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

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



Case Details (Reverse Sorted by Onset Date)

This is page 419 out of 8,010

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VAERS ID: 1633039 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Ohio  
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 FC3182 / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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 fainted. we found out later she had not eaten recently and was terrified of needles. the patient recovered within a few minutes. we called the patient on 8-25 and she said she was ok after leaving the pharmacy


VAERS ID: 1633057 (history)  
Form: Version 2.0  
Age: 37.0  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Paraesthesia, Thirst
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Dehydration (broad)

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

Write-up: Tingling to left side of face and left forearm, headache, and excessively thirsty. Found out about it 8/24 when she came in office


VAERS ID: 1633060 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-01-08
Onset:2021-08-23
   Days after vaccination:227
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / UNK - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / UNK - / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Laboratory test
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Senna
Current Illness: NA
Preexisting Conditions: Hypertension, Hemiplegia and Hemiparesis following a Cerebral Infarction affecting L non-Dominant side, Nontraumatic Intraccerebral Hemorrhage, Major Depressive Disorder, Muscle Spasm, GERD, Constipation, Hyperlipidemia, Dementia without Behavioral Disturbance.
Allergies: NKA
Diagnostic Lab Data: rapid test
CDC Split Type:

Write-up: Routine Testing done.


VAERS ID: 1633079 (history)  
Form: Version 2.0  
Age: 71.0  
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 (MODERNA)) / MODERNA 020B21A / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Activated partial thromboplastin time, Back pain, Blood alcohol, Blood magnesium, Chest X-ray, Chest pain, Computerised tomogram abdomen, Differential white blood cell count, Electrocardiogram, Full blood count, International normalised ratio, Lipase, Metabolic function test, Prothrombin time, Respiratory viral panel, Troponin
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 8/23 tests ran: blood alcohol, CMP, CBC with diff, lipase, magnesium, PT/INR, PTT, Sars/flu/rsv, troponin, CT abdomen, EKG, chest xray
CDC Split Type:

Write-up: back/chest/epigastric pain


VAERS ID: 1633081 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
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 (MODERNA)) / MODERNA 059E21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Differential white blood cell count normal, Full blood count abnormal, Platelet count decreased
SMQs:, Haematopoietic leukopenia (broad), Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mycophenolate sodium; multivitamin; calcium; vitamin D-3
Current Illness: No
Preexisting Conditions: SLE; ITP
Allergies: Shellfish
Diagnostic Lab Data: CBC, normal except the palette count was 18,000, WBC differential, normal.
CDC Split Type: vsafe

Write-up: I experienced a low CBC and called my Hematologist and ordered some labs of a CBC with a white blood cell differential on 08/23/2021and 08/24/2021. I''m scheduled to have another CBC done on 08/26/2021 to find out if my palette count went back to normal.


VAERS ID: 1633095 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Florida  
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 FC3182 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Tinnitus
SMQs:, Hearing impairment (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: Claratin
Current Illness: Covid 2 weeks prior
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Ringing and warmness in left ear. Tinnitus like symptoms


VAERS ID: 1633105 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Pennsylvania  
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 017E21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cholecalciferol (VITAMIN D) 1000 UNITS capsule Multiple Vitamins-Minerals (MULTIVITAMIN ORAL)
Current Illness: No known illnesses
Preexisting Conditions: Anxiety
Allergies: No known allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient presents for covid vaccination. Vaccination administered, and patient was observed after 15 minutes for reaction. Felt lightheaded and diaphoretic 15 minutes after vaccine administration- did not lose consciousness; thinks it is anxiety related. Complete resolution of symptoms with supine positioning with slow elevation of head of bed over 15 minutes.


VAERS ID: 1633130 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Pennsylvania  
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 088D21A / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dizziness, Feeling abnormal, Headache, Injection site erythema, Injection site swelling, Injection site warmth, Nausea, Pain, Paraesthesia, Pyrexia, Sleep disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre 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), 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: Chriari 1 brain malformation with syringomyelia
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I woke up at 1am the next morning very sick. I had a fever of 101, body aches, chills, nausea, vomiting, headache, dizzy, and just felt absolutely horrible. I kept getting a strange tingly feeling that would start in my scalp and go down to my toes every now and then. Injection site has a big round red mark that?s hot and swollen.


VAERS ID: 1633142 (history)  
Form: Version 2.0  
Age: 27.0  
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 (MODERNA)) / MODERNA - / 1 LA / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Induration, Product administered at inappropriate site, Skin warm
SMQs:, Drug abuse and dependence (broad), Extravasation events (injections, infusions and implants) (broad), 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Large lump that is hard and warm to touch. Injection not given on deltoid.


VAERS ID: 1633150 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: California  
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 - / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Chest discomfort, Chest pain, Myocarditis, Nausea, Troponin increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: amiloride, wellbutrin generic, atorvastatin, zinc, vitamin C, vitamin B12, folate,
Current Illness: MCTD (mixed connective tissue disease) Sero-Negative Rheumatoid Arthritis
Preexisting Conditions: Covid 19 on March 20, 2020, migraines, MCTD (Mixed Connective Tissue Disease), Sero-Negative Rheumatoid Arthritis, Raynauds phenomenan
Allergies: sulfa, terbinafine, mango, papaya, guava, passion fruit,
Diagnostic Lab Data: On 8/24/2021 my Triponin levels were 1.6 (reference range of 0.00 - 0.04) and my C Reactive Protein levels were 8.97 (reference range of 0.20 - 1.0)
CDC Split Type:

Write-up: On 8/22/2021 at 3:05pm I received my 3rd dose of Pfizer Covid vaccine. At 1:15am on 8/23/2021 I had a wave of nausea followed by horrible pain in my chest. It felt like someone wrapped my chest tightly and laid a ton of bricks on top of my chest. Around 2:15am I was transported to Medical Center where I was monitored. Tests were run that were negative. I was released at 6am promising the ER doctor that I would contact my Cardiologist that morning. My cardiologist ran a bunch of tests on 8/24/2021 and diagnosed me with Covid related Myocarditis.


VAERS ID: 1633157 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-17
Onset:2021-08-23
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest discomfort, Chest pain, Computerised tomogram, Dyspnoea, Echocardiogram, Headache, Inflammation, Malaise, Neck pain, Right atrial dilatation, Right ventricular dilatation, Scan with contrast
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin C
Current Illness: None
Preexisting Conditions: 10 year breast cancer survivor
Allergies: None
Diagnostic Lab Data: In the ER I had labs drawn, CT Chest Scans with Contrast, Chest XRays , A Transthoracic Echocardiogram. I was given nitroglycerine to relieve & tylenol to relieve pain. Results show R Ventricle is moderately dilated, R Atrium is moderately increased. The cardiologist documented inflamed chest wall.
CDC Split Type:

Write-up: Monday morning 8/23/21 woke up at 6:00AM not feeling well. By 7:15 Acute onset of intense chest pain and pressure along with neck pain, severe headache, and labored breathing. I could not lay down because the pressure and pain were so intense. I got Covid tested around 4PM, negative. I went to ER with chest pain and discomfort around 6PM.


VAERS ID: 1633160 (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: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose decreased, Dizziness, Dyskinesia, Eye disorder, Facial paralysis, Feeling abnormal, Feeling cold, Heart rate decreased, Hypotension, Pallor, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dyskinesia (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (narrow), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: All Day allergy generic ZYRTEC
Current Illness: None
Preexisting Conditions: Asthmatic
Allergies: Codeine; ALLEGRA; Dust
Diagnostic Lab Data: The pharmacy took his pulse, he had low pressure. They had to call the paramedics. The paramedics also took his pulse, blood pressure and blood sugar and everything had dropped.
CDC Split Type:

Write-up: 15 minutes after vaccine injection, my son said he was feeling bad, that he need air and water he was dizzy. He stopped talking and his mouth turned to the side. One eye was open the other was shut, he was shaking and had arm movements then he got cold and pale and his eyes were white.


VAERS ID: 1633163 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-07-30
Onset:2021-08-23
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Anticoagulant therapy, Chest pain, Human rhinovirus test positive, Hypoxia, Lung infiltration, Pneumonia, Pulmonary embolism, Rhinovirus infection, SARS-CoV-2 test negative
SMQs:, Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: asthma, obesity
Allergies: none
Diagnostic Lab Data: 8/24/2021: CT angiogram chest: +bilateral segmental pulmonary emboli COVID19 negative x 3 tests (PCR) +rhinovirus PCR - NP swab
CDC Split Type:

Write-up: Patient was hospitalized with hypoxia, chest pain 3 weeks after 1st shot of COVID19 Pfizer. Found with bilateral segmental pulmonary emboli and small infiltrates bilateral, also had +PCR for rhinovirus. Being treated for pulmonary emboli and pneumonia with anticoagulation and antibiotics Improved since anticoagulation started, unclear if this is a side effect from COVID19 vaccine, patient will be getting 2nd shot while on anticoagulation.


VAERS ID: 1633343 (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: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Chills, Feeling hot, Headache, Nausea, Neck pain, Pain, Pain in extremity, Pain in jaw, Sensitive skin
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: DAY 1 11:45 AM- vaccinated 07:42 PM- Pain to whole left arm including wrist requiring tylenol 10:58 PM- Body aches DAY 2 01:12 AM- chills, shivering, hypersensitive skin 02:18 AM- feeling hot, severe headache 05:30 AM- aching jaw and neck pain 06:45AM- whole body pain, joint pain, hypersensitivity to skin 07:45AM- nausea 99.8*F, horrible body pain 05:54PM- 99.7*F


VAERS ID: 1633353 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Virginia  
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 - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Blood test, Echocardiogram abnormal, Haematemesis, Headache, Hepatic enzyme increased, Hepatomegaly, Hyperhidrosis, Liver function test, Pyrexia
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Elevated liver numbers. Enlarged liver and throwing up blood. Sweating high fever headache severe abdominal pain


VAERS ID: 1633378 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
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 048C21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Diarrhoea, Diplopia, Dizziness, Headache, Injection site pain, Lethargy, Migraine, Musculoskeletal stiffness, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Ocular motility disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: SLE
Allergies: Penicillin, amoxicillin, avelox, ancef, codeine, oxycodone, morphine, flexeril.
Diagnostic Lab Data: None to date.
CDC Split Type:

Write-up: Right deltoid pain x4 days. Headache/migraine ongoing since 2 hours after vaccine, lethargy started day after vaccine and still continues, stiff neck with muscle and joint aches started day after vaccine and continues, nausea x4 days, diarrhea started day after vaccine and continues, NEW symptom of vertical double vision and dizziness started 3 days after vaccine and continues. Initially it was both eyes, but today is more severe in the left eye and a bit more mild in the right eye.


VAERS ID: 1633564 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Arizona  
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 FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Hypoaesthesia, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: Mother advised after her daughter received the Pfizer COVID-19 vaccine, she reported the following side effects: numbness / tingling in legs, pain in opposite arm of injection (right), and headache. Patient has been experiencing symptoms for 3 days. stated she has given patient Tylenol to help with side effects.


VAERS ID: 1633574 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Ohio  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Heart rate increased, Heart rate irregular, Influenza like illness
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiac arrhythmia terms, nonspecific (narrow), Dehydration (broad)

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

Write-up: Patient reported flu like symptoms after the vaccine but what we are noting is what happened on the night/morning of Monday 8/23. Patient had a headache and fast heartrate. She said she couldn''t calm it down and was pacing the room. Her heart was beating irradically. Today she reports it to be better.


VAERS ID: 1633578 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
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 FD8448 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mobility decreased, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: patient said she''s had rotator cuff issue in right arm in the past
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient''s shoulder swollen and hard to lift arm


VAERS ID: 1633580 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Missouri  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

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

Write-up: Nausea, vomiting, diarrhea for days


VAERS ID: 1633586 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Mississippi  
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 053E21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Localised infection, Peripheral swelling, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), 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: unknown
Current Illness: none that we know
Preexisting Conditions: unknown
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient states she has infection in her arm for which she has been prescribed antibiotics by tele doc. Patient states arm is swelled, red, and hot.


VAERS ID: 1633608 (history)  
Form: Version 2.0  
Age: 43.0  
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 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Discomfort, Fatigue, Feeling abnormal, Feeling cold, Headache, Impaired work ability, Insomnia, Irritability, Nausea, Night sweats, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Fibromyalgia
Preexisting Conditions:
Allergies: Not aware
Diagnostic Lab Data:
CDC Split Type:

Write-up: About four hours after shot, I started feeling funny. I was not able to sleep all night. During the night, I felt as if I needed to urinate. My feet and rest of body were extremely cold to touch. Later, I develop a headache and fever. It was hard to get out of bed. My body felt as if I had a boulder holding me down. Around 2:30 I decide to take 800 ml of Tylenol. When I tried to open my eyes, I could not keep them open for more that three seconds. I lost my appetite for more than 14 hours feeling nauseated. For 18 hours I was tired and irritable. For all the reasons above, I had to call in sick to work. I had night sweats two nights.


VAERS ID: 1633763 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-08-16
Onset:2021-08-23
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Hyperhidrosis, Myalgia, Pyrexia, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Fever, sweats, achy joints, achy muscles, chills. I tested multiple times to see if I have the virus, but I don''t. I still have my sense of smell too.


VAERS ID: 1633775 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site rash
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)

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

Write-up: redness, rash at injection site developed after 5 days, continues to get bigger per patient


VAERS ID: 1633973 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Georgia  
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 062E2A1 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time normal, Blood creatine phosphokinase MB normal, Blood magnesium normal, Bundle branch block left, Bundle branch block right, Chest X-ray normal, Dyspnoea, Electrocardiogram abnormal, Extrasystoles, Full blood count normal, Headache, Heart rate increased, Heart rate irregular, Laboratory test normal, Metabolic function test normal, Palpitations, Prothrombin time normal, Pyrexia, Sinus tachycardia, Troponin normal, Ventricular extrasystoles
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Supraventricular tachyarrhythmias (narrow), Ventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Tachyarrhythmia terms, nonspecific (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: Runny nose
Preexisting Conditions: None
Allergies: Iodinated contrast. latex
Diagnostic Lab Data: EKG. - Abnormal- Sinus tachycardia with frequent ectopic beats. Incomplete right bundle branch block Labs cbc, cmp, PT, PTT, Troponin, CKMB, Magnesium- all normal. Chest xray- negative EKG- abnormal- Sinus tachycardia, Ventricular premature complex LAD, consider left anterior fasicular block.
CDC Split Type:

Write-up: Upon awakening the morning after receiving the 2nd dose of Moderna Covid vaccine, I was slightly short of breath and my heart was racing. Heart rate sustained most all day between 120-130s, with increasing palpitations. (I was experiencing a headache and low grade fever also). This continued all day. Went to local Urgent Care, there were 28 patients ahead of me so I left. Went home and called cardiology office to ask for appt. Was told to go to the ER, that a heartrate that high and lasting over 20 minutes is an emergency and put me at rick for stroke. My husband drove me to the ER, where there was a 5 hour wait. I then left there and went to my PCP urgent care office. Was seen by NP. An ekg was done and I was told it was abnormal and to go back to the ER. My heartrate at that time had slowed down some- to the 110s. I returned to the ER and was seen soon after. Labs, EKG, and a chest xray was done. Labs and chest xray were all okay. EKG was abnormal so was monitored for a short while. Still having palpitations at that time but less frequently. Was told by the ER physician that the increased heartrate and irregular beats/incomplete beats/ palpitations were a reaction to the vaccine. This started at 0700am on August 23. I returned home from the ER at around 1100pm.


VAERS ID: 1634180 (history)  
Form: Version 2.0  
Age: 31.0  
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 FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest pain, Full blood count, Laboratory test, Mobility decreased, Musculoskeletal discomfort, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Plaquenil, methotrexate, leucovorin, prednisone, robaxin, baclofen
Current Illness: Lupus related
Preexisting Conditions: Lupus
Allergies: None
Diagnostic Lab Data: Laboratory blood draw at the ER, CBC
CDC Split Type:

Write-up: The patient stated that she experienced the following side effects directly after vaccination: lost of mobility in her neck, pain and loss of mobility from both shoulders down to her elbows, pain in her chest, and she stated could barely move her arm.


VAERS ID: 1634206 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Headache, Hyperhidrosis, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, multivitamin, Zinc, elderberry
Current Illness: None
Preexisting Conditions: None
Allergies: None except bee stings
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Sweats, chills, fever of 102?F, body aches, headache, joint pain, fatigue, nausea. Sweats, chills, and fever lasted 8 hours. Body aches, headaches, joint pain, and fatigue lasted for 4 days. Intermittent nausea which was most severe on first day and less severe for the preceding 3 days


VAERS ID: 1634871 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-23
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood immunoglobulin G, Blood immunoglobulin M, Therapy non-responder
SMQs:, Lack of efficacy/effect (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: Test Date: 20210823; Test Name: IgM; Result Unstructured Data: Negative; Test Date: 20210823; Test Name: IgG; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210846539

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex, unknown race, and ethnic origin. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, 1 total, administered on MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 23-AUG-2021, the patient had just come back from the doctor and the doctor had drawn the patient''s blood to see where the patient''s antibodies level was to see if the patient needed a booster. The patient''s IgG (Immunoglobulin G), and IgM (Immunoglobulin M) were both negative. When the patient told the doctor that the patient received the Johnson and Johnson vaccine, the doctor said that he was prohibited from giving the patient a booster and that they had to wait to see what the CDC (Centers for Disease Control and Prevention) said. The patient asked about getting another brand of vaccine and the doctor said said that he would have done it, but he needed orders from a Johnson and Johnson doctor sent to him. The patient did not know how to get that. The patient stated that he was walking around without any immunity and he was told that the protection would last 8 months. The patient was planning to get a vaccine in November again, but without any antibodies, the patient felt that he needed a vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint number: 90000190615.; Sender''s Comments: V0: 20210846539-COVID-19 VACCINE AD26.COV2.S-confirmed immunological vaccine failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1634887 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-08-23
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dysphonia, Headache, Nasal congestion, Pain, Pain in extremity
SMQs:, Parkinson-like events (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210849030

Write-up: VOICE SOUNDS LIKE A FROG; STUFFED UP IN NOSE AREA; BODY ACHES FROM HEAD TO TOE; CHILLS; HEADACHE; SORENESS IN ARM; This spontaneous report received from a patient concerned a 58 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204B21A, and expiry: UNKNOWN) dose was not reported, administered on 23-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 23-AUG-2021, the patient experienced soreness in arm. On 24-AUG-2021, the patient experienced voice sounds like a frog. On 24-AUG-2021, the patient experienced stuffed up in nose area. On 24-AUG-2021, the patient experienced body aches from head to toe. On 24-AUG-2021, the patient experienced chills. On 24-AUG-2021, the patient experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from soreness in arm, was recovering from chills, and had not recovered from body aches from head to toe, stuffed up in nose area, voice sounds like a frog, and headache. This report was non-serious.


VAERS ID: 1636138 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-23
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 test, Suspected COVID-19, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210823; Test Name: COVID-19 virus test; Result Unstructured Data: positive
CDC Split Type: USJNJFOC20210846305

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height and weight were not reported. No past medical history or concurrent conditions were reported. The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029 and expiry: unknown) dose was not reported, 1 total administered on 12-MAR-2021 to right deltoid for prophylactic vaccination. No concomitant medications were reported. On 23-AUG-2021 the patient had suspected clinical vaccination failure and suspected covid-19 infection. The patient underwent laboratory test included: COVID-19 virus test with result positive The action taken with Covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the suspected clinical vaccination failure and suspected covid-19 infection was not reported. This report was serious (Other Medically Important Condition). This report was associated with a product quality complaint: 90000190583.; Sender''s Comments: V0: 20210846305 -Covid-19 vaccine ad26.cov2.s-Suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1636143 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-08-23
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 310017 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 test, Suspected COVID-19, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (beer 2 weeks then he wont drink for 5 to 6 months); Cigarette smoker (10 cigarettes per day); Cocaine abuse (Uses cocaine occasionally but its not an addiction); Hypertension
Preexisting Conditions: Medical History/Concurrent Conditions: Automobile accident (Was in a previous car accident 26-FEb-2020 which he now gets therapy); Comments: The patient had no known drug allergies.
Allergies:
Diagnostic Lab Data: Test Date: 20210823; Test Name: COVID-19 virus test; Result Unstructured Data: positive.
CDC Split Type: USJNJFOC20210849124

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient concerned a 46 year old Hispanic or Latino male. The patient''s height, and weight were not reported. The patient''s past medical history included: was in previous car accident on 26-FEB-2020 which he now gets therapy for, and concurrent conditions included: hypertension, cocaine abuse (uses occasionally but its not an addiction), alcohol user (beer 2 weeks then he wont drink for 5 to 6 months), and cigarette smoker (10 cigarettes per day), and other pre-existing medical conditions included: The patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 310017, and expiry: UNKNOWN) dose was not reported, 1 total, administered on left arm on 12-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 23-AUG-2021, the patient had an appointment at the hospital because of previous car accident and did Covid test which came out positive (suspected covid-19 infection and suspected clinical vaccination failure). The reporter only notified the doctor where he goes and gets his therapy. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from suspected covid-19 infection, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0.20210849124-covid-19 vaccine ad26.cov2.s -suspected clinical vaccination failure . This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1636190 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Dizziness, Dysphagia, Dyspnoea, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), 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), 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 500 mg Tylenol, 400 mg ibuprofen, prenatal vitamin
Current Illness:
Preexisting Conditions:
Allergies: Sulfa, latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 15 minutes post injection, difficulty swallowing, throat swelling, lightheadness, weak. Took 50 mg of Benadryl, contacted the nurse for assistance. Was given nebulizer treatment of albuterol and Ipratropium. NP stated my throat was swollen and difficulty passing air in right lower lung base. Vitals stable. Sent to ED for evaluation. 5 days of prednisone, every 8 hour dose of 25 mg Benadryl, and emergency inhaler if needed.


VAERS ID: 1636401 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-06
Onset:2021-08-23
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: quadricuspid aortic valve
Allergies: sulfa drugs
Diagnostic Lab Data: August 24 - in-person observation by Plastic Surgeon - felt for fluid under skin (no sign of infection of implant found)
CDC Split Type:

Write-up: August 15 - large red patch on left arm at injection site (9 days after vaccine) went away within 48 hours August 23 - large red circular patch on upper right breast (17 days after vaccine) went away within 48 hours - this is the symptom I am concerned about. I had a breast aug in March 2020 and when this spot appeared I thought that there could be an infection in the implant (even though that would be very rare) - The surgeon saw photos and wanted to see me immediately to rule out infection. He was not able to figure out why I had this rash/inflammation. Very similar to the one I had on my arm the week before, but I can''t find any research on anyone facing similar symptoms.


VAERS ID: 1636422 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Patient stated feeling dizzy, diaphoretic and weak post vaccination.


VAERS ID: 1636426 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Migraine
SMQs:

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: migraines, asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: caused recurrent migraine. more severe than typical


VAERS ID: 1636429 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-07
Onset:2021-08-23
   Days after vaccination:77
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Positive test for Covid 19


VAERS ID: 1636431 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-23
Onset:2021-08-23
   Days after vaccination:122
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Blood test, Chills, Diarrhoea, Fatigue, Gingival swelling, Headache, Joint swelling, Lymphadenopathy, Migraine, Muscle spasms, Muscle twitching, Myalgia, Pain, Paraesthesia, Paraesthesia oral, Peripheral swelling, Pyrexia, Sleep disorder, Urticaria, Vertigo, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dyskinesia (broad), Dystonia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Birth control - norethindrone acet/eth 1/20 B12 and D3
Current Illness: None
Preexisting Conditions: Hemochromatosis
Allergies: Penicillin, erythromycin, sulfa drugs, cipro, Paxil, lexapro, Zoloft, Effexor. Food - kiwi, steak sauce, cocktail sauce, Intolerances to beef and bacon
Diagnostic Lab Data: Blood tests
CDC Split Type:

Write-up: Extreme fatigue for 15 weeks The first 6 days I had vomiting and diarrhea. The first 4 days I had severe muscle and joint pain. And muscle cramping. Diarrhea started 4/23 and lasted until 8/14 On 5/3 my hands , feet and lips started to tingle and were kind of numb. That lasted u til 5/20. On 5/5 my gums swelled, worse on the left side. It was very painful to eat. This will last for about 4 days then go away. Continued issues with this as 8/26. On 5/9 severe vertigo. Vertigo continues as of 8/26. Have been seeing a physical therapist. It?s currently mild. On 5/19 Lymph nodes on the left side of body swelled to golf ball size. After 3 weeks they shrunk to about pea size. Today, 8/26, they will shrink and then swell to pea size randomly. 6/3 broke out in hives just on arms and hands. Spiked a fever of 100 that lasted for about 3 days. 6/3 severe chills at night. I have uncontrollable shivering and teeth chattering. This continues to happen at least once a week. Keeps me awake because I can?t get warm. No fever with chills. 6/6 left side of my face has uncontrollable muscle twitches. This continues today, 8/26 6/11 hands, feet and ankles swelled to twice their size and was painful to walk. Last about 12 hours 8/6 headache came on and has Remained Ocular migraines since 5/17


VAERS ID: 1636447 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-11
Onset:2021-08-23
   Days after vaccination:193
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / 1 UN / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044A21A / UNK UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cough, Nausea, Oropharyngeal pain, Pyrexia, Respiratory tract congestion
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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Eliquis, Tylenol arthritis tablet, penicillin G potassium, Nplate
Current Illness:
Preexisting Conditions: Chronic ITP (idiopathic thrombocytopenia) Thyroid Disease
Allergies: penicillins (Hives) Nitro-Dur (Rash) ampicillin (Hives, Rash)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nausea, sore throat, congestion, nonproductive cough, fever


VAERS ID: 1636468 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-08-16
Onset:2021-08-23
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, 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? 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: 1 Week after the shot patient started to have erythema (red and warm) at the injection site. This continued for a few days which alarmed patient who then called the pharmacy to report adverse event.


VAERS ID: 1636550 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Decreased appetite, Dehydration, Full blood count, Headache, Myalgia, Nausea, Productive cough
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Dehydration (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: None.
Current Illness: Covid in mid November of 2020.
Preexisting Conditions: Long standing cardiomyopathy, hypothyroidism.
Allergies: None.
Diagnostic Lab Data: CBC
CDC Split Type:

Write-up: Chills, shivers, severe headache, nausea, muscle aches, phlegm in throat, weak, no appetite, was put on IV for nausea and was given fluids for dehydration, prescribed toradol,


VAERS ID: 1636558 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-06-17
Onset:2021-08-23
   Days after vaccination:67
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Haematochezia, Rectal haemorrhage, SARS-CoV-2 test positive
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Patient presented to the ED for evaluation of bright red blood per rectum on 8/19/2021. He has had intermittent bright red blood in stools since July. Tested positive for COVID on 8/23/2021.


VAERS ID: 1636578 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-25
Onset:2021-08-23
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 8/25/21 COVID/SARS2, Naat, Positive
CDC Split Type:

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


VAERS ID: 1636653 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: U07.1 - COVID-19 virus infection


VAERS ID: 1636664 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Dizziness, Headache, Hypoaesthesia, Paraesthesia, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Possibly B12 2020, Tetanus 2021 unknown brands
Other Medications: Estradiol
Current Illness: None
Preexisting Conditions:
Allergies: Codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe headache, Tingling numbness in arms hands and feet, swelling of the face around eyes, dizzy and confused.


VAERS ID: 1636689 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site rash, Pyrexia
SMQs:, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT REPORTED RASH AT INJECTION SITE 8/25/21. PATIENT REPORT LOW GRADE FEVER 8/24/21 ONLY. NO ITCHING OR SPREADING.


VAERS ID: 1636697 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-10
Onset:2021-08-23
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cardiac arrest, Resuscitation, SARS-CoV-2 test positive
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TRAZODONE, LISINOPRIL, LEVOTHYROXINE, ATORVASTATIN, ASPIRIN
Current Illness:
Preexisting Conditions: Hypercholesterolemia Hypertension
Allergies: PENICILLIN, SINGULAIR, SULFA DRUGS
Diagnostic Lab Data: POSITIVE COVID TEST 08/18/2021 @ 1928
CDC Split Type:

Write-up: cardiac arrest - cpr in progress. COVID POSITIVE


VAERS ID: 1636736 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-21
Onset:2021-08-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Extra dose administered, Headache, Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth, Interchange of vaccine products, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Third shot was Moderna. First two were Pfizer, last pfizer injection was given in January 2021. No side effects to first two. Third moderna shot had 48 hours of fever, chills, severe headache. 1.5 to two days later developed ''covid arm'': swollen, hot, red, mildly itchy 6 inch area around injection site. Improving on and off with otc cortizone cream with symptoms currently milder but continuing.


VAERS ID: 1636740 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-03
Onset:2021-08-23
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen 1,000mg q4hrs as needed famotidine 20mg BID for Hives or reflux Ibuprofen 400mg q6hrs as needed levonorgestrel 52mg Intrauteral
Current Illness: None Documented
Preexisting Conditions: Smoker Depression Anxiety HPV
Allergies: Ampicillin - Hives Lyrica - Hives Morphine - Hives
Diagnostic Lab Data:
CDC Split Type:

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


VAERS ID: 1636754 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bruxism, Dizziness, Flushing, Hyperhidrosis, Malaise, Memory impairment, Muscle spasms, Respiration abnormal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypersensitivity (broad), Respiratory failure (broad), Hypoglycaemia (broad)

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

Write-up: I was rubbing my injection site and I started getting very flush and felt like I might faint. I told my husband I didn''t feel well and then I started to cramp up and breathe weird (at this point I don''t remember anything). My husband said I had my hands cramped up and I was breathing through my teeth like my jaw was clenthed. Then he said I quit breathing and so he stood me up and screamed at me. I then felt like I came to (like I was just coming back from fainting) and was drenched in sweat. I layed down and slowly started to feel better.


VAERS ID: 1636784 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939901 / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Extra dose administered, Pollakiuria, Pyrexia, Urinary tract infection
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: moderna 2nd vaccine had fever 2/17/2021
Other Medications: vitamin b complex b3 and iron
Current Illness: standard medical conditions that go with autism
Preexisting Conditions: autism
Allergies: sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Weakness, Excessive urination ,Dizziness, developed chills and fever also UTI .


VAERS ID: 1636811 (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: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

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

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

Write-up: Feeling of being poked, similar to a needle or several splinters. First day was only in arms. Second, third and fourth day is moved to abdomen but mainly in lower body. Symptoms worse at night and with touch of clothes or blanket.


VAERS ID: 1636818 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Pt had not previous reported symptoms with dose 1. Patient fainted after receiving dose 2. Feet elevated bed and some juice and water offer. Patient verbalized was fine and no report any dizziness. Patient was directed to observation area to complete monitoring time by a nurse. Patient left in stable condition


VAERS ID: 1636934 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-21
Onset:2021-08-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram head, Dizziness, Dysarthria, Electrocardiogram, Extra dose administered, Headache, Interchange of vaccine products, Magnetic resonance imaging head, Transient ischaemic attack, Ultrasound Doppler, Vertebrobasilar insufficiency
SMQs:, Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Medication errors (narrow), 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? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril 10mg QD, bupropion 150mg QD, quetiapine 150mg, estrogen hormone replacement daily, fluconazole 150mg weekly
Current Illness: none
Preexisting Conditions: hypertension, depression, recurrent vaginal yeast infections
Allergies: iodine medium contrast
Diagnostic Lab Data: CT head 8/24; MRI brain 8/25; carotid ultrasound doppler 8/25; EKG 8/24
CDC Split Type:

Write-up: Patient had received 2 doses of vaccine in home country in Spring 2021. On a visit in August 2021, received a Pfizer booster on 8/21. Felt well for about 60 hours, travelled back to home country. The evening (local time) of 8/23, patient developed some dizziness. The next morning 8/24, noted worsening dizziness, headache, dysarthria. Presented to ED and was admitted to the hospital. Diagnosed with Transient Ischemic Attack of posterior circulation. Discharged from hospital after 24h admission to stroke ward.


VAERS ID: 1636948 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 presented to facility today for her appointment and noted that she received her booster shot at location on Monday. She presented today with significant swelling, redness, and heat at the site of injection. She denies pain in the area and can palpate it without discomfort. She did note that it occasionally feels itchy.


VAERS ID: 1637019 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-07
Onset:2021-08-23
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vertigo
SMQs:, Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3, prenatal gummies for lactation, sunflower lecithin
Current Illness: Mastitis in July
Preexisting Conditions: PAI 1 insufficiency
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vertigo starting on day 14 after 1st injection


VAERS ID: 1637031 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-04
Onset:2021-08-23
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Tested positive for COVID19 on 8/23/2021


VAERS ID: 1637054 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-23
Onset:2021-08-23
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 - / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 - / SYR

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

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

Write-up: COVID +


VAERS ID: 1637091 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-01
Onset:2021-08-23
   Days after vaccination:53
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster, Skin abrasion
SMQs:, Accidents and injuries (broad), Opportunistic infections (broad)

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

Write-up: Herpes zoster without complication. Treated with valacyclovir 1000 mg TID for 7 days. Due to excoriations over affected areas, patient also treated with keflex 500 mg 4x daily for 7 days.


VAERS ID: 1637121 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-17
Onset:2021-08-23
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Fasciotomy, Peripheral ischaemia, Thromboembolectomy
SMQs:, Embolic and thrombotic events, arterial (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Acute limb ischemia of right leg required an open thromboembolectomy of right common femoral, SFA and profunda artery and a right lower extremity 4-compartment fasciotomy


VAERS ID: 1637130 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nursing staff alert us for a patient with a tachycardia Upon arrival patient is alert, conscious and oriented. She reports having an episode of tachycardia and feeling anxious. She is kept under observation. Patient reports improvement with symptoms and leaves the center.


VAERS ID: 1637279 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / -

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: over 42 days 1st dose 04/14/21, 2nd dose 08/23/21


VAERS ID: 1637307 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling cold, Headache, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: thyroxine,Keytruda,lanoprost,trazodone,zolpidem
Current Illness: diverticulitis, lung cancer
Preexisting Conditions: lung cancer
Allergies: codeine, conch
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe rash, fever, chills, headache lasting about 5 days (not yet over it) Treated with prednisone


VAERS ID: 1637349 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-19
Onset:2021-08-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood count abnormal, Blood test abnormal, Heavy menstrual bleeding, Menstruation irregular, Thrombosis, Vaginal haemorrhage
SMQs:, Haematopoietic leukopenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: I got a blood test done. My blood count is low. So far we haven?t ran all the test we need yet to figure out this issue.
CDC Split Type:

Write-up: On 07/19/2021 I got my first covid vaccine. That same day started my period, I always have regular menstrual cycles so on the fourth or fifth day I am only spotting then it?s gone, this time around unseats of only spotting began to have huge amounts of blood clots coming out of me, so far it?s been 3 days of these huge blood clots and hemorrhaging. I?ve never experienced this in my life. I went to see my doctor and he doesn?t know what to say or what to do, I call my obgyn she didn?t want to see me until I repetitively called over over finally I can see her tomorrow. I went to the ER they don?t know what to do. No one is helping me so far.


VAERS ID: 1637377 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F C3182 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blister, Chest pain, Headache, Pain, Pyrexia, Throat irritation
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Nurse hit ulnar nerve and caused inflammation to my shoulder, neck and vocal cords. Was approximately 5 years ago in my place o
Other Medications: Vitamin c, zinc, quercetin, garlic, turmeric, vitamin b complex, fish oil
Current Illness: NA
Preexisting Conditions: I have psoriasis on each elbow. I do not have it any where else on my body
Allergies: Penicillin
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Chest pain within 1 hour. Took acetaminophen. Pain was gone in 30 minutes. Headache, body aches ,throwing up and fever of 100.3 within 12 hours that lasted for 24 hours. Two blisters have shown up on my right arm now. It''s been 72 hours since my shot. One the size of a nickel and the other a dime .


VAERS ID: 1637815 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Dizziness, Dysstasia
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad)

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

Write-up: PATIENT FELT FAINT AND DIZZY AND NEEDED ASSISTANCE TO STAY UPRIGHT. STATED THAT IT ALWAYS HAPPENS WHEN THEY GET A VACCINE


VAERS ID: 1637834 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site mass, Injection site pain, Injection site pruritus, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (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: VYVANSE, ADDERALL, UBRELVY, ESTRADIOL, PROGESTERONE, FOLIC ACID, VITAMIN D
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: SULFA DRUGS
Diagnostic Lab Data:
CDC Split Type:

Write-up: PER PATIENT HER LEFT ARM DEVELOPED A RED CIRCULAR AREA AROUND THE SITE OF INJECTION THAT BECAME INCREASINGLY LARGE AND LESS CIRCULAR. IT IS WARM TO THE TOUCH AND SEEMS TO BE A "POCKET UNDER THE SKIN". PATIENT REPORTS THE AREA ITCHES/BURNS/HURTS. IT SEEMED TO BE A SOLID MASS AT FIRST BUT NOW IS MORE PLIABLE.


VAERS ID: 1638430 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Dizziness, Headache, Pain in extremity, Vertigo
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine 100
Current Illness:
Preexisting Conditions: Hypothyroiditis
Allergies: Bactrim
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore arm Dizziness Vertigo Headache Upset stomach


VAERS ID: 1638416 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Guam  
Vaccinated:0000-00-00
Onset:2021-08-23
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Body temperature, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LANTUS SOLOSTAR; HUMALOG
Current Illness: Abstains from alcohol; Non-smoker; Type 1 diabetes mellitus (patient uses sliding scale to adjust insulin doses)
Preexisting Conditions: Comments: Patient had no known allergies.
Allergies:
Diagnostic Lab Data: Test Date: 20210823; Test Name: Body temperature; Result Unstructured Data: 101.8 F; Test Date: 20210823; Test Name: Body temperature; Result Unstructured Data: 101.2 F; Test Date: 20210823; Test Name: Body temperature; Result Unstructured Data: 102.4 F
CDC Split Type: GUJNJFOC20210850237

Write-up: FEVER; This spontaneous report received from a consumer concerned a 27 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: type 1 diabetes, non-smoker, and non alcohol user, and other pre-existing medical conditions included: Patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1816022, expiry: 29-SEP-2021) dose was not reported, administered on 23-AUG-2021 for prophylactic vaccination. Concomitant medications included insulin glargine for type 1 diabetes, and insulin lispro for type 1 diabetes. On 23-AUG-2021, the patient experienced fever. Laboratory data included: Body temperature (NR: not provided) 101.8 F, 102.4 F, 101.2 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever. This report was non-serious.


VAERS ID: 1638417 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Guam  
Vaccinated:0000-00-00
Onset:2021-08-23
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Body temperature, Feeling cold, Pain in extremity, Pollakiuria, Pyrexia, Thirst
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Patient did not have any significant medical history.
Allergies:
Diagnostic Lab Data: Test Date: 20210823; Test Name: Body temperature; Result Unstructured Data: 100.8 F
CDC Split Type: GUJNJFOC20210852018

Write-up: INCREASED THIRST; MORE FREQUENT URINATION; SHARP SHOOTING RIGHT LEG PAIN; FEELING COLD; FEVER 100.8F; This spontaneous report received from a consumer concerned a 39 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: Patient did not have any significant medical history. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 1816022 expiry: 29-SEP-2021) dose was not reported, administered on 23-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 23-AUG-2021, the patient experienced increased thirst. On 23-AUG-2021, the patient experienced more frequent urination. On 23-AUG-2021, the patient experienced sharp shooting right leg pain. On 23-AUG-2021, the patient experienced feeling cold. On 23-AUG-2021, the patient experienced fever 100.8f. Laboratory data included: Body temperature (NR: not provided) 100.8 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever 100.8f, sharp shooting right leg pain, feeling cold, increased thirst, and more frequent urination. This report was non-serious.


VAERS ID: 1638912 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-23
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Dyspnoea, Injection site pain, Insomnia, Panic reaction, Paraesthesia, Pyrexia, Restlessness
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (less than once per month); Asthma (patient had short acting inhaler, Diskus inhaler (name unknown) and Foracort for relief); Non-smoker; Seasonal allergy (triggered inhaled use)
Preexisting Conditions: Medical History/Concurrent Conditions: Sleep disorder; Comments: The patient did not have history of drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 20210824; Test Name: Body temperature; Result Unstructured Data: 99.2 F
CDC Split Type: USJNJFOC20210849801

Write-up: FEVER OF 99.2 F; BREATHLESSNESS; COULD NOT SLEEP; FELT PANIC; FELT RESTLESS; TINGLING SENSATION ALL OVER BODY; LEFT ARM PAIN AT THE SITE OF INJECTION; This spontaneous report received from a pharmacist concerned a 49 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included: sleep disorder, and concurrent conditions included: asthma, seasonal allergy, alcohol use, and non smoker, and other pre-existing medical conditions included: The patient did not have history of drug abuse or illicit drug usage. The patient was previously treated with diphenhydramine hydrochloride/paracetamol for sleep. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, expiry: 21-SEP-2021) dose was not reported, administered on 23-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On AUG-2021, treatment medications included: budesonide/formoterol fumarate. On 23-AUG-2021, the patient experienced breathlessness. On 23-AUG-2021, the patient experienced could not sleep. On 23-AUG-2021, the patient experienced felt panic. On 23-AUG-2021, the patient experienced felt restless. On 23-AUG-2021, the patient experienced tingling sensation all over body. On 23-AUG-2021, the patient experienced left arm pain at the site of injection. On 24-AUG-2021, the patient experienced fever of 99.2 f. Laboratory data included: Body temperature (NR: not provided) 99.2 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from tingling sensation all over body, fever of 99.2 F, and left arm pain at the site of injection, and the outcome of could not sleep, felt panic, breathlessness and felt restless was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure since case was assessed as non serious


VAERS ID: 1640728 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Chest pain, Condition aggravated, Crohn's disease, Diarrhoea, Dyspnoea, Grip strength decreased, Joint swelling, Palpitations
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal premalignant disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Crohn?s disease- remission. Had colonoscopy July 2021 (1 month prior) and there was no evidence of Crohn?s
Allergies: Humira
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received the vaccine around 9am. Chest pain/palpitations started around 12pm, lasting about an hour. Tuesday, August 24, 2021, chest pain on and off all day, stomach pains. Wednesday , August 25, 2021, Crohn?s disease (that was in remission) starting flaring up. Stomach pains, joint pains. Wednesday, August 25, 2021, could barely grip a shopping cart from joint swelling/pain, diarrhea, chest pain. SOB Thursday, August 26, 2021, more diarrhea, joint pain/swelling, chest pains on and off all day , Shortness of breath (SOB) on and off all day. Friday, August 27, 2021 (today), joint swelling/pain, stomach pain, chest pain (5am), SOB


VAERS ID: 1640989 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Incorrect dose administered, No adverse event, Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Patient administered undiluted Pfizer vaccine. Patient has not endorsed any adverse effects from receiving undiluted dose.


VAERS ID: 1640991 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A/09-21-2 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electrocardiogram, Heart rate increased
SMQs:, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl Breo Allegra Montelukast Escitalopram Vitamin D Tagamet
Current Illness:
Preexisting Conditions: asthma nasal polyps
Allergies: NSAIDs shellfish alliums (garlic, onion) mango nitrile gloves (the accelerant used to blow them off the molds, inside the gloves) bandage tape cumin mint (very mild) trees mold
Diagnostic Lab Data: 8/25/21 - ECG, nothing found
CDC Split Type:

Write-up: Heart rate spiked approximately 30+ bpm consistently for any movement, and 15 bpm at rest, per data. (It may not be as accurate as medical testing, but is sufficient to show changes within its own data-set, which go back several years.) Heart rate would spike to 150 gently walking up a flight of steps. Drinking a soda also spiked my heart rate for 5-6 hours, which is abnormal. (On the plus side, I now know how long before bedtime to avoid caffeine, since it apparently processes out of my system in 5-6 hours.) Over four days, gradual improvement back to normal. However, for the first two days, I couldn''t do anything more than lay down and avoid anything even slightly stressful to avoid a dangerously high heart rate. The simple act of standing took it up 15 points, to the area it would normally have been if I was running up and down the steps with full baskets of laundry. Shot was Sunday afternoon, reaction started shortly after midnight on Monday. I was woken up by my cardiac response, so this wasn''t anxiety-induced. I also wasn''t particularly worried about the shot so, again, not anxiety-induced. And I was doing slow breathing and such to calm my heart rate, so not anxiety-induced. At about 3 am on Tuesday morning, I was laying down and my heart rate abruptly jumped 15 points out of nowhere, which was the final straw and I went to the ER. Of course, it was the final straw - my heart rate had started normalizing, so they found nothing on the ECG. The next day, my heart rate was nearing normal. The day after (Thursday), it was seemingly completely back to normal. However, if I had been TOLD that an extreme racing heart was a potential side effect and should normalize within 3-4 days, rest if it happened and see a cardiologist if it doesn''t normalize within four days, take these precautions if it exceeds XXXX bpm, visit the ER if YYYYY happens, I would have been spared an ER visit.


VAERS ID: 1640995 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-06
Onset:2021-08-23
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 1 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Aplasia, Aspiration bone marrow abnormal, Biopsy bone marrow abnormal, Haemoglobin decreased, Pancytopenia, Platelet count decreased, White blood cell count decreased
SMQs:, Agranulocytosis (narrow), Haematopoietic cytopenias affecting more than one type of blood cell (narrow), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Congenital, familial and genetic disorders (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Malignant lymphomas (broad), Myelodysplastic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multivitamin, vitamin b12 Diamond, Norvasc, Xanax, Astelin, Jardiance, Flonase, Xalatan, metformin, metoprolol, Prilosec, Crestor, Effexor
Current Illness: None
Preexisting Conditions: Essential hypertension, DM2, GERD, Chronic kidney disease, anxiety, b12 deficiency, PVCs, osteopenia, panic disorder, allergic rhinitis, hyperlipidemia
Allergies: Codeine, Lipitor, lexapro, lisinopril, losartan, sertraline, meperidine
Diagnostic Lab Data: Bone marrow aspiration and biopsy 8/25/21 revealed aplastia.
CDC Split Type:

Write-up: Patient presented with profound pancytopenia on 8/23/2021 WBC 1000 Hgb 4g/do Plt 2000


VAERS ID: 1641102 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-21
Onset:2021-08-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dehydration, Pain, Tonsil cancer
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Oropharyngeal neoplasms (narrow), Non-haematological malignant tumours (narrow), Dehydration (narrow)

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

Write-up: Patient with new diagnosis SCC of right tonsil, presenting to emergency center 2 days following vaccination for dehydration and uncontrolled pain. Recent radiation to neck. Patient discharged from emergency center.


VAERS ID: 1641154 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Rash pruritic, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (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: with first pfizer covid vaccine. employee thought it was poison ivy but symptoms came back immediately after shot.
Other Medications: unknown
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 5 days later itchy , burning rash developed. persisted . facial swelling . swelling persited for 2-3 weeks treated succesfully with steroids.


VAERS ID: 1641175 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-21
Onset:2021-08-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Chest pain, Echocardiogram normal, Electrocardiogram ST segment elevation, Myocarditis, Sinus tachycardia, Troponin increased
SMQs:, Myocardial infarction (narrow), Supraventricular tachyarrhythmias (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: lansoprazole
Current Illness: None
Preexisting Conditions: Asthma, but no medications in the last 1.5 years and a history of GI ulcer that was treated.
Allergies: None
Diagnostic Lab Data: Troponin 8/24 0618am : 0.77, 10:46am:2.09, 9:11pm: 4 8/25 554am: 7.93 8/26 739am: 4.01
CDC Split Type:

Write-up: Presented to the ED due to midsternal dull ache in his chest. Two days prior, he had received his second Covid-19 vaccine dose. EKG was done which showed sinus tachycardia without ST elevation. Troponin was found to be elevated. Was given motrin, which improved chest pain. Consulted cardiology who recommended admission to hospital. Believed to be myocarditis secondary to covid vaccine. Upon admission, began trending troponin and obtained echo. Echo was read as normal. Troponin began doubling with each check, prompting a consult to cardiology. Cardiology recommended moving to once daily troponin checks, repeat EKG, and beginning aspirin. Repeat EKG was significant for ST elevation. GI was consulted for stress ulcer prophylaxis due to aspirin and recommended beginning protonix, and discontinuing prevacid. Another repeat EKG was ordered which was significant for ST elevation similar to last EKG. When troponin began downtrending, patient was assessed for discharge and discharged yesterday 8/26/2021.


VAERS ID: 1641204 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Unknown  
Location: Puerto Rico  
Vaccinated:2021-07-27
Onset:2021-08-23
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA KM9090 / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anal dilatation, Defaecation disorder
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Enlarged anus, can''t hold poop


VAERS ID: 1641247 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-14
Onset:2021-08-23
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pruritus, Injection site rash, Injection site reaction, Injection site warmth, Sensitive skin, Skin tightness
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 1000mg fish oil Zyrtec Melatonin 10mg
Current Illness: None
Preexisting Conditions: High cholesterol managed with Zetia High blood pressure managed through lisinopril
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itchy near injection site. Mild fever at site. Skin tight at site and mild rash is developing. Does not hurt but is sensitive. Treated site with cortisone 10 OTC.


VAERS ID: 1641270 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-23
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Nausea, Pyrexia
SMQs:, Anaphylactic reaction (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: Covid test-positive.
CDC Split Type:

Write-up: Pt came to ER c/o nausea, fever, cough, fever started on 8/18/21.


VAERS ID: 1641276 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-19
Onset:2021-08-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest pain, Headache, Heart rate increased, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Pt came to ER c/o headache, sore throat, fever, elevated HR, and chest pain. Symptoms started same day.


VAERS ID: 1641306 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-16
Onset:2021-08-23
   Days after vaccination:99
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Anxiety, kidney stone, migraine.
Allergies: Morphine
Diagnostic Lab Data: Covid test-positive and chest xray.
CDC Split Type:

Write-up: Pt came to ER with cough and exposure to covind 19. Onset 1 day ago.


VAERS ID: 1641320 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-23
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: DM, HTN, Ovarian CA, seizure.
Allergies: Lisinopril, dilaudid, dilantin, PCN.
Diagnostic Lab Data: Covid test-positive.
CDC Split Type:

Write-up: Pt came to ER, said she received first Moderna dose on 8/13/21 and she is not feeling well, head congestion, body aches.


VAERS ID: 1641329 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-23
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray, Diarrhoea, Malaise, SARS-CoV-2 test positive
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Pt came to ER stated he had all the covid symptoms including diarrhea. Stated he recieved his 1st moderna dose on 8/13/21.


VAERS ID: 1641366 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-08
Onset:2021-08-23
   Days after vaccination:137
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 AR / SYR

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

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

Write-up: POSITIVE COVID


VAERS ID: 1641370 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Injection site bruising, Injection site erythema, Injection site swelling, Lymphadenopathy, Pain, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), 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? 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 red, swollen, and bruised at site of injection. Thursday, four days after the vaccination, the swelling in the left arm was still actively increasing despite frequent ibuprofen and ice application. Patient reported constant pain. The patient also had significant axillary lymph node swelling on the left side.


VAERS ID: 1641380 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-14
Onset:2021-08-23
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Afib, HTN, Thyroid disease.
Allergies: Amoxicillin
Diagnostic Lab Data: Covid test-positive.
CDC Split Type:

Write-up: Pt called to return to hospital for covid testing as her husband tested positive. Dry cough and nasal congestion.


VAERS ID: 1641428 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-07-28
Onset:2021-08-23
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7454 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amenorrhoea
SMQs:, Fertility 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: Congenital Heart block
Allergies: clindamycin, bananas
Diagnostic Lab Data: none
CDC Split Type:

Write-up: has not had her menstrual cycle since getting the vaccine. She was due before her initial vaccine meanig she would have been late, however it never came on and it has been 2 months now.


VAERS ID: 1641458 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Hyperhidrosis, Pallor, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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: Minocycline 100mg capsules, Depo Provera IM injection. Cindagel topcial ,
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient was hot, sweaty and shaky. Her face was extremely pale. I had her lay down on the ground with an ice pack and some gatorade.


VAERS ID: 1641472 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-19
Onset:2021-08-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dysgeusia
SMQs:, Taste and smell disorders (narrow)

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

Write-up: Metallic Taste Mouth


VAERS ID: 1641632 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Presyncope
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No known medications
Current Illness:
Preexisting Conditions: PMH significant for Gallbladder Surgery in 2012 and a positive PPD s/p treatment in 2015.
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: "10mins post vaccination, pt c/o dizziness and the pt had a near syncopal event. Vitals: BP 92/66, HR 63, RR 16, SpO2 96% -- $g 145/65, 73, 16, 99% -- $g 110/72, 80, 16, 100%. Pt stable and released from vaccination site. No known allergies or medications. PMH significant for Gallbladder Surgery in 2012 and a positive PPD s/p treatment in 2015. More recent PMH unavailable to this writer."


VAERS ID: 1641672 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site pruritus, Injection site reaction, Injection site warmth, 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: Took Cimzia injections on July 30, 2021
Current Illness: none
Preexisting Conditions: rheumatoid arthritis Sjogren''s disease
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Large red rash at injection site but more prominently at underside of injected arm ; goes to crux of elbow- 6 or 7 inches long; gets quite hot and very itchy. Started August 23 and is still present August 27th.


VAERS ID: 1641776 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cellulitis, Injection site bruising, Injection site erythema, Injection site pain, Injection site vesicles, Injection site warmth
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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Spirinolactone 50mg, OCP
Current Illness: none
Preexisting Conditions: PCOS, Von Willebrand Disease
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Large area of redness, warmth, bruising, and centralized blistering, pain to area, which is worsening. Treated with cephalexin for cellulitis.


VAERS ID: 1641788 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-07-23
Onset:2021-08-23
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Flushing, Lymph node pain, Lymphadenopathy, Pharyngeal paraesthesia, Pharyngeal swelling, Stomatitis, Swollen tongue
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre 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: Drospirenone
Current Illness: none
Preexisting Conditions: none
Allergies: Augmentin,shellfish,minocycline
Diagnostic Lab Data: None, instruction was given over the phone as listed above
CDC Split Type:

Write-up: immediately after vaccine experienced throat tingling,tongue felt swollen,flushed face. approximately a week later had swollen lymph nodes of neck, upper chest and soreness,of the lymph nodes at that time Winthrop Pediatrics was notified, and recommendations for ibuprofen were given.Then a few days later I had mouth sores, my throat was still thick feeling and sore, and still had swollen lymph nodes. These symptoms were reported by my mother to Winthrop Pediatrics. I was instructed to rinse with salt and water for the sore throat. At this date I am still experiencing swollen lymph nodes but less swollen, other symptoms are gone.


VAERS ID: 1641794 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Pt has a hx of allergy to Amoxicillin.
Diagnostic Lab Data:
CDC Split Type:

Write-up: "Pt has a hx of allergy to Amoxicillin. No other known PMH. 19mins post vaccination, pt c/o itchy throat w/ no difficulty breathing. Vitals: @17:25 BP 179/99, HR 79, RR 20 -- $g @118/80, HR 68, RR 18. Pt stable and released from vaccination clinic."


VAERS ID: 1641809 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-21
Onset:2021-08-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 noticed a rash on her torso (mainly her back) and arms that appeared the Monday following her shot. She said on Thursday and today (Friday) it is on her face and fingers. She has not seen a doctor. She is going to take Benadryl and will follow up with us on how she is doing. She knows if there is any swelling in her face/throat/lips or difficulty breathing to go into the ER.


VAERS ID: 1642026 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dizziness, Echocardiogram, Electrocardiogram, Headache, Pericardial effusion, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: ECHO and EKG performed on 8/25/2021 revealing slight Pericardial Effusion Follow up ECHO and EKG performed on 8/27/2021 showed that condition was subsiding, if not gone. Chest tightness still present, however.
CDC Split Type:

Write-up: PT complained of chest pain, chest tightness, dizziness, headache, and fever (100.4) approximately 19 hours after receiving the first dose of the Pfizer COVID-19 vaccine. As a result of her symptoms, she was seen by a cardiologist on 8/25 and diagnosed with Pericardial Effusion. PT was given 400 mg ibuprofen twice daily to treat symptoms.


VAERS ID: 1642033 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-23
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site rash, Pain in extremity, Peripheral swelling, Rash erythematous
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Swollen and sore arm persistent over the course of a week; red rash on arm and mainly around injection sight


VAERS ID: 1642048 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-02-26
Onset:2021-08-23
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

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

Write-up: Sore arm.


VAERS ID: 1642262 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Echocardiogram normal, Electrocardiogram ST segment elevation, Myocarditis, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Echo showed good function and no abnormalities. Serial EKGs showed mild ST segment elevation and early repolarization. Troponin peaked around 8 and steadily fell.
CDC Split Type:

Write-up: 13 year old identical twin boy who started having chest pain approximately 24 hours after 2nd dose of vaccine. Chest pain was persistent and he then developed shortness of breath so was brought to ED. Found to have troponin very elevated and EKG with some ST segment elevation and was admitted for acute myocarditis.


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