Anaphylaxis 20 mins after receiving the first dose of Pfizer covid vaccine (throat swelling, difficulty swallowing, dizziness, shortness of breath). Epinephrine 0.3mg given Intramuscular 10 mins after symptoms of anaphylaxis. EMS called and went to hospital via ambulance.


VAERS ID: 1629287 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Nervousness, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Client received COVID19 Pfizer 1st dose vaccine (Lot#FC3183) at 18:48 pm. The client came to get vaccinated with her teenage son, and after receiving her injection, they both went to sit in the observation area. At 19:05, the client expressed to EMT she feels a tingling sensation in her left forearm. EMT waived for Lead RN to come over. Lead RN asked the client if she was experiencing any shortness of breath, difficulty breath, or chest pain, to which the client responded, no. The client stated she had anxiety about getting the vaccine and it might just be nerves. She also stated she had been sitting for 15 minutes before it started. She said she has had her purse hanging on the forearm while in the observation area and that maybe the tingling came from finally removing her purse from her forearm. Lead RN asked the client if she has any underlying health conditions, takes any medications, and/or has any allergies, and the client responded no. The client stated her arm was already starting to feel better and the tingling was starting to go away. Lead RN asked the client if she felt the sensation in any other limbs or on any other part of her body, or if she had experienced any changes in vision. The client responded no. The client continued to state she was feeling fine and really believes it was just nerves. Lead RN educated client on both the potential side effects and adverse effects of the vaccine, when to seek medical attention, and ER precautions. Client stated she understood. Lead RN observed client and her son exit the observation room at 19:20 walking with a steady gait.


VAERS ID: 1629312 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-19
Onset:2021-08-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident, Eye pain
SMQs:, 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), Glaucoma (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: Viagra
Current Illness: None
Preexisting Conditions: None
Allergies: Bee Stings
Diagnostic Lab Data:
CDC Split Type:

Write-up: Eyes hurt afterwards, felt like stroke


VAERS ID: 1629319 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Facial pain, Feeling cold, Pain in jaw, Pyrexia, Sinus pain, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Osteonecrosis (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: shingles - fatique, nausea
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Excessive vomiting, chills, fever. Achey and painful, face, sinuses, jaw.


VAERS ID: 1629513 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

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

Write-up: PATIENT STARTING FELLING DIZZY, THEN FAINTED. WHEN SHE CAME AROUND , SHE STARTED FEELING NAUSEOUS AND LATER VOMITTED.


VAERS ID: 1629543 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (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: Vitamin C (5,000mg) / B Complex (1,103mg) / Glucosamine (1,500mg) / Acetaminophen (500mg)
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Strong heart beat and chest discomfort.


VAERS ID: 1629716 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dysphonia, Palpitations, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

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

Write-up: PATIENT CAME UP TO PHARMACY COUNTER AFTER ABOUT 10 MINS POST VACCINATION SAYING SHE FELT DIZZY WITH RACING HEART. I IMMEDIATELY TOOK HER TO A ROOM AT OUR CLINIC WHERE SHE COULD RECLINE. SHE PROGRESSED TO HAVING TINGLING IN HER FACE AND LEFT ARM AND HOARSENESS SO I ADMINISTERED, WITH HER CONSENT, 25 MG ORAL BENADRYL LIQUID. I TOOK HER BP AND IT WAS NORMAL AS WELL AS HER PULSE OX (99 - 100%). SHE SAID SHE STARTED TO FEEL SOME BETTER, BUT STILL HAD THE TINGLY FEELING IN HER FACE AND ARM SO I ADVISED AT THAT POINT, AFTER BENADRYL NOT HELPING, TO SEEK EMERGENT CARE AT ER. SHE REPORTED TO HER MD AND WAS GIVEN STEROIDS.


VAERS ID: 1629873 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-19
Onset:2021-08-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, chills, fatigue, muscle pain entire body


VAERS ID: 1632004 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

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

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

Write-up: Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient passed out a few minutes after receiving the 2nd dose of Pfizer vaccine. She came back from fainting about a minute or two. We called 911 and the paramedic came over to access her. Patient''s mother was with her whole time and patient had no problem and left the store without going to the hospital.


VAERS ID: 1632020 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Systemic: Body Aches Generalized-Medium, Systemic: Chills-Medium, Systemic: Fever-Medium, Additional Details: pt said has fever but doesn''t know what it is, also has chills


VAERS ID: 1632023 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Chest Tightness / Heaviness / Pain-Mild, Additional Details: Patient reported mild difficulty breathing about 20 minutes after vaccination. They also reported chest tightness. They refused calling ambulence multiple times. Patient stayed in the store for about another hour, and was given water and 50mg of benadryl. She stated her breathing felt better after she took her mask off, but still felt the the chest tightness (likened it to asthma). She called her Dr while in store, explained the situation, and made an appt for later in the week before leaving.


VAERS ID: 1632028 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Severe Headache for two day, shortness of breath with exertion


VAERS ID: 1632236 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-03-01
Onset:2021-08-23
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Fatigue, Malaise, Myalgia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NICOTINE PATCH, MELOXICAM, GLIPIZIDE, CERTIRIZINE, DICOLFENAC GEL, ALOGLIPTIN, LO/OVRAL, LEVEMIR
Current Illness: NONE
Preexisting Conditions: MORBID OBESITY, TOBACCO DEPENDENCE, TYPE 2 DM, ASTHMA, ALLERGIC RHINITIS, ADJUSTMENT DISORDER, TEAR FILM INSUFFICIENCY, ASTIGMATISM
Allergies: AMOXICILLIN, AZO
Diagnostic Lab Data: 08/23/21: POSITIVE SARS-COV-2 RNA
CDC Split Type:

Write-up: COUGH, DIFFICULTY BREATHING, FEELING TIRED/SICK, MUSCLE PAIN


VAERS ID: 1632247 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-22
Onset:2021-08-23
   Days after vaccination:213
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 8/24 Sars-Cov2, naat posititve
CDC Split Type:

Write-up: Covid-19 positive $g14 days post vaccine series


VAERS ID: 1632263 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspepsia, Headache, Muscle spasms, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Gastrointestinal nonspecific dysfunction (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: Flonase, Wixela, metoprolol, losartan, amlodipine, pantoprazole, 81mg aspirin, multivitamin, vitamin d, calcium, vitamin b, fish oil
Current Illness: None
Preexisting Conditions: HBP, history of pancreatic cancer, asthma
Allergies: Sulfa, penicillin, amoxicillin, codeine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever and chills for 26 hours started 12 hours after the shot Muscle spasms for 4 hours started 12 hours after the shot Heartburn for 8 hours started 30 minutes after the shot - I got this with the first shot too Headache 2 days


VAERS ID: 1632279 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Confusional state, Feeling abnormal, Headache
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: Fuzzy headed confusion day after vaccine, fuzzy headed two days after vaccine, headaches, joint pain,


VAERS ID: 1632300 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-23
Onset:2021-08-23
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Pyrexia
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)

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: HOSPITALIZED AFTER VACCINE, SOB FEVERS


VAERS ID: 1632371 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-07-26
Onset:2021-08-23
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: Client was asked if interested in being vaccinated for COVID while our team was on outreach. Reported never being vaccinated before and wanted to receive vaccine today. Team was unable to find client on Immunisation Registry so vaccine was administered. After the fact, it was discovered client had previously been vaccinated on 4/26 and 6/7 with Moderna.


VAERS ID: 1632373 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased
SMQs:, Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Temperature of 104.8 degrees for 8 full hours. Unable to get temperature to lower.


VAERS ID: 1632382 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-07-28
Onset:2021-08-23
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: Client was asked if interested in being vaccinated for COVID while our team was on outreach. Reported never being vaccinated before and wanted to receive vaccine today. Team was unable to find client on Immunisation Registry so vaccine was administered. After the fact, it was discovered client had previously been vaccinated on 4/26 and 6/7 with Moderna.


VAERS ID: 1632403 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Remicade 100 mg/8 weeks; Lialda 2.4 grams/day; Lipitor 10 mg/day; fish oil 1,000 mg/day; B6 100 mg/day; B12 1,000mcg/day; Folic Acid 400mcg/day; Benadryl 25 mg/prn; Tylenol 325 mg/prn
Current Illness: Ulcerative Colitis; high cholesterol and non-alcoholic fatty liver
Preexisting Conditions: Ulcerative Colitis since 1980 and chronic low back pain
Allergies: NKA
Diagnostic Lab Data: None at this time.
CDC Split Type:

Write-up: 08/23/2021 about 8:30 PM observed round/oval red rash 2 inches in diameter between left ankle and heel on outside of left leg. Saw doctor 08/24/2021 who prescribed DOXYCYCLINE HYC 100 mg twice a day if rash a bacterial infection and KETOCONAZOLE 2% Cream twice a day if rash a fungal infection. Advised to go to the ER if the rash gets worse and fever develops. Pharmacy counselled that there were no adverse drug interactions expected.


VAERS ID: 1632419 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Hypoaesthesia, Pain, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bisoprolol, synthroid, Viibryd, gabapentin, Xanax, seroquel, crestor, celebrex
Current Illness: None
Preexisting Conditions: Overweight, blood pressure, cholesterol
Allergies: Saphris
Diagnostic Lab Data:
CDC Split Type:

Write-up: Face numb, headache, fever, chills, rash on chest, body aches


VAERS ID: 1632439 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 called me at the pharmacy on 08/24/2021 after receiving the Pfizer vaccine the day before. He reported "rash on face and itchiness on face and neck" the day after receiving the first dose of Pfizer. I asked him to see a doctor regarding his reaction and unsure if he has yet.


VAERS ID: 1632464 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: none
CDC Split Type:

Write-up: Moderna Vaccine mistakenly given to a 16 y/o patient. No adverse effects, hospital pharmacist called patient and her parent to discuss the off label use of the vaccine.


VAERS ID: 1632486 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Injection site erythema, Injection site pain, Injection site swelling, Nausea, Skin sensitisation
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad)

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

Write-up: Chills the night of, skin very sensitive all over my body, very tired and nauseous, Very dizzy and skin sensitivity the next day. injection sight very swollen , red and painful to touch.


VAERS ID: 1632496 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

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

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

Write-up: Body aches and fatigue for 12 hours. Injection site soreness for 3 days.


VAERS ID: 1632517 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dizziness, Full blood count, Metabolic function test, Muscle twitching, Pyrexia, SARS-CoV-2 test, Urine analysis, Vomiting, X-ray
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: GERD
Allergies: pseudophedrine
Diagnostic Lab Data: chemistry, cbc, covid test, x-ray, urinalysis
CDC Split Type:

Write-up: Patient developed fevers, chills, muscle twitches, vomiting, and dizziness one day after receiving the vaccine. 2 ED visits since the reaction


VAERS ID: 1632526 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Cardiac flutter, Depersonalisation/derealisation disorder, Fatigue, Heart rate decreased, Heart rate increased, Hyperhidrosis, Injection site erythema, Injection site pain, Joint swelling
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tachyarrhythmia terms, nonspecific (narrow), Arthritis (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: I passed out when i had the BCG vaccination
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: A the time of injection my heart rate dropped to 49 BPM and for 30 minutes yoyoed between 50 BPM and 120BPM.My heart rate stabilized after time and I was encouraged to leave the vaccine site and contact ambulance if the problem persisted. Upon returning home i found myself extremely fatigued and slept earlier than usual as i did not feel myself. On 08/24/2021 I woke with pain in my left ankle, similar to an ankle sprain with minor swelling. I have been checking my temperature to check for fever and i am running from 98.1-99.00. I usually record a temperature at around 96.5. I regularly record my heart rate on my apple watch and have noticed that my resting heart rate has been higher since vaccination. aprox 10-20 BPM increase from my usual resting rate. I have also dropped to 54 BPM on occasion which is not normal for me,. I also notice that my heart rate has entered the exercise range even when i have been inactive however this seems to stopped on day three of vaccination. I have noticed a fluttering feeling in my chest which i am attributing to my heart. This has been less noticeable since vaccination. Additionally i have some soreness and redness at the injection site. I live in a humid area but also notice that i may be sweating more than usual.


VAERS ID: 1632528 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-03
Onset:2021-08-23
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 - / -

Administered by: Public       Purchased by: ?
Symptoms: Cough, Dyspnoea, Exposure to SARS-CoV-2
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Actos 30mg PO atorvastatin 40mg PO at bedtime Catrate 600 + D qday Celebrex 200mg oral qday lisinopril 20mg at bedtime metformin 1000mg PO qPM oxybutynin 5mg PRN PO bid Synthroid 100mcg PO qday Vitamin B12 1000mcg qday Vitamin D3 1000 intl
Current Illness:
Preexisting Conditions: Graces disease H/O thyroidectomy Hypotyroidism NOS toxic multinodular goiter
Allergies: NKMA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt has been having shortness of breath with dry cough for 4 days. She lives with daughter and son who both have been diagnosed with COVID.


VAERS ID: 1632530 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-24
Onset:2021-08-23
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2, Malaise
SMQs:, COVID-19 (narrow)

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

Write-up: Patient was exposed to a positive co-worker at place of employment and started with symptoms 3 days later.


VAERS ID: 1632546 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

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

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

Write-up: Patient was questioned about receiving a previous dose of covid-19 vaccination and she stated she did not and that it was an error on the state reporting form. We administered the pfizer covid-19 vaccine. When the technician called the other pharmacy to have the state registry entry corrected they stated she did get the shot and they had signatures on file. When re-questioned, the patient stated she had gaps in her memory due to a recent panic attack and may have gotten it but did not have any memory of it.


VAERS ID: 1632547 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-21
Onset:2021-08-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood potassium decreased, Chest pain, Hypoaesthesia, Muscle twitching, Sleep disorder
SMQs:, Peripheral neuropathy (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypokalaemia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: GERD, hot flashes d/t menopause, Hypotension
Allergies: Codeine, Garlic, Novocain, Onion, Sulfites, Sulfur, Honey bee venom, Nickel
Diagnostic Lab Data: Potassium 3.3
CDC Split Type:

Write-up: 46-year-old female presents to the emergency department for evaluation of a suspected allergic reaction. The patient states that she received the COVID-19 vaccine on Saturday. She states that later that evening she started having intermittent episodes of muscle twitching. States that she 1st noticed it in her face with some associated facial numbness. Reports that she was also having episodes in her arms, legs and feet. The patient reports that she treated her symptoms with Benadryl and Motrin with no improvement. Reports that she had difficulty sleeping last night and continued symptoms today so came to the emergency department for further evaluation. The patient states that she has multiple allergies and was initially hesitant to get the COVID-19 vaccine because of fever that she would have a reaction to it. The patient states that along with the intermittent episodes of twitching she has also had chest pain that she describes as intermittent nonradiating and nonexertional 6/10 pain. She denies fevers, chills, nausea, vomiting, diarrhea, sick contacts, recent travel, shortness of breath and diaphoresis.


VAERS ID: 1632565 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Depersonalisation/derealisation disorder, Feeling abnormal, Flushing, Injection site swelling
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Patient disclosed that had a "bad" reaction to a flu vaccine in the past
Other Medications: Pt stated that has a PCP Doctor F. and stated that also sees rheumatologist . Pt stated that take Hydroxychloroquine. Patient stated "my rheumatologist wanted me to get the vaccine".
Current Illness: To the best of my knowledge, patient hasn''t disclosed any at the time of the vaccine.
Preexisting Conditions: Please contact patients PCP
Allergies: States that has had "bad reaction" to influenza immunizations in the past.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Reported feeling flushed, some swelling at the injection site, stated "I just don''t feel right" Patient was stable, was being monitored. BP checked 147 systolic. Pt reported feeling worse "I just don''t feel myself" Paramedics were called and transported patent from the hospital


VAERS ID: 1632569 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-02-18
Onset:2021-08-23
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Condition aggravated, Cough, Dyspnoea, Respiratory failure, SARS-CoV-2 test positive, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (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), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lasix, Proscar 5mg, Azithromycin, Zyrtec, Lioresal, Aspirin 81mg, Ferrous sulfate 325, Bumex
Current Illness: Thrombophletitis
Preexisting Conditions: 1. GI Blood loss from AVM 2. COPD exacerbation 3. Acute or chronic hypoxic respiratory failure 4. Chronic heart failure with preserved ejection fraction 5. Paroxysmal atrial fibrillation
Allergies: Levaquin, Loratadine-pseudoephedrine
Diagnostic Lab Data: COVID PCR 8/23/21 Positive Chest XRay 8/23/21- Lower lobe predominant multifocal airspace disease. Correlate with COVID status.
CDC Split Type:

Write-up: "Pt received his second dose of Pfizer COVID-19 on 2/18/21. Pt was admitted to reporting hospital on 8/23/21 with an admitting diagnosis of COVID-19 Pneumonia and acute on chronic hypoxic respiratory failure. Pt was reported in ER to have worsening shortness of breath, wheezing and cough on 6L of oxygen. Patient''s wife is also positive for COVID. Admission test for COVID was positive per PCR NP swab on 8/23/21. Pt is currently admitted.


VAERS ID: 1632612 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Chills, Diarrhoea, Headache, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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:
CDC Split Type:

Write-up: Fever (100.9), Nausea/Vomiting, Sever headache, Chills, Diarrhea.


VAERS ID: 1632634 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-01-12
Onset:2021-08-23
   Days after vaccination:223
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Senior Living       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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID 19 positive PCR test
CDC Split Type:

Write-up: COVID 19 positive


VAERS ID: 1632643 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Burning sensation, Erythema, Headache, Paraesthesia, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Swelling and readness of arm, pin and needles feeling in arm 3 days now. Massive headache on right side behind ear, stabing and burning pains


VAERS ID: 1632670 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EC3184 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest discomfort, Chills, Dyspnoea, Headache, Neck pain, Nervousness
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: Shaking, chills, difficulty breathing, weakness, chest tightening, severe neck and head aches. The latter symptoms have not abated.


VAERS ID: 1632682 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Chills, Dizziness, Food allergy, Headache, Lymphadenopathy, Malaise, Neck pain, Painful respiration, Pyrexia, Sleep disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypothyroid (Hashimoto''s)
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I developed a high fever and chills the night after my second Pfizer Covid-19 shot. By the following day, 8/24/21, the fever persisted all day and I had a terrible headache, joint pain, neck pain, swollen lymph nodes on th right side of my neck, and shoulder pain. By the late evening of 8/24/21, I was very ill. I could not sleep because of a persistantly high fever (102.2 degrees) and a terrible sensation of "heartburn," though I have never had heartburn in my life. It felt like I had swallowed a pill that got stuck in my throat and burned throughout the night. I had chest pain, shoulder pain, pain when breathing, etc. I also vomitted twice in the night and felt dizzy. By 8/25, the fever has continued.


VAERS ID: 1632696 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-29
Onset:2021-08-23
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chest X-ray abnormal, Condition aggravated, Cough, Diarrhoea, Headache, Lung opacity, Pain, Pneumonia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (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: Tenormin, Wellbutrin Sr, Cosopt, Hydrodiuril, Xalatan, Arava, Lisinopril 40mg, Zofran, Percocet, Prednisone 10mg, Aldactone
Current Illness: Diarrhea, AKI, Adrenal insufficiency with hypotension, essential HTN, Hyponatremia
Preexisting Conditions: rheumatoid arthritis, adrenal insufficiency, dyslipidemia, HTN, depression, osteoporosis, and chronic pain
Allergies: Amoxicillin
Diagnostic Lab Data: COVID PCR Test Positive 8/23/21 8/24/21 Chest Xray - Patchy opacity in the right upper lobe consistent with pneumonia.
CDC Split Type:

Write-up: Pt received her second dose of Moderna COVID-19 on 3/29/21. Lot number is not specified in medical record. Pt was admitted to reporting hospital on 8/23/21 with an admitting diagnosis of weakness and diarrhea. Pt was reported in the ER to have diarrhea, generalized body aches, headaches, cough and weakness. Admission test for COVID was positive per PCR NP swab on 8/23/21. Pt is currently still admitted.


VAERS ID: 1632697 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-02-12
Onset:2021-08-23
   Days after vaccination:192
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Coronavirus test positive, Dyspnoea, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Coronavirus test: 08232021 - positive
CDC Split Type:

Write-up: This patient is an 86-year-old woman. The patient developed a fever several days ago, apparently this last Friday. She lives at an assisted living facility with staff, it seems like she is isolated her to her room. Today, she states she continued to feel fine and staff tested her for COVID. She apparently was tested positive and was sent here for further evaluation. On evaluation here, she was found to have a pulse ox of 90% on room air. We were contacted for admission. The patient, otherwise, is without much complaints. She does have COPD and has oxygen that she does not use but does state that she has been using that in the last several days for some shortness of breath. She has had some mild myalgias as well. She is fully vaccinated. DISCHARGED 08/24/2021: Patient verbalizes understanding of discharge instructions including medications (prednisone), when to take them, home oxygen therapy, and when to call healthcare provider. Patient connected to portable oxygen tank and transported here for ride. Taken via wheelchair to main lobby and home with home health care.


VAERS ID: 1632710 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-27
Onset:2021-08-23
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Asymptomatic COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Tested positive during facility''s outbreak testing; is asymptomatic


VAERS ID: 1632724 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-03-08
Onset:2021-08-23
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Bilevel positive airway pressure, COVID-19, Continuous positive airway pressure, Coronavirus test positive, Cough, Diarrhoea, Dyspnoea, Nausea, Pain, Respiratory distress, X-ray
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (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), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Coroavirus Test: 08232021 = positive
CDC Split Type:

Write-up: Pt arriving via emergency services with c/o respiratory distress. Tested covid + on the 17th. Initial O2% at home in 70''s on 5L. Put on Cpap in route with a saturation of 86%. AxOx4. C/o SOB, cough, aches. Given 1 duoneb Patient is 70-year-old female with a history of sleep apnea on 2 L at night, childhood asthma who the 16th of this month diarrhea and nausea and weakness. She underwent COVID-19 testing on the 18th and was positive. She states that in March of this year she was x-ray of COVID 19. She presents tonight due to having increased her home O2 for shortness of breath. EMS was called there she was satting 75% on 5 L nasal cannula. Currently she is currently tolerating BiPAP and says her dyspnea is markedly improved.


VAERS ID: 1632779 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-23
Onset:2021-08-23
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Cerebrovascular accident, Chest X-ray abnormal, Dyspnoea, Hemiparesis, Lung opacity, Malaise, Nausea, Oxygen saturation decreased, Pulmonary oedema, SARS-CoV-2 test positive, Vomiting
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Interstitial lung disease (narrow), 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), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Respiratory failure (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: obesity, HTN, insulin-dependent T2DM, CKD, recent stroke on 8/9 with residual L-sided weakness,
Allergies: nkma
Diagnostic Lab Data: Reason For Exam SOB, COVID+ Report EXAMINATION: XR Chest Portable INDICATION: SOB, COVID+ VIEWS: Single view COMPARISON: None FINDINGS: Normal cardiomediastinal silhouette. Mild bilateral central predominant hazy pulmonary opacities. No pleural effusions. No pneumothorax. No acute osseous abnormalities. IMPRESSION: Pulmonary findings compatible with COVID-19 pneumonia, however pulmonary edema may have a similar appearance.
CDC Split Type:

Write-up: Chief Complaint Per EMS, pt had a one time SBP of 190 and they transferred to the ER for concern of new HTN. History of Present Illness This is a 65-year-old female with history of stroke on 08/09 who is currently receiving inpatient rehabilitation at Rusk who presents for evaluation of a 2 to 3-day history of generalized malaise and a 1 day history of nausea and vomiting. Patient states that she is having difficulty keeping up with her PT at the outside facility due to her weakness. She states that starting earlier yesterday morning, she began to have nausea and approximately 4 episodes of emesis. Denies any hematemesis or coffee-ground emesis. She does state that she feels a little short of breath; she reportedly desaturated to the mid 80% at the outside facility and was placed on nasal cannula at 4 L with improvement of oxygen saturations. She has no other complaints at this time including any recent fevers, congestion, rhinorrhea, chest pain, abdominal pain, diarrhea, constipation, pain in her extremities, or numbness/tingling.


VAERS ID: 1632790 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-01-06
Onset:2021-08-23
   Days after vaccination:229
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Bilevel positive airway pressure, COVID-19, Dyspnoea, Flank pain, Hypoxia, Oxygen saturation decreased, Respiratory distress, SARS-CoV-2 test positive, Tachypnoea
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Coronavirus test: 08232021 = positive
CDC Split Type:

Write-up: Pt Admitted 08232 presents via EMS w respiratory distress, covid + 8/19, admitted and received monoclonal antibodies, sent home w 2L NC. today found O2 sat in 80''s on 2L, no change on 6L, better to 90''s on 15L nonrebreather. pt alert Was doing well until today when noticed pulse ox was running in 80s and tachypneic, also noted lower flank to almost hip pain on left. Bumped O2 up but stayed low 90s, called EMS and found to be hypoxic. Placed on 55L when in ED and I got a repeat ABG -paO2 still 49 - now on bipap. Says she just can''t catch her breath or take a deep breath. I do not see a PE on CTA but do see COVID changes, although not so severe to cause this level of hypoxia.


VAERS ID: 1632797 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-23
Onset:2021-08-23
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 2 LA / IM

Administered by: Pharmacy       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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: allopurinol 100mg daily amlodipine-benazepril 5mg/20mg daily glipizide 20 mg daily metformin 1000 BID omeprazole 20mg daily sildenafil 25mg daily PRN for ED
Current Illness: Nothing documented
Preexisting Conditions: Hypertension GERD Migraine Hyperlipidemia Steatosis of liver Diastolic Dysfunction Small bowel obstruction Type 2 Diabetes Insulin resistance syndrome vitamin d deficiency
Allergies: No known Allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient contracted COVID-19 while being fully vaccinated


VAERS ID: 1632807 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-11
Onset:2021-08-23
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL3180 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia, Livedo reticularis, Skin discolouration
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: swollen/painful lymph nods under right arm on 2nd day after x24hrs. Treated with ice packs and resolved by third day/morning af
Other Medications: none.
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none.
CDC Split Type:

Write-up: on Sept 23rd noticed the inside of 2nd toe of left foot pink, which became progressively darker red with noticeable purple mottling . Area with sensation not intact, ie. numbness noted. Symptom has continued for two days until present. No worsening or improvement noted. No itching, swelling, or open areas noted. N.P. at work concurs that it doesn''t appear to be cellulitis, as it is not warm to touch or appear inflamed, and skin intact without drainage. This could be Covid toe but could not locate anyone who has seen/ Dx''ed this condition. Contacted both locale hospital systems to locate someone who has seen and Dx''ed this condition, but unable to find at present; still working on this.


VAERS ID: 1632853 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Chills, Pain
SMQs:

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: Body aches and chills


VAERS ID: 1632870 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-01-05
Onset:2021-08-23
   Days after vaccination:230
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Work       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Arthralgia, Aspartate aminotransferase normal, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium normal, Blood chloride increased, Blood creatinine normal, Blood glucose normal, Blood sodium normal, Blood urea decreased, C-reactive protein increased, COVID-19, Carbon dioxide normal, Chest X-ray abnormal, Cough, Fatigue, Glycosylated haemoglobin, Haemoglobin normal, Human chorionic gonadotropin negative, Oropharyngeal pain, Platelet count normal, Pneumonia, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive, White blood cell count normal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tubulointerstitial diseases (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? No
Previous Vaccinations:
Other Medications: Wellbutrin 150 mg/day Sumatriptan 25 mg PRN Annovera
Current Illness: None
Preexisting Conditions: None
Allergies: PCN, cephalosporins
Diagnostic Lab Data: 8/24: CXR: peribronchial cuffing and thickening, WBC: 6, Hgb: 14.2, Plt: 179K, Glucose: 96, HbA1c: 4.9%, BUN: 7, Creat: 0.7, Na: 140, K: 3.5, Cl: 107, CO2: 26, Ca: 9.4, Albumin: 4.1 , Tbili: 0.7, AST: 25, ALT: 17, AlkPhos: 64, CRP: 12, HCG <5
CDC Split Type:

Write-up: Mild symptoms of fatigue, sore throat and low grade fever of 99F started the evening of 8/22/2021. Tested positive for COVID-19 on 8/23/2021. Symptoms included Severe arthralgia, fever 102F, cough, congestion. Treated with Regeneron antibodies on 8/24. CXR on 8/24 showed early pneumonia and also treated with steroids and inhaler.


VAERS ID: 1632897 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Pain, 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shingles vaccine
Other Medications: OTC calcium, multi-vitamin, Vitamin D3
Current Illness: none
Preexisting Conditions: none
Allergies: Bactrim
Diagnostic Lab Data: none
CDC Split Type:

Write-up: achy and feverish the next day only: redness, itchy and slightly swelling around the injection site for at least four days afterward


VAERS ID: 1632986 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-25
Onset:2021-08-23
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Infection, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Breakthrough case. Covid positive on 8/23/2021 by PCR test


VAERS ID: 1632994 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-01-20
Onset:2021-08-23
   Days after vaccination:215
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: non obstructive CAD, DMT2, dyslipidemia and a.fib
Allergies: iodine, diltiazem
Diagnostic Lab Data: COVID test was positive on 08/23/2021
CDC Split Type:

Write-up: COVID-19 breakthrough case, COVID test was positive on 08/23/2021


VAERS ID: 1633033 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-14
Onset:2021-08-23
   Days after vaccination:221
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Headache, Pain, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: bodyache, runny nose and headache fully vaccinated test positive for Covid-19


Result pages: prev   319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=418&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166