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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 423 out of 8,010

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VAERS ID: 1713193 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage 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: Error: Improper storage/temperature.


VAERS ID: 1713278 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: 13 Year-old administered the Moderna vaccine. No side effects reported by patients mother or patient


VAERS ID: 1713551 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Dizziness, Limb mass, Pain, Palpitations, Peripheral swelling, Pyrexia, Rash erythematous
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Dizziness and heart palpitations upon receiving injection. Red rash, bruising, sore & swollen arm. Fever and masses knot in arm.


VAERS ID: 1713706 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage 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: Error: Improper Storage (temperature)-


VAERS ID: 1713708 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage 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: Error: Improper Storage (temperature)-


VAERS ID: 1713761 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage 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: Error: Improper Storage (temperature)-


VAERS ID: 1713782 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage 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: Error: Improper Storage (temperature)-


VAERS ID: 1713798 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage 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: Error: Improper Storage (temperature)-


VAERS ID: 1714073 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage 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: Error: Improper Storage (temperature)-


VAERS ID: 1714150 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage 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: Error: Improper Storage (temperature)-


VAERS ID: 1714201 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage 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: Error: Improper Storage (temperature)-


VAERS ID: 1714359 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage 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: Error: Improper Storage (temperature)-


VAERS ID: 1714361 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage 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: Error: Improper Storage (temperature)-


VAERS ID: 1714403 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not known
Current Illness: none reported
Preexisting Conditions: Asthma, Kidney disease
Allergies: None reported
Diagnostic Lab Data: NO
CDC Split Type:

Write-up: Swollen tongue, and swollen lips


VAERS ID: 1714419 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (broad)

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

Write-up: Patient had gotten the Pfizer shot at our pharmacy on 8/23/21 and when he was getting the second dose at another facility they noticed that prior to getting Pfizer 1st dose he had gotten Jassen vaccine on 4/5/21 somewhere else. On the consent form patient had selected "No" for "Have you ever received a dose of COVID-19 vaccine." There are no known adverse events.


VAERS ID: 1714444 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-17
Onset:2021-08-23
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Impaired healing, Rash, Skin weeping
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Singular Zirtec mult vitamin
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type: 6PcBoc

Write-up: Weeping rash on face, erupts, doesn''t heal , continues to break open . Started about 1 week after vaccine


VAERS ID: 1714898 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002S21A / 1 - / -

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

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

Write-up: Swollen area in the lower lip.


VAERS ID: 1715470 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram, Dyspnoea, Echocardiogram, Electrocardiogram, Electrocardiogram ambulatory, Fatigue, X-ray
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Swelling of lymph nodes under both arms, numbness in left arm and hurt to lay on and had fever in arm, 46 yrs, Nov of 2019, Flu
Other Medications: None
Current Illness: Diabetes and hypothyroidism
Preexisting Conditions: Diabetes and hypothyroidism
Allergies: IVP dye and metronidazole
Diagnostic Lab Data: X-ray, CT scan, EKG, will have an Echo and halter monitor tomorrow
CDC Split Type:

Write-up: Shortness of breath, chest pain, fatigue and burning in my heart


VAERS ID: 1715593 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-21
Onset:2021-08-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FV8448 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cough, Diarrhoea, Headache, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test negative, Vomiting
SMQs:, Anaphylactic reaction (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: Asthma
Allergies: Peanuts; shrimp; avocado
Diagnostic Lab Data: COVID Test Negative (08/29/2021), COVID Test Negative (09/05/2021)
CDC Split Type: vsafe

Write-up: A few days after the 1st dose, he experienced a sore threat, congestion; however, the cough was dry and became worse after a few days along with the congestion. It went away and started again. I took him to local urgent care and they ran a COVID test that came back negative. I called the school to make sure he was clear to return to school but they wanted him to quarantine for 10 days and had to do another one because the cough continued and then had to stay out of school after receiving the 2nd dose on 09/11/2021 and his cough returned on 08/19/2021 along with a headache and I gave him some ibuprofen for it and the vomiting/diarrhea lasted a few days or so. I called the school and they felt that his symptoms from receiving the vaccine so it was not necessary to quarantine him.


VAERS ID: 1715652 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Balance disorder, Dizziness, Fall, Hypoacusis, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Hearing impairment (narrow), Vestibular disorders (broad)

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

Write-up: About an 1.5 hours after receiving the vaccine, I started feeling dizzy and would randomly start leaning/falling over at random. It felt as if the ground wasn''t even and my sense of balance has been affected since I received the vaccine. Along with this came a loud ringing in my ears that persists to today. I have difficulty hearing certain frequencies because of the loud ring sound. I have notified my provider of these issues from the vaccine and have not received a response yet as to what to expect and if treatment is available.


VAERS ID: 1716561 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Dizziness, Fatigue, Immediate post-injection reaction, Influenza like illness, Menstruation irregular, Migraine, Nausea, SARS-CoV-2 test negative, Smear cervix abnormal
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Fertility disorders (broad), Hypersensitivity (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: Flu shot many years prior
Other Medications: Lexapro
Current Illness: No sickness since February 2021.
Preexisting Conditions: None
Allergies: Cephalexin, amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness at time of vaccination, fatigue immediately after after first dose and for 3-4 weeks following, nausea, migraine headaches 3-4 times a week, first menstrual period in 540 days 3 weeks after first does with IUD, onset of bacteria shown in Pap smear 10 days post first dose, flu like symptoms for 3-4 weeks since first dose with negative covid results twice within the same timeframe, lack of appetite for 3-4 weeks post vaccination.


VAERS ID: 1716907 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Malaise, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

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

Write-up: He felt sick the following day.(Monday) On Tuesday he still felt sick. Wednesday he felt better, but began to wheeze. He started taking his Xopanex to help him breathe. By Saturday he had to have his xopanex every 4 hours and it would not work. We increased his dosage, but it still wore off. On Sunday he was prescribed a steroid. The steroid didn?t work completely. On Friday he was prescribed more steroids and a separate bronchodilator. He finally felt better the following week.


VAERS ID: 1718243 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Diffuse myalgia, numbness in extremities, symptoms persist 4 weeks after 3rd dose of vaccine. No such symptoms after first or second dose.


VAERS ID: 1718250 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chills, Dysgeusia, Headache, Nausea, Night sweats, Pain, Pain in extremity, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: WELLBUTRIN; ACYCLOVIR [ACICLOVIR]; ESTRIOL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Date: 20210823; Test Name: low grade fever; Result Unstructured Data: Test Result:low grade fever Fahrenheit; Comments: low grade fever
CDC Split Type: USPFIZER INC202101103157

Write-up: Arm pain; headache; body aches; nausea; vomiting; low grade fever; chills; night sweats; Metallic taste in my mouth immediately after injection.; This is a spontaneous report from a contactable nurse. This 54-year-old female Nurse reported for herself that she received bnt162b2 (BNT162B2 Solution for injection), dose 1 via an unspecified route of administration, administered in Arm Left on 23Aug2021 10:15 (Batch/Lot Number: EW0182) as DOSE 1, SINGLE for covid-19 immunisation (54 years at the age of vaccination). Medical history included covid-19 from an unknown date and unknown if ongoing. Concomitant medication included bupropion hydrochloride (WELLBUTRIN) 150 unk daily taken for an unspecified indication, start and stop date were not reported; acyclovir [aciclovir] (ACYCLOVIR [ACICLOVIR]) taken for an unspecified indication, start and stop date were not reported; estriol (ESTRIOL) taken for an unspecified indication, start and stop date were not reported. If covid prior vaccination was yes and If covid tested post vaccination was no. The patient experienced Arm pain, headache, body aches, nausea, vomiting, low grade fever, chills , night sweats and Metallic taste in my mouth immediately after injection on 23Aug2021 16:00. The patient underwent lab tests and procedures which included body temperature: low grade fever fahrenheit on 23Aug2021 low grade fever. Therapeutic measures were taken as a result of all events (Zofran). The outcome of the events was resolving. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1718271 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, 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: PROMETRIUM [PROGESTERONE]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Sulfonamide allergy (Sulfa)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101164175

Write-up: headache; tingling in my scalp; This is a spontaneous report from a contactable consumer reported that. A 45-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection), via an unspecified route of administration, administered in Arm Left on 22Aug2021 10:30 (Batch/Lot number was not reported) as DOSE NUMBER UNKNOWN, SINGLE for covid-19 immunization (Age at vaccination 45 years). The patient was not pregnant at the time of vaccination. The patient past Medical history included known allergies: sulfa from an unknown date and unknown if ongoing. Concomitant medication(s) included progesterone (PROMETRIUM [PROGESTERONE, strength 100mg) taken for an unspecified indication, and Multivitamin. 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 vaccine within 4 weeks prior to covid-19 vaccination. After the administration of vaccine, the patient developed a headache on day one which has persisted every day since coming and going and tingling in her scalp on 23Aug2021. The events result in Doctor or other healthcare professional office/clinic visit. No treatment was received. The event outcome was not recovered. The lot number for the vaccine BNT162B2 was not provided and will be requested during follow up.


VAERS ID: 1718837 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-22
Onset:2021-08-23
   Days after vaccination:213
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Intensive care, Mechanical ventilation, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Acute central respiratory depression (broad), Respiratory failure (broad), Infective pneumonia (broad), 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? No
Hospitalized? Yes, 26 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine breakthrough, symptomatic. Inpatient admit 8/27 to present, still inpatient 9/21. ICU on vent, ongoing high oxygen needs currently


VAERS ID: 1718868 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-08-03
Onset:2021-08-23
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Antiphospholipid antibodies, Blood creatinine normal, Blood urea decreased, Computerised tomogram head abnormal, Fall, Full blood count, Haematocrit normal, Haemoglobin normal, Head injury, Headache, Loss of consciousness, Magnetic resonance imaging abnormal, Metabolic function test, Nausea, Platelet count normal, Thrombosis, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: MRI: 9/20/21: subacute thrombus occluding the right transverse sinus and right sigmoid sinus as well as the upper portion of the right internal jugular vein. CT head: 9/20/21: venous congestion noted in the right temporal occipital region. Antiphospholipid panel sent 9/21/21 CBC 9/20/21: hemoglobin 16.5/ hematocrit 49.7 / platelets 154 K/mcl BMP 9/20/21: BUN 6/SCr 0.68
CDC Split Type:

Write-up: Patient reported having headaches with coughing/sneezing approximately 8/16/21-8/23/21, not able to give specific dates but states about 4 weeks ago. Patient presented 9/20/21 after acute headache with nausea and vomiting while working as an electrician. Briefly lost consciousness and fell out of his car onto his head now with persistent headaches. MRI with subacute thrombus occluding the right transverse sinus and right sigmoid sinus as well as the upper portion of the right internal jugular vein. Patient initially started on heparin continuous infusion 9/20/21 transitioned to therapeutic enoxaparin 1 mg/kg bid subcutaneously on 9/21/21. Plan to transition to oral anticoagulant on 9/22/21 pending enoxaparin tolerability and insurance coverage. Patient''s headache still remains relieved with acetaminophen currently, in addition to nausea and photophobia.


VAERS ID: 1718974 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Lip swelling, Swelling face, Swelling of eyelid
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Swelling of the face, lips, eyelids within 3 hours of vaccine administration. Took benadryl orally and aspirin and within 24 hours, the swelling went down.


VAERS ID: 1719092 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthma, Diarrhoea, Myalgia, Nausea, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Asthma/bronchospasm (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: metforman and vitamins
Current Illness:
Preexisting Conditions: mass cell activation sendrum , type 2 diabetes
Allergies:
Diagnostic Lab Data: reaction to the vadination (Moderna)
CDC Split Type: vsafe

Write-up: bad joint and muscle pain, diarrhea, nausea, rash, asthma worsened


VAERS ID: 1719116 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821280 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Back pain, Blood test, Burning sensation, Dizziness, Electromyogram, Head discomfort, Headache, Hypoaesthesia, Magnetic resonance imaging, Magnetic resonance imaging head, Magnetic resonance imaging neck, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (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: Levocetirizine, multivitamin
Current Illness: none
Preexisting Conditions: C6,7 and L5-S1 disc herniation
Allergies: Augmentin
Diagnostic Lab Data: 8/30/21- Emergency room visit- blood work up for stroke including brain MRI- normal 9/1/21- ,Neurology consult, EMG, blood work to rule out acute transverse myelitis 9/9/21- MRI-cervical, Thoracic, Lumbar 9/15/21- Neurology consult- started on steroids and gabapentin, 9/16/21- Started Physical therapy
CDC Split Type:

Write-up: Very severe lower back and abdominal pain with constant left sided (upper and lower extremities) weakness, numbness, tingling, burning sensation and pain on cuff muscles that started on day 2 after receiving the vaccine.- still persists as of 9/21/21 but decreased symptoms after taking steroids. Accompanied by dizziness , headache or heavy headedness (feeling like I am about to black out)- Very mild and occasional.


VAERS ID: 1719331 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-07-27
Onset:2021-08-23
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac failure congestive, Dyspnoea
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol 4, Pioglitazone 30mg,Low dose asprin, Ropinrole 3mg,Astrovastatin 80mg, Metoprol 25mg
Current Illness: N/A
Preexisting Conditions: Diabetes, Heart Attack (2), High Blood Pressure
Allergies: STADOL, Tide Laundry soap, and Downy Fabric Softener
Diagnostic Lab Data: You''d have to ask the hospital. I do not know.
CDC Split Type:

Write-up: Shortness of breath/Congestive Heart Failure Hospital Stay over night,


VAERS ID: 1719500 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0S2E21A / UNK UN / UN

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

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

Write-up: The patient brought by her parent came to the health center for a nurse visit appointment for the COVID vaccine. An administration error and deviation occurred, the clinical staff associate administered the incorrect COVID vaccine for her age. She was given a first dose of the Moderna COVID vaccine and scheduled for a second dose appointment. Patient arrived at health center on 9/20 for her 2nd dose of Moderna and was unable to receive. The incident was forwarded to management. Nurse manage was able to gather the necessary information from parent. The mother denied her daughter having any adverse or abnormal signs and symptoms from receiving the Modera COVID vaccine, she stated "she actually did really well,


VAERS ID: 1719524 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-01
Onset:2021-08-23
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / IM

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

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

Write-up: numbness, tingling, parathesias in Right arm, the arm the vaccine was given for a month after first Maderna vaccination


VAERS ID: 1719753 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-15
Onset:2021-08-23
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Blood test normal, Cough, Dyspnoea, Electrocardiogram normal, Fatigue, Feeling abnormal, Hyperhidrosis, Magnetic resonance imaging abnormal, Oxygen saturation decreased, Pain, Pulmonary fibrosis, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol; Singulair; Synthroid; Estrogen
Current Illness: no
Preexisting Conditions: pulmonary damage; asthma; Hypothyroid
Allergies: Septra; Macrodantin; seasonal allergies; dog and cats - I take allergy injections but I haven''t had them lately.
Diagnostic Lab Data: I had a MRI at an ER (can''t remember the name of it) - doctor ordered- to rule out an embolism in chest. And on the 30th I had a COVID test - it was negative by then. They did an EKG while I was there and bloodwork - EKG was good. They were looking for enzymes in my bloodwork and that was fine. On the MRI - I have old scarring - they could see where I had pneumonia which was in the process of getting better.
CDC Split Type: vsafe

Write-up: Loss of taste, smell and fatigue. I had a terrible cough. Fuzzy brain - still fuzzy. My oxygen saturations were low. Short of breath. And I just hurt all over - I felt like my body was hit by a truck. It hurt bad. Profuse sweating. We did telemed visit the first time. He prescribed Steroids and a z-pack. And had me take Vit D3, Vit C and zinc supplements. Those did not help with my symptoms. I called back on Monday, August 30th - and went in to the doctor''s office and I was prescribed Doxycycline and another round of steroids and nebulizer treatments. Those treatments helped. I am getting there - as far as recovery.


VAERS ID: 1720326 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac flutter, Headache, Heart rate increased, Mouth swelling, Rash
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Oropharyngeal allergic conditions (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Tachyarrhythmia terms, nonspecific (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Patient reports rash, swelling of my mouth, headache, rapid heart beat and fluttering heart rate and pounding headache


VAERS ID: 1720538 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Blood thyroid stimulating hormone increased, Injection site pain, Laboratory test, Muscle spasms, Myositis, Pain, Physical examination, Red blood cell sedimentation rate increased, Tendonitis
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Arthritis (broad), Tendinopathies and ligament disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu shot 2016, preservative free
Other Medications: Toprol XL 50 mg, Prilosec 25mg, 200 mg celebrex twice a day, Keppra 750 mg, multivitamin, vitamin D, calcium/magnesium complex.
Current Illness: none
Preexisting Conditions: charcot marie tooth disease, tachycardia
Allergies: none
Diagnostic Lab Data: Physical exam showed myositis, muscle spasms, tendonitis and muscle spasms. Labs showed an increase in sedimentation rate and TSH levels are doubled.
CDC Split Type:

Write-up: 1st day very sore left arm applied ice and took tylenol. Pain started radiating up my neck and had shooting pain in my shoulder down to my shoulder blade. No one could even touch my arm it hurt so much. 2nd day- Soreness increased around my shoulder joint up my neck and down my shoulder blade. My injection site was still very sore. Felt like I was in a car accident not given a safe shot. 3rd day- Injection site soreness started to calm down. Pain increased around my shoulder joint, up my neck and down my shoulder blade. 4th day until now- it hasn''t changed, I have to ice my arm several times a day, complete stretches/physical therapy. My doctor increased my celebrex from 200 mb twice a day to 400 mg twice a day.


VAERS ID: 1721765 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / 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: COVID-19 virus test; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: We tested positive We must have already had covid when we got the shot although we didn''t know it; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (We tested positive We must have already had covid when we got the shot although we didn''t know it) 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 18-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 COVID-19 (We tested positive We must have already had covid when we got the shot although we didn''t know it). At the time of the report, COVID-19 (We tested positive We must have already had covid when we got the shot although we didn''t know it) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 23-Aug-2021, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. The patient received anti-body on 26-Aug-2021. This case was linked to MOD-2021-319706 (Patient Link).


VAERS ID: 1721920 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Work       Purchased by: ?
Symptoms: Dysgeusia, Hormone level abnormal, Inflammation, Urticaria, Vaginal infection, Visual impairment, Vulvovaginal inflammation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (If covid prior vaccination: Yes); Lichen sclerosus; Pelvic congestion; Pudendal neuralgia
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101191435

Write-up: Metallic taste in mouth; Hives all over; Flare in inflammation or pudendal nerve; Spike in hormone level; Vaginal inflammation; Vaginal infection; Change in vision; This is a spontaneous report received from a contactable other healthcare professional (patient). A 49-years-old non-pregnant female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot Number: Unknown), via an unspecified route of administration, administered in Arm Left on 23Aug2021 as dose 1, single and a second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot Number: Unknown), via an unspecified route of administration, administered in Arm Left on 23Aug2021 10:00 (both doses at the age of 49-years-old) as dose 2, single for COVID-19 immunisation. Medical history included pudendal neuralgia, lichen sclerosis, pelvic congestion, covid-19 from an unknown date and unknown if ongoing. The patient concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was diagnosed with COVID-19. Since the vaccination, did not patient been tested for COVID-19. The most recent COVID-19 vaccine facility was administered in workplace clinic. The patient experienced metallic taste in mouth, hives all over, flare in inflammation or pudendal nerve, spike in hormone level, vaginal inflammation, vaginal infection, change in vision on 23Aug2021 10:00. Treatment was received for the events (prescription for infection). Patient visited Doctor or other healthcare professional office/clinic visit. The outcome of the events was reported as not recovered. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1722464 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebrovascular accident
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

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

Write-up: patient had a stroke 5 days after vaccine


VAERS ID: 1722505 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Migraine, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vericare 5mg PO daily
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Migraine headache and blurry vision.


VAERS ID: 1722575 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-03-18
Onset:2021-08-23
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002B21A / 2 LA / SYR

Administered by: Senior Living       Purchased by: ?
Symptoms: Ageusia, Cough, Nasopharyngitis, Pneumonia, Productive cough, SARS-CoV-2 test negative, Sinusitis
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu - 40 years ago. No vaccines since
Other Medications: no
Current Illness: no
Preexisting Conditions: Heart disease, Type 2 Diabetes . high cholesterol and high triglesolol
Allergies: no
Diagnostic Lab Data: Covid - Negative
CDC Split Type: vsafe

Write-up: Symptoms started last week of Aug 2021. Loss of sense of taste, sinus infection and lung. 4 months after the month . lots of coughing , no fever, spitting phelms . Took anti biotics . The head cold went into lungs. Covid testing were negative. Finally got prednisone finally helped. My weight is 165 pounds.


VAERS ID: 1722579 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939901 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Headache, Pain, Peripheral swelling, Pruritus, Pyrexia, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna (flu like symptoms)
Other Medications: Clozapine
Current Illness:
Preexisting Conditions: Low White count; Low Plate count
Allergies: Mold; pollen
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: My left arm swollen and hot. After 3 days, my arm became itchy, and I had a fever. I had body ache and ongoing headaches. But the headaches have continued to this day. My temperature was 101. My headaches are in the frontal lobe, it feels like a stress headache.


VAERS ID: 1722584 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Rhinorrhoea
SMQs:

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

Write-up: Headache and runny nose that started the day of the first vaccine and hasn''t stopped since.


VAERS ID: 1722646 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-08-23
   Days after vaccination:136
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 1 UN / UN
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Abdominal hernia, Abdominal pain, Acute respiratory failure, Anaemia, Blood alkaline phosphatase increased, Blood creatinine increased, Blood glucose increased, Blood urea increased, Brain natriuretic peptide increased, COVID-19, COVID-19 pneumonia, Cardiac failure congestive, Chest X-ray abnormal, Computerised tomogram abdomen abnormal, Computerised tomogram head normal, Condition aggravated, Cough, Decreased appetite, Drug screen positive, Dyspnoea, Electroencephalogram normal, Fatigue, Fluid balance positive, Headache, Hypoaesthesia, Hypoxia, Imaging procedure abnormal, Intensive care, Melaena, Mental status changes, Oesophagogastroduodenoscopy normal, Partial seizures, Pneumonia, Pneumonia bacterial, Pulmonary congestion, Pulmonary oedema, Pyrexia, SARS-CoV-2 test positive, Seizure like phenomena, Tachypnoea, Thrombocytopenia, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (narrow), Liver related investigations, signs and symptoms (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), 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), Convulsions (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Drug abuse and dependence (broad), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (narrow), Biliary system related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), 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 (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), Infective pneumonia (narrow), 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, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol, Norvasc, Vitamin C, Aspirin, Lipitor, Tums, Alphagan, Coreg, Vit D3, Catapres, Cardizem CD, Iron, Flonase, Lasiz, Apresoline, Vistaril, hyoscyamine, Insulin Aspart, Insulin detemir, Isordil, Lamictal, Levalbuterol, Synthroid, Anti
Current Illness: She previously was hospitalized from 6/11-6/20 for acute CHF and found to have chronic diastolic heart failure
Preexisting Conditions: CAD,CKD stage3, depression, diastolic CHF, Hypertension, Hypotension, seizure disorder, sick sinus Syndrome
Allergies: paper tape, Zoloft (Selective Serotonin Reuptake Inhibitors)
Diagnostic Lab Data: Patient is a 73 y.o. female with PMHx of CHF, HTN, Seizures, CAD post-CABG, CKD3, DM2 who presented to the ED on 8/29 with complaints of AMS, fatigue, fevers, and hypoxia. Patient tested positive for Covid on 8/23. She also complained of SOB, cough, HA, chronic abdominal pain, reduced appetite. She also tested for numbness in her lower left leg. She previously was hospitalized from 6/11-6/20 for acute CHF and found to have chronic diastolic heart failure. In the ED, she was significant for tachypnea and hypoxia, cocaine positive, anemia, thrombocytopenia. Her glucose was elevated at 239, BUN 62, Cr 1.89 (at baseline) and ALP of 244. She had elevated troponins with a 2 hour delta of +3, BNP of 17000+. CT of head was negative for acute changes. CT of abdomen revealed abdominal wall hernia. CXR showed findings consistent with Covid penumonia and mild congestion/pulmonary edema. She was started on Rocephin and azithromycin for suspected CAP and admitted into the hospital for Severe Covid infection with acute hypoxic respiratory failure and superimposed bacterial CAP. In the hospital, she was started on Decadron, remdesivir, covid panels. Rocephin and Azithromycin were continued to treat pneumonia. Lasix was started to treat CHF exacerbation. Seizure disorder was noted and continued on home medications. Dm2 was treated with insulin and HTN medications were continued. Other comorbidities were assessed and treated as needed. During her hospital stay, patient was notable for having focal seizures under 5 minutes. Patient used her vagal stimulator to help extinguish them. Decadron and remdesivir were subsequently discontinued for possibly lowering seizure threshold. The patient was transferred to the ICU due to protocol for needing a bear hugger. EGD was also performed to evaluate for a potential ulcer after tarry stools,but was negative for active bleeding. Patient finished antibiotic course and their respiratory status improved and was on room air by end of hospital course. She was discharged to facility in stable and improved condition Readmitted on 9/12-9/16/21 73 y.o. female with h/o known seizure disorder on AED''s, CAD s/p CABG, SSS s/p PPM placement, HTN, HLD, GERD, hypothyroidism, depression/anxiety, and recent hospitalization for COVID-19 pneumonia, who presents to BW ER today now 4 days out from recent discharge with SAR staff concern for seizure-like episodes. She reportedly had 2 separate seizure-like events at this facility prior to presentation on 09/12, described by care staff as convulsing of bilateral arms and left leg initially, followed by convulsing of bilateral arms and bilateral legs. She also had another episode during the admitting physician''s interview in which she was fully alert and talking, but also notably convulsing. Lamictal levels were noted to by supratherapeutic on admission. She was admitted for EEG monitoring and Lamictal dose was adjusted. Neurology followed and with patient back to her baseline with EEG completed and without seizures recorded, cleared patient for discharge and would plan on outpatient follow-up with epilepsy Clinic with recheck levels of Lamictal and zonisamide in 1 week. With patient stable she was discharged back to her facility. During this hospital stay patient was noted to be fluid positive both clinically and imaging that she was started on IV Lasix twice daily. Her volume status had been monitored and when clinically euvolemic she was transitioned back to her oral diuretics
CDC Split Type:

Write-up: Hospitalized 8/29/21-9/8/21 COVID-19 positive 8/23/21; fully vaccinated


VAERS ID: 1722853 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939901 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphemia, Memory impairment, Neuropathy peripheral
SMQs:, Peripheral neuropathy (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Neuropathy in feet, stuttering during speaking, memory problems


VAERS ID: 1722906 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-16
Onset:2021-08-23
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test, Chest pain, Dyspnoea, Inflammatory marker increased
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit. C,A,D
Current Illness: none
Preexisting Conditions: none
Allergies: sulfur,eggs,wheat
Diagnostic Lab Data: Blood work showed inflammation levels were slightly high.
CDC Split Type:

Write-up: Joint pain in feet and hands sticking pain in chest and breathing problems occasionally.


VAERS ID: 1723243 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

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

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

Write-up: Patient had an alergic reaction to the vaccine and his eyes were swollen . The pharmacist suggested going to the doctors office and a couple of day later the patient was fine. He returned today to the pharmacy and everything was okey.


VAERS ID: 1723262 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

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

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

Write-up: Rash-like symptoms on the chest and back. Discoloration similar to sunburn with no sun exposure. Texture of skin across breast and back have crepe appearance and has not changed since initial onset.


VAERS ID: 1725278 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-08-23
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, Product storage 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: USJNJFOC20210941128

Write-up: OUT OF SPECIFICATION PRODUCT USE; TEMPERATURE EXCURSION (EXPOSED TO 27F DEGREES FOR 44 MIN); This spontaneous report received from a health care professional concerned multiple patients. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin, and batch number were not reported) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 23-AUG-2021, the patient experienced temperature excursion (exposed to 27f degrees for 44 min). On an unspecified date, the patient experienced out of specification product use. The action taken with covid-19 vaccine was not applicable. The outcome of the temperature excursion (exposed to 27f degrees for 44 min) and out of specification product use was not reported. This report was non-serious.


VAERS ID: 1725370 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: 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: 08/23/2021; Test Name: COVID-19 test; Test Result: Positive; Result Unstructured Data: Positive.
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: This spontaneous case reported by a consumer, describes the occurrence of SARS-CoV-2 positive test (tested positive/must have already had COVID-19 when got the shot although didn''t know it) in a male patient, of an unknown age, who received mRNA-1273 (Moderna COVID-19 vaccine) for COVID-19 immunization. No medical history reported. On Aug 18, 2021, patient received the first dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On Aug 23, 2021, patient experienced SARS-CoV-2 positive test (tested positive/must have already had COVID-19 when got the shot although didn''t know it). At the time of the report, SARS-CoV-2 positive test (tested positive/must have already had COVID-19 when got the shot although didn''t know it) outcome: unknown. Diagnostic results: On Aug 23, 2021, SARS-CoV-2 positive test: Positive. The action taken with mRNA-1273 (Moderna COVID-19 vaccine): unknown. No concomitant medication or treatment information not provided. Patient received antibodies on August 26. This case linked to MOD-2021-319706 (patient link).


VAERS ID: 1726710 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: PATIENT RECEIVED 1 DOSE OF JANSSEN ON 08/020/2021 AT ONE LOCATION AND RECIEVED ANOTHER DOSE OF JANSSEN ON 08/23/2021.


VAERS ID: 1726882 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-16
Onset:2021-08-23
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Illness, SARS-CoV-2 test, Streptococcus test
SMQs:, 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: Annual flu shot- internal hives, severe itching, naseau, vomiting, inflammation
Other Medications: Meloxicam; Metformin; Enaprinil; Lexapro; Baclofen; Tramadol; Azathioprine; Creon; Vitamin b3, but, b12, C, D; Omega 3-6-9; artichoke leaf extract; triphala; Betrain; Pepsin; omaperozole
Current Illness: Systematic scleroderma Systematic lupus Raynaud''s Syndrome Pancreatic Insufficiency Severe Maldigestion Chronic Pancreatitis Osteoarthritis Bipolar Disorder Type I
Preexisting Conditions: Systematic scleroderma Systematic lupus Raynaud''s Syndrome Pancreatic Insufficiency Severe Maldigestion Chronic Pancreatitis Osteoarthritis Bipolar Disorder Type I
Allergies: Embryl; Flu Shot; Thiomerosol; Hydroxychloroquinine; albuterol; gold; lactose
Diagnostic Lab Data: COVID 19 rapid test 8/23/21 Strep Throat culture 8/23/21
CDC Split Type:

Write-up: I am in the COVID 19 vaccine f/u survey group. The questionnaire just asks for reports to changes in health. They symptoms are consistent with ongoing chronic illnesses. Similar illness presentations have happened at least 6 times in the 5 years prior to getting the COVID vaccine. I received a call from the CDC study asking to submit this adverse rx report.


VAERS ID: 1726917 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Erythema, Feeling abnormal, Gait disturbance, Headache, Injection site urticaria, Mobility decreased, Pain, Pyrexia, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (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: Lyrica, Adderall Hydrocortisone, Famatodine, Metroprolol, Rexultil,Prednisone, Oxycodone, Trintellix, Hydroxychloroquine
Current Illness: no
Preexisting Conditions: rheumatoid arthritis, fibromyalgia, spinal stenosis
Allergies: Celexa
Diagnostic Lab Data: I did not seek medical help. I was unable to get up and get ready to go to Urgent Care and did not want to call an ambulance so I suffered it out for 2 1/2 days until I started slowly returning to normal.
CDC Split Type:

Write-up: Woke up knowing something was very, very wrong. My body was in so much pain shooting throughout my body. I had fever, chills, headache, extreme weakness so bad I was unable to get out of bed. I needed assistance getting up to go to the bathroom. I had hives on my upper right arm where injection was administered. I still have a circular reddish purple spot on my arm.


VAERS ID: 1727036 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Zinc, vitamin C, Pepcid (otc), 1stPhorm "Opti-greens" and "Opti-reds."
Current Illness: None
Preexisting Conditions: None
Allergies: Vicodin (undiagnosed): respiratory depression
Diagnostic Lab Data:
CDC Split Type:

Write-up: 6 bouts of diarrhea, accompanied with stomach cramping


VAERS ID: 1727081 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-03-24
Onset:2021-08-23
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046A21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Myalgia, Pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: Diabetes and Hypertension
Allergies: No
Diagnostic Lab Data: Scheduled for an X-ray
CDC Split Type: vsafe

Write-up: I experienced muscle pain when movement is made in my arm that continues to radiate. I went to see my PCP and am scheduled for an X-ray on 09/28/2021. I still have the symptoms whenever I move my arm around and don''t know what''s causing it.


VAERS ID: 1728735 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Balance disorder, Chest pain, Costochondritis, Electrocardiogram, Extra dose administered, Feeling abnormal, Impaired work ability, Inflammation, Injection site bruising, Injection site nodule, Injection site pain, Injection site swelling, Musculoskeletal chest pain, Pyrexia, Varicose vein
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shingles Vaccine made me feel very sick
Other Medications: Losartan, Atorvastatin
Current Illness: N/A
Preexisting Conditions: Psoriasis, Asthma
Allergies: Naproxen Sodium
Diagnostic Lab Data: EKG Dose 1 03/05/2021 EN6204 Dose 2 04/22/2021 EP655
CDC Split Type: vsafe

Write-up: The day after the third dose I started to feel feverish and loopy. My legs were a little shaky, so I went home from work. After the third dose of the vaccine my left armpit was swollen and the veins that ran toward my breast were very swollen. I could feel nodules in my armpit. I started to get some chest pain which was very localized. It was a bruising pain in the center about a week after the shot. My chest was very tender to the touch. I was diagnosed with Costochondritis on 09/21/2021. My cardiologist said my cartilage was inflamed. I am supposed to see my doctor for further treatment. I am taking Celebrex for the pain for seven days currently. Dose 1 03/05/2021 EN6204 Dose 2 04/22/2021 EP655


VAERS ID: 1728831 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-04
Onset:2021-08-23
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 UN / UN

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

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

Write-up: Treated in ED for COVID with Regeneron antibodies. Vaccinated in April 2021.


VAERS ID: 1729068 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-22
Onset:2021-08-23
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 2 UN / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cerebral infarction, SARS-CoV-2 test positive
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospital admission for subacute occipital lobe infarct and COVID positive. Vaccinated April 2021.


VAERS ID: 1729083 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-30
Onset:2021-08-23
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, COVID-19, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (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), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 18 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted for AKI and covid positive test


VAERS ID: 1730258 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-16
Onset:2021-08-23
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling abnormal, Inappropriate schedule of product administration, Nausea, Vomiting, Weight
SMQs:, Acute pancreatitis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Test Name: Weight; Result Unstructured Data: Lost 5 pounds.
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: feels "bad"; vomiting; nausea; Less than 21 days between vaccine administrations; This spontaneous case was reported by a pharmacist and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Less than 21 days between vaccine administrations), FEELING ABNORMAL (feels "bad"), VOMITING (vomiting) and NAUSEA (nausea) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E21A) 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) (Intramuscular) 1 dosage form. On 23-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 23-Aug-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Less than 21 days between vaccine administrations). On an unknown date, the patient experienced FEELING ABNORMAL (feels "bad"), VOMITING (vomiting) and NAUSEA (nausea). On 23-Aug-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Less than 21 days between vaccine administrations) had resolved. At the time of the report, FEELING ABNORMAL (feels "bad"), VOMITING (vomiting) and NAUSEA (nausea) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Weight: decreased (abnormal) Lost 5 pounds.. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment medications were reported. Patient had experienced-Delayed reaction after taking the COVID-19 vaccine.


VAERS ID: 1730331 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-17
Onset:2021-08-23
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Influenza like illness, SARS-CoV-2 test, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Covid-19 test; Test Result: Negative ; Result Unstructured Data: Negative
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: doesn''t want to get up; fatigue; like a normal flu; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (like a normal flu), SOMNOLENCE (doesn''t want to get up) and FATIGUE (fatigue) in a 42-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 17-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Aug-2021, the patient experienced INFLUENZA LIKE ILLNESS (like a normal flu). On an unknown date, the patient experienced SOMNOLENCE (doesn''t want to get up) and FATIGUE (fatigue). At the time of the report, INFLUENZA LIKE ILLNESS (like a normal flu), SOMNOLENCE (doesn''t want to get up) and FATIGUE (fatigue) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: (Negative) Negative. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was provided. Treatment information include Antihistaminic and regular flu medicine. Reporter did not allow further contact


VAERS ID: 1730489 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / OT

Administered by: Private       Purchased by: ?
Symptoms: Endocarditis, SARS-CoV-2 test
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 20 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210903; Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC202101218583

Write-up: endocarditis; This is a spontaneous report from a Contactable Other HCP. A 45-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 intramuscular on 23Aug2021 (Batch/Lot number was not reported) as DOSE 2, SINGLE for covid-19 immunisation. Patient received the first dose of bnt162b2 on unknown date. The patient medical history was not reported. The patient''s concomitant medications were not reported. The patient experienced endocarditis on 23Aug2021 with outcome of unknown. Patient was hospitalized for 20 days. Ae resulted in Doctor or other healthcare professional office/clinic visit, Emergency room/department or urgent care, Hospitalization, Life threatening illness (immediate risk of death from the event)]. Patient had Nasal Swab on 03Sep2021 with negative result. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.; Sender''s Comments: Considering the temporal association, a causal association between administration of bnt162b2 and the onset of endocarditis 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: 1731311 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 OT / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Brexpiprazole, buprenorphine-naloxone, escitalopram, multivitamin with folic acid, trazodone
Current Illness: Cough, chest congestion, runny nose
Preexisting Conditions:
Allergies: Codeine, Pertussis vaccine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received Pfizer Covid-19 vaccine in ED. Nurse received vaccine vial from Pharmacy, she reconstituted it, drew up entire contents of vial and noted to administer 2.1ml IM. She did scan the vial and EHR indicated dose due was 30mcg/0.3ml. Patient discharged. After few hours in discussion with colleagues regarding vaccine, she realized she gave too much to patient. Nurse was not aware it was a multiple dose vial. Risk management and physician tried to reach patient multiple times, left message with grandmother and sent letter to patient to address provided. No return calls from patient or family.


VAERS ID: 1731406 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-13
Onset:2021-08-23
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute respiratory failure, Bronchitis, COVID-19 pneumonia, Cough, Dyspnoea, Fatigue, Oropharyngeal pain, Oxygen saturation decreased
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Multiple Sclerosis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: she states she has had sore throat, cough, fatigue that began on 08/07. PUI went to her provider and was also diagnosed with bronchitis and put on steroids. On 08/23, PUI went to ER due to having trouble breathing, her o2 stats were at 77% so she was hospitalized. PUI diagnosed with acute respiratory failure and covid pneumonia. Patient is fully vaccinated.


VAERS ID: 1731657 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-12
Onset:2021-08-23
   Days after vaccination:223
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: COVID 19


VAERS ID: 1731663 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-11
Onset:2021-08-23
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA748S / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Epistaxis, Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (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: Nothing
Current Illness: ITP Platelet count 48 hours before his first shot was 133 after his shot he had a lot of bruising which it took photos of and petechiae then after his second shot he got a blood nose that took an hour to stop we drew his number again and his platelet count was 66. He dropped almost 50% for taking the vaccine. we didn''t give him any other vaccines or medicine before and during and after the vaccine so we could know if he was dropping from the vaccine. i just want other parents of ITP patient to know that it is s side effect of the vaccine so they are aware of how low their child can drop. We will draw his number again in 3 weeks .
Preexisting Conditions: ITP
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: None stated.


VAERS ID: 1731998 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH DON''T KKNOW / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: rosuvadtatin 40mg, lisinopril 20mg, ezetimoble 10mg, metoprolol succinate 100mg, omeprazole 40mg all taken once a day.
Current Illness:
Preexisting Conditions: super ventricular tachacardia, heart races to dangerous levels up to 240 beats per minute until converted back to normal using verapamil IV.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: heart palpatations, heart beating too fast


VAERS ID: 1732807 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-09
Onset:2021-08-23
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Red painful rash around the injection site that lasted approximately 2 weeks


VAERS ID: 1734122 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-22
Onset:2021-08-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Pruritus, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101096366

Write-up: Vaccinated on sunday and today (tuesday) woke up feeling itchy all over; Severe diarrhea after vaccination; Also vomited about twice; This is a spontaneous report from a contactable consumer (Patient). This 30-year-old male consumer (patient) received bnt162b2 (BNT162B2, Formulation: Solution for injection, Batch/Lot number: Fc3181) dose 1, Via an unspecified route of administration, administered in left arm on 22Aug2021 at 16:00 (at the age of 30-year-old) COVID-19 as dose 1, single for Covid-19 immunisation at Pharmacy or Drug Store. Patient medical history was none. Known allergies to past drug Amoxicillin. The patient concomitant medications were not reported. Patient has not received any other vaccine in four weeks and not received any other medication in the last two weeks. The patient was not diagnosed covid-19 prior to vaccination and not tested for covid-19, post vaccination. The patient experienced severe diarrhoea. Had to run to use restroom every 30 minutes to an hour for about 9 hours day after vaccination. Also vomited about twice on 23Aug2021 at 01:15. Vaccinated on sunday and today (tuesday) woke up feeling itchy all over. The patient did not received treatment for the events. Outcome of other events was recovering. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1734166 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-21
Onset:2021-08-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Drug hypersensitivity
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101198306

Write-up: Broke out into a rash; This is a spontaneous report from a contactable physician (patient). A 45-year-old female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in the left arm, on 21Aug2021 between 10:00-11:00 AM (Lot Number: FC3180), at the age of 45 years old, as 1st single dose for COVID-19 immunisation. Medical history included allergy to many medications (unspecified). There were no concomitant medications. There were no prior vaccinations within 4 weeks from the 1st administration of BNT162b2. The patient reported that on 23Aug2021 she broke out into a rash. The patient was not sure if she was allergic to any of the ingredients in the vaccine. The patient had called her dermatologist and doctor but she did not visit any physician''s office, nor went to ER. After a week, the rash went away. The patient got her 2nd dose of BNT162b2 on 11Sep2021 and rash re-appeared on 13Sep2021. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow-up.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101199467 same reporter/patient, different dose/similar event


VAERS ID: 1734687 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Condition aggravated, Fatigue, Headache, Laboratory test normal, Muscle spasms, Oral herpes
SMQs:, Retroperitoneal fibrosis (broad), Dystonia (broad), Oropharyngeal infections (narrow), Arthritis (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Rubella vaccine (I believe) as an infant
Other Medications: L-lysine
Current Illness:
Preexisting Conditions: Arthritis in jjaw Cold cores
Allergies: Septra Rubella vaccine
Diagnostic Lab Data: Went to urgent care to get tested for kidney stones, all results came back negative
CDC Split Type:

Write-up: All symptoms appeared within 18 hours of receiving vaccine Back pain that gradually began and increased in severity for 2 weeks. It then developed into painful spasms on left side of spine near kidney, which lasted for 4 more days. Ankle joint pain - lasted 2 weeks Elbow joint pain - lasted 1 week Appearance of two cold sores, which lasted 3 days Exhaustion - lasted 3 days Headache - lasted 1 day


VAERS ID: 1735832 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-04
Onset:2021-08-23
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 1 LA / IM

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

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

Write-up: Pt received Pfizer x2. Pt tested COVID + on 8/22/21 and admitted to hospital for COVID on 8/23/2021. Pt received remdesivir and dexamethasone.


VAERS ID: 1735965 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-02
Onset:2021-08-23
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 - / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6700 / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstruation delayed, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: Tested positive for the virus one week after receiving the 1st vaccine
Preexisting Conditions: NA
Allergies: Biaxin, carrots, apples, hazelnut, macadamia nuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1 week after the 1st vaccine I went to the ER for unexpected vaginal bleeding, I was not due for my monthly menstrual cycle. It has now been 36 days, and I still have not received my period. I''ve 2 negative over the past 6 weeks.


VAERS ID: 1736004 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 15780 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Dyspnoea, Pain, Painful respiration
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad)

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

Write-up: Blood pressure skyrocketting 3 days after receiving vaccine. Started having stabbing sensations and shortness of breathe, hurt to breathe in


VAERS ID: 1737034 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-06
Onset:2021-08-23
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Diarrhoea, Fatigue, Headache, Pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: no
Allergies:
Diagnostic Lab Data: PCR collected on 8-25-21, resulted positive on 8-28-2021
CDC Split Type:

Write-up: Fever, feverish, body aches, runny nose, cough, headache, fatigue, diarrhea


VAERS ID: 1740795 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

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

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

Write-up: Cellulitis left upper arm area Body aches, headaches, nausea, fever, fatigue


VAERS ID: 1741606 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-18
Onset:2021-08-23
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Peripheral swelling, Skin discolouration, Soft tissue swelling, Synovial cyst, X-ray limb abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins D3 (2000iu), Calcium, K1, K2, magnesium
Current Illness: none
Preexisting Conditions: heart disease - pacemaker for a conduction problem (mobitz block) and had WPW (fixed with ablation)
Allergies: iodine in xray dye
Diagnostic Lab Data: xray of left hand 8/23/21 - the xray showed soft tissue swelling but nothing else abnormal
CDC Split Type:

Write-up: on 8/22/21 noticed that my left ''ring'' 4th finger was swollen at base and purple in color. Was still bad the next morning so went to Dr on 8/23 who diagnosed it as a ganglion cyst. I have never had one before. note that I have no idea if it is associated with the vaccine or not.


VAERS ID: 1741916 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-17
Onset:2021-08-23
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Influenza A virus test, Influenza B virus test, Pneumonia, Road traffic accident, SARS-CoV-2 test positive
SMQs:, Accidents and injuries (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 36 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: BPH, gout, high cholesterol, hypertension, pancreatitis
Allergies:
Diagnostic Lab Data: SARS-CoV-2 (COVID-19) and Influenza AB Antigens, POC: SARS CoV 2 DETECTED (8/23/2021)
CDC Split Type:

Write-up: 68 yo male with Hx HTN, alcohol pancreatitis and gout who presented as a level 2 trauma after MVA. Per EMS, pt was traveling on the hwy at hwy speeds when he rear ended another slower vehicle. Patient was tested for COVID-19 and found to be positive, then treated for pneumonia.


VAERS ID: 1743675 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Lymphadenopathy, Off label use, Poor quality product administered, Product temperature excursion issue
SMQs:, Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101127921

Write-up: Swollen glands; booster he received was out of super cooler but was stored overnight in refrigerator; Administered vaccine after a temperature excursion; He received a "booster dose" of the Pfizer BioNTech Covid-19 Vaccine last Monday; He received a "booster dose" of the Pfizer BioNTech Covid-19 Vaccine last Monday; This is a spontaneous report from a contactable consumer (Patient). A 66-year-old male patient received third dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot Number: FC3180) via an unspecified route of administration, administered in right arm on 23Aug2021 11:30 AM (age at vaccination was 66 years) as DOSE 3, SINGLE for COVID-19 immunization at pharmacy. The patient''s medical history was not reported. There were no concomitant medications. The patient previously received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EL0140, Expiry Date: 30Mar2021) via an unspecified route of administration, on 23Dec2020 11:00AM (age at vaccination was 65years) as DOSE 2, SINGLE for COVID-19 immunization. The patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EL0140, Expiry Date: 30Mar2021) via an unspecified route of administration, on 13Jan2021 11:00AM (age at vaccination was 65years) as DOSE 1, SINGLE for COVID-19 immunization. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 23Aug2021, the patient got administered vaccine after a temperature excursion which was a booster dose of the Pfizer biotech covid-19 vaccine last Monday after receiving the dose 3 the patient experienced swollen glands on 26Aug2021, that evening noticed the swelling, he usually had a little swelling and possibly drainage after the allergy shot but it went away in a day, this was different. Reported that his glands were still swollen five days later. The patient had not seen a doctor or emergency room and had no treatment for the swollen glands. Follow-up (30Aug2021, 30Aug2021, 08Sep2021 and 22Sep2021): It was reported that the patient had received Pfizer booster shot. Someone told caller booster he received was out of super cooler but was stored overnight in refrigerator and it should not have been. Said he does not trust anyone and checking if the storage was ok and if ok to receive booster. The outcome of the event swollen glands was recovered with sequelae on an unspecified date in 2021 and other events was unknown. Information on Lot/Batch number was available. Additional information has been requested. Follow-up (30Aug2021, 30Aug2021, 08Sep2021 and 22Sep2021): This is a follow-up spontaneous report from a Pfizer-sponsored program. A contactable consumer (patient) reported that: The patient had received Pfizer booster shot. Someone told caller booster he received was out of super cooler but was stored overnight in refrigerator and it shouldn''t have been. Said he does not trust anyone and checking if the storage was ok and if ok to receive booster. Follow-up attempts are completed. No further information was expected.


VAERS ID: 1743750 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bedridden, Fatigue, Feeling abnormal, SARS-CoV-2 antibody test
SMQs:, Dementia (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: Pfizer, Inc. EUA 027034; Pfizer, Inc. EUA 027034; Pfizer, Inc. EUA 027034; Pfizer, Inc. EUA 027034; Pfizer, Inc. EUA 027034
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure; Blood pressure high; Cholesterol; Diabetes; Diuretic effect; Kidney disorder
Allergies:
Diagnostic Lab Data: Test Date: 20210730; Test Name: blood test for Covid antibodies; Result Unstructured Data: Test Result:has antibdoies
CDC Split Type: USPFIZER INC202101225326

Write-up: after first dose, was totally whacked out and was in bed for 24 hours; Had absolutely no energy the following night; I stayed in bed for 24 hours because I was just totally exhausted; Well the first one totally wiped out so I expected that. I wasn''t surprised. I was in bed for 24 hours; This is a spontaneous report from a contactable consumer (patient himself). An 80-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, formulation: solution for injection, lot number: FC3181, expiry date: unknown) via unspecified route of administration in left arm on 23Aug2021 (age at vaccination: 80-years) as dose 1, single for covid-19 immunisation. Medical history of patient included Diabetes, Moderate kidney disease, Cholesterol, High Blood pressure, blood pressure, and water pill from an unknown date and unknown if ongoing. Concomitant medications included hydrochlorothiazide 25 mg, daily as water pill, amlodipine besilate, 10 mg daily for high blood pressure, atenolol 100 mg for blood pressure, omeprazole 20 mg daily for unknown indication, atorvastatin calcium 40 mg, daily for cholesterol. After first dose, patient had absolutely no energy the following night, Wednesday night, and stayed in bed for 24 hours because he was just totally exhausted on 23Aug2021. No additional vaccines administered on same date of the Pfizer suspect. Prior Vaccinations (within 4 weeks) was administered. Here was no emergency room visit or physicians office visit due to the adverse events. Patient underwent lab test which included blood test for Covid antibodies, with results: has antibodies, on 30Jul2021. The outcome of the events was unknown.


VAERS ID: 1743769 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101236150

Write-up: First dose: Sore left arm; This is a spontaneous report from a contactable 34-years-old female consumer(patient). A 34-year-old female patient received a dose of BNT162B2 (BNT162B2, Formulation: Solution for injection, Lot Number: unknown, Expiration date: unknown), via unspecified route, administered in left arm on 23Aug2021 (at the age of 34-year-old) as dose 1, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On 23Aug2021, after the vaccination, the patient experienced a sore left arm right away. The outcome of the event was unknown. No follow-up attempts possible. No further information expected. Follow-up (PRD/SRD (23Sep2021): This follow-up is being submitted to notify that the lot/batch number is not available despite the follow-up attempts made. Follow-up attempts have been completed and no further information is expected.


VAERS ID: 1746162 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 061E21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Fatigue, Flank pain, Hypoaesthesia, Loss of personal independence in daily activities, Muscular weakness, Musculoskeletal chest pain, Paraesthesia, Photophobia, Sedation, Tremor, Vision blurred, Visual impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (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: Nuvaring, Phentermine HCL 37.5mg, multivitamin.
Current Illness: None
Preexisting Conditions: Asthma- not requiring medications/monitoring.
Allergies: Zest soap, Irish spring soap, Neo/Poly/Dex antibiotic eye drops.
Diagnostic Lab Data: None, virtual visit with PCP on 9/23/21.
CDC Split Type:

Write-up: Dizziness, numbness/tingling in both arms and hands for 1 week after injection, severe changes in vision (blurriness/sensitivity to light) for 1 week after injection, extreme muscle weakness for about 5 days after injection to the point of visible shaking when trying to stand/walk up stairs at home. Severe fatigue/sedation to the extent of not being able to stay awake to feed self for 4-5 days after injection, pain in L ribs/flank for about 1 week after injection.


VAERS ID: 1746563 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-02-01
Onset:2021-08-23
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Back pain, Bilirubin urine present, Blood test abnormal, Computerised tomogram normal, Dehydration, Diarrhoea, Dyspnoea, Full blood count abnormal, Liver function test increased, Pain, Respiratory rate decreased, Scan with contrast, Ultrasound scan normal, Urinary retention, Vomiting, X-ray
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic leukopenia (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Biliary system related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, Metoprolol, HCTZ, Vitamin D,
Current Illness: None
Preexisting Conditions: Type 2 Diabetes High Blood Pressure (well controlled)
Allergies: NKA
Diagnostic Lab Data: CBC on 8-31-21 indicated several abnormal results, including bilirubin in urine and elevated liver issues.
CDC Split Type:

Write-up: Vomiting, diarrhea, body aches, intense abdominal pain, and intense lower right back pain for 12 days. Primary care provided an X-Ray, referred immediately to ER because I was unable to urinate other than a few drops, was dehydrated, and needed fluids. I was given a shot of Zofran and a prescription of zofran tablets as well. Bloodwork was abnormal in multiple areas. I also had difficulty taking a deep breaths several occasions but with slow deep breathing I was able to do so. At ER I was given fluids, water, and received an ultrasound and CT scan with contrast to determine if there were any potential gallbladder, appendix, or kidney stone issues. All scans were normal and I was sent home to increase fluid intake, take zofran as directed, and seek assistance if I worsened. In total I was having active vomiting and diarrhea for 12 days, it persisted for several days after the ER visit, until 9-4-21. The dr visit and ER visit were on 8-31-2021. I continued to have intermittent diarrhea through 9-15-21 as well as one more vomiting experience for overnight hours between 2:00 am-8:00 am on 9-15-21. At present I have no symptoms besides an occasional need to work to take a deep breath.


VAERS ID: 1747520 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-17
Onset:2021-08-23
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dizziness, Dyspnoea, Echocardiogram, Electrocardiogram ambulatory, Fatigue, Heart rate increased, Laboratory test, Presyncope, 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), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth Control: Jaimess
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: 2 appointments with PCP Labs drawn 9-9 9-10 cardiologist consult Emergency room visit for tachycardia and increased chest pain 9-13 9-15 24 hour holter monitor 9-17 Echocardiogram 9-24 cardiologist follow up 9-27 PCP appointment
CDC Split Type:

Write-up: Near fainting on 8/23/21 then on 8/24/21 my heart rate was in the 170s when doing simple tasks. I was having drastic increases in heart rate from laying to sitting and sitting to standing (80 when laying and 130 when standing up) To this day I am still dealing with a rapid heart rate, typically in the 130s-150s when walking and doing simple things (no previous medical history or cardiac issues). Chest pain and shortness of breath accompanies the tachycardia. Extreme fatigue and dizziness accompany the rapid heart rate while exerting and when I have been working all day As of right now I am taking Metoprolol to try and being down my heart rate (still in the 120''s-130''s with simple activities) even with an increased dose of Metoprolol


VAERS ID: 1747714 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003F21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: 15 year old received 1st dose of Moderna COVID-19 vaccination; This spontaneous case was reported by a nurse and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (15 year old received 1st dose of Moderna COVID-19 vaccination) in a 15-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003F21A) for COVID-19 vaccination. Concomitant products included FLUTICASONE 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 PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (15 year old received 1st dose of Moderna COVID-19 vaccination). On 23-Aug-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (15 year old received 1st dose of Moderna COVID-19 vaccination) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No treatment medication was provided.


VAERS ID: 1747834 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: underage patient received the first Moderna dose; This spontaneous case was reported by an other health care professional and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (underage patient received the first Moderna dose) in a 15-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On 23-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Aug-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (underage patient received the first Moderna dose). On 23-Aug-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (underage patient received the first Moderna dose) had resolved. 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. Concomitant medication use was unknown Treatment information was unknown


VAERS ID: 1747890 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blister, Burning sensation, Feeling abnormal, Feeling hot, Gait inability, Hypoaesthesia, Inflammation, Myalgia, Pain, Paraesthesia, Rash macular, Vascular pain
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug allergy (tylenol, ibuprofen or certain vitamins because body is very sensitive and that all started after getting the vaccine.)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: at the top of her left foot she got red blotches like someone had literally burned her/cannot wear socks/not only the top of the foot but all the way to her knee too; pain/was in so much pain; the burning she cannot take it/like a burning infection; cannot walk; her body is very sensitive; developed a bunch of blisters on the hand after picking up hydrocortisone; bottom of her feet became very hot/as if she had stepped on hot towels/if she stands on her feet even for just five minutes feels like a torch; toes became numb; t was tingly to the kneecap; the veins were very very inflammed, specially on top on her foot/inflammation was very bad; the veins were very painful, specially on top on her foot/it''s very sensitive/veins are like popping/veins hurt really bad; pain in the arm/soreness in the arm; This spontaneous case was reported by a consumer and describes the occurrence of FEELING HOT (bottom of her feet became very hot/as if she had stepped on hot towels/if she stands on her feet even for just five minutes feels like a torch), HYPOAESTHESIA (toes became numb), PARAESTHESIA (t was tingly to the kneecap), INFLAMMATION (the veins were very very inflammed, specially on top on her foot/inflammation was very bad) and VASCULAR PAIN (the veins were very painful, specially on top on her foot/it''s very sensitive/veins are like popping/veins hurt really bad) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Drug allergy (tylenol, ibuprofen or certain vitamins because body is very sensitive and that all started after getting the vaccine.). 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 FEELING HOT (bottom of her feet became very hot/as if she had stepped on hot towels/if she stands on her feet even for just five minutes feels like a torch), HYPOAESTHESIA (toes became numb), PARAESTHESIA (t was tingly to the kneecap), INFLAMMATION (the veins were very very inflammed, specially on top on her foot/inflammation was very bad), VASCULAR PAIN (the veins were very painful, specially on top on her foot/it''s very sensitive/veins are like popping/veins hurt really bad) and MYALGIA (pain in the arm/soreness in the arm). On 03-Sep-2021, the patient experienced BLISTER (developed a bunch of blisters on the hand after picking up hydrocortisone). On an unknown date, the patient experienced RASH MACULAR (at the top of her left foot she got red blotches like someone had literally burned her/cannot wear socks/not only the top of the foot but all the way to her knee too), PAIN (pain/was in so much pain), BURNING SENSATION (the burning she cannot take it/like a burning infection), GAIT INABILITY (cannot walk) and FEELING ABNORMAL (her body is very sensitive). The patient was treated with HYDROCORTISONE for Allergic reaction, at a dose of for 5 days and CALAMINE for Pain, at an unspecified dose and frequency. At the time of the report, FEELING HOT (bottom of her feet became very hot/as if she had stepped on hot towels/if she stands on her feet even for just five minutes feels like a torch), HYPOAESTHESIA (toes became numb), PARAESTHESIA (t was tingly to the kneecap), INFLAMMATION (the veins were very very inflammed, specially on top on her foot/inflammation was very bad), VASCULAR PAIN (the veins were very painful, specially on top on her foot/it''s very sensitive/veins are like popping/veins hurt really bad), RASH MACULAR (at the top of her left foot she got red blotches like someone had literally burned her/cannot wear socks/not only the top of the foot but all the way to her knee too), PAIN (pain/was in so much pain), BURNING SENSATION (the burning she cannot take it/like a burning infection), BLISTER (developed a bunch of blisters on the hand after picking up hydrocortisone), GAIT INABILITY (cannot walk), FEELING ABNORMAL (her body is very sensitive) and MYALGIA (pain in the arm/soreness in the arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Laboratory tests performed and included skin test. Patient found 5 doctors and nobody knows what has for the patient. Concomitant medications were not provided.


VAERS ID: 1747943 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 3 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Illness, Immunisation, Nasopharyngitis, Off label use
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Blood pressure high (Diagnosed about 15 years ago)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Blood pressure; Result Unstructured Data: Test Result:High
CDC Split Type: USPFIZER INC202101127794

Write-up: had a cold ever since the booster dose/didn''t know she was suppose to wait 8 months to even get the booster shot, she just went and they gave it to her; She has been sick with a cold; cold/had a cold for a week; had a cold ever since the booster dose/didn''t know she was suppose to wait 8 months to even get the booster shot, she just went and they gave it to her; This is a spontaneous report from a contactable consumer (patient). A 52-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EW0183), via an unspecified route of administration, administered in Arm Left on 23Aug2021 11:00 (at the age of 52-year-old) as dose 3 (booster), single for covid-19 immunisation. Medical history included ongoing High blood pressure (Diagnosed about 15 years ago). The patient''s concomitant medications were not reported. The patient previously received first dose of bnt162b2 (Batch/Lot Number: EW0182) administered in Arm Left on 21May2021 (at the age of 51-year-old) as dose 1, single and the second dose of bnt162b2 (Batch/Lot Number: EW0183) administered in Arm Left on 14Jun2021 (at the age of 51-year-old) as dose 2, single for covid-19 immunisation and after second dose she slept all day, and her arm was hurting. Additional vaccines administered on same date of the Pfizer suspect was reported as none. On 24Aug2021 at 09:00, the caller experienced cold ever since the booster dose was administered and she asked if that was a normal side effect. Caller reported she had the booster shot and has had a cold for a week. The caller remarked that she did not know she was supposed to wait 8 months to even get the booster shot, she just went, and they gave it to her. She wanted to know if this was normal. She stated she had been sick with a cold since she had the dose. The patient underwent lab tests and procedures which included blood pressure measurement: high on an unspecified date. The outcome of event cold was not recovered, and sickness was unknown. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1749816 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039C21A / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Abdominal pain, Chest pain, Diarrhoea, Dyspnoea, Electrocardiogram abnormal, Nausea, Pericarditis, Troponin normal, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Chest pain, SOB, N/V/D and abd pain. No fever, cough or sore throat. Worsen over the next 2 days prompting ED visit. Dx Pericarditis


VAERS ID: 1750293 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-22
Onset:2021-08-23
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Blood test normal, Culture stool negative, Diarrhoea, Differential white blood cell count normal, Full blood count normal, Headache, Metabolic function test normal, Nausea, Parasite stool test negative, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: slight fatigue, headache and confusion age 68 Moderna #1
Other Medications: Magnesium, calcium, vitamin C, herbal allergy pills, Vagifem 10mcg
Current Illness: allergies, fatigue, slight headache
Preexisting Conditions:
Allergies: latex, antihistamins, oral steriods, pennicyllin
Diagnostic Lab Data: Blood draw labs taken and showed all within normal range. Stool sample testing for C diff and EIA, CBC with diff, CMP, Giardia/Cryptosporidium, OVA parasites and stool culture performed 2 weeks into illness. All tested negative.
CDC Split Type:

Write-up: Severe diarrhea, abdominal cramps, nausea, headache, low grade fever from 99.6 up to 100.3. Diarrhea subsided after taking multiple doses of pepto bismol after 3 weeks. Headache and nightly low grade fever persisted for another 2 weeks.


VAERS ID: 1752006 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Immunisation, Off label use, Urine analysis, Urine analysis abnormal
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210824; Test Name: urinary analysis; Result Unstructured Data: Test Result:codeine in urine analysis; Comments: had codeine in my system
CDC Split Type: USPFIZER INC202101143234

Write-up: codeine in my urine analysis; I had my 3rd shot of the Pfizer covid vaccine; I had my 3rd shot of the Pfizer covid vaccine; This is a spontaneous report received from a contactable consumer or other non hcp via Product Quality Complaint Group. A 47-years-old male patient received bnt162b2 (Comirnaty, PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: EW0170, expiry date unknown) via an unspecified route of administration on 23Aug2021 as DOSE 3 (BOOSTER), SINGLE for covid-19 immunization. The patient medical history and patient''s concomitant medications were not reported. Historical vaccine included BNT162B2 (BNT162B2, PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: unknown, expiry date unknown) via unspecified route on an unknown date (at the age of 47-Year-Old) as dose 1, single and BNT162B2 (BNT162B2, PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: unknown, expiry date unknown) via unspecified route on an unknown date (at the age of 47-Year-Old) as dose 2, single for COVID-19 immunization. On 23Aug2021 patient stated ''I had my 3rd shot of the Pfizer covid vaccine'' and codeine in my urine analysis''. Patient stated he needed information on the ingredients of the Pfizer covid vaccine. He had a urinary analysis done. Patient stated ?I had codeine in my system. On 23Aug2021 I had my 3rd shot of the Pfizer covid vaccine. On 24Aug2021 I had a urine analysis which presented codeine in my urine analysis''. Patient was asking if codeine was in the Pfizer covid vaccine. The patient underwent lab tests and procedures on 24Aug2021 which included Urine analysis: codeine in my urine analysis. The outcome of event was unknown. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1752080 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure measurement, Chest pain, Dyspnoea, Fatigue, Headache, Heart rate, Heart rate increased, Hypertension, Malaise, Myocardial infarction, Palpitations, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Dehydration (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: Medical History/Concurrent Conditions: Cystitis; Fibromyalgia; Palpitations (heart palpitations that I take medicine for); Sulfonamide allergy (sulfa)
Allergies:
Diagnostic Lab Data: Test Date: 20210823; Test Name: Blood pressure; Result Unstructured Data: Test Result:High; Test Date: 20210823; Test Name: Heart rate; Result Unstructured Data: Test Result:Rapid; Test Date: 20210823; Test Name: COVID test: Nasal Swab; Test Result: Negative ; Comments: Post vaccination
CDC Split Type: USPFIZER INC202101226409

Write-up: I thought I was having a heart attack; chest pain; shortness of breath; pounding; rapid heart rate; high BP; headache; malaise; fatigue; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 48-years-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EW0176), via an unspecified route of administration, administered in Arm Right on 20Aug2021 (at the age of 48-year-old) as dose 2, single for covid-19 immunisation. Medical history included fibromyalgia, cystitis, palpitations (heart palpitations that I take medicine for), Known allergy: sulfa (sulfa). Patient took concomitant medications (other medications the patient received within 2 weeks of vaccination). Patient previously took BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: FA6780), via an unspecified route of administration, administered in Arm left on 30Jul2021 (at the age of 48-year-old) as dose 1, single for covid-19 immunisation. The patient did not receive any other vaccines within four weeks prior to the vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. On 23Aug2021 03:00, the patient experienced i thought i was having a heart attack, chest pain, shortness of breath, pounding, rapid heart rate, high bp, headache, malaise, fatigue. The patient underwent lab tests and procedures which included blood pressure measurement: high on 23Aug2021, heart rate: rapid on 23Aug2021, sars-cov-2 test: negative on 23Aug2021 (Post vaccination). Clinical course: Within 48 hours of my second vaccine patient woke up at about 3:00 am with chest pain, shortness of breath, pounding and rapid heart rate, high BP, headache, malaise, fatigue. Patient husband took her to the ER. Patient thought she was having a heart attack. Therapeutic measures taken as a result of events included steroids. The events resulted in emergency room and physician office visit. The events were reported as non serious. The outcome of the events was unknown.


VAERS ID: 1752140 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-20
Onset:2021-08-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Limb discomfort, Lymphatic disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: No
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101235369

Write-up: Menstrual bleeding for 19 days; Lymphatic cord in left arm; Unable to lift arm up; This is a spontaneous report from a contactable consumer reported for herself. A 41-years-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number: Fc3183, Expiration date: unknown), via an unspecified route of administration, administered in Arm Left on 20Aug2021 15:00 (age at vaccination was 41 years) as dose 1, single for COVID-19 immunization. The patient''s medical history included no from an unknown date and unknown if ongoing. The patient have known allergies. The patient''s concomitant medications were not reported. The patient did not receive any other medications in two weeks. The facility where the most recent COVID-19 vaccine was administered was the Health Clinic. 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. Since the vaccination, the patient has not been tested for COVID-19. The patient previously took cefaclor and experienced drug hypersensitivity, valium and experienced drug hypersensitivity. On 23Aug2021 the patient experienced menstrual bleeding for 19 days, lymphatic cord in left arm and unable to lift arm up. Patient visits Doctor or other healthcare professional office/clinic visit. No treatment was received for the adverse events. The outcome of the events was not recovered. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1752862 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Heavy menstrual bleeding, Peripheral swelling, White blood cell count decreased
SMQs:, Cardiac failure (broad), Angioedema (broad), Haematopoietic leukopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Started bleeding heavily bloody thick clots since day 1. I have been changing my tampon AND pad 2-3 times daily. I feel more fatigued and cannot exercise as well as I did before. More foggy sometimes blurry vision and edema and swelling in legs


VAERS ID: 1753965 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC31282 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: HYDRALOSINE; SPIRONALACTONE; LIPIZIDE; ZETIA; CRESTOR; LISINOPRIL; AMLODIPINE
Current Illness:
Preexisting Conditions: Cardiac patient, Type2 Diabetes
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme dizziness.


VAERS ID: 1754159 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-23
Onset:2021-08-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054621A / UNK LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Chest discomfort, Diarrhoea, Fatigue, Feeling hot, Headache, Night sweats, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Headache; fatigue; Chills; Cold.
Other Medications: Aspirin 81 mg 1 tablet a day Furosemide (water) 20 mg 1 tablet a day Entresto 24-26 MG Twice a day Metoprolol Succinate ER (beta blocker) 25 mg Once a day at night Lansoprazole 30 mg 1 tablet a day Spironolactone 12.5mg Once a day Zetia (
Current Illness:
Preexisting Conditions: Heart attack in 2014 which left my heart damaged. UTIs IBS
Allergies:
Diagnostic Lab Data: Covid test on August 26 result was negative.
CDC Split Type:

Write-up: Headache; Chest Pressure; Warm Body; Sweats 2 nights while sleeping; Diarrhea; Fatigue.


VAERS ID: 1755895 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-26
Onset:2021-08-23
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Burning sensation, Feeling abnormal, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Dementia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Brain fog; Bust out in rash all over the body; Rash all over body and was burning; This spontaneous case was reported by a consumer and describes the occurrence of BURNING SENSATION (Rash all over body and was burning), FEELING ABNORMAL (Brain fog) and RASH (Bust out in rash all over the body) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 002F21 and 091D21A) 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 BURNING SENSATION (Rash all over body and was burning) and RASH (Bust out in rash all over the body). On 24-Aug-2021, the patient experienced FEELING ABNORMAL (Brain fog). In September 2021, FEELING ABNORMAL (Brain fog) had resolved. At the time of the report, BURNING SENSATION (Rash all over body and was burning) and RASH (Bust out in rash all over the body) outcome was unknown. Concomitant medication information was not provided by the reporter. Treatment information was not provided by the reporter. It was reported that the pharmacist recommended to take but patient didn''t took it as she did not like drugs. 1 month after bump down arm she got injection in back and so was rash all over body. This case was linked to MOD-2021-329732 (Patient Link).


VAERS ID: 1756013 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-23
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, 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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lymphedema
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Chills for two days post second dose; pain in injection site; This spontaneous case was reported by an other health care professional and describes the occurrence of VACCINATION SITE PAIN (pain in injection site) and CHILLS (Chills for two days post second dose) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Lymphedema. 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 VACCINATION SITE PAIN (pain in injection site). On 13-Sep-2021, the patient experienced CHILLS (Chills for two days post second dose). The patient was treated with IBUPROFEN for Pain, at an unspecified dose and frequency; NAPROXEN for Pain, at an unspecified dose and frequency and PARACETAMOL for Pain, at an unspecified dose and frequency. On 15-Sep-2021, CHILLS (Chills for two days post second dose) had resolved. At the time of the report, VACCINATION SITE PAIN (pain in injection site) had not resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Concomitant medications were provided by the reporter.


VAERS ID: 1756851 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-10
Onset:2021-08-23
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Allegra, Albuterol inhaler, Benadryl , Vitamin D, C, Calcium, Magnesium
Current Illness: None
Preexisting Conditions: Asthma and allergies
Allergies: Sulfa, Aspirin, NSAIDS, levaquine, Valium, Percocet
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heavy Menstrual Bleeding for an entire month


VAERS ID: 1757205 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-02
Onset:2021-08-23
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013A21 / 1 LA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain lower, Abdominal pain upper, Blood test, Computerised tomogram abdomen, Computerised tomogram pelvis abnormal, Fatigue, Feeling abnormal, Gastritis, Intussusception, Nausea, Scan with contrast normal, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi vitamin. Dicyclomine. Claritin
Current Illness: None
Preexisting Conditions: IBS$g Diverticulitis
Allergies: Codeine.
Diagnostic Lab Data: 9/2 CT Abdomen Pelvis WO Contrast - Short segment non obstructing Entero enteral intusussuception .Gastritis 9/3 Bloodwork 9/3 CT Abdomen Pelvis W contrast - Intussusception seen one day prior had reduced with no obstruction
CDC Split Type:

Write-up: 8/23 I started with Nausea & vomiting, I vomited around 4 times in 8 hours. This was followed by a pain in my lower left quadrant and, over the next few days belly pain and a feeling of extreme tiredness, I saw my primary care doctor on 8/31 and was prescribed Augmentin but was told that if my symptoms did not start to improve within a couple of days I was to make an appointment for a CT scan. I had a CT scan, I was called by my PCP the following morning advising me to go the emergency room for a follow up as the scan had shown an entero-enteral intussusception. The follow up scan showed the intussusception was no longer there and i returned home with a follow up appointment with my Gastroenterologist. For the following 4 weeks I have felt very tired and had a brain fog which is finally starting to improve


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