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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 43 out of 8,010

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VAERS ID: 1768609 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-10-02
Onset:2021-10-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 05885 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Limb mass, Pain in extremity, Peripheral swelling, Skin warm
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma, Diabetes, Fibromyalgia, High Blood Pressure, Ankylosing Spondylitis, Mental Health Issues
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Very swollen softball size lump in arm, hot to the touch, very painful, 5 days later and it has not gotten any better


VAERS ID: 1768615 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-10
Onset:2021-10-03
   Days after vaccination:207
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 15M20A / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none documented
Preexisting Conditions: Overweight, hyperlipidemia, disorder of breast, testicular mass, history of adenomatous polyp of colon, diverticulosis, aptyalism, obstructive sleep apnea, nocturia, coronary arteriosclerosis, meralgia paresthetica, hyperuricemia, impotence, anxiety, uric acid renal calculus, cataract, Fuchs'' corneal dystrophy, head injury, kidney stones
Allergies: allopurinol 100mg daily aspirin 81mg daily Atorvastatin 40mg HS cyanocobalamin daily ibuprofen 200mg q4hr PRN magnesium oxide 800mg daily CBD oil Ultra dream sleep supplement multivitamin dialy rosuvastatin 40mg daily sildenafil 20mg prn ubiquinone daily
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient contracted COVID after being fully vaccinated Muscle aches, runny nose, fatigue, congestion, cough, headache


VAERS ID: 1768647 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-09-30
Onset:2021-10-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FFF8839 / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Bundle branch block right, Chest X-ray normal, Chest pain, Computerised tomogram normal, Echocardiogram normal, Electrocardiogram ST segment abnormal, Fibrin D dimer increased, Myocarditis, QRS axis abnormal, Red blood cell sedimentation rate increased, Troponin increased
SMQs:, Haemorrhage laboratory terms (broad), Myocardial infarction (narrow), Conduction defects (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fluoride topical toothpaste
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: See above.
CDC Split Type:

Write-up: 19 y/o male presented to ER 4 days after receiving 2nd dose of vaccine for chest pain. Pt had elevated troponin, d-dimer and mildly elevated ESR. CT, CXR, Echo normal. EKG revealed NSR with right axis deviation, incomplete RBBB and ST segment abnormalities. Pt was admitted where troponin was trended and still elevated. Pt was diagnosed with myocarditis and prescribed colchicine.


VAERS ID: 1768694 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New York  
Vaccinated:2021-10-03
Onset:2021-10-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (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: 81mg ASA, Claritin and Nasacort
Current Illness: None
Preexisting Conditions: Repaired PFO S/P Stroke
Allergies: Plavix- mouth itching
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The Patient is experiencing twitching in the mouth twitch on the left, started Sunday night, the jaw twitch started Thursday 7th of October. He has experienced a shoulder twitch on the right shoulder once on the 5th at 3 AM. He has twitching left knee on the 5th at 2 AM and then again on the 5th 230 AM


VAERS ID: 1768727 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-12
Onset:2021-10-03
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Nasal discomfort, Parosmia, Sleep disorder
SMQs:, Taste and smell disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril Calcium B complex HCTZ Qd air Albuterol MDI
Current Illness: None
Preexisting Conditions: Asthma, HTN, Fibromyalgia
Allergies: Erythromycin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Phantosmia-I continually smell coffee 24/7 sometimes at night so strong it prevents me from sleeping and at other times it burns my nose


VAERS ID: 1768842 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-30
Onset:2021-10-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Audiogram abnormal, Deafness neurosensory, Vertigo
SMQs:, Hearing impairment (narrow), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: taking Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Full audiogram Auditory MRI scheduled for 10-25-2021
CDC Split Type:

Write-up: Vertigo and sudden onset complete neurosensorial hearing loss of right ear. Sent to ENT for evaluation and Transtympanic steroid injection. Confirmation by audiology of hearing loss. Onset of symptoms 3 days after vaccine. Currently in treatment no improvement as of this date


VAERS ID: 1768941 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-30
Onset:2021-10-03
   Days after vaccination:246
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Fatigue, Headache, Nasal congestion, Oropharyngeal pain, Pain, Rhinorrhoea, Sinus congestion, Upper-airway cough syndrome, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (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: doxycycline; HTCZ; Losartan; Trazodone; Simvastatin
Current Illness: none
Preexisting Conditions: pure hypercholesterolemia; HTN; polyarthritis; situational anxiety; prediabetes
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: sore throat, cough, runny nose, headache, sinus congestion, nasal congestion, wheezing, post nasal drainage, fatigue, nonproductive cough, body aches. starting on 10/3/21. First vaccine given through employer, unable to access LOT #


VAERS ID: 1768980 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-26
Onset:2021-10-03
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019B21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Ear discomfort, Ear pain, Head discomfort, Headache, Pain in jaw, Pyrexia, Respiratory tract congestion, Rhinorrhoea
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Osteonecrosis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Furosemide; Lisinopril; Benzonate; Albuterol; Amitriptyline; Levaquin; Loratadine; Zolpidem; Klonopin; Oxycodone; Methocarbamol
Current Illness: none
Preexisting Conditions: HTN, GERD; asthma, depression; anxiety; chronic pain; dry eyes; migrane, reynolds syndrome; raynaud''s
Allergies: sulfa; adhesive tape; penicillin; cephalosporin, cipro
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, runny nose, congestion, cough, right ear plugged She''s been running a low-grade fever. Her right ear is really sore and is going down into her jaw. she has pressure in her forehead when she bends over. starting on 10/3/21


VAERS ID: 1769060 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-10-01
Onset:2021-10-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 3 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arrhythmia, Blood test, Cardiac disorder, Cardiac monitoring, Chest pain, Computerised tomogram, Echocardiogram, Heart rate increased, Magnetic resonance imaging
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Echocardiogram, blood tests, mri, ct scan, heart monitor
CDC Split Type:

Write-up: Hospitalization for arrhythmia, chest pain, elevated pulse, blood pressure. Began 2.5 days after injection. Affected heart requiring hospitalization sndctreatment


VAERS ID: 1769497 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-09-30
Onset:2021-10-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301558A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Urticaria
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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LIOTHYRONINE, SYNTHROID, VITAMIN D AND ZINC
Current Illness: CHEST COLD
Preexisting Conditions: HYPO THYROIDISM
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: HIVES STARTING ON MY FEET AND WORKING UP MY LEGS AND BACK


VAERS ID: 1769881 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-10-02
Onset:2021-10-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Back pain, Decreased appetite, Diarrhoea, Dysarthria, Fatigue, Headache, Muscular weakness, Musculoskeletal chest pain, Nasal congestion, Pain in extremity, Toothache, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Vomiting 2x started on 10/3/21 at 3pm, unable to hold head up and talk clearly, no appetite, very fatigued, legs hurt, joint pain, back pain Vomiting 1x and diarrhea 2x on 10/4/21, complained of joint pain (knees and toes), headache, no appetite, very fatigued, legs hurt, teeth hurt, stuffy nose, pain in the xiphoid process, back pain 10/5/21 fatigued, no appetite, knees hurt, headache, back pain 10/6/21 fatigued, knees hurt, legs hurt, headache 10/7/21 fatigued, knees hurt, legs hurt, headache Extra Strength Tylenol given every 6 hours but did not completely take away the headache


VAERS ID: 1769997 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-10-03
Onset:2021-10-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache
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: Vitamin d supplement, zinc and emergen c
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache that won?t go away


VAERS ID: 1770406 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Unknown  
Location: Delaware  
Vaccinated:0000-00-00
Onset:2021-10-03
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known allergies
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211011732

Write-up: DEEP MUSCLE PAIN PRIMARILY IN FLEXORS; This spontaneous report received from a patient concerned a 52 year old of unspecified sex. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: The patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808986, and expiry: 02-OCT-2021) dose was not reported, administered on 27-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-OCT-2021, the patient experienced deep muscle pain primarily in flexors. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from deep muscle pain primarily in flexors on 03-OCT-2021. This report was non-serious.


VAERS ID: 1771493 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-10-02
Onset:2021-10-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Magnetic resonance imaging head, Magnetic resonance imaging neck, Muscular weakness, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: Synthroid Alprazolam
Current Illness: Headaches
Preexisting Conditions: Graves disease Neuralgia History of Herpes zoster complicated Exophthalmos
Allergies: Sulfur
Diagnostic Lab Data: MRI Brain with and without contrast (10/7/21) MRI Cervical spine and thoracic spine with and without contrast (pending).
CDC Split Type:

Write-up: Tremors of the arms and left leg, left leg weakness developed 10/3-10/4. MRI Brain completed 10/7/21. Tremors treated with primidone, tremors slightly improved in arms, increased weakness of left leg. MRI Cervical spine and thoracic spine pending, ordered 10/8/21..


VAERS ID: 1771530 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-10-01
Onset:2021-10-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3952 / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tedafil, Crestor, 81 mg aspirin and Vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The left under arm lymph node swelled causing me concern so I visited the Nurse Practioner.


VAERS ID: 1771637 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-07
Onset:2021-10-03
   Days after vaccination:269
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

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

Write-up: PATIENT HAD PFIZER VACCINE ON 1/7/21 and 1/28/21, AND TESTED POSITIVE TO COVID.


VAERS ID: 1771654 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-10-03
Onset:2021-10-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident, Corneal reflex decreased, Facial paralysis, Hypoaesthesia, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), 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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Corneal disorders (narrow), Hearing impairment (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not known
Current Illness: Not known, none listed on form by patient
Preexisting Conditions: Not known, none listed on form by patient
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient''s wife called today to state at about 1pm on Sunday after her husband received his second dose of Moderna (given about 10:45am), that the "side of his face dropped" and his "eye locked open" because he "couldn''t blink". His face then went numb. The only medicine she gave him after was Tylenol. She said that on Monday morning he was a little better but by the evening he was worse with a swollen jaw in addition to the other issues. Tuesday they went to the doctor. The doctor gave a steroid shot and oral Prednisone 20mg bid for 7 days and also referred patient to a neurologist. Wife states that doctor''s diagnosis was a facial stroke. Wife reports that he is still not much better today.


VAERS ID: 1771661 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-10-03
Onset:2021-10-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Dyspnoea, Headache, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, chest pain, shortness of breath, joint pain, severe headache.


VAERS ID: 1771662 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-10-02
Onset:2021-10-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Migraine, Nausea, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Shellfish
Diagnostic Lab Data: lol I
CDC Split Type:

Write-up: Non stop migraine since day of injection Nausea Chills Fever Fatigue


VAERS ID: 1771674 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-30
Onset:2021-10-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B217 / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Muscular weakness, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: Adderall prenatal vitamin
Current Illness:
Preexisting Conditions:
Allergies: walnuts surgical adhesive
Diagnostic Lab Data:
CDC Split Type:

Write-up: muscles are very weak, cant grip a pen tingling and numbness through extremities


VAERS ID: 1771816 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-27
Onset:2021-10-03
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Anticoagulant therapy, Brain natriuretic peptide increased, Cardiac disorder, Computerised tomogram thorax, Cor pulmonale acute, Fibrin D dimer, Intensive care, Positive airway pressure therapy, Pulmonary congestion, Pulmonary embolism, Troponin increased, X-ray
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Myocardial infarction (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), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metroprolol-hydrochlorithiazide
Current Illness: No
Preexisting Conditions: Obesity, obstructive sleep apnea
Allergies: No
Diagnostic Lab Data: D dimer, chest CT and Xray
CDC Split Type:

Write-up: Acute Pulmonary Embolism with Acute Cor Pulmonale acute respiratory failure, vascular congestion, right heart strain, elevated BNP, troponins, and Treated with BIPAP, ICU , oxygen, heparin drip, Coumadin and lovenox


VAERS ID: 1771884 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-10-03
Onset:2021-10-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 LA / IM

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

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

Write-up: no adverse event, vaccine administered two days past BUD


VAERS ID: 1771892 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-10-03
Onset:2021-10-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, 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: no adverse event, vaccine administered two days past BUD


VAERS ID: 1771898 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-03
Onset:2021-10-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen, Sennosides, Albuterol, Lidocaine 5% patch, amiodarone, atorvastatin, calcium carbonate, dextromethorphan-guaifenesin, enoxaparin, furosemide, potassium cl, spironolactone, omeprazole, magnesium oxide, gabapentin, melatonin, m
Current Illness:
Preexisting Conditions:
Allergies: Sulfonamide antibiotics
Diagnostic Lab Data:
CDC Split Type:

Write-up: Manufacturers expiration date of 11/6/2021, but upon moving to the inpatient hospital pharmacy department the refrigerated expiration date was modified to 9/30/2021. Therefore, the dose was considered to be expired. No adverse events were associated with this administration.


VAERS ID: 1771998 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-29
Onset:2021-10-03
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Melanocytic naevus
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: None
Current Illness: PTSD; Knee Injury
Preexisting Conditions: PTSD; Physical Therapy (long standing)
Allergies: Penicillin
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: This past Sunday on 10/3/2021 I noticed the return of a mole over my right eye. I have an upcoming appointment for it.


VAERS ID: 1772058 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-01
Onset:2021-10-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster, Physical examination, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium Vitamin D Fiber supplement
Current Illness: None
Preexisting Conditions: osteoporosis Fectal incontinence
Allergies: doxycycline Catapress patch
Diagnostic Lab Data: Physical exam of the area
CDC Split Type:

Write-up: Notice rash under Rt Breast on Sunday night , red itchy irritated. took Benadryl and use hydrocortisone cream to area, Monday morning rash was the same, Monday evening rash spread to my back on the right side. Tuesday Morning went to Doctors office and was Diagnosis with shingles.


VAERS ID: 1772085 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-01
Onset:2021-10-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium Vitamin D Fiber Supplement
Current Illness: None
Preexisting Conditions: osteoporosis Fectal incontinence
Allergies: Doxycycline Catapres Patch
Diagnostic Lab Data: Physical exam
CDC Split Type:

Write-up: Noticed rash on right breast Sunday night when I was getting undress. It was only on my right breast . I took Benadryl and put hydrocortisone cream it the rash and went to sleep. Monday the rash was the same itchy and red. Monday night getting undressed noticed the rash has spread to my back on the right side only. it was red itchy and very painful. Tuesday Morning went to the Doctors office and was diagnosis with shingles.


VAERS ID: 1772099 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-10-02
Onset:2021-10-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein, Chest X-ray, Chest pain, Computerised tomogram thorax, Echocardiogram, Fatigue, Fibrin D dimer, Headache, Pain, Red blood cell sedimentation rate normal, Troponin
SMQs:, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CXR, Chest CT W/ and W/O, Echocardiogram, D-dimer, ESR, CRP, troponin panel
CDC Split Type:

Write-up: Chest pain, Body aches, headache, fatigue


VAERS ID: 1772126 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-03
Onset:2021-10-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Vaccine expired 10/2/21. Expired vaccine administered on 10/3/21. No adverse events. Error found on 10/4/21 and reported to Janssen.


VAERS ID: 1772127 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-08
Onset:2021-10-03
   Days after vaccination:237
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Asthenia, COVID-19, Cough, Dyspnoea, Fatigue, Haemoglobin normal, Haemoptysis, Haemorrhoids, Oxygen saturation decreased, Rectal haemorrhage, SARS-CoV-2 test positive, Tachypnoea
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Ischaemic colitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet amLODIPine (NORVASC) 5 MG tablet aspirin 81 MG chewable tablet atorvastatin (LIPITOR) 80 MG tablet finasteride (PROSCAR) 5 MG tablet levETIRAcetam (KEPPRA) 500 MG tablet metoprolol succinate-XL (TOPROL-
Current Illness: 9.29.21: ED - rectal bleeding, hemorrhoids, exhaustion
Preexisting Conditions: CAD (coronary artery disease) Dyslipidemia History of tobacco use Inability to maintain erection Increased BMI (body mass index) Cervical disc disorder-2004/resolved History of nephrolithiasis-one episode/2007 Benign non-nodular prostatic hyperplasia with lower urinary tract symptoms History of cardioembolic stroke Essential hypertension with goal blood pressure less than 130/85 Paroxysmal atrial fibrillation (HCC) Left leg weakness Bladder cancer (HCC) Depression with anxiety Presence of Watchman left atrial appendage closure device-8/1/18 Syncope Bradycardia Cardiac pacemaker in situ
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized (10.3.21); COVID-19 positive (10.3.21); fully vaccinated Admission Date: 10/3/2021 Discharge Date: Oct 5, 2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 [U07.1] HOSPITAL COURSE: This is a 75-year-old male with past medical history significant for coronary artery disease, paroxysmal atrial fibrillation, hypertension, hyperlipidemia, CVA and bladder cancer who presented to the emergency department with shortness of breath, cough and generalized weakness. In the emergency department, the patient was tachypneic with oxygen saturation stable on room air. He was found to be COVID-19 positive. CTA chest was performed and did not show PE but did show findings consistent with COVID-19. He received a dose of Decadron and was admitted for further management. Given lack of hypoxia, the patient qualified for monoclonal antibody therapy for which he received on 10/03. Further Decadron was held and the patient was monitor closely. The patient did have a small amount of hemoptysis, which was felt likely related to COVID in setting of aspirin and Pradaxa use. His hemoglobin remained stable. He did drop his O2 saturations to 89% while ambulating in room to bathroom without supplemental O2 but otherwise feels well and comfortable returning home today. No skilled needs on PT/OT evaluation.


VAERS ID: 1772166 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-25
Onset:2021-10-03
   Days after vaccination:192
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 1 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anaemia, Asthenia, COVID-19, Chest X-ray, Fatigue, Nausea, SARS-CoV-2 test positive, Upper gastrointestinal haemorrhage
SMQs:, Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: atenolol (TENORMIN) 50 MG tablet atorvastatin (LIPITOR) 40 MG tablet Calcium Citrate-Vitamin D (CALCIUM + D PO) cetirizine (ZYRTEC) 10 MG capsule fexofenadine (ALLEGRA) 180 MG tablet fluticasone (FLONASE) 50 MCG/ACT nasal spray levothyroxin
Current Illness: 9.24.21: ear pain
Preexisting Conditions: Osteoporosis Hyperlipidemia Thyroid goiter Female cystocele Essential hypertension Depression with anxiety History of hysterectomy including cervix Elevated TSH
Allergies: BactrimNausea/Vomiting/Diarrhea ClarithromycinNausea/Vomiting/Diarrhea Macrodantin [Nitrofurantoin]Hives PenicillinsOther
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized (10.3.21-still admitted); COVID-19 positive (10.3.21); fully vaccinated CHIEF COMPLAINT: Upper gastrointestinal bleed History of presenting illness: 73 year old with past medical history significant for hypertension, hypothyroidism who presented to the ED on 10/3 in the AM with weakness, fatigue, nausea persisting over the prior 5 days. Concern for COVID exposure (is vaccinated). Noted to have acute on chronic anemia with some signs of GI bleeding and hence transferred to the hospital for further management. COVID-19 Assessment & Plan - positive for COVID-19 on presentation - vaccinated 3/2021 Plan: - obtain chest xray - monitor resp status and oxygen requirements closely - if hypoxemic would then treat with dexamethasone; hold for now - will hold off on remdesivir given transaminitis


VAERS ID: 1772330 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-10-02
Onset:2021-10-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Myocarditis
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Symptoms similar to the myocarditis symptoms described on the cdc website


VAERS ID: 1772594 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-30
Onset:2021-10-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / UN

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest discomfort, Chest pain, Electrocardiogram, Hypertension, Hypoaesthesia, Paraesthesia, Peripheral swelling, X-ray
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (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), Hypertension (narrow), Cardiomyopathy (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: HCTZ, Aspirin
Current Illness: NA
Preexisting Conditions:
Allergies: Stadol
Diagnostic Lab Data: 10/05/2021 blood work 10/07/2021 EKG, blood work, xray
CDC Split Type:

Write-up: Chest pain, Chest cramping, left arm numbness/tingling, hand swelling, high blood pressure


VAERS ID: 1773420 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-10-03
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Lymphadenopathy, Pain in extremity, Somnolence, Tenderness, Throat irritation
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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? 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: USJNJFOC20211014945

Write-up: LIKE A GLAND WAS SWOLLEN ON THE FRONT OF NECK, LIKE A BUMP AND IT WAS TENDER TO TOUCH; TENDERNESS IN THROAT; TENDERNESS UNDER CHIN; SLEEP ALL DAY; SORE ARM; SO FATIGUED; This spontaneous report received from a patient concerned a 74 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient experienced drug allergy when treated with macrogol. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 211A21A and expiry: 14-DEC-2021) dose was not reported, administered on 01-OCT-2021 15:00 for prophylactic vaccination. No concomitant medications were reported. On 03-OCT-2021, the patient experienced sleep all day. On 03-OCT-2021, the patient experienced sore arm. On 03-OCT-2021, the patient experienced so fatigued. On 04-OCT-2021, the patient experienced tenderness under chin. On 05-OCT-2021, the patient experienced tenderness in throat. Treatment medications included: paracetamol. On 07-OCT-2021, the patient experienced like a gland was swollen on the front of neck, like a bump and it was tender to touch. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sleep all day, sore arm, and so fatigued on 06-OCT-2021, and had not recovered from tenderness under chin, tenderness in throat, and like a gland was swollen on the front of neck, like a bump and it was tender to touch. This report was non-serious.


VAERS ID: 1773555 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-03
Onset:2021-10-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039D21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Seizure for 1-2minutes; This spontaneous case was reported by a pharmacist and describes the occurrence of SEIZURE (Seizure for 1-2minutes) in a 23-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039D21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Oct-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Oct-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced SEIZURE (Seizure for 1-2minutes) (seriousness criterion medically significant). On 03-Oct-2021, SEIZURE (Seizure for 1-2minutes) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication details were reported. The patient had experienced seizure 5 minutes after he got his first dose of the Moderna covid19 vaccine. The patient does not have any known allergies or any history of seizure. The seizure lasted for 1 to 2 minutes. No treatment medication details was reported. Company Comment: This case concerns a 23 year-old, male subject whose medical history was not provided, who experienced the serious unexpected event of Seizure. The event occurred approximately 5 minutes after the first dose of mRNA-1273. The rechallenge is unknow, as the events happened immediately after the first dose of mRNA-1273 and since no information from the second dose is provided. The benefit-risk relationship of drug x in not affected by this report.; Sender''s Comments: This case concerns a 23 year-old, male subject whose medical history was not provided, who experienced the serious unexpected event of Seizure. The event occurred approximately 5 minutes after the first dose of mRNA-1273. The rechallenge is unknow, as the events happened immediately after the first dose of mRNA-1273 and since no information from the second dose is provided. The benefit-risk relationship of drug x in not affected by this report.


VAERS ID: 1773567 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-02-01
Onset:2021-10-03
   Days after vaccination:244
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Chills, Feeling abnormal, Myalgia, Pyrexia, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), 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? 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: 20211003; Test Name: Body temperature; Result Unstructured Data: Fever 102F
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Foggy vision after 3rd dose/Vision has change after 3rd dose; Feeling crappy after 3rd dose; Body aches after 3rd dose; Chills after 3rd dose; Fever 102F after 3rd dose,Fever keeps coming back; This spontaneous case was reported by a consumer and describes the occurrence of VISION BLURRED (Foggy vision after 3rd dose/Vision has change after 3rd dose), FEELING ABNORMAL (Feeling crappy after 3rd dose), MYALGIA (Body aches after 3rd dose), CHILLS (Chills after 3rd dose) and PYREXIA (Fever 102F after 3rd dose,Fever keeps coming back) in a 49-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In February 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In June 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 02-Oct-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Oct-2021, the patient experienced FEELING ABNORMAL (Feeling crappy after 3rd dose), MYALGIA (Body aches after 3rd dose), CHILLS (Chills after 3rd dose) and PYREXIA (Fever 102F after 3rd dose,Fever keeps coming back). On 04-Oct-2021, the patient experienced VISION BLURRED (Foggy vision after 3rd dose/Vision has change after 3rd dose). The patient was treated with IBUPROFEN for Adverse event, at an unspecified dose and frequency. At the time of the report, VISION BLURRED (Foggy vision after 3rd dose/Vision has change after 3rd dose) had not resolved and FEELING ABNORMAL (Feeling crappy after 3rd dose), MYALGIA (Body aches after 3rd dose), CHILLS (Chills after 3rd dose) and PYREXIA (Fever 102F after 3rd dose,Fever keeps coming back) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 03-Oct-2021, Body temperature: 102 (High) Fever 102F. No concomitant medications were provided. This case was linked to MOD-2021-339821 (Patient Link).


VAERS ID: 1774961 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-10-03
Onset:2021-10-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Hypoaesthesia, Lower respiratory tract congestion, Motor dysfunction, Muscular weakness, Nausea, Pain, Pupillary reflex impaired, Retching, Sinus congestion
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Infective pneumonia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Covid-19 Pfizer 6203 on 2/27/2021
Other Medications: Breo Ellipta
Current Illness: None
Preexisting Conditions: mild asthma
Allergies: Grass, trees, ragweed, mold, dust, apples, peaches, tomato, onion, gluten
Diagnostic Lab Data: Office exam. Steroids, aspirin and hydroxychloroquin were prescribed
CDC Split Type:

Write-up: Extreme chills, nausea with dry heaving, extreme fatigue, persistent headache, numbness in feet, weakness in leg muscles with aching, slowed pupilary reflex response to light, slowed overall motor reflexes, aggravated bronchial congestion and sinus congestion


VAERS ID: 1774967 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-17
Onset:2021-10-03
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (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: Pre natal vitamins
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: At 5 weeks pregnant dose 1 was administered at 8 weeks a complete spontaneous miscarriage occurred


VAERS ID: 1775004 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-10-02
Onset:2021-10-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Headache, Oropharyngeal pain, Pain, Pain in extremity, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trazodone; PRISTIQ; SINGULAIR
Current Illness: N/a
Preexisting Conditions: Asthma
Allergies: Cephalosporin; nickel
Diagnostic Lab Data: Covid Test - negative - 10/7/2021
CDC Split Type: vsafe

Write-up: I woke up on Sunday morning with a low grade fever, chills, body aches and headache. I took ibuprofen at about 10AM and stayed on it for every 4HRs that day. Monday I did not have anything but a sore arm and then on Tuesday the body aches, congestion, chills, fever and headache were back as well as joint paint. It is also allergy season and I have asthma. I stayed on ibuprofen again Tuesday and then on Wednesday I had the same symptoms as Tuesday as well. Thursday is when my work got me tested through the employee health program. I do still have a sore throat, fever, body aches and sore throat today and it is 10/9.


VAERS ID: 1775160 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-10-03
Onset:2021-10-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Hypoaesthesia, Injection site erythema, Pain in extremity, Paraesthesia, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin 1000 mg Glimepiride 6 mg Lisinopril -HCTz 10-12.5 mg x 2
Current Illness: none
Preexisting Conditions: diabetes mellitus type 2 hypertension
Allergies: Penicillin Sulfa IVP contrast dye Nickel shrimp
Diagnostic Lab Data: none
CDC Split Type:

Write-up: left jaw tingling and numbness x 2 lasting 15-20 minutes each time headache stabbing/pinching pains in finger tips and toes. thigh pain muscle and joint pain fever 100.9 fatigue left arm swelling and redness at injection site lasted 7 days


VAERS ID: 1775321 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-17
Onset:2021-10-03
   Days after vaccination:228
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: lipitor, metformin, glipizide,atenolol, cozaar, norvasc
Current Illness: DM2, HTN, CAD
Preexisting Conditions: see above
Allergies: lisinopril
Diagnostic Lab Data: +covid
CDC Split Type:

Write-up: hospitalization


VAERS ID: 1775470 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-14
Onset:2021-10-03
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, COVID-19, Chest X-ray normal, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Supraventricular tachyarrhythmias (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol, amlodipine, atorvastatin, vit D, doxazosin, fluticasone, losartan, tramadol
Current Illness: UTI
Preexisting Conditions: C-spine DDD with radiculopathy, COPD, DVT, Depression, HFpEF, HTN, PAD, Raynaud''s, R Carotid stenosis, CVA
Allergies: lisinipril
Diagnostic Lab Data: PCR + 10.4.2021. CXR: negative
CDC Split Type:

Write-up: breakthrough covid + 10.3.21 w/ new onset Afib RVR, no resp symptoms


VAERS ID: 1775489 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-10-01
Onset:2021-10-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cough, Headache, Malaise, Neck pain, Oropharyngeal pain, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Arthritis (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: Clonazepam
Current Illness: None
Preexisting Conditions: Acid Reflux
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore throat, cough, malaise, runny nose. Neck pain. Headache


VAERS ID: 1775726 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-10-01
Onset:2021-10-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Erythema, Headache, Rash, Rash erythematous, Sleep disorder
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin 40mg, Modafinil 200mg (Generic for Provigil 200mg), Nature Made Multi-Vitamin for Her50+, B-100 Complex (TR), Vit.C 1000mg w/RoseHips(TR), Vit.D3 5000iu, L-Lysine 500mg, Potassium Gluconate 550mg, Biotin 5000mcg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Bright red ring around neck, red rash on upper abdomen and back, no itching. Intermittent right mastoid pain (q15-20min), No itching. No elevated temp. Difficulty sleeping possibly due to stress of aforementioned symptoms.


VAERS ID: 1775752 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-29
Onset:2021-10-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood test, Contusion, Deep vein thrombosis, Immunoglobulin therapy, Pain in extremity, Petechiae, Platelet count decreased, Rash, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Probiotic, Janumet, Jaridance, Bentyl, Loratadine, Lipitor, Multi Vitamin, Metoprolol, Norvasc
Current Illness: None
Preexisting Conditions: Diabetes, PAC, IBS, HTN, sleep apnea
Allergies: Levaquin
Diagnostic Lab Data: Platelets: 10/07/21. 3 10/08/21. 14 10/09/21 113 10/10/21. 195 Doppler 10/08/21. Positive DVT R calf
CDC Split Type:

Write-up: Bruising on arms on Sunday and Bruising and Petechial Rash showing up on legs and feet on Tuesday , Blood Work Drawn and Visit to Doctor on Thursday , Doctor had me rush to the hospital to be emergently admitted with a platelet count of 3. A hematologist was called in and I was admitted to hospital for four day had received 2 days if IVIG and 4 Days of IV Dexamethasone, on day 2 of admission had pain in my right lower leg calf area a doppler showed a DVT , upon discharge 4 days later my platelets came to 195 and I was started in Eliquis to treat DVT and will be on the Eliquis for next 3 months.


VAERS ID: 1775824 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-22
Onset:2021-10-03
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Activated partial thromboplastin time shortened, Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood creatine phosphokinase decreased, Blood lactate dehydrogenase increased, C-reactive protein increased, Chest discomfort, Conjunctivitis, Cough, Diarrhoea, Dyspnoea, Echocardiogram normal, Erythema, Fibrin D dimer, Headache, Immunoglobulin therapy, International normalised ratio increased, Lip dry, Lip erythema, Macule, Malaise, Nausea, Platelet count decreased, Procalcitonin increased, Protein total decreased, Pyrexia, Rash, Rash erythematous, Red blood cell sedimentation rate increased, SARS-CoV-2 antibody test, Serum ferritin increased, Strawberry tongue, Tongue discolouration, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Liver-related coagulation and bleeding disturbances (narrow), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Dehydration (broad), Sepsis (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 10/10/2021 3:30 EDT Total Protein 5.9 grams/deciliter Low Procalcitonin 6.00 Nanograms/Milliliter High C-Reactive Protein 8.96 mg/dL High 10/09/2021 3:45 EDT LDH 263 Int''l Unit/Liter High Procalcitonin 14.23 Nanograms/Milliliter High C-Reactive Protein 11.60 mg/dL High 10/08/2021 9:08 EDT PT 15.5 sec INR 1.2 PTT 35 sec D-Dimer Quantitative 2.10 ug/mL FEU High 10/08/2021 4:30 EDT Procalcitonin 24.18 Nanograms/Milliliter High 10/07/2021 18:25 EDT ALT/SGPT 147 Int''l Unit/Liter High AST/SGOT 203 Int''l Unit/Liter High Ferritin 438.7 ng/ml High CPK, Total 34 Int''l Unit/Liter Platelets 138 X10E+09/L Low Sedrate - Automated 14 mm/h C-Reactive Protein 14.90 mg/dL High SARS COV2 AB IgG SPIKE PROTEIN 24.80 ECHO normal Treated with IVIG and steroids, improving on 10/10/2021 but not resolved yet RVP pending SARS CoV2 Nucleocapsid antibody to be sent out Oct 11, 2021 to look for evidence of prior asymptomatic infection
CDC Split Type:

Write-up: Patient is a 12 year old previously healthy male presenting with bilateral conjunctivitis, fever and rash. History provided by mom and dad at bedside. On Sunday 10/3, he developed nausea and a headache. The following day he started to become febrile and has had persistent fevers since then with a Tmax of 103 at home. Fevers did respond to Tylenol at home. On Tuesday/Wednesday (105-10/6) he developed SOB, chest tightness, epigastric abdominal pain, malaise, and dry cough. Over the course of the week he had 2 days of NBNB emesis and then has had several episodes of nonbloody diarrhea daily. 10/7 he developed an erythematous rash on the soles of his feet that appeared like a sun burn. On admission he had non-purulent conjunctivitis with limbic sparing, cherry red dry lips, strawberry white tongue, red palms and soles; and non palpable discreet macules on torso. clinically consistent with MIS-C


VAERS ID: 1775839 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-01
Onset:2021-10-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cellulitis, Induration, Injection site rash, Rash erythematous, Skin warm
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Montelukast, Amlodipene, Bupropion, Buspirone, Adipex, Fish Oil Supplement, Magnesium Supplement, Vitamin D3 Supplement, Cranberry Supplement
Current Illness: None
Preexisting Conditions: Raynaud''s Syndrome
Allergies: Sulfa
Diagnostic Lab Data: Urgent department recommended treating as cellulitis. No medical tests were performed, just visual exam.
CDC Split Type:

Write-up: Vaccinated on a Friday. Sunday, a red rash formed on my arm at the injection site. By Monday it had doubled in size (about softball size), was hot to the touch and hard as a rock. Did not fade until the following Friday.


VAERS ID: 1775856 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-06-23
Onset:2021-10-03
   Days after vaccination:102
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Metabolic function test, Pulmonary embolism, Scan with contrast abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Spironolactone, birth control pill, sertraline
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: Comprehensive blood tests and CT scan with contrast dye.
CDC Split Type:

Write-up: Pulmonary embolism. Treated with morphine and Xeralto.


VAERS ID: 1775884 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-10-01
Onset:2021-10-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2507 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Mouth swelling, Mouth ulceration, Oral pain
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Systemic lupus erythematosus (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 2 Ulcers formed in mouth, still swollen and not healed 7 days later. Painful and swollen. No history of canker sores, cold sore, or ulcers in the mouth until after 2nd shot of the vaccination.


VAERS ID: 1775979 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-10-03
Onset:2021-10-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: This spontaneous case reported by a pharmacist, describes the occurrence of administered expired product (administration of an expired dose) in a 30-year-old female patient who received mRNA-1273 (Moderna COVID-19 vaccine, batch/lot# 048F21A) for COVID-19 immunization. No medical history reported. On Oct 3, 2021, patient received a dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On Oct 3, 2021, patient administered expired product (administration of an expired dose). On Oct 3, 2021, administered expired product (administration of an expired dose) resolved. The reporter did not provide any causality assessments, concomitant medication or treatment information. Reporter stated the dose administered after 30-day use by date or after manufacturer date of expiry. Storage details provide by reporter included: Date the vial was initially stored in the refrigerator: Sep 1, 2021 with a use by date of Oct 1, 2021. This case linked to MOD-2021-339392 (patient link).


VAERS ID: 1775989 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-10-03
Onset:2021-10-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / UNK - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Administration of an expired dose; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Administration of an expired dose) in a 36-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 048F21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Oct-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Administration of an expired dose). On 03-Oct-2021, EXPIRED PRODUCT ADMINISTERED (Administration of an expired dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were provided. No treatment medications were provided.


VAERS ID: 1776299 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-03
Onset:2021-10-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect route of product administration
SMQs:, Drug abuse and dependence (broad), Medication errors (narrow)

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

Write-up: The needle did not enter the patients muscle entirely, about 3/4 of the 1 inch needle made it into the deltoid muscle. The safety for the needle prevented the full entry. Thus the shot may have entered subcutaneous tissue instead of muscular tissue.


VAERS ID: 1776352 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-02
Onset:2021-10-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA MODERNA 049B21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Infection, Pain, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol, trazodone, prilosec, lexapro
Current Illness: None
Preexisting Conditions: Copy, migraines, tachycardia, premature ventricular contractions
Allergies: Movistar, Thessalon perles
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain, redness, swelling, hot to touch, infection


VAERS ID: 1776535 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-10-01
Onset:2021-10-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal distension, Arthralgia, Back pain, Blood test, Chest X-ray, Chest pain, Chills, Dyspnoea, Fatigue, Mobility decreased, Myalgia, Pyrexia, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tumeric, baby aspirin, daily vitamin
Current Illness: None
Preexisting Conditions: Wheat intolerance that acts like Crohns or Celiac, but those have never been diagnosed
Allergies: Strong immune reaction to wheat at times
Diagnostic Lab Data: I had bloodwork done and a chest x-ray done.
CDC Split Type:

Write-up: I had the flu shot on the same day in the same arm. The day after I was fine. On the second day I could not get out of bed. I had a very high fever (enough to not make sense when talking; highest recorded was 102.6), abdominal swelling, other generalized swelling, joint pain, muscle pain, couldn''t breathe well (I think from the abdominal swelling), severe chills, pain under my left rib which seemed to be at my spleen (perhaps enlarged), complete exhaustion, back pain, found it difficult to turn over in bed, could hardly get out of bed. This lasted for eight full days. Only today, day nine, am I starting to feel better.


VAERS ID: 1776767 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-22
Onset:2021-10-03
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008B21-2A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 2 UN / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 1776773 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-02
Onset:2021-10-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast swelling, Contusion, Erythema, Headache, Lymphadenopathy, Nausea, Peripheral swelling, Pyrexia, Tenderness, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Second Covid dose, I had fever chills, nausea, and a headache for 3 days.
Other Medications: Losartan; Tramadol; Magnesium; Calcium; Xarelto; Metoprolol
Current Illness: None
Preexisting Conditions: Atrial fibrillation
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: I had the vaccine on Saturday and Sunday morning my arm was swollen. The site was very swollen, red, and tender. I was nauseous. I had a low-grade fever like 99 and a headache. I also vomited. What took me to the doctor was that all throughout the day the arm was getting worse but on Monday night I noticed it was under my arm and to the side of my breast. When I looked in the mirror it turned out to be the lymph node. It was black and blue. On Tuesday I went to the doctor and he put me on an antibiotic (Doxycycline). It took several days for that swelling to go down. It seems to be ok now.


VAERS ID: 1776803 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-09-30
Onset:2021-10-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Insomnia, Lower respiratory tract infection, Malaise, Nasopharyngitis, SARS-CoV-2 test negative, Sinus disorder
SMQs:, Infective pneumonia (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: Rosuvastatin 5 mg od multivitamins
Current Illness: no
Preexisting Conditions: no
Allergies: antibiotic (can''t remember the name)
Diagnostic Lab Data: 10/05/2021- COVID-19 test-negative
CDC Split Type: vsafe

Write-up: Around 10/03/2021, I was feeling sinus, head cold type feeling. I was not running a fever, I felt like this for a couple of days. I usually get a head cold once a year. I usually get antibiotics to clear it up. . I did a tele-heath visit and the doctor suggested a COVID-19 test. I went to get a COVID-19 test on 10/05/2021-negative I thought I was getting better. We flew out on 10/07/2021. I was wearing a mask for 10 -12 hours . I did not sleep well. I was feeling pretty rough. I called telehealth for antibiotics because I was not getting any better. It was in my chest and it was infected. The doctor called in a prescription for Amoxicillin, 7 days, 2 pills a day. I have not gotten better, but I am not worse.


VAERS ID: 1776815 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-09
Onset:2021-10-03
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chemotherapy, Febrile neutropenia, Hypoxia, SARS-CoV-2 test positive, Salivary gland cancer
SMQs:, Agranulocytosis (narrow), Asthma/bronchospasm (broad), Haematopoietic leukopenia (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Oropharyngeal neoplasms (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Non-haematological malignant tumours (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID (10/3/2021) = positive
CDC Split Type:

Write-up: Patient was admitted on 10/3/2021 with neutropenic fever secondary to chemotherapy that he received for salivary gland cancer. He received casirivimab-imdevimab on 10/4/2021. He developed hypoxemia on 10/5/2021 and required 1L of oxygen. He was still febrile on this date so he was started on dexamethasone and remdesivir. He completed 5 days of remdesivir and dexamethasone while hospitalized. He was discharged on 10/9/2021 with an Rx for the remaining 5 days of dexamethasone.


VAERS ID: 1776817 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-29
Onset:2021-10-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Laryngitis, SARS-CoV-2 test negative, Streptococcus test negative
SMQs:, 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: Janumet 100/1000 Allinopurinol 300mg
Current Illness: None
Preexisting Conditions: Type 2 diabetes
Allergies: None
Diagnostic Lab Data: Covid rapid test was negative Strep test was negative
CDC Split Type:

Write-up: Laryngitis


VAERS ID: 1776855 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-12
Onset:2021-10-03
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 2 UN / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 1 UN / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies: None reported
Diagnostic Lab Data: 10/08/2021 - Positive Covid test
CDC Split Type:

Write-up: Tested positive after both vaccines


VAERS ID: 1776957 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-02
Onset:2021-10-03
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Oropharyngeal pain, Rhinorrhoea
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: runny nose, sore throat


VAERS ID: 1776967 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-10-03
   Days after vaccination:124
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Chills, Cough, Pyrexia, Respiratory tract congestion, Sneezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, chills, sneezing, chills, cough, abdominal pain, congestion


VAERS ID: 1776976 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-29
Onset:2021-10-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Mouth ulceration, Pain, Pyrexia, SARS-CoV-2 test negative, Tongue ulceration
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Rapid COVID-19 Test (negative)
CDC Split Type: vsafe

Write-up: I had 3 mouth ulcers on my tongue and they appeared 5 days after the 3rd dose of the vaccine. I went to the urgent care. He prescribed steroids and antiviral medicine and it resolved within 3-4 days. I did have a COVID-19 test done at the urgent which came back negative. I also had mild body aches, fever, and general fatigue.


VAERS ID: 1777140 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-10-02
Onset:2021-10-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Lethargy, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril Metoprolol Multivitamin Vitamin D Digestive advantage probiotic
Current Illness: None
Preexisting Conditions: None
Allergies: Zithromax Sulfa
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Chills. Used Tylenol. Lasted Body aches. Approximately 36 hours. Headache Extreme lethargy Slight nausea


VAERS ID: 1777586 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-30
Onset:2021-10-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Bone disorder
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: Gabapentin, Phenytoin, Levothyroxine Multi vitamins and minerals, calcium, Vitamin D
Current Illness:
Preexisting Conditions: Trigeminal Neuralgia, low thyroid, back pain
Allergies: Augmentin, Hydroxyzine HC Doxycycline, Hydrocodone, Sulfa, Biaxin, Indocin, Clarithromycin, latex, gold, mint
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Bone on right should moved up .


VAERS ID: 1777620 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-09-30
Onset:2021-10-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301558A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Patient states that his arm swelled past the injection site, down to his lower arm. Patient described the swelling as painful and "as large as his leg".


VAERS ID: 1778564 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-03
Onset:2021-10-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 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: 1778896 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-03
Onset:2021-10-03
   Days after vaccination:214
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022M20A / UNK 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID 19


VAERS ID: 1778956 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-09-24
Onset:2021-10-03
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Chills, Cough, Dizziness, Headache, Influenza virus test, Laboratory test normal, Lethargy, Lumbar puncture, Pyrexia, Respiratory tract congestion, Respiratory viral panel, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (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: N/A
Current Illness: None
Preexisting Conditions: None
Allergies: Ibuprofen
Diagnostic Lab Data: Multiple Covid Tests Flu Test Pneumonia Tests Lumbar Puncture-Meningitis Negative Respiratory Panel Multiple chest X-rays
CDC Split Type:

Write-up: Cough, congestion, severe headache, lethargic, dizziness, chills, fever


VAERS ID: 1779167 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-29
Onset:2021-10-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Colitis, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D 2000UI (Daily)
Current Illness: No
Preexisting Conditions: Frequent episodes of Transverse Diverticulitis
Allergies: Amitriptyline
Diagnostic Lab Data: Not applicable
CDC Split Type: vsafe

Write-up: I experienced high fever (that went the date of the vaccination and three days later with a high fever and stomach pain, I went to see my doctor and he said that it could be Transverse Diverticulitis (part of my colon was inflamed) and prescribed Amoxicillin which is making my symptoms subside.


VAERS ID: 1779301 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-25
Onset:2021-10-03
   Days after vaccination:220
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002A21A / UNK - / -

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

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

Write-up: Covid positive household contact


VAERS ID: 1779329 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-26
Onset:2021-10-03
   Days after vaccination:69
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Biliary tract dilation procedure, COVID-19, Cholelithiasis
SMQs:, Gallbladder related disorders (narrow), Biliary tract disorders (narrow), Gallstone related disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Patient found to be COVID positive though not hypoxemic. Patient started on remdesivir but not dexamethasone. He was also noted on CT scan of abdomen to have a gallstone stuck in the neck of the gallbladder as well as intra/extra hepatic ductal dilation and CBD dilation. GI consult placed but next day after review with GI it was felt patient would not benefit from consult and would need a general surgery consult. General surgery consulted on 10/5 and no plan for surgery as he does not have cholecystitis. IR consulted for biliary drain and discussed with patient how to manage at home. Patient satisfied with consultations and cleared for DC home.


VAERS ID: 1779388 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-02
Onset:2021-10-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling cold, Headache, Influenza virus test, Lymphadenopathy, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test, Streptococcus test
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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 shot swells at injection site.
Other Medications: Bupropion; vitamin d; fish oil; b complex
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Egg; sulfa antibiotics
Diagnostic Lab Data: Strep test. Flu test. COVID test, Rapid PCR.
CDC Split Type: vsafe

Write-up: Headache, fatigue, chills, fever, swollen lymph nodes, sore throat.


VAERS ID: 1779409 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-01
Onset:2021-10-03
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Patient developed Covid


VAERS ID: 1779410 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-29
Onset:2021-10-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA FF2589 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram, Chest X-ray, Chest pain, Electrocardiogram, Fibrin D dimer, Full blood count, Metabolic function test, Myocarditis, Pleuritic pain, Troponin
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None known
Preexisting Conditions: Asthma, eczema, history of DVT and pulmonary embolism.
Allergies: No known drug allergies
Diagnostic Lab Data: D dimer, troponin, CMP, CBC., EKG, CXR and CT angio.
CDC Split Type:

Write-up: Patient had left sided chest pain and was seen. Had lab work done and prescribed Naproxen and Tramadol. Diagnosed with pleuritic chest pain and told to follow up with PCP for suspected myocarditis. Seen for follow up visit.


VAERS ID: 1779419 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-20
Onset:2021-10-03
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 1 LA / IM

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

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

Write-up: Developed redness to arm


VAERS ID: 1779426 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-22
Onset:2021-10-03
   Days after vaccination:223
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 2 UN / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 1779670 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-11
Onset:2021-10-03
   Days after vaccination:234
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Basophil count normal, Basophil percentage decreased, Chest X-ray normal, Chills, Decreased activity, Decreased appetite, Differential white blood cell count, Eosinophil percentage, Fatigue, Full blood count, Haematocrit normal, Haemoglobin normal, Headache, Human chorionic gonadotropin negative, Immature granulocyte count, Lymphocyte count normal, Lymphocyte percentage, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume normal, Monocyte count normal, Monocyte percentage increased, Myalgia, Nervousness, Neutrophil count normal, Neutrophil percentage, Oropharyngeal pain, Platelet count normal, Productive cough, Red blood cell count normal, Red blood cell nucleated morphology, Red cell distribution width normal, Sleep disorder, White blood cell count decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic leukopenia (narrow), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (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: No known illnesses
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: Labs: Recent Results (from the past 24 hour(s)) CBC w/Diff Collection Time: 10/03/21 1:15 AM Result Value Ref Range White Blood Count 4.54 4.5 - 11.0 10*3/uL Red Blood Count 4.21 4.0 - 5.2 10*6/uL Hemoglobin 12.6 12.0 - 16.0 g/dL Hematocrit 39.2 36.0 - 46.0 % Mean Corpuscular Volume 93.1 80.0 - 100.0 fL Mean Corpuscular Hemoglobin 29.9 26.0 - 34.0 pg Mean Corpuscular HGB Conc 32.1 31.0 - 37.0 g/dL Red Cell Distribution Width-CV 12.5 12.0 - 16.8 % Platelet Count 241 140 - 440 10*3/uL Mean Platelet Volume 10.1 8.4 - 12.4 fL Diff Type Hospital CBC w/AutoDiff (arb''U) Neutrophils % 59.1 45 - 80 % Lymphocyte % 26.0 15 - 50 % Monocyte % 13.0 0 - 15 % Eosinophil% 1.5 0 - 7 % BASO% 0.2 0 - 2 % Immature Granulocyte% 0.2 0.0 - 1.0 % Nucleated RBC % 0 0 /100(WBC) Neutrophil Abs 2.68 2.0 - 8.8 10*3/uL Lymphocyte-Absolute 1.18 0.7 - 5.5 10*3/uL Monocyte Absolute 0.59 0.0 - 1.7 10*3/uL EOS-Absolute 0.07 0.0 - 0.8 10*3/uL Basophil Abs 0.01 0.0 - 0.2 10*3/uL Immature Granulocyte Abs 0.01 0.00 - 0.10 10*3/uL HCG,Qualitative Collection Time: 10/03/21 1:15 AM Result Value Ref Range HCG Qualitative Serum Negative Negative Radiology: Xr Chest 2vw Result Date: 10/2/2021 REVIEWING YOUR TEST RESULTS IN MYNORTONCHART IS NOT A SUBSTITUTE FOR DISCUSSING THOSE RESULTS WITH YOUR HEALTH CARE PROVIDER. PLEASE CONTACT YOUR PROVIDER VIA MYNORTONCHART TO DISCUSS ANY QUESTIONS OR CONCERNS YOU MAY HAVE REGARDING THESE TEST RESULTS. RADIOLOGY REPORT FACILITY: ER AGE:24 Y SEX:F XR CHEST 2VW DATE: 10/02/2021 HISTORY: cough. COMPARISON: August 28, 2021. FINDINGS: Two views of the chest demonstrate no pneumonic consolidation, pleural effusion, or pneumothorax. The cardiac and mediastinal contours are normal. IMPRESSION: 1. No acute cardiopulmonary radiographic abnormality. .
CDC Split Type:

Write-up: presents to the ED with frontal headache, cough productive of small clear sputum, sore throat, myalgias, fatigue and chills. She denies fever, dyspnea, sinus drainage, postnasal drip, nausea/vomiting, diarrhea, dysuria, hematuria, urinary urgency or frequency. Recommended Benzonatate 100mg (2capsules by mouth, 3x daily), Prednisone 4mg tablet dospack cetirizine 10 MG tablet Commonly known as: ZyrTEC Take 1 tablet by mouth daily for 30 days May substitute for cost/insurance purposes. Flovent HFA 110 MCG/ACT inhaler Generic drug: fluticasone Inhale 2 puffs into the lungs Twice a Day. ibuprofen 600 MG tablet Commonly known as: MOTRIN Take 1 tablet by mouth every 8 (eight) hours as needed for Pain or Fever for up to 24 doses. Mucus Relief DM 30-600 MG Tab sr12 Take 2 tablets by mouth every 12 (twelve) hours. naproxen 500 MG tablet Commonly known as: Naprosyn Take 1 tablet by mouth 2 (two) times daily with meals. Review of Systems Constitutional: Positive for activity change, appetite change, chills and fatigue. Negative for diaphoresis and fever. HENT: Positive for sore throat. Negative for nosebleeds, congestion, rhinorrhea, trouble swallowing, neck pain, neck stiffness, voice change, postnasal drip and tinnitus. Eyes: Negative for visual disturbance. Respiratory: Positive for cough. Negative for chest tightness and shortness of breath. Cardiovascular: Negative for chest pain, palpitations and leg swelling. Gastrointestinal: Negative for abdominal pain, diarrhea, nausea and vomiting. Genitourinary: Negative for dysuria, flank pain and hematuria. Musculoskeletal: Positive for myalgias. Negative for gait problem. Skin: Negative for wound. Neurological: Positive for headaches. Negative for dizziness, syncope, light-headedness and numbness. Psychiatric/Behavioral: Positive for sleep disturbance. Negative for confusion. The patient is nervous/anxious.


VAERS ID: 1780121 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-25
Onset:2021-10-03
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 UN / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE QUADRIVALENT) / SANOFI PASTEUR - / N/A UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram normal, Asthenia, Body temperature increased, Computerised tomogram abdomen, Computerised tomogram head normal, Confusional state, Dyspnoea, Fatigue, Full blood count, Hepatobiliary scan, Hyperhidrosis, Laboratory test, Lethargy, Magnetic resonance imaging head normal, Metabolic function test, Mobility decreased, Nausea, Rash, Scan normal, Somnolence, Ultrasound abdomen normal, Vomiting, West Nile virus test
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: PLAVIX 75 MG DAILY LISINOPRL 20 MG DAILY TAMSULOSIN 0.4 MG DAILY FINASTERIDE 5 MG DAILY SERTRALINE 100 MG DAILY
Current Illness: NONE
Preexisting Conditions: HYPERTENSION BPH HX OF STROKE 2012, NO LASTING SEQUELAE
Allergies: NONE
Diagnostic Lab Data: HOSPITALIZED 10/6/21 - ? STILL IN HOSPITAL. FOLLOWING WERE DONE IN HOSPITAL LAB WORK - BMP, CBC, OTHER LABS, WEST NILE VIRUS-RESULTS NOT AVAILABLE YET CT BRAIN - NEG MRI BRAIN - NEG CTA CHEST & Abdomen - NEG US - ABDOMEN - NEG HIDA SCAN - NEG
CDC Split Type:

Write-up: RASH BACK OF SHOULDERS, EXTREME FATIGUE, NAUSEA / VOMITING AT HOME X 3 DAYS. ADMITTED TO HOSPITAL 10/6/21 WHEN DEVELOPED SEVERE WEAKNESS, UNABLE TO GET UP, SHORTNESS OF BREATH, DIAPHORESIS, TEMP 99.7. ARRIVAL IN HOSPITAL - HAD TEMP $g 101. ADMITTED TO HOSPITAL. WORKUP DONE AS BELOW. POSSIBLE ENCEPHALITIS WITH ENCEPHALOPATHY - IN ADDITION TO ABOVE SYMPTOMS - SOME CONFUSION, VERY LETHARGIC, VERY DROWSY


VAERS ID: 1780487 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-24
Onset:2021-10-03
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Loss of personal independence in daily activities
SMQs:, Retroperitoneal fibrosis (broad), Dementia (broad)

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

Write-up: Severe lower back pain (mainly at left waist) started on 10/3/2021 and still won?t go away as of today 10/13/2021. Very painful to lie down or get up or turn body around, and very difficult to put on pants and socks as it caused big pain when bending over my body. Started to take Aleve pain reliever since 10/3. Dr prescribed Mobic 15mg Tab.


VAERS ID: 1782241 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-03
Onset:2021-10-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA FF2588 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Haemorrhage, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Excessive bleeding, tingling and soreness in arm, bruising still present after 9 days


VAERS ID: 1782321 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-10-03
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035CZ1A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amenorrhoea, Pregnancy test negative
SMQs:, Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily vitamin and probiotic
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Scheduled to see Obgyn on 9/25/21.
CDC Split Type:

Write-up: I received the second Moderna shot on 9/10/21 and have yet to get my period. My period usually starts on the 3rd day of each month. It?s now 10/13/21. It?s 11 days late. Took 4 pregnancy tests and all were negative. No spotting. No major PMS symptoms to report. Hoping it comes back.


VAERS ID: 1782541 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-01
Onset:2021-10-03
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angina pectoris, Breast mass, Breast pain, Cardiac discomfort, Chest pain, Electrocardiogram, Pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Lipodystrophy (broad)

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

Write-up: Left breast hurting, felt like a large lump. Went away after a few weeks. Heart and chest pains, pressure on heart, dull pain throughout the day


VAERS ID: 1782575 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-02-25
Onset:2021-10-03
   Days after vaccination:220
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Asthenia, Bacterial test positive, Body temperature increased, Breath sounds abnormal, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Choking, Condition aggravated, Confusional state, Contusion, Cough, Fall, Hypertension, Hypophagia, Limb injury, Malnutrition, Mobility decreased, Nitrite urine present, Procalcitonin, Toxic encephalopathy, Type 1 diabetes mellitus, Urinary tract infection, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

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

Write-up: 86-year-old man who presented to the ED with weakness. His daughter was in the room and provided most of the history. She states about 2 weeks ago he fell and injured his arm with some bruising but has not done well since that time. Since that time he has been weak and has not been as active as he normally was prior to the fall. About a week ago he developed a cough but did not have fevers so they did not think he had coded. Last Friday he was very weak and after going to bed he did not get out of bed for the next 3 days. He has eaten very little over the past week as well. He has been drinking some water and Ensure. He continues to have a cough. Denies shortness of breath. Still with no fevers. Vitals & T: 98.5 ?F (Oral) HR: 61(Peripheral) HR: 68(Monitored) RR: 17 BP: 129/67 SpO2: 98% WT: 61 kg VITAL SIGN LAST CHARTED MINIMUM MAXIMUM Blood Pressure 129/67 (10/03 22:30) 110/68 (10/03 20:15) 157/63 (10/03 20:00) Heart Rate 61 (10/03 22:30) 47 (10/03 20:00) 80 (10/03 19:04) Respirations 17 (10/03 22:30) 15 (10/03 20:45) 22 (10/03 20:15) Temperature 98.5 (10/03 22:30) 98.5 (10/03 22:30) 98.5 (10/03 22:30) SpO2 98 (10/03 22:30) 87 (10/03 20:34) 98 (10/03 22:30) O2 Flow Rate 3 (10/03 20:45) 3 (10/03 20:45) 3 (10/03 20:45) Weight 61 (10/03 19:04) 61 (10/03 19:04) 61 (10/03 19:04) Discharge Diagnoses: 1. Acute respiratory failure with hypoxia, Discharge, 10/03/2021 2. Pneumonia due to COVID-19 virus, Discharge, 10/03/2021 3. Type 1 diabetes, Discharge, 10/03/2021 4. HTN (hypertension), Discharge, 10/03/2021 5. Weakness, Discharge, 10/03/2021 6. Malnutrition, Discharge, 10/03/2021 Secondary Diagnosis and Comorbidities: Hospital Course Admitted with Acute respiratory failure with hypoxia secondary to covid-19 / Viral Pneumonia Vaccinated remdesivir d3 - stop at day 3 as improved dexamethasone d3 was on 3L, CXR a little worse, looks like a lot of chronic changes to me and now weaned to room air Dex causing some confusion/toxic encephalopathy from the steroid, so will stop at d3, especially since he''s on room air He has Type 1 diabetes Secondary to prior Whipple procedure Patient uses an insulin pump at 0.4 units/hour as a basal rate. We removed insulin pump and managed here while on Dex. Discharged on 10/5/2021. Readmitted on 10/12/2021. Patient is an 86 yr old male with medical history significant for recent COVID infection, complicated by pneumonia, for which he was hospitalized from 10/3-10/5. Medical history also includes type 1 diabetes r/t whipple procedure, pancreatic insufficiency, and hypertension. He was confused during his last admission, but presents to the ER today with worsening confusion. He is noted to have a temp of 101.3, procalcitonin 0.34, and his urine is positive for nitrite and 4+ bacteria with no epithelial cells. CXR is slightly improved since discharge, he is noted to have expiratory wheezes in bilateral bases and diminished breath sounds on the right. He was also noted to have mild choking when drinking water in the ER. He will be admitted for management of his presumed UTI, and will get swallow study as well. Still hospitalized in COVID-19 stepdown unit.


VAERS ID: 1782992 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-29
Onset:2021-10-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Ear discomfort, Ear pain, Hyperacusis, Pain, Pain in jaw, Rash, Rash erythematous, Rash papular, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hearing impairment (narrow), Osteonecrosis (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: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data: Ear exam 10/13/21
CDC Split Type:

Write-up: Red, raised rash on right arm 4 days after vaccine with burning and itching. Rash still faintly evident 2 weeks later despite antihistamines and hydrocortisone cream. At same time rash started, upper jaw pain extending to back of ear. Ear canal pain with ear fullness, and sensation swirling in ear moving outward. Noise sensitivity in ear as well. All on right side. Had ears examined at clinic, there is no evidence of ear infection.


VAERS ID: 1783216 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-28
Onset:2021-10-03
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Hyperhidrosis, Hypoaesthesia, Pain, Peripheral swelling, Pyrexia, Swelling face
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unkown
Preexisting Conditions: unknown
Allergies: nkda
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Per patient: had a normal reaction during the first 4 days including sweats, chills, body aches, and fever. On day 5, patient reported have facial numbness and swelling effecting half the face. Went to the hospital and noted that numbness spread to the entire face. Was sent home after 12 hours. On day 6, he reported swelling of extremities (hands/feet) and returned to the hospital. He said he was given epinephrine at the hospital.


VAERS ID: 1784639 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-09-30
Onset:2021-10-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH RX 0701316-1227 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site bruising, Injection site pain, Injection site rash, Rash, Rash erythematous, Rash pruritic, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pain in the arm where shot given, headache, tired day of the vaccine and next day. arm bruised the next day. Two days after vaccine developed a rash on my left arm. Rash has continued to get worse. The rash started out small with small bumps that itch. The bumps progressed into painful and developed blisters. The blisters last a couple of days then peel. The area remains red where the rash was. The reaction has progressed to my neck, torso, legs, back, both arms. I started out using calamine lotion to ease the itch. After6 days, I stopped by the local Pharmacy . I spoke to a male pharmacist. I showed him my arm. He recommended Cortizone 10 creme and Benadryl. I have been using this for 6 days. The rash that started originally on my upper arm is finally starting to show signs of improvement. However, the rest of me is not. I will note that I did online research and read multiple articles, particularly one from a hospital in another state. The article indicated that their study found this same reaction in patients--particularly women . Their study noted the rash lasted anywhere from 8 days to 14 days. Seeing this, I didn''t get alarmed with my reaction. It is just aggravating and uncomfortable to me.


VAERS ID: 1785011 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-26
Onset:2021-10-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Pulmonary thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Triamterne-HCTZ75-50, Benicar, Dexilant, Peroxetine, Synthroid, Allopurinol, Amlodipine, Sinvastatin, Trospium, Vitamin D3, Vitamin B12, pro Air, Breo.
Current Illness: None
Preexisting Conditions: COPD
Allergies: Penicillin and Adhesive tape
Diagnostic Lab Data: Blood clot in right lung
CDC Split Type:

Write-up: Some pain in arm


VAERS ID: 1785014 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New York  
Vaccinated:2021-10-01
Onset:2021-10-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 1 AR / -

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood creatine phosphokinase increased, Chromaturia, Injection site pain, Myalgia, Ultrasound abdomen normal
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 23 year old patient who took Johnson and Johnson COVID-19 vaccination on Friday 10/1/21 because of school requirements for vaccination. Subsequent day on Saturday, he developed muscle aches of the extremities from the site of injection to other extremities. On Sunday, he began to have dark color urine. Admission into hospital, baseline CK over 300,000 on 10/7/21, - Admission ALT 538, AST 2012. Abdomen ultrasound "Unremarkable right upper quadrant ultrasound." Patient only reported 2 acetaminophens at home since Johnson and Johnson vaccine - 10/13/21: Patient continues to be on IV fluids. The creatinine kinase is 13,691 and AST/ALT 397/335 which are both substantial improvements from admission labs - Discharged 10/14


VAERS ID: 1785063 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-30
Onset:2021-10-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acoustic stimulation tests abnormal, Audiogram abnormal, Chills, Deafness unilateral, Dizziness, Headache, Hot flush, Mobility decreased, Pain, Sudden hearing loss, Vertigo
SMQs:, Anticholinergic syndrome (broad), Parkinson-like events (broad), Hearing impairment (narrow), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: 09/30/21 at 800am, pfizer covid booster vaccine given. 10/1/21 all day body aches, dizziness, head aches, chills and hot flashes. These continued until 10/3/21. 10/3/21 at 800pm sudden hearing loss in right ear. 10/4/21 at 600am unable to get out of bed, spinning room, right ear deafness, dizzy and vertigo. Contacted Occupation Health and was directed to see Dr, ENT. 10/4/21 at 300pm consult with Dr at ENT and told that I had a rare side effect from the booster that is covid related and known. Sent to Audiology for hearing test and was confirmed 100% deaf in right ear, Went back over to ENT where Dr administered a steroid injection in to my right ear drum. 10/7/21 at 300pm back to Dr ENT for a second steroid injection and at this point no changes in my hearing. He sent me to another ENT for additional injections as he was out of the office, 10/11/21 Dr ENT, administered a third steroid injection in to my right ear drum. Also put on a weeks worth of combination oral medications to help. While in the office Dr performed another Audiology test, At this point I am still 100% deaf in my right ear. I am still having ongoing treatment but told that it is unlikely that my hearing will come back at all. 10/25/21 - MRI will be completed 11/3/21 - Dr, ENT and Audiology Appointments are scheduled.


VAERS ID: 1785140 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-03
Onset:2021-10-03
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Fall, Rhabdomyolysis
SMQs:, Rhabdomyolysis/myopathy (narrow), Neuroleptic malignant syndrome (broad), Accidents and injuries (narrow)

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

Write-up: Fell at home, admitted with Rhabdomyolysis, no Covid


VAERS ID: 1785244 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-01
Onset:2021-10-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 5mg enalapril, 20mg Xarelto,40mg Nexium, 60mg lovastatin
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: No reactions to the 1st shot (01/26/2021) No reactions to the 2nd shot (02/16/2021) VERY HIGH BLOOD PRESSURE FROM 3RD SHOT WHICH WAS ADMINISTERED 10/01/2021 ON 10/04/2021 AT 5:25 PM MY BLOOD PRESSURE WAS 239 / 143 i CALLED 911 AND WAS TAKEN TO THE ER MY PCP PRESCRIBED AMLODIPINE WHICH I TOOK MY BLOOD PRESSURE "STABILIZED" AT ABOUT 150 / 110 ON 10/06 IT SPIKE AGAIN TO 204 / 130 AT 11PM. I AGAIN WENT TO THE ER. BY 10/08 IT HAD RETURNED TO ITS NORMAL 111/ 75 IN SUMMARY: MY SIDE EFFECT WAS 1 WEEK OF VERY HIGH BLOOD PRESSURE


VAERS ID: 1785431 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-10
Onset:2021-10-03
   Days after vaccination:207
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: clopidogrel 75 mg tablet 75 mg PO DAILY lisinopril 20 mg tablet 5 mg PO DAILY tab bisoprolol fumarate 10 mg tablet 5 mg PO DAILY tab aspirin 81 mg tablet,delayed release 81 mg PO DAILY tab allopurinol 100 mg tablet 100 mg PO
Current Illness: HYPERTENSIVE HEART DISEASE, ACUTE RESPIRATORY FAILURE, ACUTE COVID-19
Preexisting Conditions: CAROTID ARTERY STENOSIS, ACUTE KIDNEY INJURY, CORONARY ARTERY DISEASE
Allergies: NO KNOWN ALLERGIES
Diagnostic Lab Data: POSITIVE COVID-19 PCR TEST ON 10/02/2021
CDC Split Type:

Write-up: BREAKTHROUGH HOSPITALIZATION


VAERS ID: 1785472 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-15
Onset:2021-10-03
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Angiogram pulmonary abnormal, Anion gap, Antibody test negative, Anxiety, Aspartate aminotransferase increased, Basophil percentage decreased, Blood albumin normal, Blood alkaline phosphatase normal, Blood bicarbonate increased, Blood bilirubin normal, Blood chloride normal, Blood creatinine normal, Blood culture negative, Blood gases, Blood glucose normal, Blood ketone body, Blood lactate dehydrogenase increased, Blood lactic acid, Blood osmolarity decreased, Blood pH increased, Blood potassium normal, Blood sodium normal, Blood urea increased, Brain natriuretic peptide increased, C-reactive protein increased, COVID-19, COVID-19 pneumonia, Carbon dioxide increased, Chest X-ray abnormal, Cough, Differential white blood cell count, Dyspnoea, Eosinophil percentage decreased, Fibrin D dimer increased, Glomerular filtration rate normal, Haematocrit normal, Haemoglobin normal, Hepatitis B core antibody negative, Hepatitis B surface antibody negative, Hepatitis C antibody negative, Immature granulocyte count, Immunology test, Inflammatory marker test, Intensive care, International normalised ratio normal, Laboratory test normal, Lipase normal, Lung consolidation, Lymphocyte percentage decreased, Mean cell volume normal, Mitogen stimulation test, Monocyte percentage, Mycobacterium tuberculosis complex test negative, Neutrophil count increased, Neutrophil percentage increased, Oxygen saturation decreased, PCO2 normal, PO2 decreased, Platelet count normal, Platelet morphology normal, Pneumonia, Polychromasia, Protein total decreased, Prothrombin time prolonged, Red blood cell count normal, Red blood cell microcytes present, Red blood cell nucleated morphology, Red cell distribution width normal, Respiratory failure, SARS-CoV-2 test positive, Serum ferritin increased, Superinfection, Troponin I normal, White blood cell count increased
SMQs:, Acute renal failure (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haematopoietic leukopenia (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant 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), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Hyponatraemia/SIADH (broad), 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 (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tamsulosin (FLOMAX) 0.4 mg Oral Cap Take 1 capsule by mouth daily . Take 30 minutes after dinner or before bed 100 capsule 3 ? Insulin NPH Human (HumuLIN N NPH Insulin KwikPen) 100 unit/mL (3 mL) SubQ Insulin Pen Inject 30 units subcutaneou
Current Illness: Sleep apnea mild -new diagnosis
Preexisting Conditions: 45 Y male with h/o DM, severe obesity (BMI 40.35), OSA, recent hospitalizations for hypoxic respiratory failure (8/22-8/26, 9/14-9/17 on prednisone taper), RAD, on chronic home O2 2L, with +COVID 9/29
Allergies: nka
Diagnostic Lab Data: 10/9/2021 04:18 NA: 136 K: 3.8 CL: 99 (L) CO2: 31 BUN: 23 CREAT: 0.60 ANION GAP4 SERPL: 6 GLUC: 132 LDH: 397 (H) BNP: 74 COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE CRP, SER QL: 0.8 FERRITIN: 424 (H) WBC: 12.4 (H) RBC''S: 5.26 HGB: 15.2 HCT: 44.4 MCV: 84 RDW, RBC: 13.2 PLT: 342 IMMAT GRANULO % AUTO: 4 (H) NRBC: 0 NEUTROPHILS % AUTO: 89 (H) ANC: 11.0 (H) LYMPHS % AUTO: 2 (L) MONOS % AUTO: 5 EOS % AUTO: 0 BASO''S % AUTO: 0 DIFF PANEL: AUTO DIF D-DIMER: 3.24 (H) 10/9/2021 08:07 GLUC BLD GLUCOMETER: 147 10/9/2021 10:03 TEMP: 97.7 (L) INSPIRED O2: 95 PH CORR ART BLD: 7.48 (H) PCO2 CORR ART BLD: 38 PO2 ADJUST TO PT''S TEMP, BLD-A: 60 (L) PH ABLD: 7.47 (H) PACO2: 38 PO2-A: 62 (L) HCO3 BLD: 28.3 (H) BE BLD: 4.4 (H) SO2, CALCULATED, ARTERIAL: 91.4 (L) 10/3/2021 06:20 NA: 126 (L) K: 3.6 CL: 93 (L) CO2: 20 (L) BUN: 6 (L) CREAT: 0.76 ANION GAP4 SERPL: 13 GLUC: 215 (H) TROPONIN I: 0.02 LDH: 752 (H) BNP: 118 (H) ALT: 24 AST: 46 (H) ALKP: 53 LIPASE: 4 TBILI: 0.8 GFR-AFRAM: $g60 GFR NONAFR AMER: $g60 COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE ALB: 3.7 CRP, SER QL: 29.6 (H) FERRITIN: 1,003 (H) LACTATE: 1.6 OSMO: 278 TP: 6.0 WBC: 12.2 (H) RBC''S: 5.05 HGB: 14.6 HCT: 43.1 MCV: 85 RDW, RBC: 13.3 PLT: 173 PLT''S, BLD QL, MAN: ADEQUATE NRBC: 0 NEUTROPHILS % MAN CNT: 85 (H) BAND''S % MAN CNT: 7 (H) LYMPHS % MAN CNT: 6 (L) LYMPHS ATYPICAL % MAN CNT: 1 MONOS % MAN CNT: 1 MACROS: 1+ (A) MICROCYTES: 1+ (A) OVALOCYTES, BLD QL, MICRO: 1+ (A) POLYCHROMASIA: 1+ (A) PLT''S MORPH: NORMAL DIFF PANEL: MAN DIFF PT: 12.7 INR: 1.0 D-DIMER: 1.46 (H) BLD CULT RSLT: Final Report... 10/3/2021 06:20 LDH: TND DIFF PANEL: MAN DIFF 10/3/2021 07:25 XR CHEST: Rpt 10/3/2021 13:01 LDH: 709 (H) BETA OH-BUTYRATE: 0.6 (H) BLD CULT RSLT: Final Report... QFT MITOGEN MINUS NIL: 5.87 QFT NIL: 0.02 QFT TB GOLD PLUS INTERPRETATION: Negative QFT TB1 MINUS NIL: 0.00 QFT TB2 MINUS NIL: 0.00 COCCI AB ID: None Detected COCCI AB CF: <1:2 COCCI IGG ELISA: 0.2 COCCI IGM ELISA: 0.2 STRONGYLOIDES SP AB, SER QN: 0.2 HEP B COREAB: NEGATIVE HEP B S AB: NEGATIVE HEP B S AG: NEGATIVE HEP C AB: NEGATIVE
CDC Split Type:

Write-up: 45 Y male with h/o IDDM, severe obesity (BMI 40.35), OSA, CT Chest findings suggestive of RAD, recent hospitalizations for hypoxic respiratory failure (8/22-8/26, 9/14-9/17 s/p prednisone taper) on home O2 2L, who presented with +COVID 9/29 with worsening shortness of breath and transferred to the ICU for rapidly escalating oxygen requirements. Hx of recent admissions for acute on chronic hypoxic respiratory failure (8/2-8/26, 9/14-9/17) on 2L home O2, possible small airway disease. OSA with CPAP but not compliant at home, likely contributory factor of OHS and OSA. Hx of CAP 8/22 s/p cftx/azithro. Recent CTA 8/22 w/ possible small airway disease. Recently seen as an outpatient (9/21). CTA performed on last admission (08/22) with questionable subtle groundglass opacities in the upper lobes left greater than right which may be infectious or inflammatory, air trapping in upper lobes on expiratory views, diff dx bronchiolitis obliterans or other small airways disease. Outpt infectious workup overall negative. Thought to be possibly environmental, as patient works at a car company on the manufacturing line and is exposed to a lot of smoke & welding fumes. S/p recent prednisone taper (9/14-9/25). Symptom onset on 9/28, SARS-CoV2 PCR positive on 9/29. spO2 95% on 40L 80% at time of presentation and required HFNC 40L 100% FiO2 to maintain SpO2 $g95%. CXR 10/3 with diffuse multifocal consolidation and opacity suspicious for pneumonia. Received remdesivir 200 mg Ivx1 and dexamethasone 6mg IV x2 in ED. CTA negative for PE but with GGO/ diffuse consolidations. ABG on 10/4 7.45/37/55. Continues to have borderline sats. Repeat ABG on 10/5 improved at 7.43/38/91. CXR unchanged. Currently with cough, SOB that may be exacerbated by anxiety and worsening COVID vs superimposed infection, although ABG improved and inflammatory markers down-trending. Procalcitonin elevated at 0.27, not elevated prior. D-dimer also elevated, suspect superimposed infection +/- PE as patient''s oxygen needs have remained despite inflammatory markers down-trending. Pt left AMA 10/9. Reason for Hospital Admission (Admitting Diagnosis): Covid Pna Pt was seen again in ED on 10/14 High Risk patient with Severe symptoms. Sx are Stable but not improving - Addressed patient''s questions about COVID-19


VAERS ID: 1785561 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-10-02
Onset:2021-10-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Arthritis; Acid Reflux; Migraines
Allergies: Flu shot; blue dye; a lot of additives put in generic drugs
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: Tiredness and a sore arm.


VAERS ID: 1785596 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-02
Onset:2021-10-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound - Week and 3 days after
CDC Split Type:

Write-up: Swollen lymph gland - right side of neck


VAERS ID: 1785616 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-09-30
Onset:2021-10-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain lower, Arthralgia, Body temperature increased, Chills, Chromaturia, Constipation, Decreased appetite, Fatigue, Pain, Renal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Kidney pain low back both sides, fatigue, upset stomach, no appetite, constipation, chills, full body ache, temperature, full body joint ache, very dark urine, low abdomen cramps


VAERS ID: 1785694 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-01
Onset:2021-10-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, simvastatin, zolpidem, alendronate sodium, CBD oil, centrum silver, calcium citrate magnesium zinc, C, CoQ10, turmeric
Current Illness: NA
Preexisting Conditions: High cholesterol, hypothyroidism, IBS, osteopenia
Allergies: Septra DS, nystatin, azithromycin, Percocet, fluocinide cream
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen lymph node in neck


VAERS ID: 1785704 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-24
Onset:2021-10-03
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PE3592 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dacryostenosis acquired, Eye infection, Eye pain, Lacrimation increased, Rhinorrhoea
SMQs:, Glaucoma (broad), Lacrimal disorders (narrow), Ocular infections (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine 5mg, 1xday Hydroxychloroquine 200mg Xalatan 1xday Toprol XL Mucinex Ofloxacin 4xday
Current Illness: none
Preexisting Conditions: several types of Arthritis High blood pressure slightly obese
Allergies: none
Diagnostic Lab Data: none
CDC Split Type: vsafe

Write-up: I had an infection in my eyes that resulted in my eyes watering, runny nose, and pain in the left and right eye. The left eye was worse. I went to an urgent care on 10/8/2021. The doctor said it was an unusual eye infection, and the ducts in my eyes were plugged. I was prescribed Ofloxacin eye drops 4xday and told to wash my eyes with cotton balls.


VAERS ID: 1786692 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-10-01
Onset:2021-10-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025021A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Breast pain, Contusion, Dizziness, Fatigue, Headache, Heavy menstrual bleeding, Injection site bruising, Injection site pain, Injection site swelling, Pain, Polymenorrhoea, Presyncope
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Lipodystrophy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Gardisil 2008, caused Crohn?s disease
Other Medications: Citalapram 20mg Infliximab Intravenous (300mg) every 6 weeks
Current Illness: None
Preexisting Conditions: Crohn?s Disease
Allergies: Moderna Vaccine mRNA-1273
Diagnostic Lab Data: Blood work Full Analysis with OBGYN
CDC Split Type:

Write-up: -early mensuration after just having normal period -pain, light headed and almost passed out, heavy blood -BLOOD CLOTS the size of tomatoes and some smaller -breast pain in left breast & very sensitive bruising -never before been irregular, has blood clots nor heavy bleeding in 22 years of having a period until the shot -Swollen painful bruise/swell at injections site, -headache, - exhaustion


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