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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 420 out of 8,010

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VAERS ID: 1642273 (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, Electrocardiogram repolarisation abnormality, Myocarditis, Troponin increased
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (narrow), Conduction defects (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 effusion or abnormalities Serial EKGs showed mild ST segment elevation with early repolarization Troponin peaked at 7 and steadily fell to 1.2 by discharge
CDC Split Type:

Write-up: 13 year old identical twin boy who started having chest pain approximately 24 hours after 2nd dose of covid vaccine. Chest pain was persistent and within 48 hours he developed shortness of breath so mom brought him to ED. Found to have elevated troponin and EKG with some ST segment elevation and was admitted for acute myocarditis.


VAERS ID: 1642276 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Connecticut  
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 939902 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), 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: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: noticed arm swelling and itching that was getting worse following shot on 8/19 and called pharmacy on 8/27. told her to call her primary care physician for followup


VAERS ID: 1642680 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: California  
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 - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Hot flush, Nasal congestion, Pruritus, Sneezing, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Viberzi, Gabapentin, Nortrel, Dicyclomine, Biotin, Vitamin C, Vitamin D3
Current Illness:
Preexisting Conditions: IBS, Hypotension
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: After dose 1 on 8/2/2021, I exprienced hot flashes all day with no fever. Starting that night, I developed persistent allergy symptoms (sneezing, itchy nose and throat, stuffy nose) despite not being exposed to allergens that I am still experiencing as of today, 8/27/2021. After dose 2 on 8/23/2021, I began having diarrhea that evening that has not ceased as of today, 8/27/2021. I know I listed IBS as a chronic health issue but this is different than my typical IBS symptoms.


VAERS ID: 1642847 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-18
Onset:2021-08-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin, Amlodipine, Lisinopril, one a day vitamin, vitamin C, vitamin D3, COQ10.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme headache (like a hang over). It lasted for 3 days with the second day being the worst then subsided.


VAERS ID: 1642979 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-23
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: 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: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies and did not have any history of drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210852508

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient concerned a 61 year old female. Initial information was processed with the additional information received on 26-AUG-2021. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: non-smoker, and non-alcohol user. The patient had no known allergies and did not have any history of drug abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, expiry: UNKNOWN) dose was not reported, 1 total, administered on left arm on 07-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 23-AUG-2021, the patient had a COVID symptoms of bowel issues and a sore throat after being exposed to a friend/coworker who tested positive on 19-AUG-2021 while on break without masks (suspected clinical vaccination failure and suspected COVID-19 infection). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the suspected covid-19 infection and suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000191140.; Sender''s Comments: V0: 20210852508- COVID-19 VACCINE AD26.COV2.S- Suspected clinical vaccination 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: 1642981 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-23
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Cough, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (Occasionally); Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: Flu like symptoms; Comments: Patient had no known allergies. Patient had no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 20210823; Test Name: Body temperature; Result Unstructured Data: 98-101; Comments: Fever of 98-101
CDC Split Type: USJNJFOC20210852621

Write-up: BODY ACHES; DRY COUGH; FEVER OF 98 TO 101; This spontaneous report received from a patient concerned a 47 year old male. The patient''s weight was 230 pounds, and height was 70 inches. The patient''s past medical history included: flu like symptoms, and concurrent conditions included: alcohol user, and non smoker, and other pre-existing medical conditions included: Patient had no known allergies. Patient had no drug abuse or illicit drug usage. The patient was previously treated with influenza vaccine for prophylactic vaccination. 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 18-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 23-AUG-2021, the patient experienced body aches. On 23-AUG-2021, the patient experienced dry cough. On 23-AUG-2021, the patient experienced fever of 98 to 101. Laboratory data included: Body temperature (NR: not provided) 98-101. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the body aches, dry cough and fever of 98 to 101 was not reported. This report was non-serious.


VAERS ID: 1651203 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / -

Administered by: Private       Purchased by: ?
Symptoms: Immunodeficiency, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Adrenal insufficiency, hypothyroidism, hypertension, asthma, pulmonary hypertension, bipolar disorder, migraine headaches
Allergies: morphine, ondansetron
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called on call doctor for her PCP office, reporting fevers (Tmax 101.3 8/26) and vomiting since her Moderna booster dose at the Dept of Public Health on Monday 8/23. She was unable to keep liquids down so she was advised to seek emergency evaluation


VAERS ID: 1651262 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal, Thrombosis, Ultrasound abdomen normal, Uterine haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: Ultrasound. 08/27/21 - no abnormalities
CDC Split Type:

Write-up: Extreme dizziness, mental fog, and abnormal heavy uterine bleeding and shedding of clots, began to notice spotting 30-60 minutes post-vaccine, bleeding has grown progressively worse. 5 weeks postpartum, exclusively breastfeeding, no menstruation should be happening at this time. Arm became very itchy 5 hours post-vaccine, itching improved but continues to be mildly itchy.


VAERS ID: 1651292 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), 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: no according to VAR
Current Illness: no according to VAR
Preexisting Conditions: no according to VAR
Allergies: no according to VAR
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient fainted in waiting area. Came to in less than a minute. Father and brother were present. Patient was extremely pale. he was given an ice pack because he fell against the wall/door. He was also given water.


VAERS ID: 1651334 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 036A2 / 2 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Bone pain, Electric shock sensation, Hypoaesthesia, Motor dysfunction, Musculoskeletal stiffness, Myalgia, Pain, Palpitations, Paraesthesia, Pyrexia, Rash, Rash erythematous, Swelling, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Osteonecrosis (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), 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:
Other Medications: Multivitimans
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Shellfish, Insects, Dust, Dander
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: there were a few adverse reactions that I received when i got the vaccine. When I got home from work I noticed that I had a fever. The fever ranged from 101 to 103 and lasted 3.5 days. I also had bone and muscle pain, soreness, tightness, and numbness especially in the chest, shoulder and arm areas and lasted 4 days. My skin had this weird pins and needles effect as well as a red rash on my left arm and I felt a swelling all over that seemed to come and go and lasted 4 days. My hair felt electric when I rubbed it and my eyes were unfocused and lasted 4 days. Now Today I notice a swelling under my left arm and my left arm is numb and occasionally looses some motor function and I think i can feel my heart in my chest and the pins and needles are back. this is ongoing.


VAERS ID: 1651394 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-03-29
Onset:2021-08-23
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 6206 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER 8734 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: admitted for 8/23/2021 to Hospital for low blood pressure and found to have COVID.


VAERS ID: 1651618 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Balance disorder, Chest discomfort, Dizziness, Ear discomfort, Eye pain, Fatigue, Headache, Muscle spasms, Muscle twitching, Neck pain, Pain in extremity, Rhinorrhoea, Vision blurred
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (broad), 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: always react to vaccines with generalized illness - never am sick otherwise
Other Medications: vitamin c , d e and magnesium .
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Have not seen a physician at this point. I sent a message to PCP office to report condition and told them I would continue to monitor
CDC Split Type:

Write-up: Shot on monday after work Started with headache and chest tightness, and a runny nose within about one hour . Sore R arm immediately . Chest tightness was constant for 2 days and now is intermittent headache is ongoing - waking up with headaches , taking advil 800 mg 2 - 3 times daily along with tylenol 1000 mg 2 x daily this is becoming less effective as the days go on. Lightheadness/ dizziness started day after on tuesday and is still present . Have been bumping into walls and have almost fallen several times . 2 days after on wednesday until friday night had fullness in R ear . This has resolved . Friday much worse headache , neck soreness, runny nose again , by the end of the work day extreme fatigue . Muscle twitching started in the R deltoid at area of shot , all over muscle twitch and cramping as been intermittent . In bed for 24 hours . Both eyes hurt , vision blurry at times . This is ongoing


VAERS ID: 1651629 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Second dose given 6 days early (22 days instead of 28 days). No adverse event reported.


VAERS ID: 1652231 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Men''s Multivitamin, Whey Protein isolate, creatine, a preworkout from time to time. No medications/prescriptions. Only dietary supplements.
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I felt fine the day of the vaccine. However the very next day before noon I started feeling very lightheaded and dizzy. That lightheaded and dizzy feeling has not gone away. I have never felt this before.


VAERS ID: 1653815 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-08-21
Onset:2021-08-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR UJ685AAA / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Epistaxis, Headache, Immunodeficiency, Influenza like illness, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flue shot Quad 2021-2022, Tramadol 50mg, atorvastatin, losartan, metformin. Inhaler, dulera.
Current Illness:
Preexisting Conditions: Asthmatic, diabetic, hypertensions
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: This is my third booster shot for Covid also took the flue shot. Had my pneumonia shot (PNEUMOVAX 23 SYRINGE) 17th of Aug. Adverse reaction the nigh off are flue like symptoms fever, slivering, headache that lasted until the next day. Heavy nose bleeding. I stop by using tissue to stop the bleeding, but the next day it happen again. It eventually stop after three days. I thought I was the only one because I do take a lot of medication, but my daughter also had nose bleeding. She did not get a vaccination that day, but she is fully vaccinated. Another daughter also said that one of her friends were having issues with nose bleeding. Not sure if this is common for vaccinated people.


VAERS ID: 1653855 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anosmia, Aphasia, Arthralgia, Asthenia, Balance disorder, Blood creatine phosphokinase, Blood magnesium, Blood phosphorus, Blood thyroid stimulating hormone, Cardiac disorder, Chest X-ray, Chest discomfort, Computerised tomogram head normal, Condition aggravated, Cough, Depressed mood, Diarrhoea, Differential white blood cell count, Disturbance in attention, Dizziness, Dysphonia, Dyspnoea, Echocardiogram, Electrocardiogram, Electrocardiogram abnormal, Emotional distress, Eye pain, Feeling hot, Fine motor skill dysfunction, Flatulence, Full blood count, Gait disturbance, Gastrooesophageal reflux disease, Glycosylated haemoglobin, Grip strength decreased, Headache, Hunger, Hyperhidrosis, Hypoaesthesia, Hypoaesthesia oral, Hypopnoea, Impaired work ability, Induration, Injected limb mobility decreased, Injection site pruritus, Injection site swelling, Injection site warmth, Lethargy, Limb discomfort, Lipase, Liver function test, Loss of personal independence in daily activities, Lower respiratory tract infection, Lymphadenopathy, Magnetic resonance imaging head normal, Malaise, Menstruation irregular, Metabolic function test, Movement disorder, Muscle tightness, Muscular weakness, Musculoskeletal discomfort, Musculoskeletal stiffness, Nasopharyngitis, Neuropathy peripheral, Night sweats, Pain in jaw, Paraesthesia, Peripheral coldness, Pyrexia, Rheumatoid arthritis, Rhinorrhoea, SARS-CoV-2 test, Sensory loss, Skin warm, Sleep disorder, Somnolence, Speech disorder, Swelling, Thirst, Throat irritation, Thyroxine, Thyroxine free, Tinnitus, Tri-iodothyronine, Troponin T, Urine analysis, Vibratory sense increased, Vision blurred, Wheelchair user
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Pseudomembranous colitis (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Osteonecrosis (broad), Fertility disorders (broad), Arthritis (narrow), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: 100mg Acetaminophen, 162mg Aspirin, 25mg Diphenhydramine HCL, 600mg Calcium, Multivitamin (Centrum Women''s), 125mcg Levothyroxine.
Current Illness: Grave''s disease.
Preexisting Conditions: Grave''s disease.
Allergies: Sulfa, Epinephrine, Naproxen, Antibiotics, Latex, Wood, Nitrous oxide, Curry, Peanuts/nuts, Bee''s wax, Chlorine, Gold, Wool, Aloe, Shea butter, Mints, Salt, Hormones, Soy, Fish, Crabs, Onions, Peppers, Seeds, Avocados, Strawberries, Peaches, Apricots, Papaya, Banana, Kiwi fruit, Mangoes, Grapes, Hibiscus, Artificial/low calorie sweetener, Helium.
Diagnostic Lab Data: 8/24/21 - XR Chest 1 FW, frontal Urinalysis Basic metabolic panel - infusion center CBC differential, automated TSH with reflex to free T4 SARS COV-2 NAA Troponin T Gen 5 Stat Creatine Kinase Lipase Hepatic function panel CT head without contrast Phosphorus Magnesium Thyroxine {T4}, free Triiodothyronine {T3}, free Troponin T Gen 5 Stat ECG 12-lead TTE MRI brain without contrast 8/25 - Hemoglobin A1C CBC and differential automated Basic metabolic panel infusion center Phosphorus Magnesium
CDC Split Type:

Write-up: 8/22- Got my 2nd jab today! 8/23- Site of injection is warm & swollen; Restricted movement of the R shoulder; Glands swollen in neck affecting tinnitus & breathing


VAERS ID: 1653895 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-05
Onset:2021-08-23
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, Asthenia, COVID-19, Chest discomfort, Chills, Cough, Fatigue, Hot flush, Hyperhidrosis, Hypoaesthesia, Ocular discomfort, Pain, Rhinorrhoea, SARS-CoV-2 test positive, Sinus congestion
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lo Loesteran (birth control) Zyrtec Phentermine
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: N/a
Diagnostic Lab Data: Positive Covid test - 8/23/2021
CDC Split Type:

Write-up: First shot March 5th. Second shot April 1st. Diagnosed with Covid 8/23. Day 6 of experiencing severe symptoms. Full body aches (more intense then ever in my life), chills, hot flashes and sweating, pressure in chest, numbness is legs, feet and hands, fatigue, body weakness, eye pressure, head congestion, runny nose, coughing and loss of taste and smell.


VAERS ID: 1653924 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Severe, Systemic: Patient has a knot at injection site-Severe, Additional Details: Patient had a knot at injection site as well as excessive bleeding. Patient is not on blood thinners. After 7 days, the knot still exist and there is slight pain, and redness


VAERS ID: 1653965 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

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

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

Write-up: GAVE PATIENT 0.6ML INSTEAD OF 0.3ML


VAERS ID: 1654033 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial enlargement, Electrocardiogram abnormal, Heart rate abnormal, Laboratory test, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D 2000 mg daily
Current Illness: None
Preexisting Conditions: Mitral Valve Prolapse (Stable)
Allergies: Sulfur
Diagnostic Lab Data: Doctor visit. Labs Done,EKG shows left atrial enlargement. Echocardiogram ordered
CDC Split Type:

Write-up: Palpatations, abnormal heart rhythm.


VAERS ID: 1654062 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Dizziness, Heart rate increased, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Dizzy, feeling very faint at random times, spikes in blood pressure, increased heart rate, fever


VAERS ID: 1654074 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 - / IM

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

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

Write-up: allergic site reaction itchy red


VAERS ID: 1655584 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Immediate post-injection reaction, Nausea, Pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Immediately after receiving the vaccination she felt as though she had to vomit. Became hot burning, itchy and chest started hurting and is in extreme pain. Body has been in extreme pain. Was sent by ambulance to the hospital. Has been to the ER 4 times since the vaccine has been administered.


VAERS ID: 1655666 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-19
Onset:2021-08-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blepharitis, Hordeolum
SMQs:, Periorbital and eyelid disorders (narrow), Ocular infections (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: styes and blepharitis on both eyes over a period of 7 days


VAERS ID: 1655705 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC 3182 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Condition aggravated, Genital herpes, Injected limb mobility decreased, Nausea, Pain in extremity, Product administered at inappropriate site, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug abuse and dependence (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Valacyclovir and birth control pill
Current Illness: No illnesses are the time of vaccination and no illnesses one month prior
Preexisting Conditions: Genital herpes
Allergies: No known drug allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: My reactions started at around 1am the same night of the vaccine. I woke up with chills, fever, unable to lift my arm, nausea, and a full body reaction from a genital herpes outbreak triggered by the vaccine. The injection was given too high up, almost in my joint instead of my muscle, which is why I couldn?t lift my arm for two days, with extreme pain. The chills, fever, and nausea lasted for 4 full days. It has officially been one week since the start of my reactions to the vaccine and my genital herpes outbreak is still occurring.


VAERS ID: 1655713 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-21
Onset:2021-08-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disturbance in attention, Feeling abnormal, Impaired driving ability, Memory impairment, Nausea, Sinus headache
SMQs:, Acute pancreatitis (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (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: Magnesium Malate Cod liver oil Vitamin E Magnesium Gylconate Vitamin C Potassium
Current Illness: Fibromyalgia
Preexisting Conditions: Fibromyalgia
Allergies: Penicillin Aspirin Tylenol Steroids Sulfa drugs Nitrous Oxide
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Sinus headache for 8 days. Severe brain fog. Would forget names of things. Would have to stop talking mid sentence because I could not remember what I was talking about. Felt unsafe driving because I could not focus. Nausea.


VAERS ID: 1655720 (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: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Lymph node pain, Neck pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zinc, calcium, magnesium, tumeric, L-lysine, L-tyrosine, collagen, D3
Current Illness:
Preexisting Conditions: Psoriatic arthritis & fibromyalgia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Very sore arm (injection site) Neck discomfort (lymph)


VAERS ID: 1655742 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-11
Onset:2021-08-23
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: hyperlipidemia, hypothyroid, GERD, Depression, VRE
Allergies: Augmentin, Bee sting, isoniazid, Paxil, statins
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was admitted to hospital on 8/17/21, asymptomatic. Tested to go OR on 8/23/21, tested positive.


VAERS ID: 1655767 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-09
Onset:2021-08-23
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called on the phone and stated that he started to have blurred vision in one eye starting 2 weeks after his 1st covid shot.


VAERS ID: 1655870 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-19
Onset:2021-08-23
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Cough, Diarrhoea, Dyspnoea, Fatigue, Headache, Myalgia, Nausea, Olfactory nerve disorder, Oropharyngeal pain, Pyrexia, Rhinorrhoea, Taste disorder, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, Muscle Aches, Runny Nose, Sore throat, New Olfactory and Taste Disorder, Headache, Fatigue, Cough, Shortness of Breath, Nausea, Vomiting and Diarrhea


VAERS ID: 1655914 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-17
Onset:2021-08-23
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019B21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache, Injection site pain, Injection site warmth, Nightmare, SARS-CoV-2 test negative
SMQs:, Dementia (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ASA, Plavix, Coreg, Albuterol inhaler
Current Illness: none
Preexisting Conditions: Heart Disease, Asthma
Allergies: Penicillin, tramadol, Z Pack
Diagnostic Lab Data: Negative Covid test on 8/24
CDC Split Type:

Write-up: 13 days after vaccine still feeling fatigue, chills at times, Headache at times. diarrhea this am. Day 6 same symptoms plus brain fog at times didn''t feel like thinking clearly, Day 7 8/24 experienced unusually multiple nightmares, 8/27 injection site became tender and warm when it had not been since 8/20, 8/28 injection site itching, 8/30 injection site no tenderness, warmth or itching,


VAERS ID: 1656021 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-10
Onset:2021-08-23
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram head, Electroencephalogram, Generalised tonic-clonic seizure, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin 325 mg daily, vit D 2000 units daily, glucosamine-chondroitin, clopidigrel 75 mg daily, Pepcid 20 mg daily, hydrochlorothiazide 25 mg daily, levetiracetam 500 mg every 12 hours, losartan 100 mg daily, potassium chloride 20 mEq ER tw
Current Illness: None known
Preexisting Conditions: 1. History of cerebrovascular accident. 2. Hypertension. 3. Hyperlipidemia. 4. Exposure to agent orange during the military in the past 5. PFO heart closure
Allergies: Codeine (unknown)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received first dose of Moderna on 8/10/21 and the seizure started 8/23/21, patient admitted to Hospital with tonic clonic seizure, underwent neurology work up including CT head EEG, patient started on Keppra. This writer contacted patient and spouse on 8/30/21 and they inquired about submitting a report. The other risk factors they mentioned were exposure to agent orange int he past, prior stroke.


VAERS ID: 1656064 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-21
Onset:2021-08-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Oral discomfort, Tongue discomfort
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: burning, acid sensation on his tongue and lips


VAERS ID: 1656083 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-10
Onset:2021-08-23
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Oropharyngeal pain, Pyrexia, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole, Lisinopril, Atorvastatin, Citalopram; Metoprolol, Metformin, Meclizine
Current Illness: none
Preexisting Conditions: hypertension; hyperlipidemia, seasonal allergies, stress incontinence, irritable bowel, type 2 diabetes
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Congestion, sore throat, cough, low grade fever starting on 8/23/2021


VAERS ID: 1656179 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-21
Onset:2021-08-23
   Days after vaccination:124
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048A21A / 1 AR / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 AR / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MEDS FOR HTN AND DM
Current Illness: NO
Preexisting Conditions: HTN DM
Allergies: UNKNOWN
Diagnostic Lab Data:
CDC Split Type:

Write-up: POSTIVE COVID


VAERS ID: 1656326 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003A21A / 2 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Influenza like illness, Oral herpes, Pain
SMQs:, Oropharyngeal infections (narrow), 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: Patient stated that she can provide a list of medications
Current Illness: Parkinson Immune Depressed Back fractions
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated that she had a fever and flu like symptom. She was having body aches.


VAERS ID: 1656359 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PC3183 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ophthalmological examination, Skin discolouration
SMQs:, Hypotonic-hyporesponsive episode (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: Trulicity, Toujeo, Jardiance, Welchol, Telmisartan, Vitamin D-3
Current Illness:
Preexisting Conditions: Diabetes, Hypertension, Hx of Colorectal Cancer
Allergies:
Diagnostic Lab Data: I went to be seen by the opthalmologist on 08/25/2021 where I underwent a thorough eye exam with dilation.
CDC Split Type:

Write-up: Within 20-25 minutes after receiving the vaccine I experienced long black lines in the outer corner of my right eye.


VAERS ID: 1656386 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product preparation issue, Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: The patient was administered a dose that had been reconstituted and drawn up the previous night. It was beyond the 6 hour limit that is recommended by Pfizer. No adverse event was reported by the patient.


VAERS ID: 1656453 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Condition aggravated, Fatigue, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: dofetilide, rivaroxaban, vit D, acetaminophen
Current Illness: atrial fibrillation, chronic lymphocytic leukemia
Preexisting Conditions: see above. Also, mild asthma
Allergies: pollen
Diagnostic Lab Data: Documented rhythm using Kardia device on iphone. No formal ECG was done at the time. My cardiologist was out of town and by the time we talked on the phone AF had resolved.
CDC Split Type:

Write-up: Prolonged episode of atrial fibrillation beginning approximately 3 days after vaccine and lasting approximately 40 hours. I had ablation procedure in March 2021 and had no known episodes of AF until the onset of this one . The episode self-resolved and has not recurred. I did have fever, fatigue, body aches following the vaccine beginning about 16 hours after the vaccine and lasting approximately 24 hours. First two vacccine doses were Jan 27 and Feb 17. I had been having intermittent AF at that time, thus the abalation in March. I did not associate AF with the vaccine doses at that time. New CLL diagnosis was made at the time of the ablation.


VAERS ID: 1656579 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Pfizer BioNTech COVID-19 Vaccine EUA: Administration Error NOT Diluted Patient received Pfizer Vaccine on 8/23/2021 that was not diluted prior to administration. Patient did not experience any untoward effects.


VAERS ID: 1656592 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal X-ray, Blood test, Confusional state, Coordination abnormal, Dysarthria, Fine motor skill dysfunction, Hallucination, Laboratory test, Lumbar puncture, Memory impairment, Repetitive speech
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: vitamin b, c d, zinc, co-q10
Current Illness: none
Preexisting Conditions: migraine, back pain
Allergies: none
Diagnostic Lab Data: Spinal tap, blood work. Patient states between 20 and 30 tests, abdominal x-ray, tested for infection
CDC Split Type:

Write-up: Patient describes experiencing intense hallucinations and confusion to the severity that he was hospitalized. Incoherent speech, and repetitious speech. Muscle coordination difficulty (could not button a shirt or tie shoe laces). Got lost while tring to get home at night. Patient states he felt that he was temporally insane.


VAERS ID: 1656798 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-14
Onset:2021-08-23
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate decreased
SMQs:, Arrhythmia related investigations, signs and symptoms (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: n/a
CDC Split Type:

Write-up: Heartrate decreased.


VAERS ID: 1656804 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

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

Write-up: racing & pounding heart - started within 30min after injection, lasted about 5 days (24/7). Was not severe. Was able to perform normal daily activities. No treatment was administered, just watched & waited.


VAERS ID: 1657239 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, No adverse event
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: The patient was administered a shot that had been reconstituted and drawn up beyond the six hour window that is required to give the vaccine. No adverse event reported.


VAERS ID: 1657546 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-04-08
Onset:2021-08-23
   Days after vaccination:137
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Aphasia, Balance disorder, Confusional state, Dysarthria, Headache, Speech disorder, Transient ischaemic attack, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: TIA: loss of balance, blurred vision, slurred speech, unable to speak, nonsensical words once I could speak, headache, confusion


VAERS ID: 1658325 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-26
Onset:2021-08-23
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ELO140 / 2 UN / IM

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

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

Write-up: PT WAS FULLY VACCINATED WITH PFIZER VACCINE - DOSE 1 1/4/21 (LOT EL0140), DOSE 2 1/26/2021 (LOT ELO140). S/O 8/23/21, TESTED + 8/27/21


VAERS ID: 1658335 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-05
Onset:2021-08-23
   Days after vaccination:140
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 2 UN / IM

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

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

Write-up: PT WAS FULLY VACCINATED WITH MODERNA. 2/26/21 (LOT 022M20A) + 4/5/21 (LOT 017B21A). S/O 8/23/2021, TESTED + 8/27/2021


VAERS ID: 1658339 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-22
Onset:2021-08-23
   Days after vaccination:62
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821287 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: blood clot on left leg


VAERS ID: 1658460 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Fatigue, Headache, Hypoaesthesia, Influenza virus test negative, Oropharyngeal pain, Pain, Pyrexia, SARS-CoV-2 test negative, Streptococcus test negative
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, trazodone, fluoxetine, vit d, multivitamin, vit cyclobenzaprine
Current Illness:
Preexisting Conditions: Hypothyroidism
Allergies: Minocycline
Diagnostic Lab Data: Negative covid x2,neg flu, neg strep
CDC Split Type:

Write-up: Arm numbness and pain, fever 100.6-103.2, headache, fatigue, all over aching, sore throat, cough


VAERS ID: 1658483 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-20
Onset:2021-08-23
   Days after vaccination:156
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 UN / IM

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

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

Write-up: PT WAS FULLY VACCINATED WITH PFIZER 3/20/21 (LOT EN6207) + 2/26/21 (LOT EL3248). PT TESTED + 8/23/21 - S/O 8/23/21


VAERS ID: 1658543 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Mobility decreased, Musculoskeletal stiffness, Neck pain, Pain, Pain in extremity
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C Atenolol Losartan Simvastatin Medroxyprogestrone Jardiance Metformin Wegovy Toujeo Max Pregabalin Trazodone Lorazepam Asprin Hair/Skin/Nails vitamin
Current Illness: n/a
Preexisting Conditions: diabetes
Allergies: Lavender oil
Diagnostic Lab Data: Will be visiting my primary care physician on 9/1/21.
CDC Split Type:

Write-up: Right shoulder, Right Bicep and neck became stiff 3 days (8/23/21) post 2nd COVID vaccine. I notified my physician a week after symptoms started (8/30/21) as I was not sure if this was just a side effect of immunity building but she does not feel it should be this severe. My pain level is 7/10 and I am unable to move my neck, I can not lay down as this makes the pain a 10/10. As of 8/30/21, the pain continues to be right shoulder, right bicep area, neck and is now is starting to travel down my right arm past my elbow and is radiating into the right side of my jaw.


VAERS ID: 1658544 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-01-26
Onset:2021-08-23
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH RL9265 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Feeling abnormal
SMQs:, Dementia (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xeralto, Famotidine, Atovastatin, Oxicodone pain, Multivitamins
Current Illness: None
Preexisting Conditions: Back pain both lower and upper
Allergies: None
Diagnostic Lab Data: Prednisone and Acclovir 8/23/21
CDC Split Type:

Write-up: August 23. 2021. Woke up with right side of face feeling weird. Went to emergency room at hospital. diagnosed as Bell''s Palsy.


VAERS ID: 1658668 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-03
Onset:2021-08-23
   Days after vaccination:112
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: C-reactive protein increased, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Cough, Dyspnoea, Fibrin D dimer increased, Lung opacity, Lymphocyte count decreased, Myalgia, Oropharyngeal pain, Respiratory tract congestion
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Haematopoietic leukopenia (narrow), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

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: buspirone, glimepiride, gabapentin, hydrochlorothiazide, levothyroxine, metformin, metoprolol tartrate, potassium chloride ER tablets
Current Illness:
Preexisting Conditions: Type 2 diabetes mellitus, hypertension, hypothyroidism, hypercholesterolemia
Allergies: No known allergies
Diagnostic Lab Data: 8/31/21 D-dimer: 0.96 Lymphocytes: 14 Chest X-ray: moderate focal ground glass opacity in lateral mid-left lung CRP: 125.5 CT chest PE: no evidence of PE; moderate ground-glass opacities
CDC Split Type:

Write-up: On 8/23/21 the patient began experiencing symptoms of COVID-19 including sore throat, myalgias, congestion, shortness of breath, and cough. Patient presented to ED to receive a scheduled Regeneron COVID-19 monoclonal antibody therapy, but the patient was found to have an O2 sat of 88% with exertion, improving to 90% with exertion. Patient was no longer a candidate for antibody therapy and signed in to ED for evaluation. Patient was placed on 2L O2 via nasal cannula and had improvements of shortness of breath and O2 sat increased to 97%. Patient was started on 6 mg dexamethasone. The patient will be admitted to the hospital.


VAERS ID: 1658684 (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: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / IM

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

Write-up: 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: 1658726 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Lymphadenopathy, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever of 100+ Fahrenheit. Started after 18 hours, ended by 24 hours. Shortness of breathe and difficulty taking deep breathes. Started after 6 hours, last 48 hours. Enlarged lymph node in my left armpit, with pain. Started after 12 hours, lasted 96 hours. Intense pain throughout my body, like someone was stabbing me all over my body. Started at 18 hours, lasted to 36 hours. All conditions were treated with 81mg Asprin qd, 1000mg Tylenol q4h. 600mg Ibuprofen q6h


VAERS ID: 1658774 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Peripheral swelling, Pharyngeal swelling, Swelling face
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: After 30 minutes observation for history of anaphylaxis to codeine, pt left ambulatory and asymptomatic. Returned complaining of face, throat, and bilateral extremity swelling and difficulty breathing. EpiPen was administered . Signs and symptoms began to resolve immediately. Pt agreed to go directly to urgent care


VAERS ID: 1658806 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Headache, Injection site pain
SMQs:, Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: Arithromicyn
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headaches, diarheaa, soreness at injection site,


VAERS ID: 1658839 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-16
Onset:2021-08-23
   Days after vaccination:68
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

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

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

Write-up: Vaccinated patient hospitalized with COVID-19.


VAERS ID: 1658921 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003F21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Pain, 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: melatonin, Flonase, Temazepam, Trazodone, paxil, buspirone, naproxen
Current Illness: scratchy throat,
Preexisting Conditions: GERD, DUB, Migraine, chronic pain, dysphagia, arthritis, seasonal allergic rhinities
Allergies: No known drug allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Diarrhea, emesis, body aches, fatigue


VAERS ID: 1658951 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-24
Onset:2021-08-23
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Infusion, Malaise, 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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Novolog; Vascular Injections; Calcium with Vitamin D; Baby Aspirin; Metoprolol.
Current Illness:
Preexisting Conditions: Diabetes.
Allergies:
Diagnostic Lab Data: COVID-19 positive.
CDC Split Type: vsafe

Write-up: I just got sick with COVID-19. I went to ER, they admitted me into the hospital gave me an infusion.


VAERS ID: 1658968 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-08-17
Onset:2021-08-23
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA OSIE21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Guillain-Barre syndrome, Injection site pruritus, Injection site warmth, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Seasonique; Lexipro; Allertec; and vitamins/supplements: C, D3, Magnesium, Potassium, Multi-vitamin, Zinc, Fiber, ACV
Current Illness: None
Preexisting Conditions: Guillan Barre Syndrome
Allergies: None
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: 1) COVID-Arm: Appeared Aug. 23-24. Red 2 inch diameter circle that was itchy and hot where I received the COVID shot. Was clear of color by Wednesday, Aug. 25, yet still itchy 2) Neuro: Tingling in left hand 8/19; apx. 1:25 p.m. for about 5 minutes. Tingling in right ring and pinkie fingers on 8/27 8:20 a.m. for about 5 minutes. Extra vigilant in anything out of the ordinary given Guillan Barre Syndrome history.


VAERS ID: 1659070 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-21
Onset:2021-08-23
   Days after vaccination:124
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / 1 LA / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstruation irregular, Pneumonia, Pyrexia, Thrombosis, Ultrasound scan normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Eosinophilic pneumonia (broad), Fertility disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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, 17 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: antibiotics
Diagnostic Lab Data: ultrasound - nothing (04/25)
CDC Split Type:

Write-up: started menstrul cycle, pnemonia came back , high fever, several bloodclots,


VAERS ID: 1659103 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-08-05
Onset:2021-08-23
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Heart rate increased, Palpitations, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Increased heart rate at irregular time . Mostly felt it during rest hours or while trying to sleep or in mid of sleep. Heart rate goes up for few minutes and then becomes normal. At such times, can feel the heart is pumping and makes body shake automatically.


VAERS ID: 1659259 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Nodule, Pain in extremity, Swelling, Tinnitus
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Sudden onset of Tinnitus (varying severity throughout the day and has lasted for over a week - ongoing problem) Dizziness the night of vaccine (subsided by morning) Severe arm pain with swollen lump (subsided in 4 days)


VAERS ID: 1659459 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Cardiac discomfort, Oedema peripheral, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: I had pain in armpit after that it was a little vet swelling for 5 days when I got vaccine I feel uncomfortable around the heart area I got swelling on the throat and chest
Current Illness:
Preexisting Conditions:
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had pain on armpit and a little bit swelling , uncomfortable around the heart area and rush on my throat


VAERS ID: 1659466 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-21
Onset:2021-08-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad)

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

Write-up: Left side of head down neck and to elbow sensation


VAERS ID: 1659715 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-01
Onset:2021-08-23
   Days after vaccination:144
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Chronic obstructive pulmonary disease, Condition aggravated, Cough, Hypoxia, SARS-CoV-2 test positive, Viral sepsis, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol inh, alendronate, azelastine nasal ap, azithromycin, Symbicort inh, citalopram, diltiazem, duloxetine, ferrous sulfate, fluticasone nasal sp, folic acid, gabapentin, Norco PRN, methocarbamol PRN, montelukast, omeprazole, Percocet
Current Illness:
Preexisting Conditions: Stage IIIa NSCLC 2006 s/p neoadjuvant chemotherapy and L upper lobectomy in remission, COPD (with possible asthma overlap) with chronic respiratory failure on 2L oxygen, chronic back pain, fibromyalgia, depression/anxiety, chronic anemia
Allergies: Sulfa
Diagnostic Lab Data: COVID status positive on 8/23/21.
CDC Split Type:

Write-up: Patient received Pfizer COVID vaccine on 3/14/21 and 4/1/21. On 8/23, she was admitted to our facility with COVID-19 pneumonia (acute on chronic respiratory failure with hypoxia) and viral sepsis. She was given weight dosed remdesivir and completed a 5-day course. She was able to wean down to her home oxygen. Due to intermittent desaturations with coughing fits, and ongoing COPD exacerbation, she was treated with 5 day course of dexamethasone starting 8/28. Her wheezing improved on steroids and she was stable on her home oxygen. As of 8/29 she was at her baseline and was discharged to home.


VAERS ID: 1659727 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-17
Onset:2021-08-23
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Asthenia, COVID-19, COVID-19 pneumonia, Cough, Decreased appetite, Diarrhoea, Dyspnoea, Fatigue, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Chlorthalidone, isosorbide mononitrate, losartan, metoprolol succinate ER, nitroglycerin SL PRN, rosuvastatin
Current Illness:
Preexisting Conditions: Aortic regurgitation status post aortic valve replacement with bioprosthetic valve, ascending aorta enlargement, hypertension, congestive heart failure, hypercholesterolemia, alcohol and tobacco use disorder
Allergies: Lisinopril
Diagnostic Lab Data: COVID status positive on 8/23/21.
CDC Split Type:

Write-up: Patient received Pfizer COVID vaccine on 8/17/21 (only 1 dose). Patient had ~3 weeks history of shortness of breath, cough, generalized weakness, fatigue, loss of appetite, and intermittent diarrhea before he was admitted to our facility on 8/23/21 for acute respiratory with hypoxia due to COVID-19 pneumonia. Patient was discharged home on 8/27 in stable condition on 2L nasal cannula with a prescription of dexamethasone to complete a 10 day course. Patient did not receive remdesivir due to being out of window.


VAERS ID: 1659733 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-17
Onset:2021-08-23
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine, baby aspirin, metformin
Current Illness:
Preexisting Conditions: Type 2 diabetes and hypertension
Allergies: NKDA
Diagnostic Lab Data: COVID status positive on 8/24/21.
CDC Split Type:

Write-up: Patient received COVID vaccine on 7/17/21 in another country then received Pfizer COVID vaccine on 8/17/21 in the states. On 8/23/21, patient was admitted to our facility for acute hypoxic respiratory failure due to COVID-19 pneumonia (symptoms started 8/17/21). Patient received remdesivir and dexamethasone 8/24/21-8/28/21. Patient discharged home on 8/29/21 in good condition.


VAERS ID: 1659923 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-15
Onset:2021-08-23
   Days after vaccination:69
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Acute respiratory failure, COVID-19, COVID-19 pneumonia, Chills, Dyspnoea exertional, Oxygen saturation decreased, Pyrexia, Respiratory distress, SARS-CoV-2 test positive, Tachypnoea, Thrombocytopenia, Tremor
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen PRN, amlodipine, atorvastatin, vitamin D, famotidine, fluticasone nasal sp, magnesium oxide, MVI w/folic acid, mycophenolate EC, prednisone, Bactrim, tacrolimus
Current Illness:
Preexisting Conditions: History of previous CKD stage V now s/p DDR T March 27, 2021 followed by transplant center. Patient is on mycophenolate, prednisone and tacrolimus. Also history of hypertension, hyperlipidemia, GERD and allergic rhinitis/seasonal allergies.
Allergies: Lisinopril
Diagnostic Lab Data: COVID status positive on 8/20/21 and 8/23/21.
CDC Split Type:

Write-up: Patient received Pfizer COVID vaccine on 5/24/21 and 6/15/21. On 8/10/21 patient began to develop symptoms of GI upset and subjective fevers and chills. Patient then had progressive respiratory distress and therefore seen at ED on 8/20/21 with thrombocytopenia and positive COVID status. Patient discharged in stable condition. Patient was called at home and told to present to the ED (our facility) for infusion of REGEN-COV (which was completed). However patient was noted to be shaking with chills, afebrile, mildly tachypneic. And upon further evaluation was noted to be satting as low as 89% on room air about exertion. Patient also required 2 L nasal cannula to maintain ox saturations greater than 94%. Patient admitted to our facility for acute hypoxic respiratory failure secondary to COVID-19 pneumonia on 8/23/21. As of today (8/31/21), patient is still in the inpatient setting.


VAERS ID: 1660308 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Patient received undiluted pfizer


VAERS ID: 1660317 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Flank pain, Musculoskeletal chest pain, Musculoskeletal pain, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Retroperitoneal fibrosis (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Physician formula eye vitamins, 250 mg Vit C, k2mk4. (45mg/day), 81 mg aspirin, 10 mg atoravastatin, Cimzia injections monthly with last shots around 7/23
Current Illness: RA, osteopenia, borderline pulmonary hypotension, mild atherosclerosis, splenic artery aneurism, kidney stone
Preexisting Conditions: RA, osteoporosis, psoriasis, splenic artery aneurysm , kidney stone, mild leak in mitral valvue
Allergies: N/A
Diagnostic Lab Data: Only a video exam as mentioned above and an exam on 8/31 by a vascular dr who agreed it must be a muscular issue? possibly a vaccine reaction
CDC Split Type:

Write-up: The evening of the day I had the shot ( in the morning), I had severe left rib and under the rib pain as well as pain on my left side and left lower back. The pain was intermittent day and night from Aug 23 thru Aug 29 when it magically disappeared as quickly as it had come upon me. I had a video call Dr. Appt on 8/26 with a GP who thought it must be muscleoskeletal although I had no pother precipitating event besides the covid 19 shot. I also saw a vascular doctor on 8/31 even though the pain was gone because there was also some swelling under the skin covering my rib which did not disappear and I wanted to make sure my situation was not related to my spleen issues


VAERS ID: 1661230 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-02-15
Onset:2021-08-23
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / OT

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test, 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: SARS-COV-2& Influenza A/B PCR molecular test. Nasal Swab Test Positive; Comments: Nasal Swab.
CDC Split Type: USPFIZER INC202101091612

Write-up: This is a spontaneous report from a contactable nurse. A 30-years-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19, Solution for injection, Batch/Lot Number: EL3247), intramuscular, administered in left arm on 15Feb2021 (at the age of 30-years-old) as DOSE 2, SINGLE and first dose of BNT162B2 (PFIZER-BIONTECH COVID-19, Solution for injection, Batch/Lot Number: EL3247), intramuscular, administered in left arm on 25Jan2021 (at the age of 29-years-old) as DOSE 1, SINGLE for covid-19 immunisation. The patient medical history was and concomitant medications were not reported. The patient experienced lack of efficacy and tested positive for covid19 with symptoms on 23Aug2021. It was unknown if patient had other vaccine in four weeks or if Covid prior vaccination. The patient underwent lab tests and procedures which included SARS-COV-2 & Influenza A/B PCR molecular test. Nasal swab test positive on 23Aug2021. Treatment for AE was unknown. The outcome of event was unknown. No follow-up attempts are possible. No further information is expected. Sender''s Comments: The vaccine efficacy varies from one patient to another and can be affected by different factors, however, a contributory role of the suspect vaccine BNT162B2 to the vaccination failure (LOE) and COVID-19 event cannot be ruled out. The impact of this report on the benefit/risk profile of the product is evaluated as part of procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, as appropriate.


VAERS ID: 1661255 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-05-07
Onset:2021-08-23
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anosmia, COVID-19, Headache, Pain, Pyrexia, SARS-CoV-2 test, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210825; Test Name: Nasal Swab; Test Result: Positive.
CDC Split Type: USPFIZER INC202101103326

Write-up: This is a spontaneous report from a contactable consumer or other non hcp (patient herself). A 48-years-old female patient received bnt162b2 (BNT162B2, Formulation: Solution for injection, Lot number: EW0175, Expiry date: Unknown) via an unspecified route of administration on 07May2021 as dose 2, single for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient did not have COVID prior vaccination. Patient tested positive post vaccination. The patient previously received bnt162b2 (lot number: EW0162) as dose 1 on 16Apr2021 for COVID-19 immunisation. The patient was not pregnant. On 23Aug2021, the patient tested positive for covid today aka breakthrough case, headache, fever, loss of smell, and body aches. The adverse event resulted in emergency room/department or urgent care. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 25Aug2021. It was unknown if therapeutic measures were taken for the events. The outcome of the events was recovering.


VAERS ID: 1661257 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-01-20
Onset:2021-08-23
   Days after vaccination:215
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test, 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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Coronary artery disease; Dyslipidemia; Pulmonary arteriovenous fistula; Type 2 diabetes mellitus
Allergies:
Diagnostic Lab Data: Test Date: 20210823; Test Name: COVID-19 (SARS-COV-2) PCR; Test Result: Positive; Comments: Nasal Swab.
CDC Split Type: USPFIZER INC202101103473

Write-up: This is a spontaneous report from a contactable pharmacist. An 88-year-old non-pregnant female patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), via unknown route of administration on 20Jan2021 (lot number: EL1283) (age at vaccination 88-year-old) as dose 2, single for COVID-19 immunisation. The patient had allergies of iodine and diltiazem. The patient medical history included non-obstructive CAD (May2017) and unknown if ongoing, DMT2, dyslipidemia, and PAF from an unknown date and unknown if ongoing. The patient concomitant medications were not reported. The patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection) on 30Dec2020 (lot number: EL1283) as dose 1, single for COVID-19 immunisation. Prior to the vaccination, it was unknown whether the patient was diagnosed with COVID-19. Since the vaccination, the patient had tested positive for COVID-19. The patient had COVID-19 breakthrough infection on 23Aug2021. The patient was hospitalized due to the event for one day. The laboratory investigation included Nasal Swab COVID-19 (SARS-COV-2) PCR and result was found to be positive on 23Aug2021. Treatment was received was unknown. The outcome of the event was unknown. No follow-up attempts are possible. No further information is expected. The vaccine efficacy varies from one patient to another and can be affected by different factors, however, a contributory role of the suspect vaccine BNT162B2 to the vaccination failure (LOE) cannot be ruled out. The impact of this report on the benefit/risk profile of the product is evaluated as part of procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, as appropriate.


VAERS ID: 1662161 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-25
Onset:2021-08-23
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin (HALFPRIN) 81 MG tablet buPROPion (WELLBUTRIN-SR) 150 MG SR tablets cilostazol (PLETAL) 50 MG tablet citalopram (CELEXA) 20 MG tablet clopidogrel (PLAVIX) 75 MG tablet Glucosamine-Chondroitin (OSTEO BI-FLEX REGULAR STRENGTH) 250-200
Current Illness: None known
Preexisting Conditions: COPD (chronic obstructive pulmonary disease) (HCC) PAD (peripheral artery disease) (HCC) Hiatal hernia Tuberculosis S/P insertion of iliac artery stent vascular Hyperlipidemia HTN (hypertension) Umbilical hernia without obstruction and without gangrene OSA (obstructive sleep apnea) Nocturnal hypoxemia Venous stasis ulcer of other part of lower leg limited to breakdown of skin with varicose veins, unspecified laterality (HCC) Embolism and thrombosis of arteries of the lower extremities (HCC) Chronic hypoxemic respiratory failure (HCC) Venous stasis ulcer limited to breakdown of skin with varicose veins (HCC) Pulmonary fibrosis (HCC)
Allergies: Augmentin
Diagnostic Lab Data: Patient reported COVID-19 positive test on 8/23/2021.
CDC Split Type:

Write-up: Patient presented to emergency department on 8/26/2021 with cough and shortness of breath that started 5 days prior. He tested positive for COVID-19 at an outside facility on 8/23/2021. He was admitted for further management. He required additional oxygen supplementation about his baseline of 3L. He was also treated with remdesivir and decadron. Patient''s symptoms improved and was discharged home on 8/30/2021.


VAERS ID: 1662178 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-23
Onset:2021-08-23
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Acute respiratory failure, Adenovirus test, Angiogram pulmonary abnormal, Blood potassium decreased, Bordetella test negative, COVID-19, COVID-19 pneumonia, Chlamydia test negative, Computerised tomogram abnormal, Computerised tomogram thorax abnormal, Convalescent plasma transfusion, Coronavirus test negative, Cough, Dyspnoea, Enterovirus test negative, Human metapneumovirus test, Human rhinovirus test, Hypokalaemia, Influenza A virus test negative, Influenza B virus test, Lung infiltration, Lung opacity, Mycoplasma test negative, Respiratory syncytial virus test negative, SARS-CoV-2 test positive, Scan with contrast abnormal, Viral test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Interstitial lung disease (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler amLODIPine (NORVASC) 10 mg tablet atorvastatin (LIPITOR) 40 mg tablet benzonatate (TESSALON) 100 mg capsule dexAMETHasone (DECADRON) 6 mg tablet losartan (COZAAR) 100 mg table
Current Illness:
Preexisting Conditions: Nervous LLQ pain Circulatory Hypertension Digestive Constipation Diverticulitis of colon Diverticulosis Infectious/Inflammatory COVID-19 virus infection Other Epidermal inclusion cyst Bloating
Allergies: Sulfamethoxazole-trimethoprim
Diagnostic Lab Data: 08/23/21 2046 Respiratory virus detection panel Collected: 08/23/21 1946 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected Procedure Component Value Ref Range Date/Time CT angiogram chest pulmonary embolism with and without contrast Resulted: 08/30/21 0802 Order Status: Completed Updated: 08/30/21 0802 Narrative: CTA CHEST PULMONARY EMBOLISM W WO CONTRAST IMPRESSION: 1. Limited exam for the assessment of pulmonary embolism. No large central embolism present. 2. Findings characteristic for COVID related lung disease. END OF IMPRESSION: INDICATION: Shortness of breath and cough, COVID positive, assess for pulmonary artery embolism. TECHNIQUE: Enhanced helical CT scan of the chest was performed from the lung apices to below the diaphragm. 2 mm axial reconstruction with MPR coronal, oblique and sagittal images were created. 3D shaded surface images also created on a separate workstation and permanently stored. Images were obtained without and with contrast. CONTRAST: 80mL of IODIXANOL 320 MG IODINE/ML INTRAVENOUS SOLUTION administered INTRAVENOUS. Quality of contrast opacification was inadequate. COMPARISON: 12/13/2012. FINDINGS: Exam is limited by poor opacification of the pulmonary arteries. No large central embolism is identified in the main pulmonary arteries. The heart, aorta, and main pulmonary artery are within normal limits in size. Calcified plaque is noted in the aorta and coronary arteries. There is moderate predominantly peripheral patchy groundglass opacity bilaterally, characteristic for COVID-19 lung disease. No endobronchial lesions are identified. No pleural effusion nor pneumothorax is present. No acute findings are identified in the upper abdomen. There is mild degenerative change in the spine. There are no acute bone findings.
CDC Split Type:

Write-up: Cough, Acute hypoxemic respiratory failure ED to Hosp-Admission Discharged 8/23/2021 - 8/28/2021 (5 days) Hospital covid, hypoxia, htn Presenting Problem/History of Present Illness/Reason for Admission COVID-19 virus infection Hospital Course 60-year-old female presented with acute respiratory insufficiency secondary to COVID-19 pneumonia with bilateral infiltrates on CT scan and negative for PE She was placed on oxygen had convalescent plasma and a 5-day course of remdesivir and she started on dexamethasone 6 mg daily Her oxygen was weaned to room air but needs 6 L with exertion and sleep and she is on room air with being awake at rest She has essential hypertension she presented with severe hypokalemia the potassium was 2.6 her blood pressures were on the low side we held her blood pressure medication she had AKI as well her losartan was held as well The AKI resolved the hypokalemia resolved with replacement and we restarted her on her blood pressure medications amlodipine and losartan but hold the hydrochlorothiazide which she might restart at home depending on what her blood pressures are. The blood pressure at the time of discharge is 130/80 with a heart rate of 70


VAERS ID: 1662292 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-02-14
Onset:2021-08-23
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

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

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

Write-up: Hospitalization due to COVID-19 Reported per Pfizer COVID-19 Vaccine EUA


VAERS ID: 1662326 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect dose administered, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was injected with an empty syringe that did not contain vaccine. A second syringe with vaccine was injected, and patient''s mother believes he was first injected with a used syringe due to a sore arm that was "hard as a rock"


VAERS ID: 1662328 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-01-23
Onset:2021-08-23
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: End stage COPD
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization due to COVID-19 Reported per Moderna COVID-19 Vaccine EUA


VAERS ID: 1662360 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-02-20
Onset:2021-08-23
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Relugolix
Current Illness:
Preexisting Conditions: History of prostate cancer
Allergies:
Diagnostic Lab Data: COVID-19 PCR positive with cycle threshold of 21.6 on 8/23/2021
CDC Split Type:

Write-up: Hospitalized for COVID-19 Reported per Pfizer COVID-19 Vaccine EUA


VAERS ID: 1662376 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Cold sweat, Depressed level of consciousness, Feeling hot, Hyperhidrosis, Immediate post-injection reaction, Loss of consciousness, Sensory disturbance, Thirst, Urinary incontinence
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: After receiving the shot I immediately felt like there was hot water running through my entire body , I was sweaty thirsty and clammy , when I woke up I was on the ground and told me I was out for over 10 minutes and I had pee all over , she thought it might have been a seizure as she was unable to rouse me . She called the ambulance and I was checked out at and sent home


VAERS ID: 1662434 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-02
Onset:2021-08-23
   Days after vaccination:82
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Blood culture negative, Blood sodium decreased, COVID-19, Calculus urinary, Chest X-ray normal, Computerised tomogram abnormal, Condition aggravated, Cough, Culture urine positive, Decreased appetite, Flank pain, Hydronephrosis, Nausea, Pyelonephritis, Red blood cells urine positive, Renal colic, SARS-CoV-2 test positive, Staphylococcal infection, Ultrasound kidney abnormal, Ureteral stent insertion, Ureterolithiasis, Urinary tract infection, Urine analysis abnormal, Vomiting, White blood cells urine positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Tubulointerstitial diseases (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet amLODIPine (NORVASC) 5 MG tablet atorvastatin (LIPITOR) 20 MG tablet gabapentin (NEURONTIN) 300 MG capsule HYDROcodone-acetaminophen (NORCO) 7.5-325 MG per tablet insulin glargine (LANTUS SOLOSTAR) 100
Current Illness: NA
Preexisting Conditions: Renal colic UTI (urinary tract infection) Ureterolithiasis Renal colic on left side MRSA UTI
Allergies: ibuprofen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient hospitalized; Positive for COVID-19 (after being vaccinated) BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider at Discharge: None Physician, MD None Admission Date: 8/23/2021 Discharge Date: 8/27/2021 Active Hospital Problems Diagnosis Date Noted POA ? MRSA UTI 08/27/2021 Yes ? Renal colic 08/24/2021 Yes ? UTI (urinary tract infection) 08/24/2021 Yes ? Ureterolithiasis 08/24/2021 Yes ? Renal colic on left side 08/24/2021 Yes Resolved Hospital Problems No resolved problems to display. DETAILS OF HOSPITAL STAY: 58-year-old man presenting to our institution with left-sided flank pain. Reports that this pain felt similar to previous kidney stones he experienced in the past. Pain was present for 4-5 days prior to admission, social with poor appetite, nausea and significant vomiting, likely secondary to pain. No fevers or chills associated. He presented to an outside emergency department, with urinalysis showing 2-5 red blood cells, CT showed obstructing 6 mm urolithiasis at the left ureteropelvic junction. He was discharged home for supportive care. Patient presented back, with worsening flank pain. The emergency department his identified to have sodium of 128, urinalysis showed 73 WBCs. Renal ultrasound showed mild left-sided hydronephrosis. Patient also was identified to have COVID-19, the setting of vaccination, having received to Johnson Johnson vaccine in March 2021. Patient was admitted to the general medicine service. He was seen in consultation with Urology. He was felt inappropriate candidate for surgical intervention due to acute infection. The patient underwent placement of a left ureteral stent on 08/25/2021. Urology is planning an outpatient ESWL in 2-4 weeks. Urine culture revealed MRSA. This is unusual organism in the setting of a community acquired pyelonephritis. Blood cultures were obtained x2 as Staph aureus bacteria can be associated with bloodstream infection, and culture results negative after 3 days. Patient will discharge on oral Bactrim to continue while the stent is in place. In regards to his COVID-19 infection, patient developed some mild cough. Chest x-ray was obtained which showed no evidence of an infiltrate. Patient was treated with Regeron monoclonal antibody infusion on 08/24/2021. Remained on DVT prophylaxis throughout the hospitalization. Patient has acute kidney injury which was present on admission, resolved with hydration.


VAERS ID: 1662451 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 18 / UNK LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Fatigue, Headache, Nasal discomfort, Pain, Pyrexia, Respiratory viral panel, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control , iron and nuvigil
Current Illness: Nothing healthy
Preexisting Conditions: Nothing
Allergies: Nope
Diagnostic Lab Data: Just CVOID testing along with all upper raspatory test that came back negative
CDC Split Type:

Write-up: tiredness headache fever body aches all over extremely ache to any movement nose burns on the inside


VAERS ID: 1662593 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / 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: all vaccines since childhood has not had a reaction or vaccine in 18 years
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fainted for approximetly 4 to 5 seconds


VAERS ID: 1662665 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-03-29
Onset:2021-08-23
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003B21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: docusate-senna (SENOKOT-S) 50-8.6 mg per tablet Take 1 tablet by mouth 2 times daily . Patient not taking: Reported on 8/23/2021. glucose blood VI test strips (BLOOD GLUCOSE TEST STRIPS) strip One Touch Ultra Blue test strips Test bl
Current Illness: ? Bilateral leg edema 6/11/2021 6/2021?begin compression stockings ? Bladder infection, chronic ? Diabetes mellitus type 2, uncomplicated (HCC) 6/19/2007 A1C: 9/1210.9, 3/13 Lipid Panel: 3/13 Urine microalbumin/cr: 3/13 Eye Exam: Foot Exam:3/13 Creatinine: 3/13 ? Essential hypertension ? Neurogenic bladder 1/20/2021 - refer to abnormal urine ? Paroxysmal atrial fibrillation (HCC) 2/2/2017 1/2017 ? Patellar bursitis of right knee 1/28/2019 2018?Seeley Lake aspiration, treated with antibiotics, right side ? Pyelonephritis 10/25/2019 10/2019?emergency room, trial Ceftin., CT scan 10/2019?grew Candida glabrata. Unhelped by Ceftin so begin fluconazole 200 mg a day for 10 days ? Syncope 10/12/2015 10/15 EKG ? Unspecified hypothyroidism 6/19/2007
Preexisting Conditions: See section 11
Allergies: ? Lisinopril Caused cough
Diagnostic Lab Data: SARS-CoV-2 RNA Resp Ql NAA+probe DETECTED Ordered Test: SARS-CoV-2 RNA Resp Ql NAA+probe Status: Final Specimen Source: SOFT TISSUE SAMPLE Specimen Site: ENTIRE NASOPHARYNX Specimen Collection Date/Time: 2021-08-23 13:13:00.0
CDC Split Type: 1003026

Write-up: Case completed MOderna Covid vaccine series on 3/29/21, then was admitted to the hospital on 8/23/21 for treatment of Covid pneumonia.


VAERS ID: 1662737 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin c, elderberry
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: EKG, chest xray, blood draw
CDC Split Type:

Write-up: chest pain, chest tightening


VAERS ID: 1662756 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-07
Onset:2021-08-23
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: C-reactive protein, COVID-19, Chest X-ray normal, Cough, Decubitus ulcer, Feeding tube user, Fibrin D dimer, Glossectomy, Headache, Hunger, Leukocytosis, Metabolic function test, Multimorbidity, Musculoskeletal chest pain, Nausea, Pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: atorvastatin (LIPITOR) 40 MG tablet; B-D UF III MINI PEN NEEDLES; bacitracin 500 UNIT/GM ointment; baclofen (LIORESAL) 5 MG tablet; chlorhexidine (PERIDEX) 0.12 % solution; cholecalciferol (VITAMIN D3) 50 MCG (2000 UT) capsule; FLUoxetine (
Current Illness: COVID-19 positive; Procedure to convert G-tube to GJ-tube 7.29.21 (anesthesia); Tongue cancer
Preexisting Conditions: Hospital; CRI (chronic renal insufficiency), stage 3 (moderate); Type 2 diabetes mellitus with stage 3 chronic kidney disease, with long-term current use of insulin (HCC) Essential hypertension; Schizophrenia, unspecified type (HCC); Hx of tongue cancer; OAB (overactive bladder); COVID-19 with multiple comorbidities; GERD (gastroesophageal reflux disease) Suspected adult maltreatment; Non-Hospital; Mixed hyperlipidemia Morbid obesity with BMI of 45.0-49.9, adult (HCC); Asthma, mild intermittent; Major depressive disorder, recurrent, moderate (HCC); Auditory hallucinations; Generalized anxiety disorder; Anemia of renal disease; Lumbosacral pain; Irritable bowel syndrome Anemia, iron deficiency; Tongue cancer (HCC); Steroid-induced hyperglycemia
Allergies: Acetaminophen Throat swelling; Latex Throat swelling; Nuts Throat swelling; Aspirin Swelling
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient hospitalized with COVID-19; fully vaccinated. HISTORY OF PRESENT ILLNESS: Patient is a 65 y.o. female with a history of oral cancer and type 2 diabetes who presents today with cough. She has been residing in Home for rehabilitation after hemiglossectomy last month. Her caregiver expresses concerns about neglect at the facility and does not wish her to go back there. She was diagnosed with COVID-19 earlier in the day at the facility. She has been having cough and body aches. She denies fever. She is fully vaccinated with the Pfizer vaccine. On arrival, she is on her baseline supplemental oxygen use of 2 L. She does have leukocytosis. There is no radiographic evidence of pneumonia. On exam, she says she is nauseated and hungry. She otherwise complains of a mild headache. Plans are discussed for admission and she is agreeable. She wishes to be listed as full code status. 8/26 DR Chest: No acute cardiopulmonary disease is present. Assessment/Plan; COVID-19 with multiple comorbidities; Fully Vaccinated with Pfizer. CXR negative for any acute findings. Repeat CXR on 8/26 no acute cardiopulmonary disease; Trach in place. Positive date 8/23/21; daily CMP/CRP/D-dimer; Tylenol PRN; Robitussin PRN; Tessalon PRN; PT/OT recommends placement back to skilled nursing facility; Continue Decadron 6 mg Day 7; Remdesivir completed; H/o tongue cancer; S/p hemiglossectomy 7/20/21; Feeds through PEG tube; Trach care per ENT, can do radiation outpatient after placement to SAR; cap trach today, if respiratory status stable for 24 hours, can decannulate per the patient''s ENT; Rib pain; Improving. Secondary to cough. Patient unable to take Tylenol and wary of NSAIDs given CKD3. Lidocaine patch without relief. Flexeril does offer some relief added tessalon perles to better control cough no topical NSAID available; Flexeril 5mg TID PRN; if more relief needed, 1x toradol would be appropriate as kidney function stable. Pressure sore; Present under tracheostomy site. No signs of infection on exam. Foam pad, antibiotic ointment may benefit from barrier ointment ie Aquafor or similar if continues to be irritated; GERD; Protonix; Asthma Albuterol PRN; OAB Oxybutynin; Schizophrenia Prozac; Latuda 40 mg; Hypertension; Currently poorly controlled. 25 mg of Hydralazine daily; Increase lisinopril to 20mg BID; DM2 Poorly controlled and on Dexamethasone Currently on 36 units glargine nightly and high dose corrective q4 hours. On tube feeds 1600-1000. Continue CSI very high dose; increase glargine to 40 units nightly; CKD 3; Baseline around 1.3; CMP daily; Suspected Maltreatment Patient and care give giver report mistreatment from Mission Point; DISPO: COVID treatment with decadron and remdesivir. Placement difficult. Code Status: Full code; Diet: PEG; DVT ppx: Lovenox 40 mg BID.


VAERS ID: 1662806 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-22
Onset:2021-08-23
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Condition aggravated, SARS-CoV-2 test positive, Spinal column injury, Staphylococcal infection, Staphylococcus test positive, Wound infection, Wound treatment
SMQs:, Accidents and injuries (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ascorbic acid (VITAMIN C) 500 MG tablet carbidopa-levodopa (SINEMET) 25-100 MG per tablet doxycycline (ADOXA) 100 MG tablet flecainide (TAMBOCOR) 50 MG tablet fluticasone (FLONASE) 50 MCG/ACT nasal spray furosemide (LASIX) 20 MG tablet guai
Current Illness: COVID-19 positive, fully vaccinated status post left hip hemiarthroplasty and initiation of nonoperative treatment of a left proximal humerus fracture. pressure sores staph infection
Preexisting Conditions: Presence of Watchman left atrial appendage closure device History of TIA (transient ischemic attack) Barrett''s esophagus without dysplasia Hypertension Hyperlipidemia PSVT (paroxysmal supraventricular tachycardia) ETD (eustachian tube dysfunction) Impacted cerumen Chronic mastoiditis Persistent atrial fibrillation Parkinson''s disease BPH (benign prostatic hyperplasia) Mixed hearing loss, unilateral SNHL (sensorineural hearing loss) Constipation, unspecified constipation type Fall Fracture of neck of femur Fracture of left humerus with routine healing Fracture of head of femur Fracture of seventh cervical vertebra Fall from ground level Pressure injury of left heel, stage 4 Pressure injury of sacral region, stage 4 Pressure injury of left elbow, unstageable
Allergies: penicillins - GI upset
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized; COVID-19 positive; fully vaccinated. Brief Overview: Admission Date: 8/23/2021 Discharge Date: 8/26/21 HOSPITAL PROBLEMS 1. Stage IV pressure wound on coccyx, infected 2. Covid 19 infection 3. Stage IV pressure wound on left heel 4. Pressure injury of left elbow, unstageable 5. Parkinson''s dementia 6. BPH 7. Atrial fibrillation PRESENTING PROBLEM Chief Complaint Patient presents with ? WOUND PROBLEM wounds to left heel and coccyx tested positive for staph 8/13. Has been on doxycycline with worsening to wounds. Pt also tested positive for COVID today. Has been vaccinated HOSPITAL COURSE Patient is a 81 y.o. male with history of Parkinson''s dementia who was recently admitted for rehab after sustaining a fall with left femur and humerus fracture. While there he developed pressure ulcer on his heel, elbow, and coccyx. This started smelling foul and wound culture was growing MRSA. He was started on doxycycline there. His wounds continued to worsen and he presented to hospital. He was admitted and started on Vancomycin. Wound consult was performed with recommendations for wound management including dressings. He was additionally evaluated by therapy with recommendations for SAR. He was tolerating oral intake, VSS, and was felt stable for discharge. He was discharged for therapy and wound care. He was discharged on doxycycline to complete antibiotic course. Of note, patient did test positive for Covid-19 prior to presentation to hospital. He was asymptomatic and did not require any treatments for Covid. He was previously vaccinated. Follow-Up: - Ongoing wound care management - Post-hospitalization follow-up including doxycycline course completion.


VAERS ID: 1662849 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-18
Onset:2021-08-23
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 6205 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 6203 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: hospitalized 8/23 throu 8/27 for unknown reason. case not interviewed.


VAERS ID: 1663047 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-08-19
Onset:2021-08-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram abdomen, Full blood count, Hypophagia, Liver function test, Metabolic function test, Nausea, Scan with contrast, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Overweight, possible hemochromotosis
Allergies: No known allergies
Diagnostic Lab Data: CT A/P with contrast, RUQUS 26AUG2021 CBC, LFTs, BMP, 26AUG2021
CDC Split Type:

Write-up: symptoms of nausea, abdominal pain, and vomiting started 23AUG and progressed with inability to tolerate oral intake, resulting in hospitalization for fluids and electrolyte repletion. Symptoms resolved 01SEP2021.


VAERS ID: 1663048 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-26
Onset:2021-08-23
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: positive test 8/23/2021
CDC Split Type:

Write-up: breakthrough infection 8/23/2021


VAERS ID: 1663055 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-12
Onset:2021-08-23
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 6206 / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Malaise, 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: No e
Preexisting Conditions: BMI 36 Pre-hypertension
Allergies: None
Diagnostic Lab Data: Positive covid tests on 8/24 & 8/25
CDC Split Type:

Write-up: On 8/23 I started to have mild symptoms and on 8/24 I tested positive for COVID-19. So far my symptoms have not been severe or required hospitalization but I was and am symptomatic.


VAERS ID: 1663068 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-08-09
Onset:2021-08-23
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

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

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

Write-up: Patient developed Shingles 2 weeks after receiving the vaccine


VAERS ID: 1663139 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-23
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Condition aggravated, Decreased appetite, Dizziness, Mental status changes, Migraine, Nausea, Thirst decreased, Vertigo
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Immuno allergy therapy shots Zendocrine detoxification capsules Optase Eyestusis Tylonel
Current Illness: Migraines
Preexisting Conditions: Migraines
Allergies: Pencilin Xanax
Diagnostic Lab Data: Blood work 8/29/2021
CDC Split Type:

Write-up: Vertigo, migraine, nausea , loss of appetite/loss of thirst, altered mental status Started about 3 days after I got the shot. Currently taking meclizine for dizziness and butalibital for migraine


VAERS ID: 1663237 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-09
Onset:2021-08-23
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anosmia, COVID-19, Chest pain, Chills, Computerised tomogram thorax normal, Cough, Dyspnoea, Fibrin D dimer, Headache, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: alendronate, aspirin, buspirone, famotidine, furosemide, gabapentin, loratadine, losartan, metformin, metoprolol, dulera, montelukast, potassium chloride ER tablets, pravastatin, Spiriva, tizanidine, venlafaxine, ergocalciferol
Current Illness:
Preexisting Conditions: degenerative disk disease, GERD, vitamin D deficiency, asthma, stress urinary incontinence, anxiety, obstructive sleep apnea, allergic rhinitis, migraines, hyperlipidemia, osteopenia, fatty liver, Morbid obesity (BMI 65.6), recurrent major depression, cardiomegaly, PTSD, prediabetes
Allergies: NKA
Diagnostic Lab Data: 9/1/21 CT Chest PE: negative for PE, clear lungs D-dimer: 0.64 8/29/21 COVID-19 rapid: positive
CDC Split Type:

Write-up: Patient initially presented to ED on 8/29/21 with symptoms consistent with COVID-19 (loss of smell, cough, shortness of breath, fever, chills). Patient did test positive for COVID-19 on 8/29 and was discharged with orders to receive a Regneron infusion on 8/31/21. The patient did receive the infusion. The patient presented to ED again on 9/1/21 with chest pain and shortness of breath as well as headache. The patient was found not to have any evidence of PE and O2 sat 96%. The patient''s headache was treated with dexamethasone and promethazine. The patient will be discharged home.


VAERS ID: 1663395 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-19
Onset:2021-08-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 reported that she noticed "red dots/patches" all over her legs, back, breast/stomach area after getting the second dose of the Pfizer vaccine which have not gotten better.


VAERS ID: 1663925 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-02-04
Onset:2021-08-23
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 2 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: CG tested positive for COVID 8/24


VAERS ID: 1665379 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:0000-00-00
Onset:2021-08-23
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Chest pain, Dizziness, Dyspnoea, Fatigue, Injection site pain, Lethargy, Nausea, Renal pain, Somnolence
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Cigarette smoker (patient smokes cigarettes)
Preexisting Conditions: Medical History/Concurrent Conditions: Adenoidectomy; Gallbladder removal; Splenectomy; Tonsillectomy; Comments: The patient had no known allergies and no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210848930

Write-up: SHORTNESS OF BREATH; DIZZINESS; KIDNEY PAIN; LOWER BACK PAIN; CHEST PAIN; ALMOST LETHARGIC; PAIN AT INJECTION SITE; VERY TIRED; NAUSEA; SLEPT THE MOMENT HE GOT VACCINE; This spontaneous report received from a consumer concerned a 44 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included: adenoids removed, spleen removed, gallbladder removed, and tonsils removed, and concurrent conditions included: cigarettes smoker, and no alcohol use, and other pre-existing medical conditions included: The patient had no known allergies and no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A, 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 slept the moment he got vaccine. On 24-AUG-2021, the patient experienced shortness of breath. On 24-AUG-2021, the patient experienced dizziness. On 24-AUG-2021, the patient experienced kidney pain. On 24-AUG-2021, the patient experienced lower back pain. On 24-AUG-2021, the patient experienced chest pain. On 24-AUG-2021, the patient experienced almost lethargic. On 24-AUG-2021, the patient experienced pain at injection site. On 24-AUG-2021, the patient experienced very tired. On 24-AUG-2021, the patient experienced nausea. Treatment medications (dates unspecified) included: naproxen sodium. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the dizziness, kidney pain, lower back pain, very tired, pain at injection site, chest pain, shortness of breath, almost lethargic, nausea and slept the moment he got vaccine was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure as case assessed as non-serious.


VAERS ID: 1665383 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-08-23
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 antibody test, Therapy non-responder
SMQs:, Lack of efficacy/effect (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient was allergic to NSAIDS and had no previous medical history.
Allergies:
Diagnostic Lab Data: Test Date: 20210823; Test Name: SARS-CoV-2 IgG antibody test; Result Unstructured Data: Negative; Test Date: 20210824; Test Name: SARS-CoV-2 IgG antibody test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210854725

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient concerned a 59 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: The patient was allergic to NSAIDS and had no previous medical history. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A, and expiry: UNKNOWN) dose was not reported, 1 total, administered on 03-APR-2021 to right arm for prophylactic vaccination. No concomitant medications were reported. On 23-AUG-2021, the patient received a negative IgG antibody test and then again on 24-AUG-2021 (confirmed immunological vaccine failure). The patient was calling to inquire if there is any information regarding that situation. She had no other symptoms to report. Patient received vaccination aged 58 years, had birthday week after vaccination and experienced adverse event aged 59 years. 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).; Sender''s Comments: V0:20210854725-covid-19 vaccine ad26.cov2.s-confirmed immunological vaccine 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


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