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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 421 out of 8,010

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VAERS ID: 1665395 (history)  
Form: Version 2.0  
Age: 75.0  
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 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210855614

Write-up: VACCINE ADMINISTERED ON 23-AUG-2021 FROM A VIAL THAT WAS PUNCTURED ON 19-AUG-2021 (VACCINE GIVEN AFTER 6 HOURS OF PUNCTURE); This spontaneous report received from a pharmacist concerned a 75 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: penicillin allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: 21-SEP-2021) dose was not reported, administered on 23-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 23-AUG-2021, the patient experienced vaccine administered on 23-aug-2021 from a vial that was punctured on 19-aug-2021 (vaccine given after 6 hours of puncture). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of vaccine administered on 23-aug-2021 from a vial that was punctured on 19-aug-2021 (vaccine given after 6 hours of puncture) was not reported. This report was non-serious. This case, from the same reporter is linked to 20210855201 and 20210854749.


VAERS ID: 1665396 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Arizona  
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 1805020 / 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: Hypertension (controlled by medication); Non-smoker; Social alcohol drinker
Preexisting Conditions: Comments: The patient had known allergies and no drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data: Test Date: 20210823; Test Name: SARS-CoV-2 IgG antibody test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210855625

Write-up: Confirmed Immunological Vaccine Failure; This spontaneous report received from a patient concerned a 39 year old female. The patient''s weight was 210 pounds, and height was 69 inches. The patient''s concurrent conditions included hypertension controlled by medication, social alcohol user, and non-smoker. The patient had known allergies and no drug abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 1805020 expiry: 23-AUG-2021) dose was not reported, 1 total, administered on 05-APR-2021 to right arm for prophylactic vaccination. No concomitant medications were reported. On 23-AUG-2021, the patient underwent COVID-19 SARS-CoV-2 Antibody (IgG), Spike, Semi-quantitative test, and it came back negative (confirmed immunological vaccine failure). The patient reported that according to the package, this particular test provides insight to antibody response to infection and exposure to the vaccine. The patient not discussed this results with her health care provider (HCP). The patient performed this test because of the recent discussion of boosters, and she wanted to know if she was still covered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with a product quality complaint: 90000191192.; Sender''s Comments: V0. 20210855625-covid-19 vaccine ad26.cov2.s-Confirmed immunological 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: 1665397 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Massachusetts  
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: Diarrhoea, Headache, Nausea, Oropharyngeal pain, SARS-CoV-2 test, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (A glass of wine a night.); Non-smoker
Preexisting Conditions: Comments: Patient had no known drug allergies and no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 20210823; Test Name: SARS-CoV-2 rapid diagnostic test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210855639

Write-up: SORE THROAT; DIARRHEA; VOMITING; HEADACHE; NAUSEA; This spontaneous report received from a patient concerned a 40 year old female. The patient''s weight was 165 pounds, and height was 68 inches. The patient''s concurrent conditions included: alcohol use, and non smoker, and other pre-existing medical conditions included: Patient had no known drug 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, expiry: UNKNOWN) dose was not reported, administered on APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 23-AUG-2021, the patient experienced sore throat. On 23-AUG-2021, the patient experienced diarrhea. On 23-AUG-2021, the patient experienced vomiting. On 23-AUG-2021, the patient experienced headache. On 23-AUG-2021, the patient experienced nausea. Laboratory data included: SARS-CoV-2 rapid diagnostic test (NR: not provided) Negative. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the diarrhea, sore throat, headache, vomiting and nausea was not reported. This report was non-serious.


VAERS ID: 1665957 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Error: Incorrect Reconstitution-


VAERS ID: 1666254 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-14
Onset:2021-08-23
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / UNK - / -

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

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

Write-up: Client was in contact with Covid at school


VAERS ID: 1666275 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-04
Onset:2021-08-23
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A218 / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Sars test - nasal swab
CDC Split Type:

Write-up: Patient tested positive for Covid.


VAERS ID: 1666295 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-24
Onset:2021-08-23
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / -

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

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

Write-up: Covid positive due to contact with positive daughter


VAERS ID: 1666319 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 938893 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site induration, 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? Yes
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: macrobid
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient returned to pharmacy on 9/1/21 stating she had the following symptoms evening following vaccination: extreme swelling, red, large knot at injection site (size of golf ball). Patient states that symptoms started to improve after one week. As of today, small amount of swelling remaining.


VAERS ID: 1666342 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-09
Onset:2021-08-23
   Days after vaccination:136
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / UNK - / -

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

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

Write-up: Covid positive due to contact with positive household member


VAERS ID: 1666361 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-20
Onset:2021-08-23
   Days after vaccination:215
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / UNK - / -

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

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

Write-up: COVID-19 positive due to possible contact with family member or at work.


VAERS ID: 1666379 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-26
Onset:2021-08-23
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / UNK - / -

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

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

Write-up: Covid positive. Contact unknown


VAERS ID: 1666384 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Anion gap, Aspartate aminotransferase normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood lactate dehydrogenase increased, Blood lactic acid, Blood potassium normal, Blood sodium normal, Blood urea normal, Brain natriuretic peptide increased, C-reactive protein increased, COVID-19, COVID-19 pneumonia, Carbon dioxide normal, Cardiomegaly, Chest X-ray abnormal, Cough, Dyspnoea, Extra dose administered, Glomerular filtration rate normal, Inflammatory marker test, International normalised ratio, Liver function test normal, Lung opacity, Oxygen saturation decreased, Patient isolation, SARS-CoV-2 test positive, Serum ferritin increased, Staphylococcus test negative, Tachypnoea, Transaminases increased, Troponin I normal
SMQs:, Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amoxicillin 500 mg Oral Cap; Sig: Take 1 capsule by mouth 4 times a day for 7 days; Baclofen (LIORESAL) 10 mg Oral Tab; Sig: TAKE 0.5 TO 1 TABLET ORALLY 3 TIMES A DAY; Patient not taking: No sig reported; Cetirizine (ZyrTEC) 10 mg Oral Tab;
Current Illness: None
Preexisting Conditions: afib on coumadin, CAD (positive MPS in 6/2019), moderate MR, DM (diet control), CKD
Allergies: Allergies; Allergen; Reactions; Ciprofloxacin GI Symptoms; Severe heartburn. Feeling of impending doom. Fentanyl; Blood pressure/anxiety; Tolerated during conscious sedation for colonoscopy; Flomax [Tamsulosin] GI Symptoms; Severe heartburn. Succinylcholine Chloride; Anaphylaxis
Diagnostic Lab Data: Results as of 9/2/2021 09:32; 8/23/2021 14:35; NA: 138; K: 4.2 CL: 103; CO2: 29; BUN: 15; CREAT: 1.08; ANION GAP4 SERPL: 6; GLUC: 177 (H); TROPONIN I: <0.02; BNP: 213 (H); GFR-AFRAM: $g60; GFR NONAFR AMER: $g60; COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE; 8/23/2021 14:54; 8/23/2021 15:28; 8/23/2021 17:30; LACTATE: 1.1; 8/23/2021 23:25; 8/24/2021 00:55; 8/24/2021 03:48; NA: 137; K: 4.0; CL: 103; CO2: 28; BUN: 18; CREAT: 0.95; ANION GAP4 SERPL: 6; MG: 1.9 GLUC: 124; TROPONIN I: <0.02; LDH: 194; ALT: 18; AST: 18; ALKP: 70; TBILI: 0.5; COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE; CRP, SER QL: 11.3 (H); FERRITIN: 307; 8/30/2021 04:17; NA: 139; K: 4.2; CL: 105; CO2: 26; BUN: 18; CREAT: 1.04; ANION GAP4 SERPL: 8; GLUC: 152; TROPONIN I: <0.02; BNP: 129 (H) ALT: 85 (H); AST: 68 (H); ALKP: 87; TBILI: 0.4; GFR-AFRAM: $g60; GFR NONAFR AMER: $g60; COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE; CRP, SER QL: 5.3 (H); 8/30/2021 04:33; 8/30/2021 15:40; 8/31/2021 06:58; NA: 141; K: 4.2; CL: 105; CO2: 28; BUN: 24; CREAT: 0.94; ANION GAP4 SERPL: 8; GLUC: 164 (H); ALT: 70 (H); AST: 43 (H); ALKP: 93; TBILI: 0.5; COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE; CRP, SER QL: 2.8 (H) S AUREUS METHICILL RESIST ISLT; Final Report ; No Methicillin resistant Staph aureus isolated; XRAY CHEST; ** HISTORY **: Male, age 79 years: COUGH Possible COVID patient ** TECHNIQUE **: 1 view of the chest acquired. COMPARISON: Radiograph 8/23/2021 ** FINDINGS ** LUNGS: Lungs are hazy with airspace disease in left midlung. No pneumothorax. MEDIASTINUM/OTHER: The heart is enlarged.
CDC Split Type:

Write-up: 79 y/o man with Diabetes Mellitus type II (not on meds), Afib(on Warfarin), MDD, chronic kidney disease stage 3 (baseline creat 1-1.3), Coronary artery disease (per MPS 6/2019, previously medical management), who is fully COVID-19 vaccinated (including 3rd shot 8/20/21), presents to ED with decreased O2 sat of 87% when ambulating at home in setting of 2 week history of dry cough (sxs starting 8/15) and positive COVID-19 test on 8/23/21, found to have COVID-19 pneumonia. Patient with mild desat at rest but very tachypneic with ambulation so was admitted for further monitoring and treatment. Started on Remdesivir and Decadron. Patient had stable respiratory status with improvement in SOB. Was able to ambulate without any desaturation or shortness of breath. COVID-19 Pneumonia- Symptom onset on 8/15. COVID positive on 8/23. Now on RA at rest and with exertion. Inflammatory markers improved. Will continue Decadron 6mg PO qday for another 7 days; Remdesivir 200mg IV x1 (8/30-), followed by 100mg IV daily. Stop after today''s dose; Daily LFTs stable; Pepcid for GI prophylaxis; Patient on Warfarin; continue isolation in hospital per Regional/Local ID guidance. Mild transaminitis: no abdominal symptoms. Improving Afib: rate controlled; Cont Metoprolol 25mg BID; Warfarin per protocol. INR has been supratherapeutic. Hold Warfarin 8/31. INR check 9/1/21; Diabetes Mellitus type II: A1c 6.7 3/16/21. Not on meds. Was placed on correctional scale insulin during hospitalization. Overall controlled even with Decadron. Coronary artery disease: per MPS. No chest pain. Patient previously on ASA, Atorvastatin, unclear why no longer on this. F/u with PCP; Chronic kidney disease stage 3: stable monitor; Reason for Hospital Admission (Admitting Diagnosis): COVID-19 Pneumonia; Previous COVID Vaccine History; 8/20/2021 Given 0.3 mL Lt deltoid IM PFR EW0191 PFIZER COVID-19 VACCINE (PF) Delete History; 3/1/2021 Given 0.3 mL Lt deltoid IM PFR EN6201 PFIZER COVID-19 VACCINE (PF) Delete History; 2/8/2021 Given 0.3 mL Lt deltoid IM PFR EN6201 PFIZER COVID-19 VACCINE (PF) Delete History.


VAERS ID: 1666390 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-09
Onset:2021-08-23
   Days after vaccination:136
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / UNK - / -

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

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

Write-up: Covid positive due to contact with church member


VAERS ID: 1666439 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-02-26
Onset:2021-08-23
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Oropharyngeal pain, SARS-CoV-2 test positive, Upper-airway cough syndrome
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin 500mg 2xday; Adderall 30mg; Lexapro
Current Illness:
Preexisting Conditions: PCOS; Endometriosis
Allergies: Levaquin; Calcifate
Diagnostic Lab Data: COVID Test
CDC Split Type: vsafe

Write-up: I woke up with post nasal drip and a sore throat. I thought it was just a cold. On Wednesday 25th I got tested for COVID, strep and flu. I came back COVID positive. I haven''t had a fever the whole down. My oxygen has stayed the same. Mostly postnasal drip and sore throat. A little of a cough. I went to the urgent care.


VAERS ID: 1666550 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hepatic enzyme increased, Hepatitis acute, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatitis, non-infectious (narrow), Acute pancreatitis (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multiple
Current Illness: Multiple
Preexisting Conditions: Multiple
Allergies: Ibuprofen, Aspirin
Diagnostic Lab Data: Multiple
CDC Split Type:

Write-up: Acute Hepatitis, Liver enzymes 6X normal limit Vomiting


VAERS ID: 1666551 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abscess, Activated partial thromboplastin time prolonged, Antimitochondrial antibody normal, Antineutrophil cytoplasmic antibody, Antineutrophil cytoplasmic antibody increased, Antinuclear antibody negative, Antiphospholipid antibodies positive, Biopsy skin abnormal, Blood immunoglobulin A, Blood immunoglobulin M increased, Blood lactate dehydrogenase increased, Cardiolipin antibody positive, Complement factor C3, Complement factor C4, Cytomegalovirus test negative, Drug hypersensitivity, HIV test negative, Haptoglobin increased, Hepatitis A virus test, Hepatitis B virus test, Hepatitis C virus test, Herpes simplex, Inflammation, Intensive care, International normalised ratio increased, Metabolic function test, Mononucleosis heterophile test negative, Mouth swelling, Mycoplasma test negative, Necrosis, Palpable purpura, Pharyngeal swelling, Protein C, Prothrombin time prolonged, Rheumatoid factor negative, SARS-CoV-2 test negative, Smear buccal abnormal, Smooth muscle antibody positive, Ulcer, Ultrasound Doppler, Varicella virus test positive
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal ulceration (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vasculitis (broad), Skin tumours of unspecified malignancy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (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? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: hydralazine, metoprolol, amiloride, calcitriol,magnesium, Symbicort, albuterol
Current Illness:
Preexisting Conditions: hypertension, asthma
Allergies: Protonix, latex (rash)
Diagnostic Lab Data: Work-up summary thus far for palpable purpura: OSH workup: HAV, HBV, HCV, HIV, CMV, COVID negative; VZV IgG+; IgM elevated (733) and IgA wnl (133); F-actin Ab elevated (36). 8/26 buccal bx at OSH showed ulcer with mixed inflammation, submucosal necrosis, and epithelial microabscess -dermatology consulted -8/29 skin bx tissue culture NGTD -ID work-up: 8/28 CMV, mononucleosis, and mycoplasma negative; 8/29 BCx NGTD -autoimmune work-up: 8/28 RF, C3, C4 wnl, proteinase 3 elevated (6.2), c-ANCA 1:40, cardiolipin Ab elevated (108), anti-smooth muscle Ab elevated (30), PT, INR, aPTT, PTT-LA, DRVVT all mildly elevated on lupus anticoagulant panel -coagulation work-up: 8/28 protein C activity, and PT/INR wnl -rheumatology consulted -8/30 ANA panel wnl, anti-mitochondrial Ab negative -8/30 elevated LDH (355) and haptoglobin (224) -8/31 venous doppler normal
CDC Split Type:

Write-up: On the afternoon of the day of the second shot, palpable purpura began appearing on patient''s thighs. Patient was taken to hospital. While there, similar lesions began appearing on the forearms. She was taken to the ICU, where she had a reaction to Protonix (swelling of the mouth and throat). She was transferred for further care, started on IV methylprednisolone due to concern for Sweet''s syndrome. Skin biopsy stained positive for HSV and she was started on acyclovir.


VAERS ID: 1666575 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature, Feeling cold
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: Allopurinol, Tacrolimus, Metropolol, Eliquis, Calcium with Vitamin D, Sodium Bicarbonate,, Vitamin D (AM Medications)
Current Illness:
Preexisting Conditions: Kidney Transplant, Gout, Atrial Fibrillation Anemia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills, temperature,


VAERS ID: 1666737 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-10
Onset:2021-08-23
   Days after vaccination:225
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Headache, Myalgia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose12/21/21, 2nd dose01/10/21, Diagnosed covid positive:08/24/21, Symptom onset:08/23/21. Exposure: Symptoms: Cough, fatigue, muscle aches, runny nose, HA, congestion.


VAERS ID: 1666738 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-27
Onset:2021-08-23
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Cough, Fatigue, Headache, Myalgia, Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 2nd dose01/27/21 Diagnosed covid positive:08/24/21 Symptom onset:08/23/21 Exposure:home Symptoms:fever, cough,fatigue,muscle aches,loss of smell/taste, sore throat, chills,runny nose,HA


VAERS ID: 1666741 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-01-29
Onset:2021-08-23
   Days after vaccination:206
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Fatigue, Headache, Myalgia, Oropharyngeal pain, Pyrexia, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/08/21 2nd dose01/29/2021 Diagnosed covid positive:08/24/21 Symptom onset:08/23/21 Exposure:travel Symptoms:fever, fatigue,sorethroat,muscle aches, runny nose, HA


VAERS ID: 1666745 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-07
Onset:2021-08-23
   Days after vaccination:197
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Diarrhoea, Dyspnoea, Exposure to SARS-CoV-2, Fatigue, Headache, Myalgia, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (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), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/10/21 2nd dose02/07/21 Diagnosed covid positive:08/24/21 Symptom onset:08/23/21 Exposure:Home Symptoms:SOB, FATIGUE, COUGH, MUSCLEACHES, SORETHROAT, DIARRHEA, CHILLS, RUNNY NOSE,HEADACHE.


VAERS ID: 1666747 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-03
Onset:2021-08-23
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/13/21 2nd dose02/03/21 Diagnosed covid positive:08/23/21 Symptom onset: Exposure: Symptoms:Asymptomatic


VAERS ID: 1666750 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-01-28
Onset:2021-08-23
   Days after vaccination:207
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/07/21 2nd dose01/28/21 Diagnosed covid positive:08/23/21 Symptom onset: Exposure: Symptoms:Asymptomatic.


VAERS ID: 1666879 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-05
Onset:2021-08-23
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Nasopharyngitis, 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: Flu vaccine. I''ve only had flu vaccine twice and both times I got really sick with the flu. I will never get the fly vaccine e
Other Medications: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Allergic to codeine. Lactose intolerant
Diagnostic Lab Data: At home covid test (Abbot OTC BinaxNOW Antigen self test) was used.
CDC Split Type:

Write-up: I got forst shot on 8/5/21. On 8/23 i syarted to feel like I had a cold. So i cancelled my second shot scheduled for 8/26. I tested negative for covid on 8/26 and 8/28. Symptoms continued to get worse and I tested positive on 8/30. Pretty lame that I did not stop my daily activities or traveling all through covid and NEVER got sick... but then due to all the media pressure, I acquiesce and get this stupid vaccine and 2 weeks later develop covid. And now they are saying people.with natural immunity are having better immunity against the delta variant. The exact same situation for my husband. Exact. Thanks for nothing.


VAERS ID: 1666893 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-12
Onset:2021-08-23
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

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

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

Write-up: Delayed Covid arm. Large area of redness, heat soreness around vaccine site appearing 12 days after vaccine. Has lasted more than 8 days.


VAERS ID: 1666907 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Underdose
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Alprazolam PRN, metoprolol, MVI w/iron
Current Illness:
Preexisting Conditions: Anxiety/panic disorder, heart palpitation, pre-diabetes
Allergies: Nickle, egg
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received Pfizer COVID vaccine on 7/22/21 and 8/23/21 in our facility, Medical Center. During 2nd dose administration on 8/23/21, patient only received 0.2mL (instead of 0.3mL). Per CDC guideline, no additional dose is needed if given volume $g 50% of recommended dose. No adverse event occurred with the patient. This is being reported as an administration error.


VAERS ID: 1669883 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Basedow's disease, Cardiac disorder, Cardiac failure, Cardiac failure congestive, Echocardiogram, Heart rate decreased
SMQs:, Cardiac failure (narrow), Arrhythmia related investigations, signs and symptoms (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Hyperthyroidism (narrow), Immune-mediated/autoimmune disorders (narrow)

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

Write-up: Systemic: Cardiac Disorder (diagnosed by MD)-Severe, Systemic: Severe decrease in heart rate and CHF-Severe, Additional Details: The patient states that he has Graves Disease. After receiving the COVID vaccine he states that his heart rate dropped dangerously low, he was hospitalized and had cardiac problems and developed heart failure. He is now out of the hospital, but is still recovering and is requiring monitoring and echocardiograms to asses his heart function.


VAERS ID: 1670090 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-16
Onset:2021-08-23
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZERFD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Cardiac flutter, Chest discomfort, Dyspnoea, Dyspnoea exertional
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (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: Xarelto 20mg
Current Illness: None
Preexisting Conditions: Had a blood clot, thought to be due to testosterone treatment. (Around 48 years old)
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: My heart would intermittently begin to flutter a few times a day. Roughly 1 week ago I began having intermittent shortness of breath (especially after exercise) and I have a constant slight pain or discomfort in the middle of my back around or just below my shoulder blades. As of a couple days ago, I can feel this discomfort in the center of my chest.


VAERS ID: 1670167 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-20
Onset:2021-08-23
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Body temperature increased, COVID-19, Confusional state, Disorientation, Hyporesponsive to stimuli, Mental status changes
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Chief Complaint Alterd Mental status from home Covid + 3 days ago, today drastic change in mentation Possible sepsis. History of Present Illness Patient is a pleasantly demented 81-year-old white male comes ER with complaints of altered mental status. Apparently had worsening of his mentation over the last 2 days. He has been disoriented, confused, and had decreased responsiveness. Unfortunately patient is unable to given HPI at this time. 14 point review of systems attempted, unobtainable due to decreased mental status. Objective Vitals & Measurements (Last Charted) T: 98.9 ?F(Oral) TMIN: 98.3 ?F(Oral) TMAX: 103.5 ?F(Oral) HR: 59 RR: 18 BP: 137/49 SpO2: 100% WT: 94.0 kg BMI: 32.53


VAERS ID: 1670315 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-01
Onset:2021-08-23
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Injection site pain, Injection site reaction, Injection site swelling, Injection site vesicles, Injection site warmth, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (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? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: tiredness, headache and fever
Other Medications: Pemazyre, Fish Oil
Current Illness: Cholagiocarcinoma
Preexisting Conditions: Cholagiocarcinoma= Bile duct cancer
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: profuse Swelling in the area and fever. Then like burning sensation accompanied by water bubbles in the skin area, like when you get burned by fire. Now I am peeling my upper left arm skin.


VAERS ID: 1670382 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-01-01
Onset:2021-08-23
   Days after vaccination:234
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Decreased appetite, Dyspnoea, Illness, Pneumonia, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: date and clinic for vaccines unknown. sick at home for 5-6 days prior to ED admit with SOB, pneumonia, fever 100.9, loss of appetite, cough tested + 8/25/2021; Remdesivir, Decadron, Lovenox, Azithromycin, Rocephin; O2


VAERS ID: 1670443 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

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

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

Write-up: Patient became light- headed and fainted


VAERS ID: 1670541 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-08
Onset:2021-08-23
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043L20A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary normal, Chest X-ray normal, Chest pain, Chills, Dyspnoea, Dyspnoea exertional, Electrocardiogram normal, Hypoxia, Musculoskeletal chest pain, Musculoskeletal disorder, Pleurisy, Productive cough, Sinus congestion, Spleen scan normal, Troponin normal, Ultrasound spleen
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ALPRAZolam (XANAX) 1 MG tablet Blood Glucose Monitoring Suppl (CONTOUR NEXT MONITOR) w/Device KIT Contour Next Test Strips naloxone (NARCAN) 4 mg/0.1 mL LIQD nasal liquid oxycodone-acetaminophen (PERCOCET) 7.5-325 MG per tablet propranolol
Current Illness: (8.21) Monday got very ill again, I have a sore throat, headache, major fatigue again, blurry vision on and off, slight fever, night sweats, deep bone pain all over, and I am getting confused or forgetful. Called PCP office on 8.26.21. Hospitalized 8.28.21 - positive for COVID (fully vaccinated)
Preexisting Conditions: Essential Thrombocythemia and Myelofibrosis History of kidney stones Endometriosis Anxiety Hemorrhoids, internal Arthritis Scoliosis Thrombocytosis (HCC) ADHD (attention deficit hyperactivity disorder) Chronic low back pain without sciatica, unspecified back pain laterality Chronic migraine without aura without status migrainosus, not intractable Severe episode of recurrent major depressive disorder, without psychotic features (HCC) Calcified granuloma of lung (HCC) Postnasal drip Obesity (BMI 30-39.9) Perimenopausal symptoms Abnormal blood cell count Long-term current use of high risk medication other than anticoagulant History of acute pancreatitis Mixed hyperlipidemia Pneumonia due to COVID-19 virus
Allergies: Latex - Rash
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized; COVID-19 positive (8.28.21); fully vaccinated Admission Date: 8/28/2021 Discharge Date: 8/31/2021 PRESENTING PROBLEM: COVID-19 virus detected [U07.1] COVID-19 [U07.1] HOSPITAL COURSE: Patient is a 44-year-old female with past medical history significant for GERD, status post Nissen and a recent diagnosis of hypocellular bone marrow/myelofibrosis and thrombocythemia (was following with benign Hematology, yet to follow-up with heme Onc) presents to the hospital on 08/28 due to dyspnea and chest pain. Patient was vaccinated in January. 7 days PTA, patient started to notice productive cough, sinus congestion, chills and then went on to develop dyspnea on exertion. In ER she was noted to be 98% on room air but desaturated at 84% with ambulation. Chest x-ray was clear CTA was negative for PE or infiltrates. COVID-19 infection: No evidence of pulmonary infiltrates/pneumonia however patient with exertional hypoxia and dyspnea. Remdesivir has been initiated but can be discontinued when patient discharges irrespective of completion of course. Pulmonary rehab as already arranged home oxygen. Chest pain is felt to be musculoskeletal versus pleurisy. Evaluation negative with EKG/troponins and PE. Patient was diagnosed to have hypocellular bone marrow and was told to have thrombocythemia and myelofibrosis and has an upcoming appointment to see Heme-Onc. She had been seeing benign Hematology so far. Patient was supposed to have a ultrasound of the spleen scheduled as outpatient , this was completed inpatient and was unremarkable . She will follow up with hematology and her PCP as outpatient , she was discharged in stable condition. Consultations: None Procedures: CT angiogram thorax negative for PE or pulmonary infiltrates.


VAERS ID: 1670700 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-13
Onset:2021-08-23
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Blood test, Chest X-ray, Chest discomfort, Chest pain, Computerised tomogram, Dyspnoea, Electrocardiogram abnormal, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins & vitamin d3.
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: 9/1/2021- They did an ekg & that test result was abnormal. They also did chest X-ray, ct scan & took blood. Said my heart was inflamed.
CDC Split Type:

Write-up: A little over a week after getting 2nd dose, I started getting a high resting heart rate, chest pain, chest tightness, shortness of breath & joint pain.


VAERS ID: 1670740 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-30
Onset:2021-08-23
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 - / IM

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

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

Write-up: Tested COVID-19 positive and was fully vaccinated.


VAERS ID: 1670804 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO187 / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Diarrhoea, Haematochezia, Mobility decreased, Muscle spasms, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Dystonia (broad), Parkinson-like events (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfur antibiotics
Diagnostic Lab Data: None to this date. A teledoc appointment for allergist is scheduled through my work because vaccines was given at the medical facility I work at .
CDC Split Type:

Write-up: Right arm pain ad could only lift right arm 45degrees. Extreme abdominal pain and cramping. Nauseous . Diarrhea for 5 days. Abdominal and back muscle cramping 5 days post vaccine. 7 days post vaccine blood in stool. Abdominal pain ceased 12 days post vaccine.


VAERS ID: 1670825 (history)  
Form: Version 2.0  
Age: 99.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

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

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

Write-up: was dispensed from to give in- home Covid-19 vaccines. are given all the supplies needed to prepare and administer Pfizer vaccines. In this case the nurse did not reconstitute the vial of Pfizer vaccine before drawing up the dose. Therefore, this client received a concentrated dose of Pfizer vaccine. The nurse realized there was not much remaining in the vial, and reported her mistake to the health department.


VAERS ID: 1670881 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-21
Onset:2021-08-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Feeling cold, Hypoaesthesia, Injection site pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (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: Xarelto, 20mg daily
Current Illness: Pulmonary embolism in left lower lung lobe and DVT in left lower leg.
Preexisting Conditions:
Allergies: Sensitive to aspirin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Continued pain at injection site as well as numbness and a cold sensation that runs from point of injection to fingertips, as well as arthritic like pain in left wrist and joints of each finger.


VAERS ID: 1670954 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Cough, Extra dose administered, Fatigue, Pain in extremity, Pyrexia, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ocrevus Vitamin D Claritin
Current Illness: None
Preexisting Conditions: Multiple Sclerosis
Allergies: None
Diagnostic Lab Data: Tested negative for Covid on 8/27/21
CDC Split Type:

Write-up: The day after the 3rd dose, I started experiencing a dry cough and mild pressure in the chest, along with other known side effects of the vaccine (fatigue, joint pain, sore arm, low fever 100.3).


VAERS ID: 1671604 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Dizziness, Hypoaesthesia, Influenza like illness, Pain, Pyrexia, Tinnitus
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Numbness in left arm, hand, left side of face. Dizzy, light headed. At 12:23am: woke up achy, fever, ringing in ears. Achy flu like symptoms including severe stomach cramps the next day.


VAERS ID: 1672974 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-08-23
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test
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: Test Date: 20210823; Test Name: Tested positive for Covid 19; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: tested positive for covid-19; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (tested positive for covid-19) in a 54-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 23-Aug-2021, the patient experienced COVID-19 (tested positive for covid-19). At the time of the report, COVID-19 (tested positive for covid-19) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 23-Aug-2021, SARS-CoV-2 test: positive (Positive) Positive. Concomitant medication were not reported. Treatment medication were not reported.


VAERS ID: 1673342 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Mass, Vaccination site pain
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ENALPRIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high (Verbatim: High Blood Pressure)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101090383

Write-up: Arm is little bit sore where I got the shot; pain in my arm where they give me the shot and it was sore; I noticed like a lump, not at the injection site where I got the shot. It is more like on my collar bone area, my shoulder collar bone area; This is a spontaneous report from a contactable consumer (patient). A 42-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot Number: FC3181), via an unspecified route of administration in right arm, on 23Aug2021 (at the age of 42-year old) as dose 1, single for COVID-19 immunisation. Medical history included High Blood Pressure from an unknown date. Concomitant medication included enalapril maleate (ENALPRIN) taken for hypertension. On 23Aug2021, after vaccination, he experienced little bit sore where he got the shot, in his right arm and also he noticed something like a lump, not at the injection site where he got the shot. It was more likely on his shoulder collar bone area. No treatment was given in response to the events. The patient was not sure if the events was related to the shot. The outcome of the events was unknown.


VAERS ID: 1674561 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / IM

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

Write-up: Patient 63 years old was in the observation area and tells her daughter she''s having palpitations after the 1st PFIZER vaccine administration. Daughter tells the EMT that she was anxious before coming to the vaccination clinic. Patient was taken to the incident observation area at 3:20pm to evaluate and to take her vitals: 67 pulse, 95 sat, 150/90 BP, 23 respirations, and palpitations 55. At 3:34 vitals are retaken: 150/90 BP, 97 saturation, 80 pulse, and 22 respiration.


VAERS ID: 1674612 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-19
Onset:2021-08-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / UN

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

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

Write-up: Iam 8 weeks pregnant. I was fine until day 4 after my vaccine then I woke up completely numb all over my body and face. Doctors can''t understand what the Vaccine did to me. Numbness keeps getting worse especially in my legs. Moderna Never should have been released!!


VAERS ID: 1674743 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-15
Onset:2021-08-23
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Tinnitus
SMQs:, Hearing impairment (narrow)

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

Write-up: Have always had slight ringing from tinnitus in right ear for at least 10 years. After my first moderna vaccine shot I noticed that the ringing has increased a lot . Was not sure if it was related to the vaccine, but after reading all the similar complaints, it would make sense to think the vaccine may have something to do with the increased level of ringing. Not sure if I need to continue with my second doasage at this point.


VAERS ID: 1674813 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear discomfort
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Plaquenil; Prednisone; Lipitor
Current Illness: Lupus/undifferentiated collagen vascular disorder
Preexisting Conditions: Lupus/autoimmune collagen vascular disorder
Allergies: Ampicillin; Sulfamethoxazole; Bextra
Diagnostic Lab Data:
CDC Split Type:

Write-up: Muffled/clogged ears like being on an airplane. Middle ear pressure that cannot be resolved by yawning, chewing or swallowing. Only improves after lying down to sleep but upon awakening, again feels like cotton is stuffed in both my ears. It has not improved since it started on 8/23/2021. No ear problem prior to the vaccine. I have not had this particular ear problem previously only transiently on the airplanes or mountainous high elevation.


VAERS ID: 1674954 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-19
Onset:2021-08-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Diarrhoea, Feeling of body temperature change, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: phenytoin, citalopram, levothyroxine
Current Illness: none
Preexisting Conditions: seizures and thyroid
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: approx 72 hours after receiving vax I started feeling hot then cold. through the night I also started experiencing body and muscles aches. during the next day I also had a 100.6 temp and diarrhea. all symptoms were gone within 24 hours except the diarrhea, which lasted another 2 days.


VAERS ID: 1675078 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angina pectoris, Blood test normal, Chest pain, Electrocardiogram abnormal
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 2 Ekg august 28th 2021-both abnormal Blood test august 28th 2021-normal Echocardiogram and stress test schedule.
CDC Split Type:

Write-up: Shortly after receiving my vaccine I had heart/chest pain. In the first few days the pain would come and go and many times throughout the day if felt as if I had run a marathon. I have never experienced any heart pain before. On Saturday August 28th 2021 I went to the emergency room because of the pain. I was told I needed to see a cardiologist because of my EKG. I went to the cardiologist on Friday Sept 3rd and he has requested a echocardiogram and stress test


VAERS ID: 1675602 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Dizziness, Headache, Hot flush, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: -Headache -Fever -Chills -Body aches -Joint pain *These symptoms started at 11pm on 8/23 and lasted through 8/27 -Dizziness -Hot flashes *These symptoms started at 11pm on 8/23 and are ongoing to this date


VAERS ID: 1675752 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Intermenstrual bleeding, Polymenorrhoea
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: My menstrual cycle stopped. I was on the 2nd day of my cycle, which typically lasts approximately 7 days (2nd and 3rd days are the heaviest). It completely stopped the same day as my vaccination. There was slight spotting again on 8/27.


VAERS ID: 1676807 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-21
Onset:2021-08-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA D53E21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Dysstasia, Pain in extremity, Spinal pain
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Scoliosis diagnosis
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe spinal pain, mild leg and hip soreness and pain. Spinal pain is mild when I sit in a fixed position. Sharp spinal pain flares up when bending or using lower back to make any movement. I could not stand up or get myself out of my bed without assistance until I received pain medication. Spinal pain persists from 8/23/2021 through 9/7/2021 (ongoing). ER visited on 8/27/2021 for treatment.


VAERS ID: 1677146 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-04-09
Onset:2021-08-23
   Days after vaccination:136
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
SMQs:, Medication errors (narrow)

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

Write-up: Dose interval more than 42 days; This spontaneous case was reported by a nurse and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Dose interval more than 42 days) in a 39-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037A21B) for COVID-19 vaccination. Concurrent medical conditions included Penicillin allergy (PCN). On 09-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 23-Aug-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Dose interval more than 42 days). On 23-Aug-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Dose interval more than 42 days) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No Concomitant drugs were reported. No Treatment information were reported Most recent FOLLOW-UP information incorporated above includes: On 24-Aug-2021: Added second dose onset date Event Inappropriate schedule of vaccine administration and narrative was update accordingly.


VAERS ID: 1677183 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-20
Onset:2021-08-23
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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

Write-up: 1st dose 20Apr201, no 2nd dose yet; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (1st dose 20Apr201, no 2nd dose yet) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 20-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Aug-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (1st dose 20Apr201, no 2nd dose yet). At the time of the report, PRODUCT DOSE OMISSION ISSUE (1st dose 20Apr201, no 2nd dose yet) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant products was provided by the reporter. No treatment information was provided by the reporter. Reporter did not allow further contact


VAERS ID: 1677227 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-23
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 RA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Vaccination site erythema, Vaccination site mass, Vaccination site pruritus
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: DULOXETINE; CLONAZEPAM; GABAPENTIN; AMOXICILLIN
Current Illness:
Preexisting Conditions: Comments: No medical history was provided
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: She had her arm a little sore for the first couple of days; a little bump size of a quarter appeared; Last night her arm started itching at the injection site; a red spot; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (She had her arm a little sore for the first couple of days), VACCINATION SITE MASS (a little bump size of a quarter appeared), VACCINATION SITE PRURITUS (Last night her arm started itching at the injection site) and VACCINATION SITE ERYTHEMA (a red spot) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002F21A) for COVID-19 vaccination. No medical history was provided. Concomitant products included DULOXETINE, CLONAZEPAM, GABAPENTIN and AMOXICILLIN for an unknown indication. On 13-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Aug-2021, the patient experienced VACCINATION SITE MASS (a little bump size of a quarter appeared), VACCINATION SITE PRURITUS (Last night her arm started itching at the injection site) and VACCINATION SITE ERYTHEMA (a red spot). On an unknown date, the patient experienced PAIN IN EXTREMITY (She had her arm a little sore for the first couple of days). At the time of the report, PAIN IN EXTREMITY (She had her arm a little sore for the first couple of days) and VACCINATION SITE PRURITUS (Last night her arm started itching at the injection site) had resolved, VACCINATION SITE MASS (a little bump size of a quarter appeared) had not resolved and VACCINATION SITE ERYTHEMA (a red spot) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Relevant concomitant medication also includes Inhaler. It was stated that pharmacist recommended Benadryl cream which she could not use


VAERS ID: 1677251 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21 / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling abnormal, Headache
SMQs:, Dementia (broad)

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

Write-up: headaches following; Fuzzy headed/ should make important decisions type feeling/mind has started to clear but continues to have a bit of fuzziness; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (Fuzzy headed/ should make important decisions type feeling/mind has started to clear but continues to have a bit of fuzziness) and HEADACHE (headaches following) in a 36-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002f21) for COVID-19 vaccination. The patient''s past medical history included Pregnancy induced hypertension. On 22-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Aug-2021, the patient experienced FEELING ABNORMAL (Fuzzy headed/ should make important decisions type feeling/mind has started to clear but continues to have a bit of fuzziness). On an unknown date, the patient experienced HEADACHE (headaches following). At the time of the report, FEELING ABNORMAL (Fuzzy headed/ should make important decisions type feeling/mind has started to clear but continues to have a bit of fuzziness) was resolving and HEADACHE (headaches following) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. It was stated have not seen physician yet. No concomitant medication was reported. No treatment medication was reported.


VAERS ID: 1677268 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

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

Write-up: 3 patients administered expired doses from 27July2021; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (3 patients administered expired doses from 27July2021) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 23-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (3 patients administered expired doses from 27July2021). At the time of the report, EXPIRED PRODUCT ADMINISTERED (3 patients administered expired doses from 27July2021) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medication was not reported. Treatment information was not reported. Most recent FOLLOW-UP information incorporated above includes: On 31-Aug-2021: follow up information received on 31-AUG-2021 contains No new information


VAERS ID: 1677467 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood urine present, SARS-CoV-2 test
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (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: VITAMIN D 3; PHENTERMINE
Current Illness: Birth control (no periods due to birth control)
Preexisting Conditions: Medical History/Concurrent Conditions: Atrial fibrillation; Eosinophilic esophagitis; Fatty liver
Allergies:
Diagnostic Lab Data: Test Date: 20210823; Test Name: Nasal Swab; Test Result: Negative ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101090896

Write-up: Blood in pee; This is a spontaneous report from a contactable consumer (patient). A 31-year-old female (not pregnant) patient received BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in the left arm, on 23Aug2021 at 12:45 (Batch/Lot Number: Fc3181), at the age of 31 years old, as 1st single dose, for COVID-19 immunisation. Medical history included fatty liver disease, esophilic esophagitis, atrial fibrillation, all from 2019, and no periods due to birth control. There were no known allergies. Concomitant medications included colecalciferol (VITAMIN D 3), and phentermine (PHENTERMINE). The patient had not received any other vaccines in the 4 weeks prior to BNT162b2 vaccination. The patient never had COVID prior to vaccination. The patient complained about blood in pee on 23Aug2021 at 13:45 and specified that she no longer had periods anymore due to birth control. No treatment was required for the event. The patient had a COVID test (nasal swab) post vaccination on 23Aug2021 that resulted negative. The patient had not recovered from the event. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1677567 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Lymphadenopathy
SMQs:, Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Psoriasis; Psoriatic arthritis
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101132853

Write-up: Swollen glands; Extreme tiredness; Joint pain; Severe head pain; This is a spontaneous report from a contactable healthcare professional, the patient. A 51-year-old non-pregnant female patient received the third dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 22Aug2021 at 16:30 (at the age of 51-years-old) as a single dose for COVID-19 immunisation. Medical history included psoriasis/psoriatic arthritis. The patient had no known allergies to medications, food, or other products. The patient did not receive any concomitant medication within two weeks of vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 23Aug2021, the patient experienced swollen glands, extreme tiredness, joint pain and severe head pain. Therapeutic measures were not taken as a result of the events. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. The clinical outcome of the events swollen glands, extreme tiredness, joint pain and severe head pain was resolving at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1678140 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-07-26
Onset:2021-08-23
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Epistaxis, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Nose bleed; Chills; Body aches; Fever; This spontaneous case was reported by a nurse and describes the occurrence of EPISTAXIS (Nose bleed), CHILLS (Chills), MYALGIA (Body aches) and PYREXIA (Fever) in a 23-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 011D21A and 004C21A) for COVID-19 vaccination. No Medical History information was reported. On 26-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 23-Aug-2021, the patient experienced CHILLS (Chills), MYALGIA (Body aches) and PYREXIA (Fever). On 24-Aug-2021, the patient experienced EPISTAXIS (Nose bleed). At the time of the report, EPISTAXIS (Nose bleed) had resolved and CHILLS (Chills), MYALGIA (Body aches) and PYREXIA (Fever) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The concomitant medication were not reported. No treatment medication were reported by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 24-Aug-2021: FU received on 24-AUG-2021 contains No new information


VAERS ID: 1678146 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZOLOFT; VERTEX [BETAHISTINE HYDROCHLORIDE]; OMEGA 3 [DOCOSAHEXAENOIC ACID;EICOSAPENTAENOIC ACID;TOCOPHEROL]; MAGNESIUM; ZINC; B3 NIACIN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: heart rate; Result Unstructured Data: the heart is elevated, but not a whole lot
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: kind of panicking; The heart is elevated, but not a whole lot; Thought that it was anxiety; felt like her heart was beating "really bad/it happened again during the day. And last night, it happened again; This spontaneous case was reported by a consumer and describes the occurrence of TACHYCARDIA (felt like her heart was beating "really bad/it happened again during the day. And last night, it happened again), HEART RATE INCREASED (The heart is elevated, but not a whole lot), ANXIETY (Thought that it was anxiety) and PANIC ATTACK (kind of panicking) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 009C21A) for COVID-19 vaccination. Concomitant products included SERTRALINE HYDROCHLORIDE (ZOLOFT), BETAHISTINE HYDROCHLORIDE (VERTEX [BETAHISTINE HYDROCHLORIDE]), DOCOSAHEXAENOIC ACID, EICOSAPENTAENOIC ACID, TOCOPHEROL (OMEGA 3 [DOCOSAHEXAENOIC ACID;EICOSAPENTAENOIC ACID;TOCOPHEROL]), MAGNESIUM, ZINC and NICOTINIC ACID (B3 NIACIN) for an unknown indication. On 23-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Aug-2021, the patient experienced TACHYCARDIA (felt like her heart was beating "really bad/it happened again during the day. And last night, it happened again) and ANXIETY (Thought that it was anxiety). On 24-Aug-2021, the patient experienced HEART RATE INCREASED (The heart is elevated, but not a whole lot). On 25-Aug-2021, the patient experienced PANIC ATTACK (kind of panicking). At the time of the report, TACHYCARDIA (felt like her heart was beating "really bad/it happened again during the day. And last night, it happened again) and HEART RATE INCREASED (The heart is elevated, but not a whole lot) had not resolved and ANXIETY (Thought that it was anxiety) and PANIC ATTACK (kind of panicking) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Heart rate: high (High) the heart is elevated, but not a whole lot. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications included Women''s multivitamins. No treatment details were reported. It was stated that she has a Whoop band that tracks the heart rate during exercise and every time she felt like her heartbeat was elevated. She was planning on going to the doctor today


VAERS ID: 1678153 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-25
Onset:2021-08-23
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Gait disturbance, Headache, Mobility decreased, Pain, Sluggishness, Vaccination site pain
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (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:
Other Medications:
Current Illness: Blood pressure; Thyroid disorder
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: painful breathing; fatigue / tired; whole body hurts; can''t lift anything; can hardly walk; right arm hurts at injection site; feeling sluggish; light headaches; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (painful breathing), FATIGUE (fatigue / tired), PAIN (whole body hurts), MOBILITY DECREASED (can''t lift anything) and GAIT DISTURBANCE (can hardly walk) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 033C21A and 022C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Blood pressure and Thyroid disorder. On 25-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 23-Aug-2021, the patient experienced DYSPNOEA (painful breathing), FATIGUE (fatigue / tired), PAIN (whole body hurts), MOBILITY DECREASED (can''t lift anything), GAIT DISTURBANCE (can hardly walk), VACCINATION SITE PAIN (right arm hurts at injection site), SLUGGISHNESS (feeling sluggish) and HEADACHE (light headaches). At the time of the report, DYSPNOEA (painful breathing), FATIGUE (fatigue / tired), PAIN (whole body hurts), MOBILITY DECREASED (can''t lift anything), GAIT DISTURBANCE (can hardly walk), VACCINATION SITE PAIN (right arm hurts at injection site), SLUGGISHNESS (feeling sluggish) and HEADACHE (light headaches) outcome was unknown. No concomitant medication was mentioned. No treatment medication was mentioned.


VAERS ID: 1678263 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-01-19
Onset:2021-08-23
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Body temperature, Dizziness, Extra dose administered, Fatigue, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Blood pressure abnormal (Blood pressure); Depression
Preexisting Conditions: Medical History/Concurrent Conditions: Enlarged prostate; Heart attack; Non-Hodgkin''s lymphoma (He had cancer 20 years ago)
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: Body temperature; Result Unstructured Data: 100 degrees
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (Weakness), DIZZINESS (Dizzy/ dizziness), FATIGUE (feeling tired/ exhausted), PYREXIA (He had fever of 100 degrees/ experienced temperature) and EXTRA DOSE ADMINISTERED (he received the third dose) in a 74-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Heart attack, Enlarged prostate and Non-Hodgkin''s lymphoma (He had cancer 20 years ago). Concurrent medical conditions included Depression and Blood pressure abnormal (Blood pressure).On 19-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 23-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In 2021, the patient experienced ASTHENIA (Weakness), DIZZINESS (Dizzy/ dizziness), FATIGUE (feeling tired/ exhausted) and PYREXIA (He had fever of 100 degrees/ experienced temperature). On 23-Aug-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXTRA DOSE ADMINISTERED (he received the third dose). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. On 23-Aug-2021, EXTRA DOSE ADMINISTERED (he received the third dose) had resolved. At the time of the report, ASTHENIA (Weakness), DIZZINESS (Dizzy/ dizziness), FATIGUE (feeling tired/ exhausted) and PYREXIA (He had fever of 100 degrees/ experienced temperature) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In 2021, Body temperature: 100 (High) 100 degrees. No concomitant medications were reported. Patient reported that he did not experience any adverse events with the first two doses.


VAERS ID: 1678279 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-01
Onset:2021-08-23
   Days after vaccination:234
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Myalgia, Vaccination site erythema, Vaccination site reaction
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), 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: Drug allergy (Allergy to reclast.); Immunocompromised
Preexisting Conditions: Medical History/Concurrent Conditions: Breast cancer (Patient had infiltrating lobular breast cancer in one breast and ductal cancer in the other.); Vasculitis (Patient had vasculitis secondary to an allergic reaction 5-6 years ago to Reclast which patient was taking for osteoporosis.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: COVID arm; Arm only slightly sore; Red spot at injection site/Spots going half way down to elbow; Inappropriate schedule of vaccine administered; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE REACTION (COVID arm), MYALGIA (Arm only slightly sore), VACCINATION SITE ERYTHEMA (Red spot at injection site/Spots going half way down to elbow) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Breast cancer (Patient had infiltrating lobular breast cancer in one breast and ductal cancer in the other.) and Vasculitis (Patient had vasculitis secondary to an allergic reaction 5-6 years ago to Reclast which patient was taking for osteoporosis.). Previously administered products included for an unreported indication: METHOTREXATE (Patient has been off the methotrexate for 2-3 weeks now.). Concurrent medical conditions included Drug allergy (Allergy to reclast.) and Immunocompromised. In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 23-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 23-Aug-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered). On 25-Aug-2021, the patient experienced VACCINATION SITE REACTION (COVID arm), MYALGIA (Arm only slightly sore) and VACCINATION SITE ERYTHEMA (Red spot at injection site/Spots going half way down to elbow). On 23-Aug-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered) had resolved. At the time of the report, VACCINATION SITE REACTION (COVID arm), MYALGIA (Arm only slightly sore) and VACCINATION SITE ERYTHEMA (Red spot at injection site/Spots going half way down to elbow) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were provided. No treatment medications were provided. Patient states that she is feeling fine. Patient also states that with the first two shots she couldn''t tell anything and relates the symptoms having now to body producing antibodies.


VAERS ID: 1678657 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-19
Onset:2021-08-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes ophthalmic, Oral herpes
SMQs:, Oropharyngeal infections (narrow), Ocular infections (narrow), Opportunistic 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: Prozac Busparone
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Sulfa
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Herpes outbreak in eye and mouth.


VAERS ID: 1678707 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-25
Onset:2021-08-23
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood sodium decreased, C-reactive protein increased, COVID-19, Chest X-ray abnormal, Dyspnoea, Lung opacity, Pleural effusion, Procalcitonin, Serum ferritin increased, White blood cell count normal
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: A 71 year old female who has a past medical history significant for asthma, diabetes, hypertension, obesity, and diabetic neuropathy who presented to ED with worsening SOB secondary to COVID19. Patient states she was diagnosed with COVID-19 5 days ago. She had been experiencing shortness of breath that continually got worse. Patient states that she became concerned so she came to the ED. In the ED she was found to have O2 sats in the 80s. She improved on 2-3L O2. She was afebrile with stable WBC. Labs showed procal 0.84, CRP 329.5, Ferritin 764, Na 133. Her chest xray showed patchy airspace opacities bilaterally in the mid lung zones, greater than than left.


VAERS ID: 1678750 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling abnormal, Nausea, Pyrexia, Vaccination site pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Current Medications: Albuterol 90mcg/act 1-2 inh Q6hrs PRN Wheezing Vitamin D3 400units PO Daily Restasis 0.05% unknown frequency
Current Illness: Of note, the morning of the patient''s COVID vaccination, pt was seen for PFTs due to ongoing SOB. During that test, the patient experienced anxiety and a panic attack after one attempt of spirometry. Vitals at that time: BP 119/73, HR 88, SpO2 100%. Staff offered transport to the ED or 911 call due to his complaint of chest pain and difficulty breathing. Pt refused, indicating that this is a common occurence but no one can figure out what is wrong with him. Pt was able to follow instructions to slow down his breathing and follow commands. Pt remained in the pulmonary clinic for 30 mins. Discharge vitals: BP 119/73, HR 101, RR 24, O2Sat 100% RA. Shortly after leaving the PFT appointment, the pt arrived at the Covid vaccination clinic located onsite.
Preexisting Conditions: PMH significant for anxiety, panic attacks, depression, is currently on disability d/t extreme fatigue (most likely brought on by depression and anxiety), and ongoing SOB.
Allergies: Pt w/ a hx of allergy to cows milk (SOB, abdominal disorder, fatigue).
Diagnostic Lab Data:
CDC Split Type:

Write-up: "Pt w/ a hx of allergy to cows milk (SOB, abdominal disorder, fatigue). PMH significant for anxiety, panic attacks, depression, is currently on disability d/t extreme fatigue (most likely brought on by depression and anxiety), and ongoing SOB. Current Medications: Albuterol 90mcg/act 1-2 inh Q6hrs PRN Wheezing Vitamin D3 400units PO Daily Restasis 0.05% unknown frequency 16mins post vaccination, pt c/o nausea, soreness at the vaccination site, feeling feverish, and overall ""not feeling good"". Pt brought to the triage area from the observation area. Vitals @12:52pm BP 106/74, HR 73, RR 14 Pt assessed and monitored by nurse and NP. Pt states that he is feeling better and improving. Released from vaccination site in stable condition and recommended to f/u w/ PCP. F/u instructions provided. Of note, the morning of the patient''s COVID vaccination, pt was seen for PFTs due to ongoing SOB. During that test, the patient experienced anxiety and a panic attack after one attempt of spirometry. Vitals at that time: BP 119/73, HR 88, SpO2 100%. Staff offered transport to the ED or 911 call due to his complaint of chest pain and difficulty breathing. Pt refused, indicating that this is a common occurence but no one can figure out what is wrong with him. Pt was able to follow instructions to slow down his breathing and follow commands. Pt remained in the pulmonary clinic for 30 mins. Discharge vitals: BP 119/73, HR 101, RR 24, O2Sat 100% RA. Shortly after leaving the PFT appointment, the pt arrived at the Covid vaccination clinic located onsite. "


VAERS ID: 1678857 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-18
Onset:2021-08-23
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Pyrexia, SARS-CoV-2 test positive, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omnicef, cranberry caps, B12, D3, Vitamin C, iron, neurontin, levothyroxine, Toprol XL, multi-vitamin, pamelor, prilosec, mirapex, flomax, demadex
Current Illness:
Preexisting Conditions: eczema, restless leg syndrome, irritable bowel syndrome, generalized anxiety disorder, HTN, chronic diastolic congestive heart failure, hypothyroidism, anemia, GERD, iron deficiency anemia, urinary retention, S/P gastrostomy, CKD stage 4, recurrent UTI''s,
Allergies: latex, ace inhibitors, diclofenac, flurbiprofen, norco, misoprostol, oxaprozin, sertraline, tramadol, citalopram, sulfa
Diagnostic Lab Data: COVID positive test on 08/23/21.
CDC Split Type:

Write-up: Fully COVID vaccinated patient admitted to hospital through ED with dyspnea, fever, and tachycardia. Started on O2, remdesivir (2 doses), decardron, antibiotics (potential UTI). On day 2 of admission patients symptoms had improved. Patient given option to return home or stay for continued observation, patient opted to return home.


VAERS ID: 1678924 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-03
Onset:2021-08-23
   Days after vaccination:112
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal hernia, Abdominal pain, Abdominal wall oedema, Acute respiratory failure, Anticoagulant therapy, Atelectasis, Blood alkaline phosphatase increased, Brain natriuretic peptide increased, COVID-19, Cardiac failure acute, Cardiac failure congestive, Cardiomegaly, Chest X-ray abnormal, Chest pain, Computerised tomogram abdomen, Computerised tomogram abnormal, Computerised tomogram head abnormal, Condition aggravated, Cough, Decreased appetite, Dyspnoea, Echocardiogram abnormal, Ejection fraction decreased, Fatigue, Headache, Hypoaesthesia, Hypoxia, Intervertebral disc degeneration, Lung opacity, Mental status changes, Mitral valve incompetence, Neurological examination normal, Pelvic fluid collection, Pleural effusion, Pyrexia, Renal cyst, Respiratory tract congestion, SARS-CoV-2 test positive, Suicidal behaviour, Tricuspid valve incompetence
SMQs:, Cardiac failure (narrow), Liver related investigations, signs and symptoms (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Suicide/self-injury (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Acute central respiratory depression (narrow), Biliary system related investigations, signs and symptoms (broad), Pulmonary hypertension (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 325 MG tablet ascorbic acid (VITAMIN C) 500 MG tablet aspirin 81 MG enteric coated tablet atorvastatin (LIPITOR) 40 MG tablet brimonidine (ALPHAGAN) 0.2 % ophthalmic solution calcium carbonate (TUMS) 500 MG chewable
Current Illness: Hospitalized due to COVID-19 Found to be COVID positive 8.28.21. Iron infusions
Preexisting Conditions: Diastolic CHF Hypertension Diabetes Depression Seizure disorder Sick Sinus Syndrome Chronic Kidney Disease Stage 3, GFR 30-59 mL/min Coronary artery disease (CAD) hypothyroidism Acute hypoxemic respiratory failure due to COVID-19
Allergies: Tape Itching Zoloft [Serotonin Reuptake Inhibitors]
Diagnostic Lab Data: Chest x-ray FINDINGS: Again, pacemaker generator pack in neural stimulator generator pack obscures portions of both the left and right chest. There is similar cardiomegaly. The visualized pulmonary vascularity does appear slightly congested. In addition to this, there are patchy areas of groundglass opacity right more pronounced than left. No sizable effusion or discernible pneumothorax. The adequately visualized portions of the implanted devices appear intact. __________________________________________________ CT head FINDINGS: 1. Patchy areas of hypodensity are noted in the periventricular and in the subcortical white matter. This is nonspecific but most likely represents chronic small vessel ischemic change of the white matter. There are no new areas of abnormal brain attenuation. No acute intracranial hemorrhage is identified. 2. The ventricles, sulci and the cisterns are prominent reflecting intracranial volume loss that is felt to be appropriate when allowing for the patient''s age. No mass effect, midline shift nor extra-axial fluid collections are noted. 3. There is mild scattered mucosal thickening in the paranasal sinuses. The mastoid air cells are well aerated. 4. No skull abnormalities are noted. 5. Calcified atherosclerotic plaque is noted within the cavernous internal carotid arteries. ___________________________________________________ CT abdomen pelvis FINDINGS: Lung Bases: Multifocal small patchy opacities in the right middle lobe and right lower lobe likely representing pneumonia. Small layering right pleural effusion with prominent dependent atelectasis in the right lung base. Small left pleural effusion with mild dependent atelectasis in the left lung base. Mild cardiomegaly. Hepatobiliary: The liver has normal morphology and size with no focal lesion on this noncontrast study. The gallbladder is not identified likely due to a prior cholecystectomy. There is no biliary ductal dilatation. Pancreas: The pancreas is normal. Spleen: The spleen is normal. Adrenals: Poorly visualized. Kidneys, Ureters, & Bladder: There are bilateral renal cortical cysts. The kidneys are otherwise normal in appearance allowing for lack of intravascular contrast. There is no hydronephrosis. The ureters and bladder are normal. Gastrointestinal: The stomach, duodenum and remainder the small bowel are normal in appearance. There are no thick walled or abnormally dilated loops of small bowel. The colon is normal. No evidence of diverticulitis or acute colitis. Reproductive Organs: Status post hysterectomy. Lymphatic System: There is no lymph node enlargement within the abdomen or pelvis. Vasculature: There is severe calcific atherosclerotic disease involving the abdominal aorta and iliac arteries with extensive calcific atherosclerotic disease throughout the remainder of the abdomen. There is no abdominal aortic aneurysm. Peritoneum: Tiny amount of free fluid in the pelvis which is nonspecific. No other ascites. No free intraperitoneal air. Abdominal Wall & Musculoskeletal: There is a fat-containing abdominal wall hernia along the lateral margin of the left rectus sheath in the lower abdomen/high pelvic region. The ventral abdominal wall defect measures about 12 mm in diameter. The herniated fat measures up to 4.5 cm in diameter. There is extensive body wall edema. There is severe degenerative disc change at the L5-S1 level. There is no lumbar spine compression fracture. There is no lytic or blastic lesion involving the lumbar spine or bony pelvic ring. Assessment of the solid organs and soft tissues is limited as this is a noncontrast scan.
CDC Split Type:

Write-up: Patient hospitalized with COVID-19; Still hospitalized (ICU); Fully vaccinated. Admission Note H&P: HISTORY OF PRESENT ILLNESS: Patient is a 73-year-old female with past medical history of diastolic CHF, hypertension, hyperlipidemia, seizure disorder s/p VNS, coronary artery disease status post CABG, sick sinus syndrome status post permanent pacemaker, CKD 3, diabetes type 2, GERD. Patient was recently hospitalized from 06/11/2021 to 6/20 3/21 for acute congestive heart failure found to have chronic diastolic CHF. Patient during this visit was suicidal and was EN route to facility when she developed chest pain and taken to Hospital. During hospitalization patient was noted to have chronic abdominal pain, a possible seizure that was followed up with an EEG and neuro evaluation all unremarkable. Patient denies suicidal ideations once admitted therefore no further psych placement needed and she was discharged to subacute rehab. Today patient is coming from facility with complaints of altered mental status from baseline, increased fatigue, fevers, and hypoxia. On 08/23 patient was diagnosed with COVID-19. Patient complains of some shortness of breath, cough, severe headache, abdominal pain but this appears chronic, numbness testing into her left lower leg. States having reduced appetite but no loss of taste or smell. ASSESSMENT/PLAN: Severe COVID-19 infection with acute hypoxic respiratory failure - First onset of symptoms: unknown, roughly week - Tested Positive: 8/23 - Decadron: 6mg PO daily, day #1 - continue home PPI - Give Remdesivir *Daily renal and liver function monitoring for kidney and liver toxicity due to Remdesvir is required. - Oxygen Requirements: 2L, wean as tolerated - COVID lab panel: - D-Dimer = ordered - CRP = ordered - alkaline phosphatase = 244 - DVT Prophylaxis: Heparin - treat CHF keeping euvolemic, encourage proning, IS - PRN albuterol, tessalon, tylenol Superimposed Bacterial CAP - procal mildly elevated at 0.29 - ER started Rocephin day 1/5 and Azithromycin day 1/3 - sputum culture, legionella, strep pneumoniae, blood cultures ordered Acute exacerbation of chronic diastolic CHF -last echo 6/12/21 EF 57%, diastolic dysfunction grade 2, right ventricle mildly to moderately decreased, mild MR, moderate TR right ventricular systolic pressure 43.1 mmHg -chest x-ray shows findings of mild congestion; BNP 17,476 -start Lasix 40 mg IV push 2 times a day *The patient is on IV Lasix which requires daily monitoring of electrolyte and renal function to monitor for the following toxicities: renal failure, hyper/hyponatremia, hypokalemia, metabolic alkalosis. -2 L fluid restriction, strict I&Os, daily weights Indeterminate high sensitivity troponins -trope 61 with a 2 hour delta of +3 -demand ischemia from CHF exacerbation and in the presence of CKD


VAERS ID: 1679117 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-13
Onset:2021-08-23
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstruation irregular, Oligomenorrhoea
SMQs:, Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Zinc, Juneal fe120(oral contraceptive)
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Menstrual cycle started 7 days early. Menstrual cycle lasted @ 11 days. I always start on the same day and have a very regular period so it was very unusual to start a week early and to last so long.


VAERS ID: 1679173 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Headache, Muscle spasms, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu vaccine- body aches, nausea and vomiting, headache x 2 day Pneumonia vaccine- nausea and vomiting x 1 day
Other Medications: Aleve, Gabapentin, Aspirin, Zyrtec, Sudafed, Flonase, Multivitamin, Meloxicam
Current Illness: No
Preexisting Conditions: Neuropathy- nerve damage bilateral upper extremities, allergies, arthritis
Allergies: NKDA, problems with flu vaccine in the past
Diagnostic Lab Data: None
CDC Split Type:

Write-up: About 9PM-10PM patient starting having body cramps, nausea, diarrhea, vomiting, chills (no fever), and headache x 3 days. Reports after 3 days symptoms started tapering off, but does continue to have dull headache and some nausea.


VAERS ID: 1679249 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anosmia, Arthralgia, Asthma, Condition aggravated, Eye swelling, Fibromyalgia, Myalgia, Visual impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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? No
Previous Vaccinations: Flu
Other Medications: Zoloft, hydroxychloroquin, levothyroxin, gabapentin, losartan, versatile, pravastatin, tylenol, benedryl
Current Illness: None
Preexisting Conditions: Asthma, fibromyalgia, arthritis
Allergies: Pesticides, chemical sprays, demerit, morphine, meloxicam, augmentin, sulfa drugs, fluorouracil, latex, duloxetine, meantime, flu vaccine, seasonal allergies.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Eyes swelled within 10 minutes of vaccine. Continued to swell. Hard to see. Told to drive home and if I couldn''t see to pull over and dial 911. I had taken a benedryl before getting the vaccine. They told me to take another one. Didn''t have them with me. I drove to store and bought some. Called a friend to meet me. I could hardly see by t hen. Waited for the benedryl to work before driving home. My asthma acted up and I had to use my inhaler. Also eyes kept swelling back up for next 2 days. I continued benedryl to get the swelling down. Also had muscle/joint pain all over similar to a fibromyalgia flare up. Lost my sense of smell.


VAERS ID: 1679268 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-08-06
Onset:2021-08-23
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004D21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Back pain, Blood test abnormal, Chest X-ray abnormal, Chest pain, Computerised tomogram, Dyspnoea, Fibrin D dimer, Malaise, Pulmonary embolism, SARS-CoV-2 test, Scan with contrast, Thrombosis
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Celebrex 200 mg 2/day Losartan HTZ 100-50. 1/day Amlodipine 5mg 1/day Humira 40mg/0.4 mL 1 shot every two weeks Tizanidine 4mg x 3 Salfisalazine 500 mg 4/day Docusate Sodium 100mg 2/day Daily multivitamin 1/ day Fiber supplement(Yerba Pr
Current Illness:
Preexisting Conditions: Rheumatoid Athritis Osteoarthritis HBP
Allergies: None
Diagnostic Lab Data: 8/23- blood test, 2 chest X-rays, 2 covid tests, ct scan with contrast.
CDC Split Type:

Write-up: Started not feeling well on August 13th. Went to doctor on the 18th. Went back to doctor on 23rd still not able to breath, chest pain, very weak, back pain. Tested my blood and my d-dimer was 3619. Was taken to hospital with blood clots found out there was one in right leg and multiple PE in lungs.


VAERS ID: 1679723 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abnormal dreams, Asthenia, Chills, Eye pain, Fatigue, Headache, Hyperhidrosis, Malaise, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Around 10pm I started to feel weird. I woke up very ill (fatigue, headache, nausea, weakness, chills). I had the worst headache and my eyes were hurting for over 24 hours. My chills turned into a high fever on the night of the 24th and I had a high fever, sweating and vivid, strange dreams that night. I continued to feel sick until Saturday August 29th with my symptoms diminishing a bit each day.


VAERS ID: 1679754 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-05
Onset:2021-08-23
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Cardiac disorder, Chest discomfort, Dizziness, Dyspnoea, Lung disorder, Pulmonary pain
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Vestibular disorders (broad)

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

Write-up: Shortness of breath, heart fluctuations, tightness of chest and lungs, dizziness, soreness in heart and lungs.


VAERS ID: 1679955 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-03
Onset:2021-08-23
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Atrial fibrillation, Echocardiogram, Electrocardiogram
SMQs:, Supraventricular tachyarrhythmias (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: Famotidine (40mg), Fish Oil (1000mg), Multi vitamin, Paliperidone (1.5 mg), Pravastatin (40 mg), Prednisolone Acetate, Tumeric Curcumin Complex (1300 mg), Co Q10.
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG, (8/23/21 and 9/1/21), Echocardiogram (9/3/21)
CDC Split Type:

Write-up: Paroxysmal atrial fibrillation, treated with Eliquis and metoprolol succinate.


VAERS ID: 1681204 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VITAMIN C ACID; VITAMIN D NOS; FISH OIL; PROBIOTICS NOS
Current Illness: Drug allergy (allergic to Fluocinonide)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: the top of my head is feeling numb; I have a rash on my legs, no itching; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA (the top of my head is feeling numb) and RASH (I have a rash on my legs, no itching) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Drug allergy (allergic to Fluocinonide). Concomitant products included ASCORBIC ACID (VITAMIN C ACID), VITAMIN D NOS, FISH OIL and PROBIOTICS NOS for an unknown indication. On 23-Aug-2021 at 6:45 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Aug-2021 at 3:30 AM, the patient experienced HYPOAESTHESIA (the top of my head is feeling numb) and RASH (I have a rash on my legs, no itching). At the time of the report, HYPOAESTHESIA (the top of my head is feeling numb) and RASH (I have a rash on my legs, no itching) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient visited Doctor''s office to make sure everything was Ok. On an unknown date, Body temperature was 97.3F and Blood pressure was 90/60mmHg No treatment information was provided. Most recent FOLLOW-UP information incorporated above includes: On 27-Aug-2021: Significant follow up-outcome reported; Updated Race information, Ethnicity, Vaccine facility information. Added body temperature and Bloos pressure in narrative.


VAERS ID: 1681207 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-21
Onset:2021-08-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site erythema, Vaccination site pruritus, Vaccination site rash
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Immune disorder (NOS); Thyroid hormones decreased
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: PVIUS2021001214

Write-up: red rash on upper left arm; Red rash on upper left arm, itchy; Red rash on upper left arm; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE RASH (red rash on upper left arm), VACCINATION SITE PRURITUS (Red rash on upper left arm, itchy) and VACCINATION SITE ERYTHEMA (Red rash on upper left arm) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination and Immune disorder (NOS). Concurrent medical conditions included Immune disorder (NOS) and Thyroid hormones decreased. On 21-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Aug-2021, the patient experienced VACCINATION SITE RASH (red rash on upper left arm), VACCINATION SITE PRURITUS (Red rash on upper left arm, itchy) and VACCINATION SITE ERYTHEMA (Red rash on upper left arm). At the time of the report, VACCINATION SITE RASH (red rash on upper left arm), VACCINATION SITE PRURITUS (Red rash on upper left arm, itchy) and VACCINATION SITE ERYTHEMA (Red rash on upper left arm) had not resolved. Not Provided No concomitant medications was provided by the reporter. Patient applied hydrocordisone cream for relief.


VAERS ID: 1681553 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:2021-07-27
Onset:2021-08-23
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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

Write-up: Diarrhea; This spontaneous case was reported by an other health care professional and describes the occurrence of DIARRHOEA (Diarrhea) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 27-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Aug-2021, the patient experienced DIARRHOEA (Diarrhea). At the time of the report, DIARRHOEA (Diarrhea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Due for second dose on 24-AUG-2021 but having diarrhea from 23-AUG-2021 No concomitant medications reported. No treatment information was reported by reporter Reporter did not allow further contact


VAERS ID: 1681560 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-23
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Myalgia, Rash macular, Vaccination site rash
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: some lingering muscular pain in my arm; two red ''blotches'' near the injection site; a slight rash that was more pronounced after a shower; This spontaneous case was reported by a consumer and describes the occurrence of RASH MACULAR (two red ''blotches'' near the injection site), VACCINATION SITE RASH (a slight rash that was more pronounced after a shower) and MYALGIA (some lingering muscular pain in my arm) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 16-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Aug-2021, the patient experienced RASH MACULAR (two red ''blotches'' near the injection site) and VACCINATION SITE RASH (a slight rash that was more pronounced after a shower). On an unknown date, the patient experienced MYALGIA (some lingering muscular pain in my arm). At the time of the report, RASH MACULAR (two red ''blotches'' near the injection site), VACCINATION SITE RASH (a slight rash that was more pronounced after a shower) and MYALGIA (some lingering muscular pain in my arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment information was provided.


VAERS ID: 1681595 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-24
Onset:2021-08-23
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Expired vaccine administered to patient; She states that they placed 1 punctured vial of Moderna COVID-19 vaccine, which was first opened yesterday 23AUG2021 around 8-10AM, in the refrigerator for more than 12 hours; This spontaneous case was reported by a nurse and describes the occurrence of PRODUCT STORAGE ERROR (She states that they placed 1 punctured vial of Moderna COVID-19 vaccine, which was first opened yesterday 23AUG2021 around 8-10AM, in the refrigerator for more than 12 hours) and EXPIRED PRODUCT ADMINISTERED (Expired vaccine administered to patient) in a 48-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016C21A) for COVID-19 vaccination. No Medical History information was reported. On 24-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Aug-2021, the patient experienced PRODUCT STORAGE ERROR (She states that they placed 1 punctured vial of Moderna COVID-19 vaccine, which was first opened yesterday 23AUG2021 around 8-10AM, in the refrigerator for more than 12 hours). On 24-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Expired vaccine administered to patient). On 24-Aug-2021, PRODUCT STORAGE ERROR (She states that they placed 1 punctured vial of Moderna COVID-19 vaccine, which was first opened yesterday 23AUG2021 around 8-10AM, in the refrigerator for more than 12 hours) and EXPIRED PRODUCT ADMINISTERED (Expired vaccine administered to patient) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Patient was administered dose using the expired punctured vial beyond 12 hours. No concomitant medications were mentioned. No treatment details were reported.


VAERS ID: 1681608 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Bone pain, Chills, Fatigue, Myalgia, Vaccination site swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: bone pain; swelling in the injection site; soreness in his arm; tiredness/ Fatigue; chills; This spontaneous case was reported by a consumer and describes the occurrence of BONE PAIN (bone pain), VACCINATION SITE SWELLING (swelling in the injection site), MYALGIA (soreness in his arm), FATIGUE (tiredness/ Fatigue) and CHILLS (chills) in a 59-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 062e21a) for COVID-19 vaccination. No Medical History information was reported. On 23-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Aug-2021, the patient experienced BONE PAIN (bone pain), VACCINATION SITE SWELLING (swelling in the injection site), MYALGIA (soreness in his arm), FATIGUE (tiredness/ Fatigue) and CHILLS (chills). At the time of the report, BONE PAIN (bone pain), VACCINATION SITE SWELLING (swelling in the injection site), MYALGIA (soreness in his arm), FATIGUE (tiredness/ Fatigue) and CHILLS (chills) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment medications were reported.


VAERS ID: 1681614 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-01
Onset:2021-08-23
   Days after vaccination:114
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: SARS-CoV-2 test, 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: Test Date: 20210823; Test Name: COVID-19; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: She has been fully vaccinated for 3 months, yet she tested positive for COVID on 8/23/21.; This spontaneous case was reported by a consumer and describes the occurrence of SARS-COV-2 TEST POSITIVE (She has been fully vaccinated for 3 months, yet she tested positive for COVID on 8/23/21.) in a 19-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In May 2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Aug-2021, the patient experienced SARS-COV-2 TEST POSITIVE (She has been fully vaccinated for 3 months, yet she tested positive for COVID on 8/23/21.). At the time of the report, SARS-COV-2 TEST POSITIVE (She has been fully vaccinated for 3 months, yet she tested positive for COVID on 8/23/21.) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 23-Aug-2021, SARS-CoV-2 test: positive (Positive) Positive. No Concomitant medication information was reported. No Treatment medications were provided.; Sender''s Comments: This case concerns a 19 years all female, who tested positive SARS-CoV-2 after 3 month of complete vaccination. Therefore, causality for this event is assessed as not applicable.


VAERS ID: 1681638 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-01-19
Onset:2021-08-23
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chills, Feeling abnormal, Nausea, Pain, Pyrexia, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Droopy; Feeling minimal pain now; Drugged; Nausea; Possible Fever; Real bad chills; Pain in left Shoulder and Neck; Couldn''t stop Shaking; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (Droopy), TREMOR (Couldn''t stop Shaking), PAIN (Feeling minimal pain now), FEELING ABNORMAL (Drugged) and ARTHRALGIA (Pain in left Shoulder and Neck) in an 87-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 047B21A, 030M20A and 041L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 19-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 23-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 23-Aug-2021, the patient experienced TREMOR (Couldn''t stop Shaking), ARTHRALGIA (Pain in left Shoulder and Neck) and CHILLS (Real bad chills). On an unknown date, the patient experienced ASTHENIA (Droopy), PAIN (Feeling minimal pain now), FEELING ABNORMAL (Drugged), NAUSEA (Nausea) and PYREXIA (Possible Fever). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. At the time of the report, ASTHENIA (Droopy), TREMOR (Couldn''t stop Shaking), PAIN (Feeling minimal pain now), FEELING ABNORMAL (Drugged), ARTHRALGIA (Pain in left Shoulder and Neck), NAUSEA (Nausea), CHILLS (Real bad chills) and PYREXIA (Possible Fever) outcome was unknown. Concomitant medication included Thyroid medication. This case was linked to MOD-2021-298768, MOD-2021-298769 (Patient Link).


VAERS ID: 1681886 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Deafness bilateral, Ear discomfort, Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19; Shellfish allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101091539

Write-up: Tinnitus one hour after vaccination, hearing loss in both ears feels like pressure but can''t clear; Tinnitus one hour after vaccination, hearing loss in both ears feels like pressure but can''t clear; Tinnitus one hour after vaccination, hearing loss in both ears feels like pressure but can''t clear; This is a spontaneous report from a contactable nurse (patient). A 25-year-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: Ew0176), via an unspecified route of administration on 23Aug2021 at 15:45 (at the age of 25-years-old) at dose number unknown, single for COVID-19 immunization. Medical history included known allergies to shellfish and COVID. Concomitant medications were reported as none. There were no other vaccines in four weeks. Vaccination facility type was reported as hospital. She was not tested for COVID post vaccination. On 23Aug2021 at 16:45, 1 hour after vaccination, the patient experienced tinnitus and hearing loss in both ears which felt like a pressure but couldn''t clear (as reported). She did not receive any treatment in response to the events. The outcome of the events was not recovered.; Sender''s Comments: Based on the known safety profile of the vaccine BNT162B2, a temporal relation between the event deafness bilateral and the administration of the vaccine cannot be excluded.The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1681918 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (if covid prior vaccination Yes)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101097851

Write-up: Numbness in face; diagnosed initially as potential bell''s palsy then later updated to psychosomatic reaction; This is a spontaneous report from a contactable consumer (Pfizer Colleague). An adult male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 intramuscular on 23Aug2021 (Batch/Lot number was not reported) as DOSE 1, SINGLE for covid-19 immunisation. The patient medical history includes COVID-19 from unknown date and unknown if ongoing (reported as if covid prior vaccination Yes). There were no concomitant medications. It was unknown if other vaccine in four weeks and if other medications in two weeks. It was reported that the patient experienced numbness in face, diagnosed initially as potential bell''s palsy then later updated to psychosomatic reaction on 23Aug2021. The event resulted in Emergency room/department or urgent care and hospitalization. It was unknown if treatment was initiated. The patient was not covid tested post vaccination. The outcome of the events was recovered. No follow up attempts are possible; Information about lot/batch number cannot be requested. No further information is expected.


VAERS ID: 1681932 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-02
Onset:2021-08-23
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, Inappropriate schedule of product administration, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Medication errors (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: Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202101098876

Write-up: Inappropriate schedule of vaccine administered; I received a positive COVID test on 23Aug; I received a positive COVID test on 23Aug; This is a spontaneous report from a contactable consumer (patient). This 57-year-old female consumer reported for herself that she received second dose of bnt162b2 ((PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: EN6202, Expiry Date: Unknown), via an unspecified route of administration, administered in left arm on 02Mar2021 (at the age of 57 years) as dose 2, single and first dose of bnt162b2 ((PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: EN6202, Expiry Date: Unknown), via an unspecified route of administration, administered in left arm on 02Mar2021 at 15:00 (at the age of 57 years) as dose 1, single for COVID-19 immunization.The patient''s medical history and concomitant medications were not reported. Facility where the most recent COVID-19 vaccine was administered was other. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. It was reported that patient received Dose 1 and Dose 2 on 02Mar2021. The patient experienced Covid on 21Aug2021. No treatment received for AE. The patient underwent lab tests and procedures which included Nasal Swab (COVID-19 Antigen rapid test): positive on 23Aug2021. The outcome of event was recovering. Device Date: 27Aug2021. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1681935 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Hypoaesthesia, Hypoaesthesia oral, Oxygen saturation decreased, Paraesthesia, Paraesthesia oral
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Respiratory failure (broad), Infective pneumonia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101098943

Write-up: Total body numbness; Fave and tongue numb and tingly; Fave and tongue numb and tingly; Fave and tongue numb and tingly; Fave and tongue numb and tingly; Severe left sided head pain; Low oxygen; This is a spontaneous report from a contactable other hcp (patient). A 47-years-old female non-pregnant patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), dose 1 via an unspecified route of administration, administered in Deltoid Left on 23Aug2021 10:30 (at the age of 48 years), (Batch/Lot Number: Fc3183) as DOSE 1, SINGLE for covid-19 immunisation at Pharmacy or Drug Store. The patient was not pregnant at the time of vaccination. The patient medical history and concomitant medications were not reported. The patient previously took sulfonamides and experienced drug hypersensitivity. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 23Aug2021 10:45, the patient experienced total body numbness, fave and tongue numb and tingly, severe left sided head pain, low oxygen. The events resulted in visit to Emergency room/department or urgent care. The treatment received for the events was unknown. Device Date was 24Aug2021. The clinical outcome of the events was not recovered at the time of report.


VAERS ID: 1682147 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-30
Onset:2021-08-23
   Days after vaccination:54
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Magnetic resonance imaging, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: Test Date: 2021; Test Name: MRI; Result Unstructured Data: Test Result:UNKNOWN RESULTS; Comments: Visit to neurologist resulted in MRI
CDC Split Type: USPFIZER INC202101154056

Write-up: Tingling in extremities 7 weeks after 2nd dose which persists/is worsening after 10 days; This is a spontaneous report from a contactable consumer, the patient. A 50-year-old non-pregnant female patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on 30Jun2021 (at the age of 50-years-old) as a single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. Prior to the vaccination, the patient was notdiagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on an unknown date as a single dose for COVID-19 immunisation. The patient had tingling in extremities on 23Aug2021, 7 weeks after the second dose, which had persisted and worsened after 10 days. The patient visited a neurologist which resulted in magnetic resonance imaging (MRI) and electromyography (EMG) was ordered to be done as soon as possible. The event resulted in doctor or other healthcare professional office/clinic visit. Since the vaccination, the patient had not been tested for COVID-19. Therapeutic measures were not taken as a result of the event. The clinical outcome of the event tingling in extremities 7 weeks after 2nd dose which persists/is worsening after 10 days was not recovered at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow-up.


VAERS ID: 1682150 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Nasal congestion, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210901; Test Name: Nasal swab; Test Result: Negative
CDC Split Type: USPFIZER INC202101154163

Write-up: Congestion; Cough ongoing; This is a spontaneous report from a contactable consumer, the patient. A 48-year-old male patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 20Aug2021 at 08:30 (at the age of 48-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. The patient did not receive any concomitant medications. On 23Aug2021 at 10:30, the patient experienced congestion and cough ongoing. The events resulted in doctors or other healthcare professional office/clinic visit and emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19. On 01Sep2021, the patient underwent COVID test via nasal swab and the result was negative. Therapeutic measures were taken as a result of events which included treatment with unspecified antibiotic for bacterial infection. The clinical outcome of the events congestion and cough ongoing were not resolved at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1682440 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-25
Onset:2021-08-23
   Days after vaccination:59
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL EXTRA STRENGTH) 500 MG tablet diphenhydrAMINE (BENADRYL) 25 MG capsule hydrochlorothiazide (HYDRODIURIL) 25 MG tablet levothyroxine (SYNTHROID) 112 MCG tablet propranolol (INDERAL) 20 MG tablet
Current Illness: None known
Preexisting Conditions: Anxiety, arthritis, asthma, gastroesophageal reflux disease, hypertension, hyperlipidemia, hypothyroidism, myocardial infarction
Allergies: None known
Diagnostic Lab Data: Patient reported COVID-19 positive on 8/23/2021.
CDC Split Type:

Write-up: Patient presented to emergency department on 8/26/2021 with fatigue, cough, and congestion. She tested positive for COVID-19 on 8/23/2021 at an outside facility. She was treated with dexamethasone and supplemental oxygen. She was discharged to rehab facility on 9/1/2021.


VAERS ID: 1682498 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Injection site pain, Nausea, Pyrexia, Sleep disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Hives following MMR shot. Age 10
Other Medications: Multi-vitamin, fish oils, vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain at injection site. Pain in arm and shoulder which received the shot. Fatigue, nausea, vomiting, fever (102), unable to sleep.


VAERS ID: 1682550 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oral herpes
SMQs:, Oropharyngeal infections (narrow), Opportunistic infections (broad)

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

Write-up: Extreme outbreak with cold sores. (Assuming it triggered my herpes simplex virus) A total of about 5 blisters on my face


VAERS ID: 1682600 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-12
Onset:2021-08-23
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adnexa uteri pain, Intermenstrual bleeding, Thrombosis, Vaginal odour
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: KEFLEX
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: A 40 year old female patient was received in the COVID-19 vaccination are in the Hospital for the second dose PFIZER vaccine accompanied by her two children. At the time of collection all the information the patient informs having an allergic reaction to her first COVID-19 PFIZER vaccine dose. She refers "after administering my first dose vaccine PFIZER I started a week later with a severe pain in my right ovary with a lot of bleeding, clots and bad odor. My period was about to come and it is always regular, and it was not the time yet, I think this happened to my because of the vaccine" It was recommended that the patient visits her primary physician before administering her the second dose. She expressed and authorizes the administration of the second dose and signs the consent. She is advised in case of bleeding again, to visit the nearest emergency room and she understands. The second dose was administered with accepted measures. the patient had no adverse reaction during the 15 minute wait and returns home.


VAERS ID: 1682720 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: B3 and Fish Oil
Current Illness:
Preexisting Conditions:
Allergies: Penicillin and Codeine
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I am still having numbness. It has gone into the chest numbness. I don''t have chest pain just numbness.


VAERS ID: 1683069 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-03-17
Onset:2021-08-23
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, 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? 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: Break through Covid + on 8/23/21 after both vaccines.


VAERS ID: 1683100 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-06
Onset:2021-08-23
   Days after vaccination:48
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding, Intermenstrual bleeding, Menstrual disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Spotting between period, period heavier than normal, cramps hurting longer and contracting harder than usual


VAERS ID: 1683139 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Virgin Islands  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 LA / IM

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

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

Write-up: Recipient was fully vaccinated as of 02-16-2021 with 2 doses of Moderna. He came to the vaccination center on 08/23/2021 and received 1st dose Pfizer. He did not inform staff that he was previously vaccinated. When contacted, the recipient stated he came for the Pfizer because he had 2 antibody tests several months after receiving the second Moderna and both were negative. So he came for the Pfizer as a booster.


VAERS ID: 1683140 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Chills, Cold sweat, Dizziness, Dyspepsia, Immediate post-injection reaction, Nausea, Palpitations
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (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? No
Previous Vaccinations:
Other Medications: No
Current Illness: No.
Preexisting Conditions: No.
Allergies: Ibuprofen
Diagnostic Lab Data:
CDC Split Type:

Write-up: It would be great if I have been told to eat before the vaccine. Immediately when I had the shot, I experienced dizzy spells and cold chills. While waiting at the hall for 15mins, I felt nauseous. The nurse got me some biscuits to eat and water to drink. I felt better after about 20-25mins. When I came home, I continue to have cold chills for two days and I took Tylenol during the two days. I had to put on a jacket, winter socks and two blankets to sleep. The cold chills were gone after I had cold sweat in the night on the 2nd day. On the 7th day, I am still experiencing heart palpitation when I went for a walk. I also felt tummy upset, something like indigestion feeliing. Two weeks has gone, and I am feeling better now.


VAERS ID: 1683169 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-20
Onset:2021-08-23
   Days after vaccination:215
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL48 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Asthma, COVID-19, Dementia Alzheimer's type, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (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), Dementia (narrow), Acute central respiratory depression (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: POSITIVE COVID TEST, ASTHMA, ALZHEIMERS, ACUTE HYPOXEMIC RESPIRATORY FAILURE


VAERS ID: 1683175 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-29
Onset:2021-08-23
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Cough, Fatigue, Headache, Nasal discomfort, Oropharyngeal pain, Pain, Respiratory tract congestion, Restlessness
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shingles, my 2nd one flu like symptoms
Other Medications: levothyroxine, magnesium, vit D, Vit C, Vit B2, zinc, calcium, tart cherry, psyllium fiber
Current Illness:
Preexisting Conditions: Asthma, Hypothyroid, Osteoporosis, arthritis
Allergies: oxytocin
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I had congestion, burning in my left side of nasal cavity, sore throat, cough, lot of body aches, headaches, restless, also extreme fatigue. I lost my taste and smell.


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