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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 441 out of 8,010

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VAERS ID: 1632637 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-18
Onset:2021-08-21
   Days after vaccination:156
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Ageusia, Anosmia, Chest pain, Cough, Fatigue, Feeling cold, Headache, Myalgia, Oropharyngeal pain, Pyrexia, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Fever, Chills, muscle aces, runny nose, sore throat, no smell or taste, headache, fatigue, cough, shortness of breath, chest pain, abdominal pain. Quarantine for the time recommended and isolate.


VAERS ID: 1632656 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Maryland  
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 FD 8448 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Blood test, Chest X-ray normal, Chest pain, Dyspnoea, Electrocardiogram normal, Headache, Magnetic resonance imaging thoracic normal, Musculoskeletal stiffness, Neck pain, Troponin T increased, Ultrasound chest, Ultrasound scan normal
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: Sunday, Aug 22nd - Urgent care - received EKG and Chest x-ray - both came back normal Monday, Aug 23rd - Cardiologist visit - chest ultrasound (normal) Bloodwork - Troponin T levels - 297 Tuesday, Aug 24th - Bloodwork - results unknown Admitted to hospital Multiple EKGs (all normal), Chest MRI - normal Bloodwork - Troponin levels .557, .33
CDC Split Type:

Write-up: Day 1 after vaccine: severe headaches, neck and back pain (constant all day) Day 2 after vaccine: severe chest pains, shortness of breath, neck stiffness (constant, all day)


VAERS ID: 1632667 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Florida  
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 FD84448 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Inappropriate schedule of product administration
SMQs:, Medication errors (narrow)

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

Write-up: Error: Booster Given Too Early-


VAERS ID: 1632686 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Alabama  
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 - / UNK - / -

Administered by: Work       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Chills, Diarrhoea, Nausea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow)

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

Write-up: Nausea, joint pain, persistent abdominal pain, chills, diarrhea, loose stools since the 24 hours post vaccination and has been going on for 5 days


VAERS ID: 1632751 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Pennsylvania  
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 - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Headache, Lip swelling, Pain in extremity, Rash, Rash papular, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: pruritic papular rash on nostril and lower lip, reported lower lip swelling. associated with headache, fatigue and arm soreness


VAERS ID: 1632806 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Unknown  
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 EW0191 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: Shortness of breath


VAERS ID: 1632842 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Florida  
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 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Cerebral infarction, Computerised tomogram head, Lacunar infarction, Mental status changes, Ultrasound Doppler, Urinary tract infection
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: clonidine, cyanocobalamin, eliquis, famotidine, losartan, memantine, phos-NaK, prednisolone, probiotic, simvastatin, allopurinol, escitalopram, ferrous sulfate, magnesium oxide, metoprolol succinate, spironolactone, sucralfate, vitamin D3,
Current Illness: atrial fibrillation, UTI, hyperlipidemia, dementia, hypertension, gastro-esophageal reflux disease, dysphagia, weakness, history of CVA in 2016
Preexisting Conditions: see above
Allergies: ace inhibitors, amlodipine, armour thyroid, aspirin, buspirone, donepezil, hydralazine, morphine, paxil, ritalin, synthroid
Diagnostic Lab Data: CT of the brain without contrast Carotid doppler This resident is currently in the hospital receiving treatment
CDC Split Type:

Write-up: This resident received the J&J vaccine on August 19, 2021. On Saturday, August 21, 2021 she began exhibiting signs of altered mental status. It was discovered that she had a urinary tract infection and was started on Macrobid. Her physician gave the order to transport her to the emergency room for further evaluation and treatment. It was discovered during her ER evaluation that she had suffered a subacute evolving lacunar infarct in the right corona radiata. The hospital notified this nurse for VAERS reporting.


VAERS ID: 1632857 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-29
Onset:2021-08-21
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ATROVENT INHALER, JANTOVEN, MESALAMINE, METOPROLOL, MONTELUKAST, OMEPRAZOLE, QVAR INHALER, TYLENOL
Current Illness: NONE
Preexisting Conditions: ALLERGIC RHINITIS, ASTHMA, CHRONIC COLITIS, DVT, ECZEMA, RENAL CYSTS, HEARING LOSS, ABSENT SPLEEN
Allergies: SULFA, ERYTHROMYCIN
Diagnostic Lab Data: 8/21/21 SARS-CoV-2 RNA (COVAS PCR test) POSITIVE
CDC Split Type:

Write-up: COVID DIAGNOSIS/HOSPITALIZATION AFTER BEING FULLY IMMUNIZED


VAERS ID: 1632891 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-12
Onset:2021-08-21
   Days after vaccination:221
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Cough, Diarrhoea, Dyspnoea, Fatigue, Headache, Myalgia, Nasal congestion, Nausea, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Labs COVID antigen test via nasal swab - COVID positive result
CDC Split Type:

Write-up: Patient fully vaccinated with Pfizer, dose 1 received on 12/22/2020 and dose 2 on 1/12/2021. Patient reported COVID symptoms of diarrhea, nausea, cough, shortness of breath, congestion, muscle aches, fatigue, headache, sore throat, chills, loss of taste and loss of smell starting on 8/21/21. Patient tested COVID positive on 8/23/21.


VAERS ID: 1632898 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Georgia  
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 / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Influenza, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu vaccine in 1998
Other Medications: Plaquenil, allopurinol, atorvastatin, paxil, temazepam, breo, aleve, benadryl, bystolic,
Current Illness: hbp, high cholesterol, asthma, arthritis, lupus
Preexisting Conditions: asthma, hbp, gout, lupus, arthritis
Allergies: amoxil, tylenol, iodinated dyes prilosec
Diagnostic Lab Data: none done for this incident
CDC Split Type:

Write-up: I developed flu symptoms, with a vey bad cough, low grade fever and chills the cough is very bad and unexpected. no problems with previous shot 1 and 2


VAERS ID: 1632924 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-02
Onset:2021-08-21
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Herpes zoster, Pain, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: Rash appeared on inner right thigh 8/21, approx 18 days after first shot. Second rash appeared on upper right buttocks 8/22. Both rashes blistered within 24 hours. Shingles was diagnosed via doctor visit and Valtrex was prescribed. At time of reporting, three separate patches of shingles exist. Inner right thigh, right knee, and upper right buttocks. Pain of the blistered areas is intermittent and moderate.


VAERS ID: 1632931 (history)  
Form: Version 2.0  
Age: 44.0  
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 FC3182 / UNK LA / -

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

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

Write-up: Left arm Injection site swelling and discoloration increasing in size 6 days after 2nd Pfizer dose


VAERS ID: 1632935 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
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 - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Echocardiogram 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? Yes
ER Visit? No
ER or Doctor Visit? No
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: Patient developed myocarditis with acute chest pain and peak troponin of 11. He required 2 nights of hospitalization. He symptomatically improved within 48 hours with troponin trending down to 6. He had normal echo.


VAERS ID: 1633014 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-01
Onset:2021-08-21
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 04/01/2021 / 2 - / -

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

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

Write-up: Covid 10 positive 8/22/21 with 8/21/21 onset


VAERS ID: 1633050 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-21
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Headache, Hypoaesthesia, Injection site rash, Lymphadenopathy
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: rash on injection site and knee pain and leg numbness(right side) and swollen lymph nodes on both armpits and light headache still present. rash lasted 3 days pain in knee and armpit still present


VAERS ID: 1633131 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: California  
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 FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: diabetes,high blood pressure
Allergies: none
Diagnostic Lab Data: do not know.
CDC Split Type:

Write-up: tiredness and mild fever went to hospital and got out next day.


VAERS ID: 1633624 (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: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (narrow)

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

Write-up: Ringing in left ear - starting approximately 38 hours after the injection and continues since.


VAERS ID: 1633770 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-01
Onset:2021-08-21
   Days after vaccination:232
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Nasal congestion, SARS-CoV-2 test positive, Sinus congestion
SMQs:, Taste and smell disorders (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oral Birth Control - Sprintec
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Amoxicillin Sulfa
Diagnostic Lab Data: Positive COVID PCR yesterday (8/24/21)
CDC Split Type:

Write-up: I tested Positive for Covid yesterday (8/24/21) and am experiencing mild symptoms including head congestion, nasal stuffiness, and loss of taste & smell.


VAERS ID: 1633806 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
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 (MODERNA)) / MODERNA 939902 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products, 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: Both patient and guardian came in to get vaccine. Asked age, guardian said 30 years instead of 13 years. Didn''t show card and patient was given moderna vaccine. Upon preparing passport card, we realized patiend has Pfizer as first shot and age not applicable to the Moderna vaccine. On questioning guardian, he said that "my English not good"


VAERS ID: 1633980 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-01
Onset:2021-08-21
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 UN / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

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

Write-up: Patient admitted to hospital with PE


VAERS ID: 1634868 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-21
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Suspected 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:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient did not have any drug abuse/illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210846436

Write-up: SYMPTOMS OF COVID-19; This spontaneous report received from a consumer concerned a 29 year old female. The patient''s weight was 165 pounds, and height was 65 inches. The patient''s concurrent conditions included: alcohol non-user, and non smoker, and other pre-existing medical conditions included: The patient did not have any drug abuse/illicit drug use. The patient experienced drug allergy when treated with amoxicillin, and clarithromycin for drug used for unknown indication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 041A21A and expiry: unknown) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 21-AUG-2021, the patient experienced symptoms of covid-19. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from symptoms of covid-19. This report was non-serious.


VAERS ID: 1634869 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-21
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0421A21 OR 042A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Blood pressure measurement, Chills, Computerised tomogram, Eye pain, Full blood count, Headache, Injection site pain, Lymphadenopathy, Pain, Pain in extremity, Paraesthesia, Ultrasound scan
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: Swollen lymph nodes (Patient developed lymph node swelling of both armpits last year when received his flu shot (but not nearly as bad as the Covid vaccine)); Comments: The patient had no known allergies. The patient had no history of drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data: Test Date: 20210822; Test Name: CT scan; Result Unstructured Data: Negative for blood clot; Test Date: 20210822; Test Name: CBC; Result Unstructured Data: Normal; Test Date: 20210822; Test Name: Blood pressure; Result Unstructured Data: 220/110 mmHg; Test Date: 20210822; Test Name: Blood pressure; Result Unstructured Data: 168/98 mmHg; Test Date: 20210822; Test Name: Ultrasound scan; Result Unstructured Data: Lymphatic mass in the left axilla
CDC Split Type: USJNJFOC20210846459

Write-up: TINGLING SENSATION/ PINS AND NEEDLES IN THE FINGERS OF LEFT ARM; JOINT ACHES; EYES HURTED; BODY ACHES; ARM SORE; CHILLS; A BASE BALL SIZE LYMPHATIC MASS IN THE LEFT AXILLA; SLIGHT HEADACHE; PAINFUL INJECTION; This spontaneous report received from a patient concerned a 48 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included: lymph node swelling of both armpits, and concurrent conditions included: non alcohol user, and non smoker, and other pre-existing medical conditions included: The patient had no known allergies. The patient had no history of drug abuse or illicit drug use. The patient was previously treated with influenza vaccine for prophylactic vaccination. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 0421A21, expiry: UNKNOWN) dose was not reported, administered on 21-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 21-AUG-2021, the patient experienced painful injection. On 22-AUG-2021, the patient experienced eyes hurted. On 22-AUG-2021, the patient experienced body aches. On 22-AUG-2021, the patient experienced arm sore. On 22-AUG-2021, the patient experienced chills. On 22-AUG-2021, the patient experienced a base ball size lymphatic mass in the left axilla. On 22-AUG-2021, the patient experienced slight headache. Laboratory data included: Blood pressure (NR: not provided) 220/110 mmHg, 168/98 mmHg, CBC (NR: not provided) Normal, CT scan (NR: not provided) Negative for blood clot, and Ultrasound scan (NR: not provided) Lymphatic mass in the left axilla. On 23-AUG-2021, the patient experienced tingling sensation/ pins and needles in the fingers of left arm. On 23-AUG-2021, the patient experienced joint aches. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chills on 22-AUG-2021, was recovering from painful injection, and arm sore, had not recovered from body aches, slight headache, eyes hurted, a base ball size lymphatic mass in the left axilla, and joint aches, and the outcome of tingling sensation/ pins and needles in the fingers of left arm was not reported. This report was non-serious.


VAERS ID: 1636113 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-04
Onset:2021-08-21
   Days after vaccination:109
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW1076 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Tested positive for COVID-19


VAERS ID: 1636114 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG4421 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Chest pain, Diarrhoea, Dizziness, Dyspepsia, Dyspnoea, Gastrooesophageal reflux disease, Headache, Muscle spasms, Nausea, Neck pain, Pain, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins, High BP medication, High cholesterol medication
Current Illness: none
Preexisting Conditions: high blood pressure, cholesterol
Allergies: aspirin, penicillin
Diagnostic Lab Data: Went to the GP on Tuesday (24/8/2021), and he prescribed some meds for Gastro
CDC Split Type:

Write-up: 12 - 18 hours after getting the second dose of the vaccine, my mother started feeling dizzy, nauseous, severe headache and full body pains. Then it moved to chest pains, reflux and heartburn, spasms in her neck and pain in her joints. Shortness of breath, hand shakes (trembling), then stomach cramps started as well with some diarrhea. it is now day 6 of these side effects, and only starting to subside now.


VAERS ID: 1636122 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Ammonia normal, Blood test normal, Blood thyroid stimulating hormone normal, Cognitive disorder, Dizziness, Feeling abnormal, Full blood count normal, Hyperhidrosis, Liver function test normal, Metabolic function test, Pain in extremity, Tachycardia, Urine analysis normal, Vitamin B12 normal, Vitamin D
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec 10mg Vitamn D 1000 IU Vitamin C 500mg Zinc 15mg
Current Illness:
Preexisting Conditions: Asthma
Allergies: SULFA seasonal allergies
Diagnostic Lab Data: 8/25 - blood work (CBC, BMP, LFTs, ammonia, Vit B12, Vit D, TSH, UA, ) All blood work currently resulted has been WNL.
CDC Split Type:

Write-up: Approximately 15 hours after injection, felt very mild dizziness and sore arm. Arm soreness went away within 24 hours, but dizziness progressively worsened. By Day 3 dizziness was accompanied by cognitive impairment/ brain fog, profuse sweating with temp of 99.0 - 99.5 deg F and tachycardia to 120s upon standing with no change in blood pressure and resting HR in the 60s. As a Registered Nurse, I was unable to care for patients in this condition. Contacted PCP. Symptoms intensified on Days 4-5. Blood work done, pending results. Follow up care to be provided by PCP. Will not be receiving second vaccine.


VAERS ID: 1636176 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Myalgia, Oropharyngeal pain, Pruritus, Pyrexia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Systemic: Allergic: Itch (specify: facial area, extremeties)-Mild, Systemic: Allergic: Rash Generalized-Mild, Systemic: Chills-Mild, Systemic: Fever-Mild, Additional Details: patient also complained of sore throat, muscle aches, fever and chills which started on Sunday 08/22/21. On Saturday 08/21; she reported initial signs of rash on both arms and chest area which still has not cleared up. currently taking Benadryl OTC orally and topically for rash on arms and chest area.


VAERS ID: 1636373 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (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: Xtandi, Xyxal, Bencair/HCT
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient experienced ringing in both ears 3 days after vaccination. Episodes only lasted for a minute at a time couple times per day. Lasted for 3 days.


VAERS ID: 1636505 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-04
Onset:2021-08-21
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Fatigue, Oxygen saturation decreased, SARS-CoV-2 test positive
SMQs:, Acute central respiratory depression (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Chronic conditions include autism, schizophrenia, epilepsy, asthma, obesity
Allergies:
Diagnostic Lab Data: Positive for SARS-CoV-2 by PCR from specimen collected 8/19/21
CDC Split Type:

Write-up: Presented to ED with fatigue, increased O2 needs


VAERS ID: 1636562 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-13
Onset:2021-08-21
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 05E21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Rash, Rash erythematous, Rash pruritic, Skin warm
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: Multi Vitamin, Caltrate-Calcium/D3, Qunol CoQ10, Orgain Collage Peptide Powder
Current Illness: none
Preexisting Conditions: none Hx:breast cancer 1994, L mastectomy-no chemo or radiation, surgical intervention only treatment
Allergies: Levaquin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Developed itchy, red , painful rash 2.5 inch width 3 inch length, very hot to touch Each day increased in size to max of 3 inch width 6 inch length Redness decreasing day 4-5 still present but seems to be resolving as of today 8/26/21


VAERS ID: 1636600 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Lymphadenopathy, Respiratory tract congestion
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Levathoroxien, Gabapentin, Cavorgolein
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 2nd dose of Phizer 08/20/2021, started experiencing symptoms 08/21/2021 of swollen lymphoids and congestion. Primary visit 08/23/2021 treated with Ibuprofen for swelling, follow-up 2 weeks.


VAERS ID: 1636604 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 3 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pyrexia, Urinary incontinence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibrance 100 mg Anastrozole 1mg
Current Illness:
Preexisting Conditions: Cancer
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Got vaccine Friday. Very feverish all day Saturday and Unable to control bladder. Sunday I was fine.


VAERS ID: 1636617 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Echocardiogram normal, Electrocardiogram normal, Illness, Myocarditis, Painful respiration, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Cough, variant asthma
Allergies: nka
Diagnostic Lab Data: Results as of 8/26/2021 09:08 8/21/2021 08:52 TROPONIN I: 1.99 (H) 8/21/2021 15:09 TROPONIN I: 2.37 (H) 8/21/2021 21:22 TROPONIN I: 19.51 (H) 8/22/2021 09:08 TROPONIN I: 19.73 (H) 8/22/2021 19:40 TROPONIN I: 22.17 (H) 8/23/2021 02:25 TROPONIN I: 23.67 (H) 8/23/2021 08:24 TROPONIN I: 15.96 (H) 8/23/2021 14:05 TROPONIN I: 14.02 (H) 8/23/2021 19:45 TROPONIN I: 11.45 (H) 8/24/2021 02:20 TROPONIN I: 6.91 (H) 8/24/2021 08:14 TROPONIN I: 3.65 (H) 8/25/2021 04:30 TROPONIN I: 0.91 (H)
CDC Split Type:

Write-up: Pt is a previously healthy 12 Y 4 M male who received his second COVID Pfizer vaccine on 8/19/21 presenting with acute onset chest pain on the morning of 8/21. He describes it as sharp, worse with inspiration, and on the left side of chest, 10/10 at worse and now at 0/10. Initial troponin was 1.99 with a normal EKG/Echo. He was admitted to local HCF and was treated with acetaminophen, ibuprofen, and toradol; but around 1700-1800, his chest pain got worse. Repeat troponin was significantly increased to 19.5. Regional cardiology recommended he be transferred to a facility with specialty. Pt was transferred to another HCF on 8/22 Suspect myopericarditis 2/2 covid vaccine, less likely myocarditis 2/2 viral illness as no sign/sx of infection. Also endorsed passive SI to multiple team members, to be assessed by psychology. Neuro: - pain: ibuprofen 600mg TID with meals, pepcid 20mg PO qHS while on ibuprofen. - discharge with total 2 week course ibuprofen and pepcid CV: - Chest pain resolves with doses of ibuprofen. - Echo and EKG normal on 8/21/21. - Troponin peaked at 23.67, downtrended and was 0.91 at discharge.


VAERS ID: 1636622 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Electrocardiogram, Fatigue, Heart rate increased, Palpitations, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: EKG 08/21/2021 Chest X-Ray 08/21/2021 Blood Work 08/21/2021
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 103.1 fever, Heart Palpations, high heart rate, and fatigue. Cardiologist recommended, Appt. 09/01/2021. Still continuing to experience symptoms.


VAERS ID: 1636677 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fluid retention, Headache, Hyperhidrosis, Hypotonia, Mental impairment, Muscle fatigue, Pyrexia, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Continuong after 1 week: Massive swelling of left side of body, liquid build up of left side of body, muscle fatigue, fever, chills, excessive sweating, head pain, diminished mental capacity, limited muscle capacity


VAERS ID: 1636685 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-21
Onset:2021-08-21
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID 19 positive on 8/21/21.
CDC Split Type:

Write-up: Patient admitted to hospital on 8/21/21 for pneumonia due to COVID-19 virus. Patient had received 2 Moderna vaccines, on 4/17/21 and 5/21/21.


VAERS ID: 1636797 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Influenza like illness, Myalgia, Palpitations, Peripheral swelling, Pruritus, Pyrexia, Swelling, Swelling face, Throat tightness
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zimtat One a Day Women''s, Caltrate, Baby Aspirin
Current Illness:
Preexisting Conditions: Epilepsy, Sick Sinus Syndrome Hypoglycemia
Allergies: Penicillin, Doxycycline Hyclate, Codeine Opiate Derivatives, Bee and Ant Venom
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: Forty minutes after getting the vaccine I was in the car and I felt like I was having heart palpitations. I then started to itch all over and I noticed that my arms were swelling. My chest started to swell too and my face was huge. My throat was starting to close, and the itching was intense but I could not really feel where I was scratching. I drove straight to the Urgent Care. I was not treated quickly with Benadryl so I took some myself. They advised Hydroxyzine. The swelling started to come back after the Benadryl started to wear off and I took two more. The next day I took more Benadryl and the Hydroxyzine. I still have no feeling in my chest after almost one week. The numb feeling is mostly close to the area of the shot and most of the swelling went down. I did have flu-like symptoms the following day which lasted for three days. I had a fever of 103, muscle aches and some diarrhea.


VAERS ID: 1636829 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-18
Onset:2021-08-21
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH E9264 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN9581 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: doxycycline (VIBRA-TABS) 100 mg tablet Take 1 tablet (100 mg) by mouth 2 times a day for 10 days albuterol HFA (ALBUTEROL, VENTOLIN BRAND,) 108 (90 Base) MCG/ACT inhaler INHALE 1-2 PUFFS BY MOUTH EVERY 4 HOURS AS NEEDED montelukast (SINGULA
Current Illness: NONE
Preexisting Conditions: Paroxysmal atrial fibrillation Bradycardia Atrial flutter Pacemaker Asthma OSA (obstructive sleep apnea) Mild persistent asthma Vasomotor rhinitis Chronic nasal congestion Benign essential tremor GERD (gastroesophageal reflux disease) Tear of medial meniscus of left knee Age-related nuclear cataract, left eye Age-related nuclear cataract, right eye
Allergies: nka
Diagnostic Lab Data: positive covid PCR on 8/25/21
CDC Split Type:

Write-up: patient developed covid-19 infection 8/21/21


VAERS ID: 1636830 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal
SMQs:, Anticholinergic syndrome (broad), Dementia (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? Yes
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: Last Friday, I have experience dizziness and get this sensation I am about to fall down.


VAERS ID: 1636839 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / UNK LA / IM

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

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

Write-up: Patient presented to community clinic requesting a Covid-19 vaccination. He reported that he had not previously received a Covid-19 vaccination. Incentives were being offered.


VAERS ID: 1637003 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-21
Onset:2021-08-21
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest X-ray abnormal, Decreased appetite, Dyspnoea, Lung opacity, Nausea, Pyrexia, SARS-CoV-2 test positive, Vaccine breakthrough infection, Wheezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril tab daily Multivitamin daily Pravastin Sodlum (Pravachol) tab daily
Current Illness: N/A
Preexisting Conditions: Essential hypertension Hyperlipidemia Hypogonadism
Allergies: Atorvastatin
Diagnostic Lab Data: COVID-19 PCR via NP, 8/12/21 Positive Chest x-ray (performed prior to admit to this hospital), 8/21/21 with mild patchy diffuse ground glass opacities
CDC Split Type:

Write-up: Pt received first dose of Moderna COVID-19 vaccine on 4/3/21, second dose on 5/1/21. Lot numbers not specified in electronic medical record (EMR). Pt was admitted to hospital 8/21/21 after initial COVID diagnosis via ER on 8/8/21. Pt admitted with intermittent breakthrough fevers as high as 102 degrees F. Persistent nausea, decreased appetite, SOB/wheezing. No vomiting. Pt admitted after substantial SOB on 8/21/21. Admitted to gen med, discharged home 8/23/21.


VAERS ID: 1637036 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-13
Onset:2021-08-21
   Days after vaccination:130
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 1 - / -

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

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

Write-up: Tested PCR Covid-19 positive 8/23/21 with onset 8/21/21


VAERS ID: 1637096 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Dizziness, Dyspnoea exertional, Injected limb mobility decreased, Nausea, Pain in extremity, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Saturday morning, I woke up with severe pain in my Left arm and was unable to raise arm above my head. I took ibuprofen and that resolved by the afternoon. Since Saturday night around 9 pm, I have been experiencing blurred vision, dizziness, nausea, back pain, joint pain and shortness of breath on exertion


VAERS ID: 1637131 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-08
Onset:2021-08-21
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: NKA
Diagnostic Lab Data: PCP visit, urgent care visit. Neurology referral, consultation pending.
CDC Split Type:

Write-up: Seizure 2 weeks after first dose of vaccine. No history of seizures.


VAERS ID: 1637141 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-16
Onset:2021-08-21
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Anosmia, Body temperature increased, Cough, Diarrhoea, Headache, Nasal congestion, Pain, Rhinorrhoea, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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? No
Previous Vaccinations:
Other Medications: vegan/pescatarian diet, elderberry, sea moss and high dose vitamin C
Current Illness: none
Preexisting Conditions: none
Allergies: allergic to latex and sesame
Diagnostic Lab Data: I took a rapid Covid test today and it came back negative. Still awaiting the results of the PCR test.
CDC Split Type:

Write-up: first 72 hours I ran a temperature of 102. Had severe abdominal cramps and loose stool. Headaches, body aches, severe cough, stuffy and runny nose. Then on Saturday August 21st, those symptoms went away and I noticed that I lost my ability to smell. Even now , almost a week later, I still cannot smell. My nostrils feel ike their boring. I also developed a sty over my right eye on Thursday, August 19th. As of today it is finally starting to drain.


VAERS ID: 1637328 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-26
Onset:2021-08-21
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Catheterisation cardiac abnormal, Dyspepsia, Electrocardiogram, Gastrooesophageal reflux disease, Myocardial infarction, Stent placement
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific dysfunction (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: Aortas, Vitamin D
Current Illness:
Preexisting Conditions: COPD, osteoporosis
Allergies: Bees
Diagnostic Lab Data: EKG
CDC Split Type: vsafe

Write-up: I wake on Saturday I okay. I eat oatmeal. I felt like I was having a heart attack. I had really bad heart burn. I went to the ER. They did EKG. Thought it was acid reflux. I did not help. So, they did another EKG, which showed that there was something going on with my heart. They decide to do a heart cath and two stents in.


VAERS ID: 1637351 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-15
Onset:2021-08-21
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: when pt received vaccine, it was redden and swallen a bit, then it was getting better, but around 5 days later, it started swallen again and getting reaaly big, it was itch all the way


VAERS ID: 1637591 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: RECEIVED 2ND DOSE OF SERIES AT DAY 14 INSTEAD OF DAY 21


VAERS ID: 1637819 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052C21A / 1 LA / SYR

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

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

Write-up: Broke out in hives on left leg. Had other small area with hives throughout the body but mainly left leg.


VAERS ID: 1638460 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Feeling abnormal, Influenza like illness, Pain
SMQs:, Dementia (broad)

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

Write-up: Took J&J Vaccine Saturday Not allowed to get out of your car for five minutes because of potential sides. Not allowed to drive away for 20 minutes because of potential sides. 12 hours later, Saturday night, I''m driving along, and my body starts to shut down with chills, aches, and flu-like symptoms. Sunday evening, I''m just meh, and feel slightly better. Monday laying on the couch, not horrible but not great. Tuesday night rolls around, and I''m taken out yet again with ''flu-like symptoms. Wednesday, my flu-like symptoms hitting me hard. Currently popping Asprin and Theraflu and am ready to call it a night yet again.


VAERS ID: 1640246 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Dizziness, Fatigue, Headache, Hyperhidrosis, Hypoacusis, Nasal congestion, Productive cough, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Two separate covid tests administered on 8/24 and 8/26. Both with negative results.
CDC Split Type:

Write-up: Headaches, fatigue, productive cough, nasal congestion, loss of smell and taste, diminished hearing, excess sweating, dizziness. Mild symptoms 24 hours post vaccine. Severe symptoms from 48 hours through day 6 post vaccine.


VAERS ID: 1640681 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (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: Zoladex injection 8-21-21
Current Illness: None
Preexisting Conditions: Metastatic breast cancer, diabetes, obesity
Allergies: Kiwi
Diagnostic Lab Data:
CDC Split Type:

Write-up: Soreness at injection site, extreme fatigue 3 days


VAERS ID: 1640727 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Wrong Dose of Vaccine - Too Low-


VAERS ID: 1640749 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA FD8448 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Loss of personal independence in daily activities, Vertigo positional
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (narrow)

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

Write-up: Systemic: Dizziness / Lightheadness-Severe, Systemic: vertigo exacerbated by positional changes-Severe, Additional Details: Pt did not have this reaction to the prior two doses. Instructed mom to bring pt to be evaluated to r/o inner ear issues, cardiac issues, etc. Pt had a rheumatologist appointment a few days after the vaccine and issue was not directly addressed by provider. Problem still persists even almost a week later. Pt unable to perform a fair amount of ADLs.


VAERS ID: 1640980 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (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: Lyrica; Plaquenil; Otezla; Prednisone; Losartan; Nifedipine; Adulate; Imuran; TRICOR; Pristiq; Furosemide; Klonopin; Oxycodone; Stanyel
Current Illness: no
Preexisting Conditions: Lupus; Arthritis; Psoriasis; Diabetes
Allergies:
Diagnostic Lab Data: No
CDC Split Type: vsafe

Write-up: Low grade fever, joint pain, fatigue.


VAERS ID: 1640986 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Electrocardiogram normal, Heart rate increased, Heart rate normal, Palpitations, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Finasteride 1mg 1tab daily. (Started taking July 24, 2021)
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NKDA, NKA
Diagnostic Lab Data: EKG: sinus rhythm HR 63 bpm Normal variant of ECG
CDC Split Type:

Write-up: Patient states he received Pfizer vaccine dose #1 19AUG2021. Palpitations started 21AUG2021 due to heart rate feeling faster and more forceful when laying down before bed and after eating food. Denies pain but has discomfort localized at chest when laying down. Denies radiation. Symptoms wake patient out of sleep one time per night. Denies nausea/vomiting. Denies numbness or tingling. Denies pain in chest, jaw, or arms. Denies similar symptoms. EKG completed 27AUG2021 with normal results and HR 63. Patient has an appointment to see surgeon for a referral to cardiology. Patient informed to follow up if symptoms worsen and as needed.


VAERS ID: 1641067 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Fatigue
SMQs:, Anaphylactic reaction (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: albuterol (2.5 MG/3ML) 0.083% IN NEBU 3 mL by Nebulization route every 4 hours as needed for Wheezing. albuterol 1.25 MG/3ML IN NEBU take 3 mL by inhalation every 4 hours as needed for Wheezing. albuterol 108 (90 BASE) MCG/ACT IN AERS (Disc
Current Illness: none noted
Preexisting Conditions: none noted
Allergies: No known allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 3 hours post vaccine patient complained of chills and fatigue. 48 hours post vaccine patient developed a cough.


VAERS ID: 1641211 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Write-up: Right leg has been numb for a week. From knee to ankle, mainly my shin area. Not asleep with the ?pins and needle? sensation but very very numb.


VAERS ID: 1641214 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / N/A - / -

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

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

Write-up: throat swelling


VAERS ID: 1641229 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 AGE 16 WAS GIVEN MODERNA VACCINE


VAERS ID: 1641250 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Full blood count, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: vaginal bleeding


VAERS ID: 1641296 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-26
Onset:2021-08-21
   Days after vaccination:117
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Acute hypoxemic respiratory failure due to COVID-19


VAERS ID: 1641402 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-06
Onset:2021-08-21
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough
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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: history of hypertension, hiatal hernia, chronic low back pain, status post laminectomy, shoulder surgery and yesterday had laparoscopic left knee surgery, nonsmoker
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient came to ED with chief complaint of cough, found to have COVID-19. She had received only one dose of COVID-19 vaccine on 8/6/21 and was admitted to the hospital on 8/21/21. During her 3 day stay, she did not require any oxygen support and physician noted she had no respiratory issues at time of discharge home.


VAERS ID: 1641403 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Joint injury, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Arthritis (broad)

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

Write-up: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-


VAERS ID: 1641564 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Condition aggravated, Dyspepsia, Gastrointestinal disorder, Headache, Inflammation, Lymph node pain, Lymphadenopathy, Nausea, Respiratory symptom
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 1st dose headaches and pain in arm and sinus, 2nd headache only
Other Medications: hydroxychloroquine - 200 milligrams; 2 tablets and prednisone 5 mg; multivitamins; Vit D3
Current Illness: no
Preexisting Conditions: autoimmune disease; fibromyalgia, asthma
Allergies: penicillin and prednisone
Diagnostic Lab Data: None.
CDC Split Type: vsafe

Write-up: Headaches, this sat chest pain and tightening, gastro issues and heartburn. Doctor on 8/25/2021 said was a reaction from the shot. Bronchitis like symptoms. left arm my lymph nodes painful and swollen. Nausea. Doctor said the vitals were good. Inflamed.


VAERS ID: 1641585 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal distension, Abdominal pain upper, Asthenia, Blood test, Diarrhoea, Fatigue
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: senior multivitamin and calcium supplement from walgreens
Current Illness: in remission from ALL from 10/20 but on maintenance meds and chemo
Preexisting Conditions: ALL leumemia, pancreatic insufficiency, hypothyrodism
Allergies: penicillin, sulfa drugs, sulfites in food, oranges, cashew nuts
Diagnostic Lab Data: None. I saw my nurse practioner yesterday for routine blood tests related to my maintenance medications and chemo to keep my leukemia from returning but nothing for the Covid diarrhea which I told her about.
CDC Split Type:

Write-up: Diarrhea and stomach pain and bloating after first Pfizer shot 7/30 which went away but diarrhea came back 8/21 the day after second Pfizer shot and I still have it. My oncologist said it couldn''t be from the vaccine. I''m not weak or tired but had to stop taking Immodium because it made me dizzy. I still have loose stools as of today and was told by my nurse practioner yesterday to eat more potassium rich foods which is difficult with diarrhea.


VAERS ID: 1641590 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anosmia, Dyspnoea, Myalgia, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Transplant recipient, diabetic
Allergies:
Diagnostic Lab Data: Negative Covid test, patient told by ER that it was likely just a severe adverse reaction 08/25/2021
CDC Split Type:

Write-up: Muscle pain, Shortness of Breath, sore throat, loss of smell, low fever starting the day following vaccination leading to ER visit on 08/25/2021


VAERS ID: 1641616 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Unknown  
Vaccinated:2020-12-30
Onset:2021-08-21
   Days after vaccination:234
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: No adverse event
SMQs:

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: None stated.


VAERS ID: 1641742 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-12
Onset:2021-08-21
   Days after vaccination:101
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Pericarditis, Pleurisy
SMQs:, Systemic lupus erythematosus (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pleurisy/pericarditis


VAERS ID: 1641786 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 developed redness and swelling at site of injection (left arm). Symptoms persists after 6 days of administration.


VAERS ID: 1641793 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Cold sweat, Lethargy, Loss of consciousness, Tremor, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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: Claritin
Current Illness: Gluten allergy
Preexisting Conditions: N/A
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Client came to the Community Center Back to School Fair and received a Covid-19 vaccination. Approximately 5 minutes after receiving the vaccine she sat down, did a full body extention, then lost consciousness. Staff gathered to tend to the client. Client regained consciousness. Cold towels were placed on clients head and neck. S/S include: Severe cold sweats, weakness, vomiting, shaking, lethargic. 911 was called at approximately 12:10. EMT''s assessed the client. BP=108/72. Blood Sugar 144. Oriented to person, place, and time. Client refused to go to hospital. Clieny waited approximately 20 minutes before attempting to leave. Once in the car, the client continued to throw up. Informed clients partner to watch for dehydration and to go to the emergency room if symptoms continue.


VAERS ID: 1641836 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site swelling, Pruritus
SMQs:, Anaphylactic reaction (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: ESTRADIOL, HYDROCHLOROTHIAZIDE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: n/a
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient stated having covid like symptoms with intense swelling /redness in the injection arm. on 8/27 pt presented with red patch of swelling on the arm down to about the elbow. pt stated itching but was improving from the day of injection.


VAERS ID: 1642255 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-14
Onset:2021-08-21
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site mass, Injection site pruritus, Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 known
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 7 days after the injection- my arm started becoming really itchy and swelled up. There was a hard lump at injection site and it was itchy for a few days. Again, it did not start until 7 days after my first Moderna shot.


VAERS ID: 1642279 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Condition aggravated, Impaired work ability, Palpitations, Panic attack
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Buspar, xanax, lisinopril
Current Illness: none
Preexisting Conditions: hypertension, anxiety
Allergies: no known allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: starting 2 days after the vaccine pt reported severe anxiety, panic attack, and heart racing, checked blood pressure, with a reading of 200/100, unable to work because of increased anxiety and panic attacks, on 8/23/21 was the first visit to the clinic to report symptoms. On 8/27/21 pt reported to the clinic for the same reason, panic attacks are not improving and wants a referral and more time off, states he is not going to be able to work due to his panic and anxiety. Pt reports feeling good and never having panic attacks until the vaccine.


VAERS ID: 1642496 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 3 RA / IM

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

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

Write-up: Red warm swelling spot in injection side arm (right) that is warm to the touch and has traveled from injection site area.


VAERS ID: 1642670 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Nodule
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: Hydrochlorothiazide
Current Illness: None
Preexisting Conditions: Htn
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Knots under both arms and in both breast


VAERS ID: 1642852 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-21
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: HYPERTENSION
Allergies: NONE
Diagnostic Lab Data: EMERGENCY ROOM VISIT WITH APPROPRIATE TESTING AND TREATMENT.
CDC Split Type:

Write-up: PATIENT HAS NOW TESTED POSITIVE FOR COVID 4 DAYS AFTER RECEIVING HIS JOHNSON & JOHNSON VACCINE AND IS HAVING A DIFFICULT CLINICAL COURSE THAT IS DEVELOPING A SARS-LIKE ILLNESS.


VAERS ID: 1642963 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-21
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Suspected COVID-19, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210847490

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient concerned a male of unspecified age, race and ethnicity. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient experienced drug allergy when treated with amoxicillin, and clarithromycin. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration not reported, batch number: Unknown, expiry date was not reported) dose was not reported, frequency 1 total, administered on APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 21-AUG-2021, the patient experienced suspected covid-19 infection. On an unspecified date, the patient experienced suspected clinical vaccination failure. The patient experienced symptoms cough, sore throat, and runny nose on 21-Aug-2021. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from suspected covid-19 infection, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This case, from the same reporter is linked to 20210846436. This report was associated with product quality complaint:90000191006; Sender''s Comments: V0: 20210847490-covid-19 vaccine ad26.cov2.s-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1645953 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-28
Onset:2021-08-21
   Days after vaccination:54
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Angiogram abnormal, Anticoagulant therapy, Chest pain, Computerised tomogram thorax abnormal, Deep vein thrombosis, Dyspnoea, Haemoptysis, Myocardial strain, Painful respiration, Pulmonary embolism, Ultrasound Doppler
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine 10mg qd HCTZ 12.5mg qd
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: LE US duplex and CTA PE (see results above)
CDC Split Type:

Write-up: Patient presented with 1 week of chest pain, hemoptysis, and worsening dyspnea and pain w/ inspiration over the past week. Found to have extensive occlusive DVT within the left common femoral, femoral, popliteal and posterior tibial veins on US Duplex and Acute bilateral pulmonary embolism with moderate to large amount of clot burden with suggestion of mild right heart strain. Pt had no personal history or family history of prior venous embolisms or clotting disorders. Pt was healthy and active with no inciting factors save for the J&J covid-19 vaccine. pt was admitted to the hospital and started on a heparin gtt with further workup pending.


VAERS ID: 1651265 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-13
Onset:2021-08-21
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Palpitations, Vaccination site swelling, Vaccination site warmth
SMQs:, Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Sexual dysfunction (broad)

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

Write-up: Swollen, hot vaccination site. Rash, numbness in arm. Heart palpitations.


VAERS ID: 1651412 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

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

Write-up: The patient presented to the pharmacy to receive the Janssen vaccine. He verbally indicated he had never received a COVID-19 vaccine in the past, as well as indicated such on the consent form. After administration of the vaccine, pharmacy personnel discovered upon reporting to the online vaccine registry that he previously received the 2-dose Pfizer vaccine series on 03/25/21 and 04/15/21. Per current recommendations, this patient was not eligible to receive the Janssen vaccine at this time.


VAERS ID: 1651503 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood magnesium, Blood phosphorus, Blood test, Computerised tomogram head, Differential white blood cell count, Dizziness, Dysgeusia, Electrocardiogram, Hypertension, Laboratory test, Nausea, Syncope, Taste disorder, Troponin, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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: Topiramate, Famotidine, Tylenol
Current Illness:
Preexisting Conditions: Migraine, Menieres Disease
Allergies: Morhine, Bee Venom
Diagnostic Lab Data: EKG 12, Blood Labs white blood cell differential, CBC, Troponin, Phosphate, Magnesium, Chemistry panel, CT head scan, IV fluids, released with medications Meclazine an Zofran 8/24/21
CDC Split Type:

Write-up: Fainting spells occured the following day and persisted over the course of 3 days. Food not tasting normal, this symtom lasted a week. Bad taste in my mouth- metallic, lasting 3 days. Hypertension, this symtom is ongoing off and on. I typically have low Blood Pressure. Dizzy spells- this symtom persists still. Vomiting- this symtom persists still. Nausea- this symtom persists still.


VAERS ID: 1651638 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-13
Onset:2021-08-21
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bupropion, MVI, Estroven, calcium, vit D & E, turmeric
Current Illness: None
Preexisting Conditions: GERD
Allergies: Declomycin Ciprofloxacin
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had my first Moderna vaccine on August 13th. On August 21st, I developed a painful, red, swollen nodule about an inch in diameter at the injection site. Fairly deep on palpitation. It also had what looked like tiny red blisters on top. Today, 8-22-21, it is still painful and I have a headache.


VAERS ID: 1652763 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abnormal dreams, Chills, Fatigue, Hallucination, Headache, Hyperhidrosis, Hypersomnia, Nausea, Pain, Pyrexia, Sleep disorder, Somnambulism
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (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: Syeda birth control, Armor thyroid, Montelukast, Vyvanse, Delta-8 CBD
Current Illness: None
Preexisting Conditions: Thyroid issues, seasonal allergies
Allergies: Chocolate, codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: I received the injection around 11:30am on Saturday, 8/21. Beginning about 7pm that evening, I started feeling very fatigued and soon after began having chills. I went to bed around 9pm and woke up several times during the night with intense nausea. I also experienced waves of chills and sweating all night and very vivid, realistic dreams. The dreams were so real and mundane that I?m not entirely certain still if they were dreams or me sleep walking/hallucinating. The next day I had extreme fatigue and both head and body aches - I felt as though I had been in a car accident. No additional nausea or chills/sweats all day Sunday, but just very intense fatigue and all over body aches. I took my temperature under my arm with my baby?s thermometer (it was all I had) and it read 104. I?m not certain of the accuracy though. I took extra strength Tylenol as frequently as the directions allowed and slept for most of the day and all night Sunday. Once I woke up Monday morning around 9am, I felt completely normal again.


VAERS ID: 1652771 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-01-19
Onset:2021-08-21
   Days after vaccination:214
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: I feel like I''m having tendon problems since having the vaccines. I thought I should let someone know.


VAERS ID: 1653758 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Myocarditis
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: inflammation of heart muscle, chest pain. Happened second day after vaccination. Symptoms resolved seventh day after vaccination.


VAERS ID: 1653779 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-15
Onset:2021-08-21
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Injected limb mobility decreased, Limb discomfort, Paraesthesia, Peripheral swelling, Pruritus, Rash, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: Progesterone
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin Codeine Have had reactions to epidural (passed out, vomiting, hives, rash)
Diagnostic Lab Data:
CDC Split Type:

Write-up: After 6 days of the shot my left arm felt very heavy and was hard to lift. Upper arm was quite swollen, red and rash going down arm. Woke up with hives, itching, and tingling all over. This lasted for several days.


VAERS ID: 1653844 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-15
Onset:2021-08-21
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Migraine, New daily persistent 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Meloxicam, Amitriptyline, Zyrtec, Metoprolol
Current Illness: None
Preexisting Conditions: Seasonal allergies, arthritis
Allergies: None
Diagnostic Lab Data: non
CDC Split Type:

Write-up: Headaches & migraines daily since the 6th day post 1st Pfizer covid vaccine


VAERS ID: 1653894 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-20
Onset:2021-08-21
   Days after vaccination:213
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 tested positive for COVID 19 after being fully vaccinated. Moderna 1st dose: 12/23/2020 025J20A 2nd dose: 01/20/2021 030L20A


VAERS ID: 1654004 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / -

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

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

Write-up: Fever. Chills headaches stomach pain


VAERS ID: 1654054 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Chest X-ray, Chest pain, Electrocardiogram, Fibrin D dimer, Full blood count, Gastrooesophageal reflux disease, Hypertension, Inflammation, Muscle tightness, Pain, Pain in extremity, Troponin
SMQs:, Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: mineral supplement, vitamin d, zyrtec, vitamin c
Current Illness:
Preexisting Conditions: allergic asthma, reflux,
Allergies: soy, white potato, nuts, coconut, peanuts
Diagnostic Lab Data: EKG, CBC, troponin, chest xray, d-dimer
CDC Split Type:

Write-up: Moderate to sever pain on left side of body - chest and upper back pain, arm pain and tightening down through left leg. The waves of pain last for an hour before relief and then return in another wave about every hour or so. Blood pressure very high - 170/77 when I am usually 110/70. Tylenol did little to resolve the pain. Went to ER twice due to level of pain. Heart assessment checked out ok. Was sent home and instructed to take tylenol. Took tylenol, benadryl and zyrtec for several days and inflammation and pain continued, but the severity has lessened. Day 8, pain waved continue. I went to Urgent care and they prescribed prednisone 40 mg for five days. First dose helped, but the flare up occurred again about 20 hours after first dose of prednisone.


VAERS ID: 1655850 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-03
Onset:2021-08-21
   Days after vaccination:140
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, COVID-19, SARS-CoV-2 test positive
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: COENZYME, PROZAC, TRICOR, NEURONTIN, SYNTHROID, MEVACOR,
Current Illness:
Preexisting Conditions: ANXIETY,ARTHRITIS, THYROID DISEASE, GERD, HYPERLIPIDEMIA
Allergies: NKA
Diagnostic Lab Data: PCR COVID-19 NASAL SWAB-POSITIVE
CDC Split Type:

Write-up: ADMITTED TO HOSPITAL ON 8/21/21 FOR CENTRALIZED ABDOMINAL PAIN TIMES 4 DAYS. LAPAROSCOPIC EXPLORATION SURGERY WAS PLANNED. NO OTHER SYMPTOMS ARE NOTED.


VAERS ID: 1656000 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Heart murmur, benign- saw Cardiology in 2018
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: She got her second COVID vaccine on 8/19. On 8/21 she developed nausea and dizziness that has persisted through today 8/30/21. She will see Cardiology and have labwork done.


VAERS ID: 1656065 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-02-19
Onset:2021-08-21
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Back pain, COVID-19, Cough, Decreased appetite, Dry mouth, Ear discomfort, Feeling abnormal, Feeling cold, Head discomfort, Malaise, Myalgia, Nausea, Pyrexia, SARS-CoV-2 test positive, Sensation of foreign body, Taste disorder, Throat irritation
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin; Vitamin D; Aspirin; Raylox
Current Illness:
Preexisting Conditions:
Allergies: Sulfa
Diagnostic Lab Data: COVID test
CDC Split Type: vsafe

Write-up: Started with a tinkle in my throat and feeling bad. I had very little energy. I started to get cough and cold fevers. I went to the doctor, and I had a 102 fever. I had muscle aches, body aches, and cotton mouth. I had bad ear pressure. I had a lot of head pressure. I have back aches are bad. Loss of appetite and nausea. I am unable to taste like normal. I have been very sick. My throat the night before lasting it felt like something was stuck in my throat I could not get out. I would feel a little better and then I would go back to feeling bad. No fever anymore and I am taking Tylenol. I went to the doctor, and they tested me for COVID. I tested positive for COVID.


VAERS ID: 1656086 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-08-14
Onset:2021-08-21
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site erythema, Injection site swelling, Injection site warmth, Musculoskeletal stiffness
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)

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

Write-up: Starting one week after vaccination (August 21) symptoms started to appear. Small, redness at injection site. On August 27, major symptoms started to appear. A large purple area, which is warm to the touch. Swollen, and minor stiffness. Patient states may have been bitten by a bug, but unsure.


VAERS ID: 1656146 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Influenza like illness, Tinnitus, Vertigo
SMQs:, Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular disorders (narrow)

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

Write-up: Tinnitus began about 11pm. Next day feelings of vertigo, dizziness. Flu like symptoms for a couple days. Dizziness comes and goes, tinnitus has been constant


VAERS ID: 1656152 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Eye pruritus, Eye swelling, Eyelid oedema, Rash, Swelling, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu shot, 2012
Other Medications:
Current Illness: None
Preexisting Conditions: Congestive Heart Failure, Diabetes, Hypertension
Allergies: Penecilin, Sulfa, Copazine, Tigan
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash all over body, itching eyes, pockets of fluid under both eyes, swelling on left and right sides of face, swelling worse on left side, left eye swollen 3/4 shut, swelling in neck. Called doctor, went into ER.


VAERS ID: 1656199 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-05
Onset:2021-08-21
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphasia, Carotid artery dissection, Carotid artery stent insertion, Carotid artery thrombosis, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Taurine
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sudden onset blurred vision left eye on 8/21 at 2230. Went to ER and sent home. Expressive aphasia on awakening at 0730 on 8/22. Internal carotid dissection on left with clot. 2 stents placed. Expressive aphasia persists. J&J given on 8/5. No history of trauma. Doctors have no idea how this occurred.


VAERS ID: 1656231 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-17
Onset:2021-08-21
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 325 mg oral tablet aspirin enteric coated 325 mg oral delayed release tablet baclofen (LIORESAL) 5 mg oral Tab clobetasol (TEMOVATE) 0.05 % sclp docusate sodium (COLACE) 100 mg oral capsule
Current Illness:
Preexisting Conditions: Acute renal failure Allergic rhinitis Anemia Arthritis Heart murmur Hypertension NSTEMI Psoriasis Sleep apnea Takotsubo cardiomyopathy Hypoglycemia AKI Tobacco use Hypovolemia shock Elevated lactic acid Fracture of cervical vertebrae
Allergies: Food extracts Metoprolol Tartrate Pollen Contrast Hazelnut Morphine Singulair Carvedilol Mold
Diagnostic Lab Data:
CDC Split Type:

Write-up: POSITIVE COVID TEST 8/29/21


VAERS ID: 1656252 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-15
Onset:2021-08-21
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: had both doses of COVID vaccine and then tested positive for COVID 19


VAERS ID: 1656346 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F20A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Fatigue, Joint swelling
SMQs:, Anaphylactic reaction (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Sofia; fire ants bits
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: Felt fatigue and tired on the way home. After 33 hours the vaccination, my both elbow swollen and red, hot to the tight. The next day, right inter wrist was swollen. They next it still did not go down. Then left inter wrist swell up as well. No redness around the site. It looked like Covid arm but not at the site.


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