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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 440 out of 8,010

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VAERS ID: 1624164 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-02
Onset:2021-08-21
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Nasal congestion, SARS-CoV-2 test positive, Sneezing, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (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: none known
Current Illness: none known
Preexisting Conditions: none known
Allergies: none known
Diagnostic Lab Data: Rapid test for Covid positive 8/22
CDC Split Type:

Write-up: Client vaccinated with Pfizer vaccines for Covid on 4/2 and 4/30/2021. Developed nasal congestion and sneezing on 8/21. Tested positive for Covid 8/22. Reported as a breakthrough Covid case in a vaccinated woman.


VAERS ID: 1624184 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Hypoaesthesia, Neck pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (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: prozac 20 mg
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: tingling, numbness from Right shoulder through right finger tips. Significant pain in upper right shoulder blade and neck. Day4 post vaccine and pain/symptoms are lingering


VAERS ID: 1624210 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chills, Headache, Hyperhidrosis, Injection site pain, Myalgia, Pain, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Stomach bug two weeks prior
Preexisting Conditions: Systemic lupus, antiphospholipid syndrome, lung scar tissue
Allergies: Sulfa allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/21/21 - Headache, soreness at injection site 8/22/21 - Overall body aches, muscle aches, chills during morning hours. By 1 PM I had a fever of 101 and increasing muscle, joint and body pain. By 7 PM my fever was 102 and began sweating and having chills. I then took one capsule of Vimovo (500mg/20mg). I sweat profusely all night long and had intense pain in both large and small joints as well as leg and back muscles. 8/23/21 - Body and muscle aches in the morning, fever of 99. By 1 PM fever was still 99 but I was beginning to feel better, with less pain. I did not take any more medication as the CDC site said there may be a better immune response without it. By 5 PM my temperature had returned to normal and I had minimal pain.


VAERS ID: 1624214 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Haematuria
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Tubulointerstitial diseases (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: same adverse event, timeline of side effects, etc. after 2nd dose of the Moderna COVID vaccine. age 22 at time of previous adver
Other Medications: Entyvio infusion, candesartan, allegra, probiotic
Current Illness: N/A
Preexisting Conditions: Crohn''s Disease, IgA Nephropathy, Hypertension (from IgA Nephropathy)
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: visible hematuria for approximately 48 hours after receiving the vaccine


VAERS ID: 1624239 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthritis, Burning sensation, Chills, Dyspnoea, Eye swelling, Headache, Hypertension, Myositis, Pruritus, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Symptoms: rash, itchiness, burning sensation, eyes are swollen, high blood pressure, chills, inflammation of joints and muscle, difficulty breathing, and headache.


VAERS ID: 1624283 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site erythema, Injection site mass, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Patient reported a bruise at injection site and lump underneath skin starting Saturday (morning after vaccination). Bruise worsened Sunday morning to size of 1/2 dollar with redness spreading down the arm. Bruise worsened again Monday morning, slightly in size, with increase redness in addition to pain/burning sensation. Patient treated with ice Monday afternoon which decreased bruise and redness slightly.


VAERS ID: 1624307 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-14
Onset:2021-08-21
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Lymphadenopathy, Tenderness
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: multi vit, calcium, vit d3, pantoprazole
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: tenderness in armpits also swollen and painful


VAERS ID: 1624342 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Lethargy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Miralax, dexmethylphenidate PO TAB 2.5 mg
Current Illness: no known illness
Preexisting Conditions: Rubienstein-Taybi Syndrome
Allergies: kna
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt spiked to 104.1 degree fever around 6:30 pm the day after her vaccination. She was lethargic and not wanting to eat or drink. She did not have a rash or difficulty breathing. Her temperature was taken in the ear. Her fever did respond to Ibuprofen and did not spike again. (remained low grade on day two without medication).


VAERS ID: 1624353 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Dizziness, Heart rate increased, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: swelling, rapid heart beat, rash, dizziness, weakness


VAERS ID: 1624355 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F3180C / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I am scheduling a urgent care visit now with facility. (8/23 @ 5 PM)
CDC Split Type:

Write-up: Had some normal and expected vaccine symptoms... But my heart has been racing, even at the slightest exercise. I also have sharp chest pain when I breathe deeply or sometimes during mild breathing.


VAERS ID: 1624541 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Back pain, Injection site swelling, Neck pain, Tenderness
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (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: Active Outpatient Medications (including Supplies): Active Outpatient Medications Status ========================================================================= 1) ATORVASTATIN CALCIUM 10MG TAB TAKE ONE T
Current Illness:
Preexisting Conditions: Ulcerative Colitis
Allergies: Bacitracin, Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injection site swelling, tender. Back, neck and stomach ached. Started on Saturday and persisted in Sunday with improvement therafter


VAERS ID: 1624558 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-10
Onset:2021-08-21
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

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

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

Write-up: PT CALLE D IN 8/23/21 @ APPROX 2:30PM_ PT EXPERIENCED DELAYED REACTION OCCURED 11 DAYS LATER AFTER VACCINATION. PT EXPERIENCED ONSET ON SATURDAY UPON WAKING UP IN THE MORNING. WARM TO TOUCH (APPROX 99.5 DEGREES) ; NOTICABLY SWOLLEN LEFT ARM; REDNESS & PAIN AT INJECTION SITE. PT ALSO DISCLOSED THAT COVID VACCINATION WAS DONE ON ARM THAT HAD A ROTATOR CUFF PROBLEM. HOWEVER, THAT WAS NOT DISCLOSED TO VACCINATING RPH . UPON COUNSELING TODAY, PT WAS ADVISED TO TAKE TYLENOL TO HELP WITH PAIN & WARM ARM REACTION, & TO SOAK ARM WITH EPSOM SALT & WARM WATER. MONITOR FOR 3 DAYS IN NO IMPROVEMENT CALL BACK PHARMACY & FOLLOW-UP WITH PT''S PCP. PT UNDERSTOOD . PT WAS ALSO NOTIFIED TODAY THAT DELAYED REACTION AFTER SEVERAL DAYS/WEEKS CAN OCCUR FOR SOME PPL. PT UNDERSTOOD.


VAERS ID: 1625028 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 called and said was having "pins and needles" type sensation that started after getting shot on Saturday and has not gone away. Feels numb and tingly in different areas of body. Advised patient to seek an exam by a medical provider and to let us know of any updates.


VAERS ID: 1625039 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / 1 - / SYR

Administered by: Military       Purchased by: ?
Symptoms: Headache, Paraesthesia, Pruritus, Skin burning sensation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, intense pins and needles over entire body, itchiness, burning feeling on skin Taking lotradine and diphenhydramine to help with no relief.


VAERS ID: 1625053 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Blood pressure monitoring was performed at the event (08/21/21)
CDC Split Type:

Write-up: The patient felt dizzy.


VAERS ID: 1625061 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site pruritus, Injection site rash, Injection site warmth
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit B12, Zinc, Vit D
Current Illness: None
Preexisting Conditions: None
Allergies: PCN, Levaquin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash and itchiness around injection site, warm to the touch. Began the day following the immunization. Treated with Cortisone cream. Duration unknown at this time, still continuing 3 days after.


VAERS ID: 1625285 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site hypoaesthesia, Injection site pain, Injection site paraesthesia, Muscle twitching, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Pain to L deltoid with numbness and tingling going down to hand with twitching.


VAERS ID: 1625451 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Eructation, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none reported by client''s mother (DOB: 10/03/1987)
Current Illness: none reported by client''s mother.
Preexisting Conditions: none reported by clients mother.
Allergies: none reported by client''s mother.
Diagnostic Lab Data:
CDC Split Type:

Write-up: On Saturday, August 21, 2021, client (DOB: 05/26/2008) received the first dose of the COVID vaccine (Pfizer, dose 1, lot# FC3183, exp: 9/17/21) in to his left deltoid at approximately XXXpm. After vaccine was administered, client was to wait in the Observation Area for 15 minutes. At 11:16am, Co-Lead RN witnessed client''s mother (DOB:10/03/1987) alert EMT that client felt like he needed to vomit. EMT handed client an emesis bag. Co-Lead RN, responded and client proceeded to belch into emesis bag one time. Client assisted to zero gravity chair. At 11:16pm, client stated he felt better after belching and notes he was feeling nauseas about 5 minutes after vaccination. Client denied abdominal pain, chest pain, shortness of breath, swelling in face or mouth, rash, itching or any other symptoms. Upon assessment by Co-Lead RN, client''s skin was dry, warm, and pink. At 11:16am vitals were taken: BP: 125/83, HR: 120, RR: 20. Client was alert and oriented x4 during entire interaction. Client''s mother states client last ate a piece of toast at 8:00 am. Per mother, client does not have a medical history, allergies, or take any prescription medications at home, but does note that the client has a history of fear to needles and injections. At 11:30am vitals were taken: BP: 113/82, HR: 105, RR: 20. The client skin was warm, dry and pink. At 11:46am, vitals were taken: BP: 105/81, HR:92, RR:20. Co-Lead RN educated client''s mother on ED precautions and advised to follow up with PCP. Client''s mother verbalized understanding. Client walked out of observation area with a steady gait at approximately at approximately 11:47pm


VAERS ID: 1625973 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Louisiana  
Vaccinated:0000-00-00
Onset:2021-08-21
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Back pain, Injection site pain, Muscular weakness, Paraesthesia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (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:
Current Illness: Abstains from alcohol; Allergic reaction to antibiotics; Non-smoker; Penicillin allergy
Preexisting Conditions: Comments: The patient was not pregnant at the time of reporting. The patient was not a drug abuse or illicit drug user.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210844104

Write-up: PAIN ON THE BACK; RASH (LOCATED ALL OVER THE BREAST); TINGLING ON LEGS AND ARMS; PAIN ON THE LEFT SIDE UNDERNEATH THE SHOULDER; WEAKNESS ON LEGS AND ARMS; INJECTION SITE PAIN (LEFT ARM); This spontaneous report received from a patient concerned a 27 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: amoxicillin allergy, penicillin allergy, sulfur allergy, non-alcohol user, and non-smoker, and other pre-existing medical conditions included: The patient was not pregnant at the time of reporting. The patient was not a drug abuse or illicit drug user. The patient experienced drug allergy when treated with codeine. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 203A21A expiry: UNKNOWN) dose was not reported, administered on 20-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 21-AUG-2021, the patient experienced pain on the back. On 21-AUG-2021, the patient experienced rash (located all over the breast). On 21-AUG-2021, the patient experienced tingling on legs and arms. On 21-AUG-2021, the patient experienced pain on the left side underneath the shoulder. On 21-AUG-2021, the patient experienced weakness on legs and arms. On 21-AUG-2021, the patient experienced injection site pain (left arm). Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from rash (located all over the breast), tingling on legs and arms, pain on the back, pain on the left side underneath the shoulder, weakness on legs and arms, and injection site pain (left arm). This report was non-serious.


VAERS ID: 1627139 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Feeling abnormal, Headache, Injection site pain, Injection site rash, Injection site swelling, Injection site warmth, Lymphadenopathy, Malaise, Pyrexia, Tenderness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol, Methimazole, guanfacine, Zyrtec, Acarbose, omeprozole, vitassium Saltsticks, Loratadine, multivitamin, vitamin D, iron supplement, tylenol
Current Illness: No acute illnesses
Preexisting Conditions: Graves disease, eosinophilic esophogitis, postural orthostatic tachycardia syndrome, environmental allergies
Allergies: Grasses, tresses, molds, animal dander, feathers, dust
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 8/21- felt light headed, brain fog, headache starting around 8:00 pm; 8/22- woke up with 100.7 degree fever, severe headache, fatigue, malaise, brain fog, dizziness, swelling in lymph node under left arm, highest measured fever 102.4 around 4:00 pm, 101.8 fever around 8:00 pm; 8/23- temp down between 100.5 around 7:00 am to 99.0 around 8:00 pm, all other symptoms from 8/22 present; 8/24- woke up around 2:00 am with swelling, warmth, and rash at injection site that is tender to the touch and tender when left elbow or shoulder are moved, continued swelling of lymph node, mild headache, fatigue, temp down to 98.1 around 5:00 am


VAERS ID: 1627917 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dysphonia, Fatigue, Headache, Oropharyngeal pain, Pain, Pyrexia, Rhinorrhoea, Sinus pain, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: synthroid, cytomel, protonix, pepcid
Current Illness: none
Preexisting Conditions: hypothroid, GERD
Allergies: pcn, morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever- aches & chills, sinusitis symptoms, nasal discharge, headache, sinus pain, sneezing, sore throat, hoarseness, fatigue ongoing- so far 3 days


VAERS ID: 1627926 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-04
Onset:2021-08-21
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Ear congestion, Vertigo
SMQs:, Anticholinergic syndrome (broad), 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: Cannabis
Current Illness: Interstitial cystitis
Preexisting Conditions: Interstitial cystitis
Allergies: Nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vertigo, lightheaded, headaches, fullness in ears,


VAERS ID: 1627949 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Nausea, Pain in extremity, Vertigo
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, zinc, selenium, vitamin C, Plaquenil
Current Illness:
Preexisting Conditions: Lupus
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness (started on the 20th, ongoing), nausea, vertigo (on August 21st), arm pain (gone by August 23).


VAERS ID: 1627980 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-01
Onset:2021-08-21
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram abnormal, Anticoagulant therapy, Arteriogram coronary abnormal, Computerised tomogram thorax abnormal, Condition aggravated, Deep vein thrombosis, Dizziness, Dyspnoea, Dyspnoea exertional, Electrocardiogram ST segment abnormal, Fibrin D dimer normal, Heart rate irregular, Incontinence, Loss of consciousness, Malaise, Muscle spasms, Myocardial strain, Pain in extremity, Peripheral swelling, Pulmonary embolism, Skin discolouration, Troponin increased, Ultrasound Doppler abnormal
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Dystonia (broad), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Other ischaemic heart disease (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zyrtec, MVI, Probiotic, Flonase
Current Illness: N/A- no significant health history. SOB upon exertion started May 2021, originally attributed to allergies.
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: 8/21/2021- While in the ED, a workup was started. Lab work was significant for a troponin of 846.5, a D-dimer of 17.15. An EKG was done and showed sinus nonspecific ST wave abnormalities. A CTCA was done and a duplex extremity was done. He was given aspirin and started on heparin. Fluids were started and oxygen support. 1. CTA of the chest 08/21/2021, impression: Positive for pulmonary embolism with large clot burden and some evidence of right heart strain. 2. Doppler studies of bilateral lower extremities 08/21/2021, impression: Acute DVT from mid femoral vein through the calf veins on the left.
CDC Split Type:

Write-up: FROM Admission H&P 8/21/2021: He reports increase in shortness of breath with exertion and some calf pain. He says the increase in shortness of breath started in May but he attributed it to possible allergies and so he started taking Zyrtec and Flonase. He saw some resolution through June and July and did not experience the increased shortness of breath; however, 1 week ago he noticed increased shortness of breath with hiking. Later that day he went swimming and when swimming he experienced left calf cramping. He has noticed most of this shortness of breath with exertion. He is a very active person and exercises almost every day through biking or other cardio activities. Today the patient was walking up a hill after a 3-hour meeting at the camp he is working at and he had to use the bathroom and felt dizzy and lightheaded. Once he got to the building he was staying in, he climbed the stairs to get to the bathroom, he called for his son because he was not feeling well and wanted him to evaluate him. Of note, his son is a 3rd-year medical student and a pharmacist. He sat down before urinating and felt like he might have lost consciousness. His son reported an irregularly irregular right radial pulse and had him do a vagal maneuver which he said got him into a regular pulse. From there he went to the bathroom but started feeling lightheaded again. His son supported him to laying down on the bed, rechecked his pulse and found it to be irregularly irregular again and repeated a vagal maneuver. His son held his legs up until EMS arrived. EMS reported that his color was gray and his oxygen saturation was in the low 80s on arrival. He was incontinent of urine in the bed. Of note his wife also reported left foot swelling a few days prior to this event. Hematology consultation 8/23/2021- He presented to our emergency department on Saturday 08/21/2021 with increasing symptoms of shortness of breath, particularly with exertion, as well as some left lower calf pain. The patient reports initially noting symptoms of shortness of breath with exercise beginning in May 2021. He attributed this to possible seasonal allergies and initiated Zyrtec and Flonase. He did have some improvement in his symptoms through June and July 2021, however, would have intermittent symptoms of shortness of breath particularly with exercise. He reports going for a hike approximately 1 week ago and noted some increasing shortness of breath during his hike. Later that day he went swimming and had cramping in his left calf. He notes he was at a meeting on Saturday morning. After the meeting he jogged uphill and noted some worsening shortness of breath, he felt dizzy and lightheaded, and was also noted to have an irregular pulse by his son. He was taken to the emergency department for further evaluation via EMS. Upon evaluation by EMS his oxygen saturations were in the low 80s. Laboratory studies revealed a troponin of 846.5, D-dimer elevated at 17.15. Doppler studies of lower extremities and CTA of the chest were performed noting evidence of pulmonary embolism with large clot burden and some evidence of right heart strain, along with acute DVT of the left lower extremity. Patient was appropriately initiated on a heparin drip. He has been since transitioned to Eliquis. He does not report any symptoms of chest pain. No worsening respiratory symptoms. No signs or symptoms of bleeding. No fevers or chills. No nausea, vomiting, diarrhea or constipation. He denies any previous history of blood clots, no recent travel, surgery, or trauma. He does report receiving his COVID-19 vaccine, the 2nd dose of Pfizer in April 2021. Otherwise no further concerns at this time. Per hematology consultation 8/23/2021: We have discussed with the patient today he will likely require lifelong anticoagulation in the setting of unprovoked clot. I have asked Dr to please ask pharmacy to report possibility of pulmonary embolism and deep venous thrombosis (DVT) following COVID-19 vaccination to our pharmacy.


VAERS ID: 1627991 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear pain, Pain, Pruritus
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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Otezla, Tylenol or Aleve as needed, Flonase, Saline spray
Current Illness: None
Preexisting Conditions: Psoriatic Arthritis
Allergies: Squash, onion, beans
Diagnostic Lab Data:
CDC Split Type:

Write-up: Due to my auto-immune disease, this was my Pfizer booster. For my first and second shots, I had no side effects other than mild discomfort at injection site and mild fatigue. For this booster, I experienced more aches and pains during 48-72 hour window following the injection, and inner right ear itching/ache. I contacted them to make sure no inner ear infection (not thinking this was vaccine related). Result was no infection, no issues found at all. Nurse recommended that I note the symptom on this site in the event this discomfort was related to the vaccine. The issue coincided with the 48-72 hour window of the other general side effects.


VAERS ID: 1627997 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (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: General body and joint aches
Other Medications: Body aches. Joint pain. No fever.
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Muscle and joint pain. General whole body aches.


VAERS ID: 1628009 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blepharospasm
SMQs:, Dystonia (broad), Periorbital and eyelid disorders (narrow), Ocular motility 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: Dexilant
Current Illness: None
Preexisting Conditions: Acid reflex
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Since taking the shot my left eye started twitching. It started on sat and has not stopped. It seems to be getting worse.


VAERS ID: 1628036 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Headache, Oropharyngeal pain, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (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: Influenza
Other Medications: Advil/Tylenol, Omega 3 -, D3 - 5000IU, Zinc, Collagen - 2 capsules, Provitalize - 2 capsules, Organic Super Greens - 1 scoop.
Current Illness: No illnesses but I was Post Op 5 weeks after receiving a Full Hysterectomy and removal of many Fibroid and Cysts.
Preexisting Conditions: None
Allergies: Iodine shot associated with Cat scans.
Diagnostic Lab Data: I have not been to my Dr. yet.
CDC Split Type:

Write-up: Day 1 - Dizziness Day 2 - Left Arm sore, throat sore, headache, joints ache, body ache, high fever then only went down to 101.4 continual for over a day. Day 3 - Left Arm sore, throat sore headache, joints ache, fever controlled by Advil/Tylenol mix., ...Still in the process


VAERS ID: 1628075 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Gait inability, Mobility decreased, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (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: ASA, Vitamins, Simvastatin, fenofibrate, sucralfate, flomax, tramadol, trulicity, gabapentin, lisinopril, janumet, chlorthalidone, primidone, farxiga
Current Illness:
Preexisting Conditions: Diabetes, hypertension
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, weakness, and unable to walk or move arms 48 hours after vaccine.


VAERS ID: 1628090 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Diarrhoea, Headache, Nausea, Somnolence, Taste disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tetanus and whooping cough vaccine, a couple days after the vaccine, I had a huge red mark on my arm the size of a tennis ball a
Other Medications: Zyrtec; Prilosec; propranolol
Current Illness: N/A
Preexisting Conditions: Asthma
Allergies: Onion; Tylenol with codeine; Augmentin; dicloxacillin; vaccine for tetanus and whooping cough; doxycycline; azithromycin; latex; levofloxacin; lisinopril; montelukast; nitrofurantoin; sertraline; sulfa drugs; ibuprofen pseudoephedrine; Dayquil; NyQuil
Diagnostic Lab Data: N/A
CDC Split Type: vsafe

Write-up: Within five minutes of getting the vaccine I had a horrible taste in my mouth. As soon as I got home I slept for 18 hours. I woke up with a horrible headache and diarrhea that lasted for 2 days. Today, most recently, I have had a temperature, nausea and vomiting. I had contacted my DR for a telehealth visit when I had the diarrhea 8/23/2021 and to see if I could be treated. The DR said I could treat at home.


VAERS ID: 1628136 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: The patient received the Pfizer covid-19 vaccine and lost consciousness after the vaccine. The EMT was called and administered assistance to the patient. She came to minutes later and was monitored for side effects. She went home with her mom after feeling ok.


VAERS ID: 1628162 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Lethargy, Lip blister, Lip pain, Lip swelling, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? No
Hospitalized? No
Previous Vaccinations: Moderna COVID 19, First shot, 02/12/2021, COVID arm
Other Medications: atenolol 50 mg, Atorvastatin 10 mg, Women centrum, calcium, aspirin, Prilosec
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I got the shot on Thursday afternoon, on Friday I was lethargic just without any energy. Saturday the arm was a little read and hurt but other than that I felt fine. Early Sunday evening I started getting blisters on my lips that swell my lips and hurt. I am prone to these blisters but have not had an outbreak in a long time and I think the shot set off the reaction and caused the outbreak of blisters because they are different and more severe this time.


VAERS ID: 1628168 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-05
Onset:2021-08-21
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 - / -

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

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

Write-up: Hospitalization 8/21/21 for sepsis COVID19. Being treated with dexamethasone and Remdesivir


VAERS ID: 1628192 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH #EWO167 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metoprolol tartrate,hctz,furosomide,klor con,aspirin,alprazolam,loratadine,extra strength ,aspercreme topical
Current Illness: hypertension,gerd,arthritis,
Preexisting Conditions: hypertension,gerd, arthritis
Allergies: codeine, demerol,morphine
Diagnostic Lab Data: none
CDC Split Type:

Write-up: RED RASH TO RIGHT ARM , itching.


VAERS ID: 1628240 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna ( second dose ) same reaction
Other Medications: Humira, Leflunomide,Amlodipine, Hydrochlorothiazide; Wellbutrin, Cymbalta, Valtrex, omeprazol, carbamazepine
Current Illness: None
Preexisting Conditions: Rheumatoid arthrites, Epilepsy, HTN, depression
Allergies: Dilantin, crabs, lactose
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Took vaccine at 1 PM and 10 PM started with chills, body aches,nausea, fever, headache and nausea. Body aches lasted for 24 hours. Fever lasted for 2 days. Today is Tuesday and I still feel very tired and somewhat nauseated. I had the same type of reaction when I had the second dose of Moderna


VAERS ID: 1628272 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-08-21
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization for Cough, dyspnea and fever treated with remdesivir


VAERS ID: 1628285 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Dehydration, Dizziness, Headache, Heart rate increased, Laboratory test, Nausea, Sleep disorder
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad), Dehydration (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: Flu Shot - Anaphylaxis
Other Medications: Lisinopril (blood pressure), Unithroid (generic for Synthroid - hypothyroidism), Xhance (for inflammed nasal turbinates).
Current Illness: UTI infection treated with Ampicillin - course ended one week before 2nd vaccination.
Preexisting Conditions: Non-Allergic Rhinitis, frequent UTI''s, high-blood pressure
Allergies: Sulfa, latex, Flagyl, MRI dye, Flu vaccination (anaphylaxic shot documented incident 2006)
Diagnostic Lab Data: Multiple, including for blood clot. Organization has the report.
CDC Split Type:

Write-up: Awoken from sleep with rapid heart beat for sustained amount of time (average 109 over approximately 2 hours), dizziness, nausea, dehydration, headache, increased blood pressure.


VAERS ID: 1628294 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Brain natriuretic peptide increased, Echocardiogram normal, Electrocardiogram ST segment elevation, Pericarditis, Troponin increased
SMQs:, Cardiac failure (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Pulmonary hypertension (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: The patient had elevated troponins and BNP upon admission to the hospital which downtrended. He also had multiple EKGs done that all showed diffuse ST segment elevation consistent with pericarditis. The patient also had an Echocardiogram done that was normal.
CDC Split Type:

Write-up: The patient had pericarditis that was treated with Colchicine with symptoms that resolved by 08/24/2021


VAERS ID: 1628295 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

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

Write-up: Pt. states that after receiving the 1st dose of Moderna 08/20/2021, started experiencing symptoms 08/21/2021 of numbness of the left side of the body. Still continuing, no noted Primary visit.


VAERS ID: 1628346 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-18
Onset:2021-08-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear pain, Ear swelling, Tinnitus
SMQs:, Angioedema (broad), Hearing impairment (narrow), Hypersensitivity (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: DILTIAZEM 240MG ONE A DAY LISYNIPRILL 12 ONE A DAY ADVIL 200MG 800 MG A DAY
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: SWELLING AND PAIN LOCATED IN LEFT EAR. THE INNER EAR IS MADE FROM TITANIUM PAIN IS A SLOW THOBBING WAVE LIKE PAIN THAT RADIATES TO THE CENTER OF MY HEAD THE TENITIS IN THAT EAR HAS INCREASED 10X MORE THAN USEAL. I TAKE TYLONOL AND ADVIL TO RELIEVE THE PAIN.


VAERS ID: 1628398 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain lower, Appendix disorder, Computerised tomogram abnormal, Dysstasia, Nausea, Sleep disorder
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Season allergies and cats
Diagnostic Lab Data: August 21, 2021 I went to the ER I was admitted they performed a CAT scan and the doctor advised me that my appendix needed to be removed. I asked him if this was some thing that had been ongoing and lead up to it he said no it had rotted pretty quickly
CDC Split Type:

Write-up: After receiving the vaccine the next night I woke up in the middle of the night and extreme pain and extreme nausea the pain was in my lower right abdomen area. I could not stand up straight or lay down I constantly felt the need to vomit I went to the ER


VAERS ID: 1628477 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chills, Dizziness, Flank pain, Headache, Hyperhidrosis, Malaise, Nausea, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cequa and FML-eye drops Depo-birth control Zyrtec- allergies
Current Illness: dry eye
Preexisting Conditions: seasonal allergies asthma
Allergies: Sulfa, latex, seasonal allergies
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Headache, dizziness, nausea, back pain, flank pain, low grade fever, chills, sweats, rash, malaise, myalgia Treated with 1gm Tylenol, 800mg Motrin, 81mg ASA, 8mg Zofran, 10mg Zyrtec


VAERS ID: 1628486 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Dysuria, Epistaxis, Headache, Pollakiuria, Pyrexia
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 50mcg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Not seen yet
CDC Split Type:

Write-up: Initially I reported frequent urination and difficulty urinating which has gone away since fever stopped. For the past three days I have experienced a slight shortness of breath however lungs are clear. Headache has now been present for 4 days and both my wife (she got her second dose 1 week ago today) have noticed blood when we blow our nose.


VAERS ID: 1628488 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Palpitations, Rash
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Mobic for arthritis
Current Illness: None
Preexisting Conditions: None
Allergies: Sulpha medications
Diagnostic Lab Data: Blood tests, EKG, Holter Monitor requested.
CDC Split Type:

Write-up: Upper body rash, pounding and racing heartbeat. No prior heart or health issues. Now I''m having anxiety due to being forced to have second shot as a City employee.


VAERS ID: 1628511 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Unknown  
Location: Utah  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal distension, Condition aggravated, Diarrhoea, Dystonia, Hemiparesis, Malaria, Musculoskeletal stiffness, Neuralgia, Pain, Pain in extremity, Paraesthesia, Skin warm, Swelling face
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), 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: Cyclobenzaprine 5mG (for dystonia and muscle stiffness) Cholestyramine packs Vitamin D-3
Current Illness: None
Preexisting Conditions: Chronic Inflammatory Response Syndrome (Unspecified innate immune system disorder) Chronic Migraines Sensory Processing Disorder Chronic dystonia or muscle stiffness in multiple muscle groups (most often face, neck) Autonomic Dysfunction Peripheral Neuropathy
Allergies: Known allergies to mold, dusts, and soil particles. May have pollen allergies
Diagnostic Lab Data: Unable to get.
CDC Split Type:

Write-up: 1. Nerve pain and tingling, and weakness in left arm and especially in left hand and fingers. Generally burning pain and soreness throughout the entire left arm. Lasted for around 12 hours and occurred ~12 hours after vaccine administration. 2. Significant flare up of muscle stiffness and dystonia, starting 2 days after vaccine. It may be a myositis-like attack. Facial muscles (scalp, tmj, forehead, sinuses) are tight, stiff, weak, and numb, and furthermore look swollen. There was an MS-squeeze like sensation in abdominal muscles that became numb and perpetually contracted; have not had this reaction since removal from known autoimmune triggers (molds). Skin above affected muscle groups is very hot, as well as numb and equally stiff. Saw a mild malar rash. Abdomen still feels stiff to the touch. 3. Significant swelling of abdomen and diarrhea 2 days after vaccine. Swelling will not go down despite eating health and very little today.


VAERS ID: 1628526 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction, Anticoagulant therapy, Arteriogram coronary normal, Catheterisation cardiac normal, Chest discomfort, Chest pain, Ejection fraction decreased, Electrocardiogram ST segment elevation, Myocardial infarction, Myocarditis, Troponin increased
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None listed in outpatient medication review
Current Illness: No past medical or surgical history
Preexisting Conditions: no past medical or surgical history
Allergies: No known allergies
Diagnostic Lab Data: 8/22: Cardiac cath lab: no coronary artery disease, findings likely represents vaccine related acute myocarditis, EF 30% 8/22 2120H Troponin 23.0; 8/22 2204H 12-lead EKG: possible anterior infarct, inferolateral injury pattern; 8/22 2253H repeat 12-lead EKG: ST elevation consider anterolateral injury or acute infarct, ST elevation consider inferior injury or acute infarct.
CDC Split Type:

Write-up: Patient presented in ED with chief complaint of chest pain, a pressure-like left sided chest discomfort since 7AM with 7/10 intensity without radiation. Patient undergone urgent coronary angiogram which according to the Cardiologist report, it was predominantly normal. He was given Morphine 2 mg IV on 8/23 0100H, metoprolol 12.5 mg PO on 8/23 0800H, Lisinopril 2.5 mg PO 8/23 0900H, Lasix 40 mg PO 8/23 0900H, Aspirin 325 mg PO 8/22 2100H.


VAERS ID: 1628533 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-01
Onset:2021-08-21
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Asthenia, Cough, Dyspnoea, Hypoxia, Malaise, Pain, Pyrexia, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: HCTZ, Folic acid, Methotrexate, Amlodipine, Flomax, CoQ-10, Multivitamin w/minerals, Selenium, Lisinopril, Omeprazole, Mag citrate, Preservision, Vitamine b 12
Current Illness: Unknown
Preexisting Conditions: BPH, GERD,HTN
Allergies: Statins
Diagnostic Lab Data: SARS COV2 COVID19 PCR
CDC Split Type:

Write-up: The patient presents with Generalized weakness and hypoxia. Patient states he has been feeling unwell for about a week. Having fevers at home, cough, loss of taste, dyspnea, body aches. Has been taking Tylenol. Was vaccinated with Pfizer vaccine in February 2021. For EMS initial saturations were 58% on room air, placed on a non-rebreather, given 350 cc fluids prior to arrival.. The onset was 1 weeks ago. The course/duration of symptoms is worsening. The character of symptoms is Generalized weakness. Therapy today: emergency medical services and Oxygen.


VAERS ID: 1628536 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-15
Onset:2021-08-21
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007M20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cymbalta 30 mg oral delayed release capsule, 30 mg= 1 CAP, PO, BID (2 times a day) dicyclomine 10 mg oral capsule, 10 mg= 1 CAP, PO, BID (2 times a day) folic acid 1 mg oral tablet, 1 mg= 1 TAB, PO, Daily gabapentin 300 mg oral capsule,
Current Illness:
Preexisting Conditions: Ablation Anemia Anxiety Appendectomy Arthritis Back pain Bunionectomy Chicken pox Cholecystectomy Colonoscopy Constipation Depression Diabetes mellitus Dissection tonsillectomy and adenoidectomy Fibromyalgia GI - Gastrointestinal bleed Inflammatory bowel disease Measles Mumps Ovarian mass Pancreatitis Panic attack Trigger finger Urinary tract infection
Allergies: ASPIRIN, IBUPROFEN, NSAIDS
Diagnostic Lab Data: POSITIVE COVID TEST 08/21/2021 @2145
CDC Split Type:

Write-up: complaints of shortness of breath , coughing and bodyches for 6 days now, positive for covid, brought in via EMS.


VAERS ID: 1628537 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-04
Onset:2021-08-21
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Atrial fibrillation, Blood glucose normal, Blood pressure increased, COVID-19, Cerebrovascular accident, Dysarthria, Facial paralysis, Hemiparesis, Malaise, Muscular weakness, Pain in extremity, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Supraventricular tachyarrhythmias (narrow), 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 encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atenolol, Norvasc, Simvastatin, ASA, Levothyroxine, Losartan, COQ 10
Current Illness: Unknown
Preexisting Conditions: HTN, Hypercholesterolemia, Thyroid disease
Allergies: No know allergies
Diagnostic Lab Data: SARS COV2 COVID 19 PCR
CDC Split Type:

Write-up: The patient presents with Stroke symptoms. Started at 7:30 p.m. tonight. Per EMS patient was in the kitchen and was staring at the refrigerator, told her husband that she did not feel well and that her left arm hurt. Husband lowered her down to the floor. When EMS got there per report she had a right facial droop and left arm and left leg weakness with slurred speech. Patient is on baby aspirin. Blood pressure for EMS was 221/151, glc 105. Arrives as a stroke alert.. The onset was 7:30 p.m. tonight. Stroke, Afib, COVID 19 incidental finding


VAERS ID: 1628547 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-11
Onset:2021-08-21
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anosmia, COVID-19, Cough, Hyperkalaemia, Laboratory test abnormal, SARS-CoV-2 test positive, Treatment delayed
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Famotidine, Cinacalcet, Ecitalopram, Odansetron, ASA, Sevelamer Carbonate, Ometa -3, Labetalol, Patiromer, Metroprolol, Atorvastin, HCTZ
Current Illness: Unknown
Preexisting Conditions: Asthma, CAD, HD, ENRD, Polycystic Kidney disease, HTN, Hypercholesterolemia, Anemia, MI, Hidradenitis suppurativa, obe, Obesity, Tobacco abuse
Allergies: Bee Stings
Diagnostic Lab Data: SARS COV2 COVID 19 PCR 08/14/2021
CDC Split Type:

Write-up: This patient is a pleasant 40-year-old lady has ESRD and is on hemodialysis. Patient was diagnosed with COVID-19 a week ago, and was tested because she was symptomatic with slight cough and loss of smell, she was told not to go to the usual center she goes for hemodialysis. therefore she missed 2 of her dialysis days. and yesterday she went to another center where they accept COVID patients. And from there she was sent to the emergency room probably because of abnormal labs. In the ED patient was found to have hyperkalemia . Hemodialysis stat has been ordered by Nephrology and patient is admitted for further treatment.


VAERS ID: 1628555 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2020-12-29
Onset:2021-08-21
   Days after vaccination:235
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Feeling cold, Headache, Myalgia, Nasal congestion, Oropharyngeal pain, Pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL EXTRA STRENGTH) 500 mg tablet diclofenac sodium (VOLTAREN GEL) 1 % gel FLUoxetine (PROzac) 40 mg capsule fluticasone (FLONASE) 50 mcg/actuation nasal spray hydrOXYchloroQUINE (PLAQUENIL) 200 mg tablet meloxicam (
Current Illness:
Preexisting Conditions: Circulatory Raynaud''s disease Varicosities of leg Digestive Esophageal reflux Genitourinary Incomplete uterovaginal prolapse Cystocele, midline SUI (stress urinary incontinence, female) Urethral hypermobility Musculoskeletal Osteoarthritis Undifferentiated connective tissue disease (CMS/HCC) Degenerative disc disease, lumbar Other Fibrocystic disease of breast Depression Family history of colon cancer
Allergies: Sulfa (Sulfonamide Antibiotics)Hives / Urticaria, Itching, Fever Sulfamethoxazole-trimethoprimHives / Urticaria, Other (document details in comments) Hydrocodone-acetaminophenNausea and Vomiting
Diagnostic Lab Data: 08/22/21 1727 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/22/21 1115 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: Fever or Chills Muscle or body aches Headache Sore throat Congestion or running nose


VAERS ID: 1628564 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Renal pain
SMQs:

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

Write-up: SEVERE LEFT KIDNEY PAIN


VAERS ID: 1628570 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Colorado  
Vaccinated:2009-08-18
Onset:2021-08-21
   Days after vaccination:4386
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Appendicectomy, Appendicitis, Blood test, Chills, Fatigue, Injection site pain, Pain in extremity, Pyrexia, Ultrasound abdomen, Urine analysis
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: viral induced asthma
Allergies: to cottonwood trees
Diagnostic Lab Data: Removal of appendix?s. She had an ultra sound, urine test, and blood test then surfery
CDC Split Type:

Write-up: a day later on the 19th she had fever and chills and pain in the injection area which from my understanding is normal. On the 19th she just had a sore arm and seemed normal and so on friday. She just felt tired tose two days. on 21st she started to have issues with her tummy in the evening. Then All day on the 22nd she was having pains in her belly region First she started feeling it in the upper body and then moved down to her lower body. on the 23rd took her to the hospital where she had an appendicitis and had surgery to remove her appendix immediately. !


VAERS ID: 1628591 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-14
Onset:2021-08-21
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA9485 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Dizziness, Headache, Nausea, Pain, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrocortisone
Current Illness:
Preexisting Conditions:
Allergies: Antibiotics
Diagnostic Lab Data: Covid test; positive on 08-21-2021
CDC Split Type: vsafe

Write-up: I got the vaccine on 08-14-2021. I tested positive for Covid on 08-21-2021. Fever, body aches, dizziness, headaches, nausea, congestion. I still have fever, body aches, dizziness, headaches, nausea, congestion. I went to see my immunologist/allergist PA as well as my PCP who prescribed antibiotics and inhaler and also prescribed some prednisone and waiting to get monoclonal antibody infusion.


VAERS ID: 1628593 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2020-12-29
Onset:2021-08-21
   Days after vaccination:235
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 mg tablet albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler ascorbic acid, vitamin C, (VITAMIN C) 500 mg tablet cetirizine (ZyrTEC) 10 mg tablet cholecalciferol, vitamin D3, 50 mcg (2,000 unit) caps
Current Illness:
Preexisting Conditions: Nervous Lumbar radiculopathy Genitourinary Excessive bleeding in premenopausal period Menorrhagia with irregular cycle Fibroid uterus Musculoskeletal Cervical disc disorder at C4-C5 level with radiculopathy Endocrine/Metabolic Hypothyroidism Hematologic Microcytic anemia Elevated platelet count Leukocytosis, unspecified type IDA (iron deficiency anemia) Immune Plaque psoriasis Other Abnormal iron saturation Cervical stenosis of spine
Allergies: MorphineHives / Urticaria
Diagnostic Lab Data: 08/22/21 0834 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/21/21 0835 | Final result | Specimen: Swab COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/22/21 0834 COVID-19 PCR Collected: 08/21/21 0835 | Final result | Specimen: Swab
CDC Split Type:

Write-up: covid exposure - ASYMPTOMATIC


VAERS ID: 1628666 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

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

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

Write-up: No symptoms involved. The Pfizer vaccine was given to an 11 year old and is only for 12 years and up.


VAERS ID: 1628670 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called 8/24/21 stating that she had a rash develop on her wrist (of the same arm as vaccination site) within 24 hours of receiving her second COVID vaccine. It has since become a widespread rash with significant pruritus. Patient was advised to treat with cetirizine (since she states she cannot take diphenhydramine), topical hydrocortisone or benadryl (if tolerated), and to seek medical attention if symptoms persist or worsen.


VAERS ID: 1628672 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Chills, Dyspnoea, Fatigue, Feeling cold, Hypoaesthesia, Inflammation, Myalgia, Pruritus, Thirst
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D 2,500 I.U. - 1 In Morning Flovent HFA 110 MCG - 1 Puff Morning, 1 Puff Night Albuterol Sulfate 90 MCG - 2 Puffs As Needed Prednisone 20 MG - 1 In Morning Montelukast 10 MG - 1 At Bedtime
Current Illness: Asthma, Unknown Autoimmune Disorder, and Partial Removal Right Side Thyroid Surgery June 21st, 2021 Because of Cancer?
Preexisting Conditions: Asthma? Unknown Autoimmune Disorder In The Process Or Figuring Out.
Allergies: None that I''m aware of at this time.
Diagnostic Lab Data: I have had no additional tests, but I saw my primary care doctor shortly after the first shot on the same day that I received my second dosage because of feeling short of breath and stepping up my asthma treatment with medicine. I have seen no one for the numb and cold, weird arm feelings but have an appointment on the 26th of August to follow up with the Asthma and was planning to go over the sensation that I''m getting in my arm.
CDC Split Type:

Write-up: Since I''ve gotten my second shot, I keep getting numbness in my right arm. It goes all the way down along, mainly in my fingers and my arm will be colder to the touch than my other arm, even more so my fingers. They don''t look discolored, but they lose all feeling and become very numb as if my hand is sleeping. I''ve also been having joint pains and muscle pains, no fever but getting chills or feeling feverish. The shot was very painful for the first day and second day; it was hard to move because of the pain but eventually; it stopped and now I just have this numbness and chilly feeling that keeps coming and going since the second shot. The only other noticeable symptoms I had were feeling extra thirsty, fatigued, and since the first shot, I''ve been itchy and having inflammation but had no rash. I also was feeling short of breath, which might be because of my asthma I already have prior to the shot and could be unrelated.


VAERS ID: 1628683 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-10
Onset:2021-08-21
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen 1,000mg q6hr atenolol 50mg Daily Baclofen 10mg TID Benazepril 40mg HS bisacodyl 5mg multiple times a day gabapentin 300mg BID Lantus 100 units/mL - 35 units daily HumaLOG 100 units/mL QID lovastatin 20mg daily metformin 1000m
Current Illness: 2/23/2021 - Right upper leg pain and cramping for 2 weeks.
Preexisting Conditions: Diverticular disease of the colon History of adenomatous polyp of colon malignant tumor of prostate Gastroesophageal reflux disease cervical radiculopatyh Type 2 diabetes benign hypertension diabetic autonomic neuropathy lactose intolerance
Allergies: Codeine - GI issues Hydrocodone-phenylpropanolamine - GI issues
Diagnostic Lab Data:
CDC Split Type:

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


VAERS ID: 1628689 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

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

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

Write-up: The patient''s parent lied about the patient''s age on the intake form. The pharmacy realized the patient had lied when we contacted Pharmacy where they received their first dose. The Pharmacy informed us that the patient was only 11 years old.


VAERS ID: 1628704 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

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

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

Write-up: Parent lied about patient''s age on intake form. When trying to bill for the vaccine the pharmacy called Pharmacy where patient form indicated they received their first dose. Pharmacy informed us that the patient was only 11 years old.


VAERS ID: 1628732 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-01
Onset:2021-08-21
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Oropharyngeal pain, Sinus congestion
SMQs:, Anaphylactic reaction (broad), 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: Allerga allergy; Flonase, Metoprolol, Naphcon A 0.3% solution
Current Illness: none
Preexisting Conditions: seasonal allergies, postpartum cardiomyoptathy; gestational diabetes, general anxiety, fatty liver, blood loss anemia
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: sorethroat and sinus congestion. Has some chills but not fever. Mild cough without any SOB, CP or pedal edema. symptoms started on 8/21/21


VAERS ID: 1628759 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-01-13
Onset:2021-08-21
   Days after vaccination:220
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: carisoprodol (SOMA) 350 mg tablet cetirizine (ZyrTEC) 10 mg tablet diclofenac sodium (VOLTAREN GEL) 1 % gel DULoxetine (CYMBALTA) 60 mg capsule fluticasone (FLONASE) 50 mcg/actuation nasal spray gabapentin 300 mg oral capsule hydrOXYc
Current Illness:
Preexisting Conditions: Nervous Arthralgia of multiple joints Circulatory Livedo reticularis Digestive Obesity Musculoskeletal Lumbar disc disease Raynaud phenomenon Lumbar spondylosis Immune Autoimmune disease Sjogren''s syndrome without extraglandular involvement Other ANA positive Long-term use of hydroxychloroquine
Allergies: NKA
Diagnostic Lab Data: 08/23/21 0239 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/22/21 1953 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/23/21 0239 COVID-19 PCR Collected: 08/22/21 1953 | Final result | Specimen: Swab from Nasopharynx
CDC Split Type:

Write-up: Cough Congestion or running nose


VAERS ID: 1628761 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B821 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Wrong vaccine administered to patient less than 18 years old. Given Moderna instead of Pfizer. No adverse reactions observed or reported by patient/mother.


VAERS ID: 1628764 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (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: Nexium, Move free
Current Illness:
Preexisting Conditions:
Allergies: Chocolate
Diagnostic Lab Data:
CDC Split Type:

Write-up: Brain fog, feeling of tightness in throat that comes and goes. Slight dizzyness


VAERS ID: 1628863 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-07-16
Onset:2021-08-21
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (broad)

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

Write-up: Bells Palsy


VAERS ID: 1628864 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-22
Onset:2021-08-21
   Days after vaccination:211
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

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

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

Write-up: PATIENT RECEIVED COVID VACCINE DOSES ON 1/22/21 AND 2/11/21, AND TESTED POSITIVE TO COVID ON 8/23/21


VAERS ID: 1629069 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Pruritus, 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? 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:
CDC Split Type:

Write-up: Consistent Itchiness throughout the body. Some temporary hives which lasted about a half hour or so.


VAERS ID: 1629088 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-21
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Joint range of motion decreased, Lymphadenitis
SMQs:, 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, Meloxicam
Current Illness:
Preexisting Conditions: Positive ANA with indication of autoimmune disorder(s)
Allergies: Synthetic dyes, corn syrup
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left axillary lymphadenopathy arising 3 days post-vaccination. Ipsilateral lymphadenopathy worsening one week post vaccination with moderate pain (5/10 scale) to left axillary hyperplastic node. Limited range of motion in left shoulder due to adenopathy.


VAERS ID: 1629093 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Lymph node pain, 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: Lynphnode swelling, 17, flu vaccine
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Large amount of welling in lymphnodes of right armpit and right pec causing pain.


VAERS ID: 1629094 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / -

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

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

Write-up: Numbing/tingling/electrical shooting feeling predominantly on left knee down to toes. Comes and goes going on 4 days now. Same feeling on right leg occasionally. Few twinge/shooting/electrical feelings on top of left hip and occasionally right forearm and hand and a few times on face. Forgot to mention the face part to my doctor it only happened a few times.


VAERS ID: 1629290 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-30
Onset:2021-08-21
   Days after vaccination:144
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018B21A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Dyspnoea, Hypoxia, Respiratory syncytial virus test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: vit c, Lipitor, vit d, entresto, metoprolol, spironolactone, torsemide
Current Illness: none
Preexisting Conditions: chf, cad, htn, hyperlipidemia
Allergies: niacin, quinapril, ibuprofen, aspirin
Diagnostic Lab Data: RSV Detected
CDC Split Type:

Write-up: Pt was admitted on 8/21/2021 with hypoxia and sob and a cough ongoing for 7 days not responsive to out pt treatment with antibiotics and prednisone. She tested positive for RSV and was admitted to the hospital. She was treated with steroids, nebulizers and oxygen and was discharged on 8/24/2021 home


VAERS ID: 1629292 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none given
Current Illness: no illness reported
Preexisting Conditions: no other conditions reported
Allergies: no known allergies
Diagnostic Lab Data: No medical test or laboratory test related to event
CDC Split Type:

Write-up: Pt cam in on Saturday 8/21/21 to receive first COVID shot around 10am. After the shot, she remained in store for 15 to 20 minutes leaving around 10:20am and reports feeling fine until she drove home and when she got out of her car she reports becoming extremely dizzy and that the feeling did not begin to resolve until between 4 to 5pm that evening [Approx. 5 to 6 hours]. She did not faint during this time period . She reports no known allergies and has never had any reaction to any previous vaccine. She has had no further dizzy spells since then as of 8/24/21 @11:15am when she reported the incident via phone.


VAERS ID: 1629296 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FV3180 / 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: None
Current Illness: None
Preexisting Conditions: High Blood Pressure
Allergies: No Known Allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Headache


VAERS ID: 1629317 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Emotional distress, Fatigue, Hypertension, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: patient''s husband reports it was mental distortion the night after taking the vaccine with some memory loss the following day. husband also reported fever, hypertension ,and extreme fatigue the night of the vaccine. The paramedics had to be called


VAERS ID: 1629322 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-18
Onset:2021-08-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Haemoptysis
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Infective pneumonia (broad)

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

Write-up: Patient complained of cough and coughed up some blood. Referred to primary doctor and to get tested for possible infection.


VAERS ID: 1629324 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Blood test, Chest X-ray, Chest discomfort, Chest pain, Electrocardiogram
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Chronic sinusitis, recurrent C. difficle infections
Allergies:
Diagnostic Lab Data: Chest X-ray, EKG 12 lead, bloodwork
CDC Split Type:

Write-up: Acute chest pain, multiple short episodes of stabbing pains in my left side(near heart), tightness in the chest and area. Increased anxiety/anxiety attack.


VAERS ID: 1629533 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA 7485. FD 844 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Chills, Feeling cold, Headache, Hypoaesthesia, Pain, Pain in extremity, Pyrexia, Sleep disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Suboxone sublingual tablets 16 mg/day Immitrex for migraines when needed usually once a month
Current Illness: End of a cold
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 20 hours after the second injection I got a fever of 102.3 that actually subsided to 100.6 by the time I went to bed 36 hours after second injection I woke up with a severe headache (I get migraines once a month) worse than any headache I ever had before. It was so painful I thought I''d have to go-to the hospital. That lasted pretty much all day until 8 pm when the headache just disappeared. Now the initial couple hours were the worst, I vomited 1 hour into the onset of the headache. 72 hours after symptom onset I was having cold chills all morning which stopped maybe after a few hours but after that I''m having pain shooting down the backside of my right arm and into the back of my armpit area, almost like a numb feeling but a little pain


VAERS ID: 1629538 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-16
Onset:2021-08-21
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

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

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

Write-up: A few days after receiving the first dose of the Moderna COVID19 vaccine, the area surrounding the spot of vaccination became very itchy, red, and swollen. 8 days later my arm is still red and swollen, occasionally itching. The red, swollen part is about 3 inches long and an inch wide.


VAERS ID: 1629861 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-01
Onset:2021-08-21
   Days after vaccination:51
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: I am very regular and have been for years, I missed my menstrual cycle this month. 3 Negative pregnancy tests.


VAERS ID: 1629863 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Hypoaesthesia, Paraesthesia, Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Flu shot same reaction of swelling itchy and redness like a wasp sting
Other Medications: Phentermine Benadryl
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling of arm redness itching like when getting stung by a wasp and I am allergic. Numbness and tingling in extremities mainly pinky and ring finger of both hands


VAERS ID: 1629886 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-03-22
Onset:2021-08-21
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / UNK RA / SC
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / UNK LA / SC

Administered by: Public       Purchased by: ?
Symptoms: Vaccine breakthrough infection
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: Flu - headcolds some years, not recently
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Breakthrough Delta


VAERS ID: 1632012 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-18
Onset:2021-08-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Headache, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lisinopril (ZESTRIL) 10 mg tablet; multivitamin 400 mcg tablet; omeprazole (PriLOSEC) 20 mg capsule
Current Illness:
Preexisting Conditions: Circulatory: Essential hypertension; Digestive: Obesity Musculoskeletal: Nontraumatic rupture of tendons of biceps (long head) Other Abnormal cardiovascular Non-smoker
Allergies: No Known Allergies
Diagnostic Lab Data: COVID-19 (SARS CoV-2,RNA Molecular Amplification) COVID-19 PCR
CDC Split Type:

Write-up: Fever, chest congestion, coughing, headache


VAERS ID: 1632202 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-14
Onset:2021-08-21
   Days after vaccination:68
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Diarrhoea, Headache, Nausea, SARS-CoV-2 test, Vomiting
SMQs:, Acute pancreatitis (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies: Not on file
Diagnostic Lab Data: COVID-19 (SARS CoV-2,RNA Molecular Amplification) COVID-19 PCR
CDC Split Type:

Write-up: Headache New loss of taste or smell Nausea or vomiting Diarrhea


VAERS ID: 1632226 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-02-23
Onset:2021-08-21
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, COVID-19, Condition aggravated, Pneumonia
SMQs:, Supraventricular tachyarrhythmias (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cefdinir; lisinopril; metoprolol tartrate; oxybutynin; protonix; zithromax
Current Illness: None
Preexisting Conditions: Atrial fibrillation; Alzheimer''s; HTN; dyslipidemia; urinary incontinence
Allergies: Lipitor
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt was admitted for 2 days due to acute episode of Atrial fibrillation and bilateral pneumonia due to SARS-CoV-2. She was discharged after the stay to a long-term care facility.


VAERS ID: 1632259 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site cellulitis, Injection site erythema, Injection site induration, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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? Yes
Hospitalized? No
Previous Vaccinations: Pneumonia 23
Other Medications: Ozempic, Metformin, Singulair. Remicade infusion $g 2-weeks prior to vaccination.
Current Illness: None
Preexisting Conditions: Diabetic; psoriatic arthritis
Allergies: Latex, PCN, ASA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Redness, induration in arm of injection site; fever. Diagnosed as cellulitis.


VAERS ID: 1632284 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Chest pain, Echocardiogram normal, Electrocardiogram normal, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multivitamin, Adderal
Current Illness: none
Preexisting Conditions: none
Allergies: zyrtec
Diagnostic Lab Data: 8/23/21 @ 1313: troponin 1356 ng/L, CRP 22.20 mg/L 8/23/21 @ 2354: troponin 840 ng/L 8/24/21@ 0626: troponin 936 ng/L 8/25/21@ 0755: troponin 188 ng/L Echo and EKG; normal
CDC Split Type:

Write-up: Pt complained of sharp, left sided chest pain. presented to ED for evaluation . found to have elevated troponins, CRP, with normal EKG and echo. Dx with myopericardititis. Treated with colchicine.


VAERS ID: 1632294 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

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

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

Write-up: Patient under age 18 was vaccinated with Johnson and Johnson, which is a vaccine error. Troubleshooting: Scribe and vaccinator did not validate age; screeners at the beginning of the process did not ask or turn away.


VAERS ID: 1632302 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, C-reactive protein increased, Cardiac flutter, Chest pain, Dyspnoea, Electrocardiogram, Headache, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: N/A
Diagnostic Lab Data: Ekg and blood work done. CRP slightly elevated.
CDC Split Type:

Write-up: Chest pain along with fluttering heart. Shortness or breath. Fever headache the second day.


VAERS ID: 1632328 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Allodynia, Asthenia, Chest pain, Fatigue, Pain, Pain in extremity, Sensitive skin
SMQs:, Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none, previous contracted covid December 2020, exposed to Delta variant 2 weeks prior to vaccination but did not become infected
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: First day 8/20: upper arm pain Second day 8/21: sharp intense pain between scapula and sternum area, radiating left chest and shoulder pain that was not relieved by Tylenol and ibuprofen, had very sensitive skin/allodynia anything that touched skin felt like needles including just wearing clothes, feeling very fatigue and weak


VAERS ID: 1632348 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood bilirubin unconjugated decreased, Blood culture negative, Blood lactic acid normal, Extra dose administered, Fatigue, Feeding disorder, Full blood count normal, Gastric disorder, Haemoglobin decreased, Headache, Herpes zoster, Liver function test normal, Lymphocyte count decreased, Metabolic function test normal, Procalcitonin normal, Red blood cell count decreased, Red cell distribution width increased, Urine analysis normal
SMQs:, Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: methotrexate, prednisone, fosamax, sulfasalizine, sulindac, folic acid, vitamin D, lipator
Current Illness:
Preexisting Conditions: JRA, osteoporois
Allergies: hydromophine
Diagnostic Lab Data: Basic Metabolic panel, cbc, hepatic function, lactate venous, procalcitonin, UA, blood culture 8/24/2021. All looked okay BP 141/72, pulse 80, ibili .1, RBC 3.83, HGB 11.1, RDW 15.6, ABSLymPH .7
CDC Split Type:

Write-up: Injection Thursday felt fine, Friday night tired, Saturday very tired, Sunday - shingles emerged, Monday started valacyclovir felt a better Tuesday extreme headache, very fatigued, couldn''t eat, stomache issues, no fever shingles much better, went to ER thought I had an infection (I am susceptible to infection without ioncreased white count and fever) They gave me fluids and torridal. Wednesday symptoms have lessened but still headahce and tired. Maybe a reaction to vaccine??? Mild fatigue with first 2 shots


VAERS ID: 1632359 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-02
Onset:2021-08-21
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, COVID-19, Fatigue, Headache, Injection site pain, SARS-CoV-2 test positive
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Headache
Other Medications: ? Once Daily Vitamin ? 800mg Prescribed Motrin
Current Illness: None
Preexisting Conditions: None
Allergies: penicillin
Diagnostic Lab Data: COVID-19 Positive on 08/21/2021
CDC Split Type:

Write-up: ? Tenderness at injection site ? Fatigue ? Anxiety ? Headaches


VAERS ID: 1632388 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-07-26
Onset:2021-08-21
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 UN / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (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: multivitamin, d3, baby aspirin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: PHYSICIAN EXAM 08/24/2021
CDC Split Type:

Write-up: BELLS PALSY DIAGNOSIS


VAERS ID: 1632524 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Dizziness, Full blood count, Malaise, Migraine, Pain, Photophobia
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: citalopram
Current Illness: no
Preexisting Conditions: anxiety and depression but she works 50 hours/week
Allergies: nkda
Diagnostic Lab Data: cbc
CDC Split Type:

Write-up: Pfzizer vaccine 8/20. ONset of back pain. onset of dizziness, migraine Saturday. Pounding migraine. photophobia and body aches. She has "never felt this sick before" pfizer ew0185


VAERS ID: 1632536 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO177 / 2 RA / IM

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

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

Write-up: Undiluted Pfizer vaccine, cc''s was administered in error


VAERS ID: 1632552 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO177 / 2 LA / IM

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

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

Write-up: Undiluted Pfizer vaccine, 0.3cc''s, was administered in error


VAERS ID: 1632564 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO177 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Incorrect dose administered, Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Undiluted Pfizer vaccine,0.3 cc''s , administered in error


VAERS ID: 1632603 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-01
Onset:2021-08-21
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Peripheral swelling, Rash, Rash erythematous, Rash macular, Rash pruritic, Swelling, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), 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)

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: Vita C, Calcium
Current Illness: None
Preexisting Conditions: None
Allergies: belladonna, sulfa, amphetamines, seconal, mercury, phenobarbital
Diagnostic Lab Data: None, just observation in-house exam, prednisone, then follow up.
CDC Split Type:

Write-up: My first event was one month later...a severe reaction to a tick bite. Swelling, rash, went to urgent care. I have had over 10 tick bites over the years & never had this happen. Then on 8/21/21 I raked the front yard of my home of 30 years, which I have done often, then 2 hours later I began to break out in a severe rash on my arms & legs, with large red splotches of raised welts, then my arms & legs began to swell. I used Benedryl, which did not help. This got worse & worse, until I went to urgent care & got prednisone. I am swollen, bumpy, itchy, then I am going to my primary on 8/31/21 for follow-up after I finish the prednisone. My immune system is going crazy.


VAERS ID: 1632625 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-14
Onset:2021-08-21
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Chest discomfort, Induration, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: The Saturday after receiving the vaccine patient started that she was having a tightness in her chest. Through out the day her arm started swelling. Patient received a fever of 104. Patient stated the swelling is tryin to come around to the inside of her arm. Under the swelling is hard. Patient also stated that she received a blister.


VAERS ID: 1632626 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discomfort, Ear discomfort, Facial pain, Feeding disorder, Hyperaesthesia teeth, Hypoaesthesia, Hypoaesthesia oral
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Glaucoma (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Teeth sensitivity that progressed into pressure and pain on right side of face. Top lip and right side nostril have been numb since Sunday. Unable to bite into anything due to constant pressure felt on front teeth and ocasional right ear discomfort.


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