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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 442 out of 8,010

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VAERS ID: 1656355 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Indiana  
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 - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pruritus, Rash, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amitriptyline, Allegra, atorvastatin, azelastine-fluticasone nasal spray, diclofenax, fluoxetine, jardiance, metformin, pataday eye drop, sumatriptan, tremfya subq, trulicity, zolpidem
Current Illness:
Preexisting Conditions: migraines, diabetes, depression, anxiety, insomnia, seasonal allergies
Allergies: sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash, warmth, and itching started the day after vaccine. Rash continually has gotten worse. Patient had been using a strong steroid cream if no relief. 5 day course of prednisone ordered.


VAERS ID: 1656377 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-01
Onset:2021-08-21
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 2 LA / IM

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

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

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


VAERS ID: 1656378 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-17
Onset:2021-08-21
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Heart rate increased, Palpitations
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

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

Write-up: Chest Pain, Pounding Heart, Fast beating Heart, Shortness of Breath.


VAERS ID: 1656449 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Tennessee  
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 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

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

Write-up: Heart palpitations that brought me to my knees felt like I was having a mini heart attack. I could feel my heartbeat through my entire body


VAERS ID: 1656474 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-25
Onset:2021-08-21
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Cough, Headache, Oropharyngeal pain, Pain, Pyrexia, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: On 8/21/21 with sore throat, cough, fever, chilld, body ache, headache, runny nose. Will quarantine for 10 days.


VAERS ID: 1657353 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
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 - / 2 - / OT

Administered by: Military       Purchased by: ?
Symptoms: Asthma, Dyspnoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (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: PARACETAMOL
Current Illness: Asthma
Preexisting Conditions: Comments: No medical history was reported.
Allergies:
Diagnostic Lab Data: Test Date: 20210708; Test Name: Covid-19 virus test; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: vaccine has triggered asthma; Breathlessness; This case was received via regulatory authority (Reference number: GB-MHRA-ADR 25832536) on 22-Aug-2021 and was forwarded to Moderna on 22-Aug-2021. This regulatory authority case was reported by a consumer and describes the occurrence of DYSPNOEA (Breathlessness) in a male patient of an unknown age who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was reported. Concurrent medical conditions included Asthma. Concomitant products included PARACETAMOL for COVID-19. On 20-Aug-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 21-Aug-2021, the patient experienced DYSPNOEA (Breathlessness) (seriousness criterion medically significant). On an unknown date, the patient experienced ASTHMA (vaccine has triggered asthma). At the time of the report, DYSPNOEA (Breathlessness) had not resolved and ASTHMA (vaccine has triggered asthma) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 08-Jul-2021, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. The report mentioned that the vaccine has triggered the patient''s asthma. No treatment information was provided. Based on the current available information and temporal association between the use of the product and the start date of the event Dyspnoea, a causal relationship cannot be excluded. Very limited information regarding the event Asthma has been provided at this time. No further information is expected at this time. Of note, the patient''s medical history of Asthma is a confounding factor that may play a possible contributory role. Moreover, the event Dyspnoea was assessed as serious by the Regulatory Authority. However, based on medical judgement and the lack of evidence of seriousness from a clinical or regulatory standpoint, the event is not considered serious.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event Dyspnoea, a causal relationship cannot be excluded. Very limited information regarding the event Asthma has been provided at this time. No further information is expected at this time. Of note, the patient''s medical history of Asthma is a confounding factor that may play a possible contributory role. Moreover, the event Dyspnoea was assessed as serious by the Regulatory Authority. However, based on medical judgement and the lack of evidence of seriousness from a clinical or regulatory standpoint, the event is not considered serious.


VAERS ID: 1657847 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Anaphylactic reaction, Feeling abnormal, Myalgia, Pyrexia, Vaccination site pain, Vaccination site pruritus, Vaccination site swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Dementia (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PLAQUENIL [HYDROXYCHLOROQUINE SULFATE]; PRADAXA; LEFLUNOMIDE; PREDNISONE; MONTELUCAST; SYNTHROID; VENTORLIN [SALBUTAMOL SULFATE]; ADVAIR; DULOXETINE [DULOXETINE HYDROCHLORIDE]; ALLEGRA; VITAMIN D 2000; TOPIRAMATE; LOSARTAN; HYDROCHLOROTHIAZ
Current Illness: Peanut allergy (anaphylaxis reaction - There was twice)
Preexisting Conditions: Medical History/Concurrent Conditions: ANA; Anaphylaxis (Anaphylaxis reaction in the past to Levaquin, sulfa, flu shot, latex gloves, pineapple, shrimp, lobster tail, raw tomatoes, most adhesives, and gadolinium contrast dye.); Antiphospholipid syndrome; Asthma; Diaphragmatic hernia; Hashimoto''s disease; Headache; Hypertension; Migraine; Rheumatoid arthritis; Scleritis
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: feel crappy; Vaccination site pruritus; Vaccination site swelling; left arm was very sore; low grade fever; Vaccination site pain; anaphylaxis reaction; This spontaneous case was reported by a consumer and describes the occurrence of ANAPHYLACTIC REACTION (anaphylaxis reaction) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 033B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Rheumatoid arthritis, Scleritis, Migraine, Headache, Asthma, Diaphragmatic hernia, Antiphospholipid syndrome, Hypertension, ANA, Hashimoto''s disease and Anaphylaxis (Anaphylaxis reaction in the past to Levaquin, sulfa, flu shot, latex gloves, pineapple, shrimp, lobster tail, raw tomatoes, most adhesives, and gadolinium contrast dye.). Concurrent medical conditions included Peanut allergy (anaphylaxis reaction - There was twice). Concomitant products included HYDROXYCHLOROQUINE SULFATE (PLAQUENIL [HYDROXYCHLOROQUINE SULFATE]), DABIGATRAN ETEXILATE MESILATE (PRADAXA), LEFLUNOMIDE, PREDNISONE, MONTELUKAST SODIUM (MONTELUCAST), LEVOTHYROXINE SODIUM (SYNTHROID), SALBUTAMOL SULFATE (VENTORLIN [SALBUTAMOL SULFATE]), FLUTICASONE PROPIONATE, SALMETEROL XINAFOATE (ADVAIR), DULOXETINE HYDROCHLORIDE (DULOXETINE [DULOXETINE HYDROCHLORIDE]), FEXOFENADINE HYDROCHLORIDE (ALLEGRA), CALCIUM CARBONATE, COLECALCIFEROL (VITAMIN D 2000), TOPIRAMATE, LOSARTAN, HYDROCHLOROTHIAZIDE, VITAMIN C [ASCORBIC ACID], CURCUMA LONGA (TURMERIC [CURCUMA LONGA]), DICLOFENAC DIETHYLAMINE (VOLTAREN EMULGEL) and SALBUTAMOL SULFATE (ALBUTEROL [SALBUTAMOL SULFATE]) for an unknown indication. On 21-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Aug-2021, the patient experienced ANAPHYLACTIC REACTION (anaphylaxis reaction) (seriousness criteria medically significant and life threatening). On an unknown date, the patient experienced FEELING ABNORMAL (feel crappy), VACCINATION SITE PRURITUS (Vaccination site pruritus), VACCINATION SITE SWELLING (Vaccination site swelling), MYALGIA (left arm was very sore), PYREXIA (low grade fever) and VACCINATION SITE PAIN (Vaccination site pain). At the time of the report, ANAPHYLACTIC REACTION (anaphylaxis reaction), FEELING ABNORMAL (feel crappy), VACCINATION SITE PRURITUS (Vaccination site pruritus), VACCINATION SITE SWELLING (Vaccination site swelling), MYALGIA (left arm was very sore), PYREXIA (low grade fever) and VACCINATION SITE PAIN (Vaccination site pain) outcome was unknown. Lab data was not provided Treatment product was not provided by the reporter. Company comment: Based on current available information and the temporal association between product sue and the start date of the events a causal relationship cannot be excluded.; Sender''s Comments: Based on current available information and the temporal association between product sue and the start date of the events a causal relationship cannot be excluded.


VAERS ID: 1658124 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immunisation, Needle issue, Syringe issue
SMQs:, Medication errors (broad)

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

Write-up: The syringe was not attached to the needle during injection. A good amount of the vaccine leaked out of the syringe during injection. The correct dose was given right after the event.


VAERS ID: 1658329 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PD8448 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injection site erythema, Injection site inflammation, Injection site pain, Injection site pruritus, Mobility decreased, Myalgia, Pyrexia, Vaccine positive rechallenge
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: COVID-19 Pfizer Bio-NTech 3/17/2021 - similar to this event, but longer time to resolution, and smaller/redder skin change. (rep
Other Medications: Cimzia (last dose 8/13/2021 - no doses since then) Methotrexate (last dose 8/8/2021 - no doses since then)
Current Illness: none
Preexisting Conditions: rheumatoid arthritis/inflammatory arthritis
Allergies: sulfa, cillins, zithromax, cefpodoxime, ciproflaxin, gluten
Diagnostic Lab Data:
CDC Split Type:

Write-up: * within the first 12 hours post-vaccination: Fever up to 101.7, joint pain, muscle aches, not able to move off the couch. ended by about 48 hours post-vaccination. * about 36 hours post vaccination developed a large enflamed, (inflammation, pain at rest and at touch, and heat) red area about 7cm by 7cm on the upper left arm. Itching started about 24 hours after enflamed area appeared. enflammed area took about 6 days to resolve, itching continued for another 2 days. Reached out to my provider on 8/24 as enflamed area was $g2 x the size that I''d developed post 2-nd vaccination dose in March. Was advised to watch and reach out if it spread or got worse. It spread a tiny bit, but did not get worse in terms of pain, heat, itching, or redness. Provider followed up on 8/30, but site was largely resolved.


VAERS ID: 1658379 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-15
Onset:2021-08-21
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphasia, Blood test, Computerised tomogram, Dysarthria, Echocardiogram, Electrocardiogram, Extra dose administered, Hemiparaesthesia, Magnetic resonance imaging, Memory impairment, Migraine, Paraesthesia, Scan with contrast, Transient ischaemic attack
SMQs:, Peripheral neuropathy (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), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Depression (excl suicide and self injury) (broad), Medication errors (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? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: lisinoprol/HTZ 10/12.5, claritin OTC, Ibuprofen as needed
Current Illness: ear infection in left ear
Preexisting Conditions: none
Allergies: Wellbutrin
Diagnostic Lab Data: I had CT, CT with contrast, EKG, bloodwork, MRI, MRI with contrast, and Echocardiogram testing done while in the hospital on 8/21/21 through 8/23/23. These tests did not show signs of significant stroke, but I was discharged with a diagnosis of TIA. I had bloodwork and stroke protocol testing done in the ER on 8/28/21. I was discharged with a diagnosis of complex migraine. I have now been referred to a neurologist for follow up and to determine if what I''ve experienced is TIA related or migraine related. I have never had any episode like this ever before in my life.
CDC Split Type:

Write-up: 6 days after receiving the booster shot for Covid (Moderna), on 8/21/2021 I was admitted to the hospital for 3 days for TIA/possible complex migraine. The entire right side of my body leg to head and to the middle of my trunk/face was numb, tingling, and I did hot have good control of my limbs. Additionally, I could not form sentences, speech was very slurred, and I could not remember things when asked on the spot. I had recurrence of these same symptions one week later on 8/28/21, but did not result in an admission to the hospital


VAERS ID: 1658450 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster, Malaise
SMQs:, Opportunistic infections (broad)

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

Write-up: Patient reports not feeling well after the shot, states it caused shingles


VAERS ID: 1658678 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-02
Onset:2021-08-21
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO217 / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO165 / 2 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Cystoid macular oedema, Retinal vein occlusion
SMQs:, Embolic and thrombotic events, venous (narrow), Retinal 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: Central Retinal Vein Occlusion with Cystoid Macular Edema


VAERS ID: 1658689 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-03-18
Onset:2021-08-21
   Days after vaccination:156
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN P475712 / 1 LA / IM

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

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

Write-up: Diagnosed and hospitalized with COVID 19.


VAERS ID: 1658783 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Norvasc 5mg , Prevacid 30mg , Pepcid 40 mg , Multivitamin, , Vitamin C , Garlic soft gel, Probiotics , Biotin , Claritin, and Benadryl .
Current Illness: N/A
Preexisting Conditions: Hypertension and Gerd
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: soreness of left arm ,fatigue, chills, muscle aches, and sinus symptoms.


VAERS ID: 1658886 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-16
Onset:2021-08-21
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Aphasia, Asthenia, Blood pressure increased, Bundle branch block right, COVID-19, Cardiac pacemaker insertion, Chest X-ray abnormal, Cognitive disorder, Cough, Dyspnoea, Echocardiogram, Ejection fraction, Electrocardiogram normal, Fall, Fluid overload, Gastrointestinal haemorrhage, Headache, Hypertension, Hypoxia, Infection, Left ventricular hypertrophy, Myocardial infarction, Nasal congestion, Pain, Pleural effusion, SARS-CoV-2 test positive, Troponin increased, Weight increased
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Conduction defects (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Ischaemic colitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Chronic kidney disease (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler allopurinol (ZYLOPRIM) 100 MG tablet amLODIPine (NORVASC) 5 MG tablet atorvastatin (LIPITOR) 20 MG tablet B Complex-C-Folic Acid (DIALYVITE TABLET) TABS c
Current Illness: Weakness; UTI; fall; seizure; ESRD; loss of consciousness; nose bleed; headaches
Preexisting Conditions: Left adrenal mass (HCC) Diabetes mellitus type 2, uncontrolled (HCC) Unspecified hypothyroidism HTN (hypertension) Chronic diastolic (congestive) heart failure (HCC) Mixed hyperlipidemia Bifascicular block Anemia End stage renal disease (HCC) Expressive aphasia AF (paroxysmal atrial fibrillation) (HCC) Gastroesophageal reflux disease Gout
Allergies: Gabapentin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Brief history and medical decision making: Volume over loaf, secondary to missed HD on Monday 08/23. Break through Covid -19 infection, continue isolation per infection control. Hold off Steroids ( anticipating HD will help with breathing) Elevated troponin mostly due to ESRD and volume overload. Asymptomatic. History CVA with expressive aphasia: Cognitive impairment: Patient have guardian. HD per Nephrology. Shortness of breath Volume overload ESRD MWF In setting of missed dialysis on Monday and patient being 5 kg above dry weight. Chest x-ray with evidence of congestion and small bilateral pleural effusions. Differentials also include breakthrough COVID-19 infection and possibility of flash pulmonary edema. History defers from patient shortness of breath worsening over last week worse in last 3 days compared to facility awareness of acutely short of breath last evening. Plan: -consult nephrology discussed with Doctor regarding dialysis today -assess SOB hypoxia with activity after -Lasix if delayed planned to start round 1pm Hypertensive urgency In setting of volume overload with no antihypertensives given on day of dialysis even though missed dialysis and without blood pressure medications today. -Continue amlodipine, imdur, coreg initial dose now and continue on none dialysis days Breakthrough COVID-19 infection Symptomatic with positive test in November 2020, vaccinated Johnson Johnson vaccine 3/2021, negative testing previously now positive test 8/24. No COVID outbreak at facility. Patient has been afebrile. Does have cough, headache. -discussed with infection control will place in isolation 10 days -Received 6 mg dexamethasone in ED. Currently not hypoxic on RA. Will hold on additional treatment currently. -With ESRD would not be candidate for remdesivir. -With current volume overload will avoid convalescent plasma unclear utility with past infection and COVID vaccination. Elevated troponin Myocardial injury In setting of ESRD with volume overload with elevated blood pressure without EKG changes remains atrial paced with right bundle-branch block previously seen. Denies chest pain. Troponin 224 -- $g 224. Previous admissions 150 to 250s. Diastolic heart failure Status post permanent pacemaker Afib not on anticoagulation due to GI bleed. Last echo 3/2021. EF 57% mild LVH. Atrial paced. Dementia Prior CVA with expressive aphasia General debility Frequent falls Currently AOx3/4 name, place, president not to date. Has court-appointed guardian. -PT/OT Chronic pain -Continue fentanyl patch q 72 hr Code Status: full unknown. Call out to guardian DVT PPX: SQH Diet: Renal fluid and sodium resricted Dispo: Obs assess after HD. Discussed with Doctor, please see their addendum. Internal Medicine Resident PGY-3


VAERS ID: 1658992 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-04
Onset:2021-08-21
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 6023169 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19 pneumonia
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 (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Obesity, Hypertension, cardiomegaly, obstructive sleep apnea, hyperlipidemia, atrial fibrillation, malignant neoplasm of colon
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID -19 pneumonia with acute hypoxic respiratory failure


VAERS ID: 1659132 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-26
Onset:2021-08-21
   Days after vaccination:207
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 LA / IM

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

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

Write-up: Vaccinated patient hospitalized for COVID-19.


VAERS ID: 1659265 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F64421 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Eye pain, Fatigue, Headache, Influenza like illness, Musculoskeletal stiffness, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Antibiotic Ciplox 500 started taking these on the same day as I was vaccinated
Current Illness: lung infection
Preexisting Conditions: Asthma
Allergies: none
Diagnostic Lab Data: severe headache body tingling with flulike symptoms. pains in eyes fatigue
CDC Split Type:

Write-up: severe head aches , pain behind eyes. stiffness, stomach discomfort


VAERS ID: 1659331 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Magnetic resonance imaging, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: Losartan; hydrochlorothiazide; Bupropion; Semaglutide; Estradiol; Aspirin; Multivitamin; L-Arginine; Magnesium; Omega 3; L-Lysine; Iron; Vitamin D; Sea Moss; Elderberry; Turmeric
Current Illness: None
Preexisting Conditions: Hypertension; Obesity; Vitamin D deficiency; Lynch Syndrome; MFH6 mutation; History of endometria cancer
Allergies: None
Diagnostic Lab Data: MRI 08/24/2021, Bloodwork 08/23/2021
CDC Split Type: vsafe

Write-up: Basically I had right arm weakness that I noticed while holding my arm up to do my hair. It is still the same I had an MRI done and I''m seeing a urologist and a physical therapist for it. They''re planning on doing a second MRI of my neck along with nerve conduction studies.


VAERS ID: 1659737 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Gait disturbance, Hypoaesthesia, Limb discomfort, Musculoskeletal disorder, Neurological symptom
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unavailable
Current Illness: Unavailable
Preexisting Conditions: History of neurological reaction to influenza vaccine
Allergies: Unavailable
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient has history of neurological side effects from influenza vaccine. 2 days after vaccine experienced similar side effects. 5 days after vaccine went to ER with numbness, limb heaviness, difficulty walking and using arms


VAERS ID: 1660137 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-18
Onset:2021-08-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 7C3181 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: dextroamphetamine 15mg once in the morning
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Sulfa Wellbutrin
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: I woke up at around 12:22 am to chest pain radiating to my left shoulder blade and shortness of breath with a pain rating of 6/10 worsening when lying flat on my back or becoming active. I figured I slept wrong so tossed and turned and went back to bed. Later that day around 6 pm I got stung twice by a wasp on my right middle finger. Normally nothing happens but small dots appearing where I was stung but this time within 1 hour my whole right hand swelled up. I took 2 tabs of Benadryl and went home with my wife and went to bed. When I woke up around 1: 33 am my whole hand was still swollen but this time it moved all the way up to my elbow along with the chest pain radiating to my left shoulder blade. I told my wife and she told me to go to the ED in the morning when I woke back up if my hand was still swollen. I went and let them know this has never happened before and I''ve been stung many times in the past and not too recently. They gave me Proctosol and a prescription for it which I never filled. I never brought up the pain in my chest though because I thought maybe I slept wrong. Later in the day, my hand got better but my chest pain still remained so I tried stretching but noticed it didn''t hurt when I moved my head like it normally does so got worried a little but didn''t do anything about it. Later that night same thing and this time I had a very difficult time sleeping so decided to go to the ER in the am for my chest pain. While in the parking lot I ran into a nurse that works in the cardiologist dept. and explained what was going on, he said unless it feels like a heart attack they probably wouldn''t do much, and unless I really think I needed to that just try and give it some more time to go away. That night it didn''t hurt as bad so I never went back. It still happens off and on but not as bad but enough that I made an appointment for Sept. 4th with my family doctor to see what he thinks about it. I brought it up to my cousin who is a nurse recently and she told my young adult like myself have been developing myocarditis or pericarditis from the mRNA vaccines so I hope it''s not that but find it very weird how the pain came along and the reaction I had to the wasp sting when that has never happened like that in my life before.


VAERS ID: 1660328 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-17
Onset:2021-08-21
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Balance disorder, Fatigue, Hypoaesthesia, Injection site pain, Injection site paraesthesia, Ligament sprain, Metamorphopsia, Neuropathy peripheral
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Retinal disorders (narrow), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (narrow), Immune-mediated/autoimmune disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3, Zinc and Vitamin B-Complex
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Codeine and synthetics, epinipherine (EPI) Milk
Diagnostic Lab Data: August 26th. Called PP and we did a teleappt. Advised not to take 2nd dosage and advised to rest for 2 weeks and avoid activities that could make me a fall risk. Upping Vitamin D3 up to 50k iu for seven days.
CDC Split Type:

Write-up: On day 1-3 Tingling and pain in injection site. On day 5 began hurting in all joints and numbness and overall fatigue By day 7 Neuropathy was noted with vision disturbances (seeing quadruple and not able to focus. Loss of balance and actually sprung right ankle. All symptoms continue to worsen and compounded


VAERS ID: 1661200 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-21
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Injection site inflammation, Injection site mass, Injection site pain, Polymenorrhoea
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)

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

Write-up: 7 days after vaccination large, inflamed lump at injection site hit to touch 7 days after vaccination - started menestral cycle 7 days early while on birth control - menestral bleeding for10 days [normal cycle is 5 days]


VAERS ID: 1661212 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / UNK RA / -

Administered by: Private       Purchased by: ?
Symptoms: Vaccination site erythema, Vaccination site pain, Vaccination site pruritus, Vaccination site swelling
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: Medical History/Concurrent Conditions: Contrast media allergy (Contrast dye allergy); Lung disease (9/11 Lung Disease); Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101082951

Write-up: arm is swollen/ Severe swelling, redness, pain and itching of injection site approximately 8 centimeters in diameter; arm is itchy/ Severe swelling, redness, pain and itching of injection site approximately 8 centimeters in diameter; My arm is so sore/ Severe swelling, redness, pain and itching of injection site approximately 8 centimeters in diameter; arm is red / Severe swelling, redness, pain and itching of injection site approximately 8 centimeters in diameter; This is a spontaneous report from a contactable nurse (patient). A 73-years-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration, administered in arm right on 20Aug2021 10:00 (Lot Number: EW0170) (at the age of 73-years-old) as dose number unknown, single for covid-19 immunisation. Medical history included 9/11 lung disease, penicillin allergy and contrast dye allergy. The patient did not receive any other medications within 2 weeks of vaccination. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient was not diagnosed with COVID-19 prior to vaccination and was not tested for COVID-19 since the vaccination. The patient stated that she just wanted to report a side effect from the COVID-19 vaccination as she had the reaction. The patient experienced severe swelling, redness, pain and itching of injection site approximately 8 centimeters in diameter on 21Aug2021 02:00 AM. The patient woke up on the morning of day of reporting and her arm was swollen, red and itchy. The adverse event led to doctor or other healthcare professional office/clinic visit. The patient did not receive treatment for the adverse event. The outcome of the events was not recovered.


VAERS ID: 1661262 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-03
Onset:2021-08-21
   Days after vaccination:199
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 2 RA / OT

Administered by: Other       Purchased by: ?
Symptoms: Drug ineffective, SARS-CoV-2 test, SARS-CoV-2 test positive
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210823; Test Name: COVID; Test Result: Positive; Comments: Nasal Swab.
CDC Split Type: USPFIZER INC202101108860

Write-up: This is a spontaneous report from a non contactable Nurse. A 27-year-old male received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was EL3248) via intramuscular route of administration on 03Feb2021 at 8:15 (age at the time of vaccination was 27-year-old) in right arm, as single dose for COVID-19 immunization. Medical his-tory and concomitant medications were not reported. Previously the patient received first dose of bnt162b2 (COMITNATY, Solution for injection, Batch/Lot number was EL3248) via intramuscular route in right arm on an unspecified date at 07:45 as a single dose for COVID-19 immunization. The patient did not have COVID prior to vaccination and was tested for COVID post vaccination. It was unknown if the patient had other vaccines in 4 weeks. On 21Aug2021, the patient experienced 8/23- live in daughter tested positive for COVID yesterday. The patient underwent lab test and procedure of SARS-CoV-2 test positive on 23Aug2021. Outcome of events was recovering. No follow-up attempts are needed. No further information is expected. As there is limited information in the case provided, the causal association between the event and the suspect drug BNT162B2 cannot be excluded. The impact of this report on the benefit-risk profile of the product and on the conduct of the study is evaluated as part of procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, as appropriate.


VAERS ID: 1662168 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-08
Onset:2021-08-21
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID-19 PCR positive with cycle threshold of 19.5 on 8/22/2021
CDC Split Type:

Write-up: Hospitalization for COVID-19 Reported per Janssen COVID-19 Vaccine EUA


VAERS ID: 1662198 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006CZ1A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Axillary pain, Headache, Pain in extremity
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Painful abdominal cramping and headaches starting on Saturday after vaccine. Left arm pain for whole arm and armpit tenderness on Tuesday following vaccine


VAERS ID: 1662630 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-14
Onset:2021-08-21
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Vestibular disorders (broad)

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

Write-up: I have been feeling lightheaded and my blood pressure been high for about 2 or 3 weeks.


VAERS ID: 1662792 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electrocardiogram abnormal, Supraventricular extrasystoles
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Hypokalaemia (broad)

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

Write-up: Patient said she developed PAC (premature atrial contractions) a day after the shot and discovered this after an EKG.


VAERS ID: 1662961 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-05
Onset:2021-08-21
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Epistaxis
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Metropolol, Breo, Avorvastatin, 81 mg Aspirin, Zyrtec, Albuterol-in Nebulizer and rescue inhaler, CPAP sleep machine
Current Illness: None
Preexisting Conditions: Heart disease, COPD
Allergies: None
Diagnostic Lab Data: nome
CDC Split Type:

Write-up: Five severe and sudden Bloody Noses: #1-8/21/2021 7:30 am, #2-8/22/2021 6 am, #3-8/24/2021 9pm, #4-8/25/2021 1:30 pm, #5-8/26/2021 1:10 pm No history of bloody noses. These came on suddenly, lasted for 15-20 minutes


VAERS ID: 1662983 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac imaging procedure abnormal, Cardiac telemetry abnormal, Chest pain, Dyspnoea, Electrocardiogram abnormal, Magnetic resonance imaging heart, Myocarditis, Pericarditis, Troponin increased, Ventricular tachycardia
SMQs:, Torsade de pointes/QT prolongation (narrow), Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: ecg done 8/23 showing signs c/w pericarditis troponin done same day and next day rising to 2 telemetry showing 8 beat NSVT on 8/24 cardiac MRI done 8/26 showing findings c/w myocarditis with LGE in the inferior and inferolateral wall
CDC Split Type:

Write-up: chest pains/sob started within 72 hours resulting in visit to ER and where pt was admitted


VAERS ID: 1663086 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-18
Onset:2021-08-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anti-thyroid antibody, Blood thyroid stimulating hormone normal, C-reactive protein increased, Full blood count normal, Thyroid pain, Thyroxine free normal, Toxic nodular goitre, Ultrasound thyroid abnormal
SMQs:, Hypothyroidism (broad), Hyperthyroidism (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: Hodgkin''s lymphoma in remission, cystic thyroid nodules
Allergies: None
Diagnostic Lab Data: Normal CBC, TSH, free T4, thyroid autoantibodies Elevated CRP 6.4 Thyroid ultrasound: "Multinodular thyroid gland. No significant interval change appreciated within the nodules when compared to recent study. The thyroid parenchyma intervening between thyroid nodules is within normal limits and without findings of thyroiditis"
CDC Split Type:

Write-up: Thyroid pain and swelling 3 days after administration of the vaccine. No other symptoms.


VAERS ID: 1663604 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Musculoskeletal chest pain, Sensation of foreign body, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tetnas shot. 2013. VA administered.
Other Medications: Lyrica, calcium, multi-vitamin
Current Illness: n/a
Preexisting Conditions: Fibromyalgia, COPD, Chronic pain disorder
Allergies: Ampacillin, Statin drugs
Diagnostic Lab Data: I did not seek help as it was the weekend and I did want to also be exposed to covid at the hospital. I still have chest pains on and off but not like the first few days. I have a Dr. appointment on Sep. 27, 2021. ( first available)
CDC Split Type:

Write-up: Severe chest pains that woke me out of sleep 3 times the first night followed by sitting on the couch all day. the second morning I woke around 4:00 am and felt like I had swallowed a beach ball. I drank carbonation but could not burp yet I almost could not even talk. by noon It felt like my rib cage was going to split apart. I had a hard time breathing and became dizzy.


VAERS ID: 1663806 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-16
Onset:2021-08-21
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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:
CDC Split Type:

Write-up: About 5 days after recieving my first dose of the Pfizer vaccine. I got out of the shower and noticed a small rash forming on my left inner leg. Since then it has spread about the back on my leg and lower buttocks and down my leg slightly.


VAERS ID: 1665718 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal discomfort, Asthenia, Feeling abnormal, Headache, Influenza like illness, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Received 2nd shot at 10am. At midnight I started to feel flu-like symptoms coming on: body aches, fever, upset stomach, headache. Symptoms progressively became worse overnight and throughout the next day. Felt slightly better the next morning. Symptoms subsided slowly througout the next day. For the following week after the 2nd shot I didn''t feel right: weakness, on/off body aches, headache. This "vaccine" needs more work, these symptoms shouldn''t have happened to me.


VAERS ID: 1665993 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Arthralgia, Breast pain, Fatigue, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Lipodystrophy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydroxychloroquine 2000mg (once daily) Super C Vitamin
Current Illness: None
Preexisting Conditions: Sjogren''s Triple Bypass Surgery (4 years ago)
Allergies: Macrodantin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pain in left elbow and breast, heart palpitations and pain, and fatigue.


VAERS ID: 1666070 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-01
Onset:2021-08-21
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Malaise, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: none
Preexisting Conditions: htn/djd/gerd/copd
Allergies: n/a
Diagnostic Lab Data: SARS-COV-2 RNA - Positive
CDC Split Type:

Write-up: COVID sx started 8/21/23 + test recorded 8/23/21


VAERS ID: 1666212 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-10
Onset:2021-08-21
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

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

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

Write-up: Contact with Covid positive neighbor


VAERS ID: 1666228 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-05
Onset:2021-08-21
   Days after vaccination:169
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Lung infiltration
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 20 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 with bilateral pulmonary infiltrates


VAERS ID: 1666231 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-10
Onset:2021-08-21
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC1122 / 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID-19 positive. No idea where came in contact.


VAERS ID: 1666251 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-01
Onset:2021-08-21
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 2 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19 pneumonia
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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pneumonia due to COVID-19 virus


VAERS ID: 1666297 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-13
Onset:2021-08-21
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Cough, Dyspnoea, Leukocytosis, Myocarditis, Pneumonia, Troponin increased, Viral infection
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Patient presented to Hospital on 8/23/21 complaining of shortness of breath and coughing and chest discomfort. Elevated Troponin and leukocytosis. Admitted with myocarditis, viral syndrome and pneumonia.


VAERS ID: 1666357 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head, Eye pain, Fatigue, Headache, Influenza like illness
SMQs:, Glaucoma (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: HPV vaccine - bad headches and pin in opposite arm.
Other Medications: Thyroid; Benadryl
Current Illness: no
Preexisting Conditions: anafluctsine; underactive thyroid
Allergies: shellfish; hazelnut; iodine; contrast dye
Diagnostic Lab Data: head CT - normal and meds. Thurdays was fine and the friday headache came back.
CDC Split Type: vsafe

Write-up: Sat night night headache started, flu like and sunday and fatigue. Monday - all gone except headache. Tuesday - telehealth - doctor said that was normal. Wed - continued to have headache. Thursday it got extreme painful. Right side to the right eye. Went ER. PCP on tuesday - sought medical 4 times and still had headaches.


VAERS ID: 1666473 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-16
Onset:2021-08-21
   Days after vaccination:66
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: positive covid 19 test on 8/21/21


VAERS ID: 1666620 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Hypoxia, Myocarditis
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Sinus infection July 17, 2021; treated with cefdinir; symptoms resolved.
Preexisting Conditions: No
Allergies: None
Diagnostic Lab Data: EKG: normal sinus rhythm. Pre-existing bilateral atrial enlargement and pre-existing right bundle branch block. Echocardiogram: normal. Troponin level: <0.1.
CDC Split Type:

Write-up: Chest pain and shortness of breath. This started on the evening of the second dose. Onset a few hours after dose given 8/21/2021. Never hypoxic. Remained outpatient. Saw PCP on 8/24/2021. Referral to cardiologist scheduled for 8/27/2021. Symptoms improving. Advised to refrain from strenuous exercise for 12 weeks. Diagnosed with post-vaccine myocarditis.


VAERS ID: 1666732 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-06
Onset:2021-08-21
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Dizziness, Fatigue, Nasal congestion, SARS-CoV-2 test positive
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose02/04/21 2nd dose03/06/21 Diagnosed covid positive:08/25/21 Symptom onset:08/21/21 Exposure: Symptoms:fatigue ,nasal congestion, light headedeness,,


VAERS ID: 1666752 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-08
Onset:2021-08-21
   Days after vaccination:225
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Myalgia, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose12/19/20 2nd dose01/08/21 Diagnosed covid positive:08/23/21 Symptom onset:08/21/21 Exposure: Symptoms:fever, cough, muscle aches.


VAERS ID: 1666770 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Injection site cellulitis
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: Synthroid, claritin
Current Illness: none
Preexisting Conditions: hypothyroidism allergic rhinitis
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: cellulitis, right arm, at site of injection. tx with Keflex. Pt has not yet f/u, so outcome unk.


VAERS ID: 1666854 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-04
Onset:2021-08-21
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Human chorionic gonadotropin positive
SMQs:, Tumour markers (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (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: Prenatal vitamin daily Iron 325 mg daily
Current Illness: None
Preexisting Conditions: None. Had a possible epileptic seizure at age 7, without further recurrence.
Allergies: Penicillin
Diagnostic Lab Data: Serum Beta HCGs 9/1/21: 13 8/25/21: 365 8/23/21 : 600
CDC Split Type:

Write-up: Spontaneous Abortion at approx. 6 weeks gestation.


VAERS ID: 1667392 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Heart rate increased, Pharyngeal swelling, Pyrexia, Swelling face, Swelling of eyelid, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: anaplyaxis: hives, swelling in face, eyelids, throat, low grade fever, increase heart rate


VAERS ID: 1669261 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Headache, Nausea, Pain, Pyrexia, Vomiting
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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: PVIUS2021001202

Write-up: Nausea/vomiting, fever, body aches, headaches, chills; Nausea/vomiting, fever, body aches, headaches, chills; Nausea/vomiting, fever, body aches, headaches, chills; Nausea/vomiting, fever, body aches, headaches, chills; Nausea/vomiting, fever, body aches, headaches, chills; Nausea/vomiting, fever, body aches, headaches, chills; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Nausea/vomiting, fever, body aches, headaches, chills), NAUSEA (Nausea/vomiting, fever, body aches, headaches, chills), VOMITING (Nausea/vomiting, fever, body aches, headaches, chills), PYREXIA (Nausea/vomiting, fever, body aches, headaches, chills) and HEADACHE (Nausea/vomiting, fever, body aches, headaches, chills) in a 30-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 in December 2020. On 21-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Aug-2021, the patient experienced PAIN (Nausea/vomiting, fever, body aches, headaches, chills), NAUSEA (Nausea/vomiting, fever, body aches, headaches, chills), VOMITING (Nausea/vomiting, fever, body aches, headaches, chills), PYREXIA (Nausea/vomiting, fever, body aches, headaches, chills), HEADACHE (Nausea/vomiting, fever, body aches, headaches, chills) and CHILLS (Nausea/vomiting, fever, body aches, headaches, chills). At the time of the report, PAIN (Nausea/vomiting, fever, body aches, headaches, chills), NAUSEA (Nausea/vomiting, fever, body aches, headaches, chills), VOMITING (Nausea/vomiting, fever, body aches, headaches, chills), PYREXIA (Nausea/vomiting, fever, body aches, headaches, chills), HEADACHE (Nausea/vomiting, fever, body aches, headaches, chills) and CHILLS (Nausea/vomiting, fever, body aches, headaches, chills) had not resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. concomitant medication was not reported treatment medication was reported by patient.


VAERS ID: 1669824 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 3 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Pain in extremity, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Achalasia (Immunosupressed "Colonic interposition" for achalasia: 15/16 previous surgeries); Iodine allergy
Preexisting Conditions: Medical History/Concurrent Conditions: Colon operation (Colonic interposition)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: severe arm pain; shaking; Fever not reduced with TylenolAdvil; Severe chills and chills in spine; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (severe arm pain), TREMOR (shaking), PYREXIA (Fever not reduced with TylenolAdvil) and CHILLS (Severe chills and chills in spine) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 059E21A) for COVID-19 vaccination. The patient''s past medical history included Colon operation (Colonic interposition). Concurrent medical conditions included Achalasia (Immunosupressed "Colonic interposition" for achalasia: 15/16 previous surgeries) and Iodine allergy. On 20-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Aug-2021, the patient experienced PAIN IN EXTREMITY (severe arm pain), TREMOR (shaking), PYREXIA (Fever not reduced with TylenolAdvil) and CHILLS (Severe chills and chills in spine). The patient was treated with PARACETAMOL (TYLENOL) for Fever, at an unspecified dose and frequency and IBUPROFEN (ADVIL [IBUPROFEN]) for Fever, at an unspecified dose and frequency. At the time of the report, PAIN IN EXTREMITY (severe arm pain), TREMOR (shaking), PYREXIA (Fever not reduced with TylenolAdvil) and CHILLS (Severe chills and chills in spine) had not resolved. No concomitant medications was reported. The dose of the vaccine was 0.5 milliliter.


VAERS ID: 1669881 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Unknown  
Location: Virginia  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, 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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: pt complained of a rash that started the day after the shot and was still a problem on date of reporting. itchy, raised, red at area of injection


VAERS ID: 1670098 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dizziness, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Dexone; Zyrtec; coronin; Ativan; vitamin C; D; A; magnesium; zinc
Current Illness: Covid
Preexisting Conditions: No
Allergies: Seafood
Diagnostic Lab Data: No
CDC Split Type: vsafe

Write-up: Fever, aches and pains, chills, dizziness, diarrhea, PODS.


VAERS ID: 1670125 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-08-18
Onset:2021-08-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Chest x-ray
CDC Split Type:

Write-up: Diagnosis - Myocarditis Symptoms - Chest pain Treatment - Naproxen 500 mg PO BID, and rest Until additional safety data are available, experts recommend that people who develop myocarditis or pericarditis after a first dose of an mRNA COVID-19 vaccine defer receiving the second dose.


VAERS ID: 1670158 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-08-21
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Back pain, COVID-19, Cough, Dyspnoea, Fatigue, Headache, Hypoxia, Liver function test increased, Pyrexia, Sepsis
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen (TYLENOL) 500 MG tablet; Cyclobenzaprine (FLEXERIL) 5 MG tablet; Ibuprofen (MOTRIN) 200 MG tablet; Metformin (GLUCOPHAGE) 1000 MG tablet; Omeprazole (PRILOSEC) 20 MG delayed release capsule.
Current Illness: COVID-19 positive 8.27.21 (symptoms started 8.21.21).
Preexisting Conditions: Palpitations
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized; COVID-19 positive 8.27.21; fully vaccinated (still hospitalized currently) Patient is a 56 y.o. female who presents to hospital. Patient only speaks Spanish, translator was used during the interview. The patient states that she has been having difficulty breathing, back pain, and worsening cough and worsening fatigue. It all started On Saturday she developed a headache and a fever. Monday, everything got progressively worse. Came in today mainly because of the worsening shortness of breath. She had a Johnson and Johnson vaccination back in April. Chief complaint; SOB, weakness. Problem List; Principal Problem: COVID-19; Active Problems: Elevated LFTs, Hypoxia; Assessment and Plan: Medical Decision Making; Sepsis secondary to COVID 19, No respiratory distress, only requiring 2L/min oxygen. Start on Decadron and Remdesivir. Date of symptom onset: 8/21/2021.


VAERS ID: 1670312 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac discomfort, Cardiac flutter, Dizziness, Palpitations
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Escitalopram Oxalate 20 mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I had made an appointment to see my doctor but there was some mix up about my insurance that I need to get worked out.
CDC Split Type:

Write-up: My heart would flutter and tighten. During the fluttering/palpitations my head would get light; if it happened while I was standing I had to hold onto something or sit down. It was happening often; say every 10 to 20 minutes. This continued on with the same severity for about a week and has gradually subsided to just a few episodes per day as of this report.


VAERS ID: 1670320 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Chills, Diarrhoea, Dyspnoea, Dyspnoea exertional, Fatigue, Headache, Hypertension, Induration, Influenza virus test negative, Nausea, Pain in extremity, Paranasal sinus discomfort, Pyrexia, Rash pruritic, SARS-CoV-2 test negative, Skin warm, Swelling
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Plaquenil, Vyfemla, cyclobenzaprine, Adderall XR, Etodolac, montelukast, Ubrelvy, relpax, enbrel (2 weeks since last shot at time of vaccine), Flonase, Azelastine HCL, fish oil, coq 10, iron, folic acid, magnesium therate
Current Illness: Psoriatic arthritis, ankylosing spondylitis, migraines, seasonal allergies
Preexisting Conditions: Psoriatic arthritis, migraines, ankylosing spondylitis, seasonal allergies
Allergies: Monistat, adhesive, Maybelline blur master stick
Diagnostic Lab Data: Negative covid rapid test, negative flu swab. High blood pressure recorded at urgent care visit.
CDC Split Type:

Write-up: Not pregnant never pregnant. Fever in low 100s the day after, arm pain, hard swelling measuring around 7 inches by 5 inches in arm lasting 4 days, arm hot to touch, itchy bumps on firearms, aching joints, nausea and diarrhea for 5 days, tightness and heaviness in chest, labored breathing and shortness of breath, severe headache, chills, sinus pressure, high blood pressure. Went to urgent care after 6 days of nausea, shortness of breath that was worsening. Given covid test and flu test both negative. Provider prescribed steroid pack, steroid cream, and Kennalog IM injection. Slowly improving symptoms, at date of writing, 2 weeks post vaccine, continued shortness of breath as evidenced by needing to pause for breath midway through a sentence, taking time to catch breath after bending over or physical activity, fatigue.


VAERS ID: 1670375 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-20
Onset:2021-08-21
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Headache, Respiratory tract congestion, SARS-CoV-2 test negative, SARS-CoV-2 test positive, Tooth extraction
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: nasal decongestion pills/ neddy pot
Current Illness: no
Preexisting Conditions: over weight/blood pressure/ thyroid/ cholesterol
Allergies: demerol
Diagnostic Lab Data: 2 - covid tests 1st one was nasal swab/ 2nd was saliva tests
CDC Split Type:

Write-up: I had a tooth extracted on 8/19 had issues lost taste smell was given amoxicillin and 5 day supply of steroid pills. that was done by 8/25. i was traveling from 8/21 to 8/28. When i got home had a rapid test for covid came in negative. On Wednesday 9/1 / i had another tests and was told on 9/2 that it was positive. i had no smell or taste for 2 weeks my taste came back last night. No fever just congested and slight headache as of now.


VAERS ID: 1670648 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-08
Onset:2021-08-21
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Heart rate increased, Heart rate irregular, Myocarditis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Experienced likely myocarditis, (chest pain, discomfort, tightness, un-ignorable sensation of rapid and erratic heartbeat)


VAERS ID: 1670667 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / IM

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

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

Write-up: Pt received her first dose of the Pfizer covid-19 vaccine on August 20, 2021 and on August 21, 2021 patient started experiencing numbness in her right arm through right pinky. As of September 3rd, 2021 she is still experiencing this numbness.


VAERS ID: 1670704 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electric shock sensation, Fatigue, Feeling abnormal, Headache, Muscle spasms, Neuralgia, Pain in extremity
SMQs:, Peripheral neuropathy (narrow), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Montelukast 10mg, Duloxetine 90mg, Metoprolol 50mg, Amitriptyline 10mg, Vitmin D3 4000IU, Loratadine 10mg
Current Illness:
Preexisting Conditions: Fibromyalgia, High Blood Pressure
Allergies: Gabapentin, Codine
Diagnostic Lab Data:
CDC Split Type:

Write-up: On August 20, 2021 I went to a local pharmacy to receive my second dose of the Cov-19 vaccine. After being injected I was told to wait in the store for 15 minutes but then I was allowed to leave. I was in no way watched for reaction of any kind, I was left to sit by myself. After leave I began to have a headache so I took 2 Tylenol. I went home and went to sleep. The nest morning I with extreme arm pain and I was very fatigued, I rested most of the day. That evening my family and I went to town for dinner, on the way home my my upper thighs began to cramp and I was experiencing nerve pain. I also felt as though I was floating almost outside of myself. Sunday I spent all day in bed resting and continued to have leg and nerve pain. Sunday night around 10 PM I started experience what I would equate to as electrical shock just above my right knee in my thigh. I could feel the shocks through the whole right side of my body. This went on at random intervals for 4 hours. I finally was able to fall asleep. The nest morning I called my doctor and asked to make an appointment. I explained my symptoms to the office and was told they would relay the message to the nurse who would call me back. That morning I was still experiencing muscle cramps and nerve pain in both thighs. A couple hours later the nurse returned my phone call and informed me the doctor said there was nothing they could do, that these were normal symptoms and I was to alternate Tylenol and Ibuprofen. I asked the nurse what I was to do if the shocks and pain continued and she was unable to give me an answer. Since then I have not experienced any more shocks, but I am experiencing nerve pain in my legs and arms above and beyond the normal of my every day life with a Fibromyalgia.


VAERS ID: 1670724 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chest discomfort, Cough, Fatigue, Limb discomfort, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Tightness in chest and cough, fatigue for 6 days. Occasional cough only lasted 3 days. Pain streaks traveling down in left arm and left leg for 3 days. At this time I have occasional discomfort in left and right leg. I have not seen a doctor, I am resting and going about my day as usual but with less energy.


VAERS ID: 1670807 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-18
Onset:2021-08-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction, Angiocardiogram, Catheterisation cardiac abnormal, Coronary arterial stent insertion, Coronary artery thrombosis
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Other ischaemic heart disease (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvastatin, lisinopril.
Current Illness: None
Preexisting Conditions: HTN, HLD, smoker
Allergies: None
Diagnostic Lab Data: Heart catheterization
CDC Split Type:

Write-up: Patient vaccinated 8/18/21, came in with STEMI 8/21/21. Thrombus to mid LAD, received stent. All others angiographically normal, no CAD history. Did have risk factors of HTN, HLD (reports these were controlled) and smoking. Timiline concerning, as this occurred within 72 hours of the first Pfizer Covid-19 vaccine.


VAERS ID: 1671148 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-03
Onset:2021-08-21
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Cough, Nasopharyngitis, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prescription heart medications
Current Illness: No
Preexisting Conditions: Atrial Fibulation; High blood pressure
Allergies: No
Diagnostic Lab Data: COVID test 8/23 negative
CDC Split Type: vsafe

Write-up: I developed a cough and it was a cold, too. August 23, I submitted an online report and they approved me to get a COVID test and it was negative. I just took cough medicine and throat lozenges. The symptoms lasted about three weeks. Still have a bit of a cough left.


VAERS ID: 1671383 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-01-28
Onset:2021-08-21
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: meloxicam 15 mg prednisone 1mg hydrochlorothiazide 12.5 mg verapamil ER 240 Rovastatin 5 mg every other day omeprazole drive 20 mg Humira multi vitamin Vitamin D
Current Illness: none
Preexisting Conditions: Rheumatoid Arthritis High Blood pressure
Allergies: Bactrim Some statins
Diagnostic Lab Data: I received the monoclonal antibody infusion on 8/22/2021
CDC Split Type:

Write-up: I tested positive for Covid on August 21, 2021


VAERS ID: 1671388 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthritis, Fall, Grip strength decreased, Limb injury, Loss of consciousness, Pain in extremity, Pelvic pain
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (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: Losartan, Synthroid, Montelukast, Vit D, Bone-up, Magnesium, Omega-3, Flaxseed Oil Capsules, Pro-Biotic
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: None
Diagnostic Lab Data: I did go to my general practitioner the following Tuesday to assure there weren''t further injury from the fall. He concluded it appeared to be an isolated event resulting from the injection and said to monitor for further symptoms the next several weeks and that I did not have an infection from the arm wound but would be quite sore in my pelvic area for some time.
CDC Split Type:

Write-up: 24 hours after injection I momentarily blacked out---gash on right arm from hitting kitchen counter and pelvic pain/discomfort from fall. At same time I had inflammation of both thumb joints--extremely painful and could not grip/lift anything without using both hands. That lasted for approximately another 12 hours and over the next 24 hours all inflammation and pain gradually subsided. I did not have any dizziness, disorientation or light headedness at time of blackout nor any joint pain. I have not had either since the initial episode.


VAERS ID: 1671399 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-03-13
Onset:2021-08-21
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Deep vein thrombosis, Pulmonary embolism, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Olmesartan 20 mg daily Hydrochlorothiazide 12.5 mg daily Multivitamin daily
Current Illness: Thrombosed hemorrhoid treated with topical medication
Preexisting Conditions: Hypertension
Allergies: Apples gives itchy eyes and swelling in throat
Diagnostic Lab Data: Ultrasound showing DVT. CT chest showing moderate burden pulmonary emboli
CDC Split Type:

Write-up: DVT with pulmonary embolism


VAERS ID: 1672721 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Pain, 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Body aches; Fever; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Body aches) and PYREXIA (Fever) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 20-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Aug-2021, the patient experienced PAIN (Body aches) and PYREXIA (Fever). The patient was treated with IBUPROFEN for Adverse event, at a dose of 1 dosage form. At the time of the report, PAIN (Body aches) and PYREXIA (Fever) outcome was unknown. Concomitant medications were not provided.


VAERS ID: 1672816 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-24
Onset:2021-08-21
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / OT

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

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

Write-up: Gave a second dose from vials that were expired past the 12 hours mark this morning; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Gave a second dose from vials that were expired past the 12 hours mark this morning) in a 31-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) for COVID-19 vaccination. No Medical History information was reported. On 24-Jul-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Gave a second dose from vials that were expired past the 12 hours mark this morning). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Gave a second dose from vials that were expired past the 12 hours mark this morning) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No Concomitant product use was provided. No Treatment information was provided. Pharmacist stated that one of her interns accidentally gave 2 patients a second dose from vials that were expired past the 12 hours mark this morning 21Aug2021 at 8:25am (vial was open since yesterday 20Aug2021, punctured at 1:35pm). She wanted to know if they need to be revaccinated right away or not? Both shots (first and second) were given in the left deltoid muscle for both patients.


VAERS ID: 1672826 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-21
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Dizziness, Heart rate abnormal, Hunger
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210821; Test Name: Fast Heartbeat; Result Unstructured Data: Increased
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Dizziness; Weakness; Feels hungry; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizziness), ASTHENIA (Weakness) and HUNGER (Feels hungry) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Aug-2021, the patient experienced DIZZINESS (Dizziness), ASTHENIA (Weakness) and HUNGER (Feels hungry). At the time of the report, DIZZINESS (Dizziness), ASTHENIA (Weakness) and HUNGER (Feels hungry) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 21-Aug-2021, Heart rate abnormal: increased (High) Increased. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided. Reporter did not allow further contact


VAERS ID: 1672827 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-22
Onset:2021-08-21
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Mobility decreased, Myalgia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: hardly can get out of bed; strong body aches; headaches; Vomiting; This spontaneous case was reported by a consumer and describes the occurrence of MOBILITY DECREASED (hardly can get out of bed), MYALGIA (strong body aches), HEADACHE (headaches) and VOMITING (Vomiting) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. unknown) for COVID-19 vaccination. No Medical History information was reported. On 22-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 21-Aug-2021, the patient experienced MOBILITY DECREASED (hardly can get out of bed), MYALGIA (strong body aches), HEADACHE (headaches) and VOMITING (Vomiting). At the time of the report, MOBILITY DECREASED (hardly can get out of bed), MYALGIA (strong body aches), HEADACHE (headaches) and VOMITING (Vomiting) outcome was unknown. Concomitant medications were not reported. Treatment medications were not reported.


VAERS ID: 1672836 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-24
Onset:2021-08-21
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / OT

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

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

Write-up: Accidentally gave 2 patients a second dose from vials that were expired past the 12 hours mark this morning 21Aug2021 at 8:25am (vial was open since yesterday 20Aug2021, punctured at 1:35pm); This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Accidentally gave 2 patients a second dose from vials that were expired past the 12 hours mark this morning 21Aug2021 at 8:25am (vial was open since yesterday 20Aug2021, punctured at 1:35pm)) in a 59-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) for COVID-19 vaccination. No Medical History information was reported. On 24-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Aug-2021 at 8:25 AM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 21-Aug-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXPIRED PRODUCT ADMINISTERED (Accidentally gave 2 patients a second dose from vials that were expired past the 12 hours mark this morning 21Aug2021 at 8:25am (vial was open since yesterday 20Aug2021, punctured at 1:35pm)). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Accidentally gave 2 patients a second dose from vials that were expired past the 12 hours mark this morning 21Aug2021 at 8:25am (vial was open since yesterday 20Aug2021, punctured at 1:35pm)) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. Treatment information was not provided.


VAERS ID: 1672859 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-08-21
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Nasopharyngitis, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: little dizzy; felt really fatigue; cold; chills; trembling; fever; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (little dizzy), FATIGUE (felt really fatigue), NASOPHARYNGITIS (cold), CHILLS (chills) and TREMOR (trembling) in a 24-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Aug-2021, the patient experienced DIZZINESS (little dizzy), FATIGUE (felt really fatigue), NASOPHARYNGITIS (cold), CHILLS (chills), TREMOR (trembling) and PYREXIA (fever). At the time of the report, DIZZINESS (little dizzy), FATIGUE (felt really fatigue), NASOPHARYNGITIS (cold), CHILLS (chills), TREMOR (trembling) and PYREXIA (fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Relevant concomitant medications were not provided. Treatment information was not provided.


VAERS ID: 1672882 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Osteitis, Vaccination site inflammation, Vaccination site warmth
SMQs:, Osteonecrosis (broad)

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

Write-up: jaw was inflamed; Head ache in the eye region and back of the skull; Warm sensation at the site of the injection.; Inflammation at the site of the injection.; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Warm sensation at the site of the injection.), VACCINATION SITE INFLAMMATION (Inflammation at the site of the injection.), OSTEITIS (jaw was inflamed) and HEADACHE (Head ache in the eye region and back of the skull) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 022C21A) for COVID-19 vaccination. No Medical History information was reported. On 21-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Aug-2021, the patient experienced VACCINATION SITE WARMTH (Warm sensation at the site of the injection.), VACCINATION SITE INFLAMMATION (Inflammation at the site of the injection.) and HEADACHE (Head ache in the eye region and back of the skull). On an unknown date, the patient experienced OSTEITIS (jaw was inflamed). On 21-Aug-2021, HEADACHE (Head ache in the eye region and back of the skull) had resolved. At the time of the report, VACCINATION SITE WARMTH (Warm sensation at the site of the injection.), VACCINATION SITE INFLAMMATION (Inflammation at the site of the injection.) and OSTEITIS (jaw was inflamed) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication were provided by the reporter. No treatment medication were provided by the reporter.


VAERS ID: 1672931 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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

Write-up: Sore arm; Muscle aches; Fatigue; Headache; This spontaneous case was reported by a pharmacist and describes the occurrence of PAIN IN EXTREMITY (Sore arm), MYALGIA (Muscle aches), FATIGUE (Fatigue) and HEADACHE (Headache) in a 43-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 20-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Aug-2021, the patient experienced PAIN IN EXTREMITY (Sore arm), MYALGIA (Muscle aches), FATIGUE (Fatigue) and HEADACHE (Headache). At the time of the report, PAIN IN EXTREMITY (Sore arm), MYALGIA (Muscle aches), FATIGUE (Fatigue) and HEADACHE (Headache) outcome was unknown. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medication was not provided Treatment information was not reported


VAERS ID: 1672962 (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: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 3 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site reaction, Vaccination site erythema, Vaccination site pain, Vaccination site pruritus, Vaccination site swelling, Vaccination site warmth
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: TELMISARTAN; CRESTOR; LORATADINE; PREDNISONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Injection site reaction; First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt; First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt; First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt; First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt; First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt.; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE REACTION (Injection site reaction), VACCINATION SITE WARMTH (First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt), VACCINATION SITE PRURITUS (First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt), VACCINATION SITE SWELLING (First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt) and VACCINATION SITE ERYTHEMA (First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939902) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included TELMISARTAN, ROSUVASTATIN CALCIUM (CRESTOR), LORATADINE and PREDNISONE for an unknown indication. On 21-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Aug-2021, the patient experienced INJECTION SITE REACTION (Injection site reaction), VACCINATION SITE WARMTH (First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt), VACCINATION SITE PRURITUS (First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt), VACCINATION SITE SWELLING (First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt), VACCINATION SITE ERYTHEMA (First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt) and VACCINATION SITE PAIN (First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt.). At the time of the report, INJECTION SITE REACTION (Injection site reaction), VACCINATION SITE WARMTH (First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt), VACCINATION SITE PRURITUS (First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt), VACCINATION SITE SWELLING (First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt), VACCINATION SITE ERYTHEMA (First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt) and VACCINATION SITE PAIN (First it was itching, then 6 inches in diameter was hot, swollen and red. Also hurt.) outcome was unknown. The concomitant medication included benadryl.


VAERS ID: 1672991 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache
SMQs:

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

Write-up: Headaches; fatigued; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (fatigued) and HEADACHE (Headaches) in a 34-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 20-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Aug-2021, the patient experienced FATIGUE (fatigued). On 23-Aug-2021, the patient experienced HEADACHE (Headaches). At the time of the report, FATIGUE (fatigued) was resolving and HEADACHE (Headaches) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were provided by reporter. No treatment medications were provided by reporter.


VAERS ID: 1673031 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 3 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthritis, Erythema, Fall, Hypokinesia, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Systemic lupus erythematosus (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: My arm is red; having arthritis in the arms and legs; I couldn''t get up from the bed, my legs and arms couldn''t move; feeling a little whizzy; I fall in my family room and couldn''t get up; This spontaneous case was reported by a consumer and describes the occurrence of WHEEZING (feeling a little whizzy), HYPOKINESIA (I couldn''t get up from the bed, my legs and arms couldn''t move), ERYTHEMA (My arm is red), FALL (I fall in my family room and couldn''t get up) and ARTHRITIS (having arthritis in the arms and legs) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002F21A) for COVID-19 vaccination. Concurrent medical conditions included Arthritis. Concomitant products included HYDROXYCARBAMIDE (HYDROXYUREA), PRAVASTATIN, DOXEPIN and LEVOTHYROXINE for an unknown indication. On 20-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Aug-2021, the patient experienced WHEEZING (feeling a little whizzy) and FALL (I fall in my family room and couldn''t get up). On 22-Aug-2021, the patient experienced HYPOKINESIA (I couldn''t get up from the bed, my legs and arms couldn''t move). On an unknown date, the patient experienced ERYTHEMA (My arm is red) and ARTHRITIS (having arthritis in the arms and legs). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. At the time of the report, WHEEZING (feeling a little whizzy), HYPOKINESIA (I couldn''t get up from the bed, my legs and arms couldn''t move), ERYTHEMA (My arm is red), FALL (I fall in my family room and couldn''t get up) and ARTHRITIS (having arthritis in the arms and legs) outcome was unknown. Patient was taking an unspecified medication for arthritis.


VAERS ID: 1673078 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-24
Onset:2021-08-21
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 2 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Depressed mood, Eye haemorrhage, Feeling abnormal, Hyperhidrosis, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Dementia (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: large broken blood vessel in his left eye on outer edge of the iris; He felt terrible/He felt emotionally terrible for 5 to 10 minutes; He felt depressed; His right arm was sore on that day after 2nd dose/He had body aches; chills on next day; At night, he sweated a lot.; His right arm was sore on that day after receiving 2nd dose; This spontaneous case was reported by a consumer and describes the occurrence of EYE HAEMORRHAGE (large broken blood vessel in his left eye on outer edge of the iris) in a 38-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 051C21A and 049E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 24-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 21-Aug-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced PAIN IN EXTREMITY (His right arm was sore on that day after receiving 2nd dose). On 22-Aug-2021, the patient experienced MYALGIA (His right arm was sore on that day after 2nd dose/He had body aches), CHILLS (chills on next day) and HYPERHIDROSIS (At night, he sweated a lot.). On 24-Aug-2021, the patient experienced FEELING ABNORMAL (He felt terrible/He felt emotionally terrible for 5 to 10 minutes) and DEPRESSED MOOD (He felt depressed). On 25-Aug-2021, the patient experienced EYE HAEMORRHAGE (large broken blood vessel in his left eye on outer edge of the iris) (seriousness criterion medically significant). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, EYE HAEMORRHAGE (large broken blood vessel in his left eye on outer edge of the iris), MYALGIA (His right arm was sore on that day after 2nd dose/He had body aches), CHILLS (chills on next day), HYPERHIDROSIS (At night, he sweated a lot.), FEELING ABNORMAL (He felt terrible/He felt emotionally terrible for 5 to 10 minutes), DEPRESSED MOOD (He felt depressed) and PAIN IN EXTREMITY (His right arm was sore on that day after receiving 2nd dose) outcome was unknown. Action taken with mRNA-1273 in response to the events was not applicable. No concomitant medication details were reported. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Further information has been requested.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Further information has been requested.


VAERS ID: 1673114 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-02
Onset:2021-08-21
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac flutter
SMQs:, Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Tachyarrhythmia terms, nonspecific (narrow)

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

Write-up: fluttering in her heart; This spontaneous case was reported by a consumer and describes the occurrence of CARDIAC FLUTTER (fluttering in her heart) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On 02-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Aug-2021, the patient experienced CARDIAC FLUTTER (fluttering in her heart) (seriousness criterion medically significant). At the time of the report, CARDIAC FLUTTER (fluttering in her heart) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment drug information provided. Patient stated that fluttering in her heart was ongoing, at the time of this report. Patient did not take any concomitant medications. She had no history of myocarditis/COVID-19. Company Comment : Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 1673336 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Pruritus, Skin mass
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101090067

Write-up: bumps feel hot an itchy like a mosquito bite; he noticed bumps in his legs; itchy like a mosquito bite; This is a spontaneous report from a contactable consumer. This is the 2nd case out of 2 cases. A 46-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: FC3180, Expiration date was not reported), dose 1 via an unspecified route of administration, administered in Arm Right on 20Aug2021 (age at vaccination 46 years) as dose 1, single for covid-19 immunisation. Medical history was not reported. There were no concomitant medications. On 21Aug2021 the patient experienced bumps feel hot an itchy like a mosquito bite, he noticed bumps in his legs, itchy like a mosquito bite. Reporter stated, noticed 6 bumps on his legs, wrist and it started itching more, bumps feel hot and itchy like a mosquito bite. Reporters husband (consumer) received his Pfizer Covid-19 vaccine first shot yesterday around the same time and his side effects were between 12:30 to 2:00 am last night, he noticed bumps in his legs when he went to the restaurant it started itching and when he went to bed, he started itching more and noticed 6 bumps on his legs and wrist, bumps feel hot an itchy like a mosquito bite. She gave answer to his questions. The patient did not receive any treatment for reported events. The outcome of event was not recovered.


VAERS ID: 1673358 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-21
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, Polymerase chain reaction
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: Test Date: 20210821; Test Name: PCR test; Test Result: Positive
CDC Split Type: USPFIZER INC202101090984

Write-up: Patient developed COVID-19 symptoms and subsequently tested positive by PCR test.; Patient developed COVID-19 symptoms and subsequently tested positive by PCR test.; This is a spontaneous report from a contactable consumer. An adult male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection, Lot Number: UNKNOWN), via an intramuscular route of administration on an unspecified date as dose number unknown, single for COVID-19 immunization. It was unknown, if patient received any vaccine in 4 weeks. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had tested for COVID-19. The patient medical history and concomitant medications were not reported. It was reported that patient developed covid-19 symptoms and subsequently tested positive by pcr test. on 21Aug2021. The patient underwent lab tests and procedures which included polymerase chain reaction: positive on 21Aug2021. It was unknown if patient received any treatment. The clinical outcome for the event was recovering. Information on the lot/batch number has been requested.


VAERS ID: 1673386 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Alabama  
Vaccinated:2021-02-24
Onset:2021-08-21
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test, 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: Test Date: 20210823; Test Name: COVID test; Test Result: Positive
CDC Split Type: USPFIZER INC202101098413

Write-up: positive COVID-19 test with symptoms; positive COVID-19 test with symptoms; This is a spontaneous report from contactable consumer via Pfizer Sales Representative. A 73-year-old male patient received BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE), second dose on 24Feb2021 at dose 2, single and first dose on 03Feb2021 at dose 1, single for COVID-19 immunisation. Medical history and concomitant medications were not reported. The patient had no serious underlying health conditions. The patient began feeling ill with symptoms of coughing, congestion, headache, body aches and fever on 21Aug2021. Patient went for COVID testing on morning of 23Aug2021 and COVID test was positive. The outcome of the event was unknown. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1673405 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-02-15
Onset:2021-08-21
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / OT

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, Polymerase chain reaction, SARS-CoV-2 test, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210825; Test Name: PCR test; Test Result: Positive ; Comments: Nasal Swab; Test Date: 20210823; Test Name: rapid test; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101109682

Write-up: received full 2-dose series of CV19 vaccine #1 on 27Jan2021 and #2 on 15Feb2021. Was PCR tested CV19 positive on 25Aug2021; received full 2-dose series of CV19 vaccine #1 on 27Jan2021 and #2 on 15Feb2021. Was PCR tested CV19 positive on 25Aug2021; This is a spontaneous report from a contactable other HCP. A 38-year-old male patient received the second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot number: EL3247), via intramuscular route of administration, in the left arm, on 15Feb2021 (at the age of 38-year-old), as single dose and received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot number: EL3247), via intramuscular route of administration, in the left arm, on 27Jan2021 (at the age of 38-year-old), as single dose, both the doses for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Unknown if other vaccine in four weeks and Unknown if other medications in two weeks. Unknown if COVID prior vaccination. On 21Aug2021, reporter staes patient received full 2-dose series of CV19 vaccine #1 on 27Jan2021 and #2 on 15Feb2021. patient was PCR tested CV19 positive on 25Aug2021. Event resulted in doctor or other healthcare professional office/clinic visit. Unknown if patient received treatment for events. The patient underwent the lab tests and procedure which included the rapid test (Nasal Swab): result was positive on 23Aug2021 and PCR test (Nasal Swab): result was positive on 25Aug2021. Outcome of the event was recovering. No follow-up attempts possible. No further information expected.; Sender''s Comments: Based on the information in the case report and a plausible temporal relationship, a possible causal relationship between the events vaccination failure, COVID-19 and suspect drug BNT162B2 cannot be excluded.


VAERS ID: 1674562 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Electrocardiogram, Fatigue, Increased tendency to bruise, Lymphadenopathy, Movement disorder, Palpitations, Sensory loss
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: occasional allergy medicine
Current Illness: none
Preexisting Conditions: long Covid
Allergies: penicillin
Diagnostic Lab Data: EKG and doctor''s exam -- 9/1
CDC Split Type:

Write-up: Immediate: intense fatigue, inability to move arm, lymph nodes massively swollen under both arms, under the left arm to the point that it was cutting off some sensation in the nerve running down my arm for 3 days Beginning 8/24: chest pressure, racing heart, feeling of shortness of breath; immense fatigue As of this report (9/4): Chest tightness/pressure, racing heart and fatigue continuing. Lymph nodes under both arms still massively swollen. I also noticed that I am bruising easily and for no reason. A day or two after the vaccine I noticed a huge bruise on my leg that I couldn''t pinpoint a reason for. Two days ago this occurred on multiple places on my right arm, also for absolutely no reason and this has never happened before.


VAERS ID: 1674590 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Intermenstrual bleeding, Pain in extremity, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Postnatal vitamin, sunflower Lecithin, Sulfurzyme (magnesium)
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extremely sore arm for 3 days. Vaginal bleeding (one week before expected cycle), bright red, heavy bleeding for 7 days, then some spoting for 2 days. Normal period has 2-3 days of red, then some brown spotting for 3-4 days.


VAERS ID: 1674714 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-14
Onset:2021-08-21
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy, Malaise, Neuralgia, Pain, Pyrexia
SMQs:, Peripheral neuropathy (narrow), 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: erythromycin, tetracycline, sulfa drugs, duricef
Diagnostic Lab Data:
CDC Split Type:

Write-up: for first week has malaise and soreness and fever, but approximately a week later started to experience nerve pain on the left side of the body, fluctuating at different points. also felt like her lymph nodes were swollen under the armpits and breast area. That has subsided, but the nerve pain still remains and fluctuates on the left side of the body(same side she received the shot on).


VAERS ID: 1674748 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood urine present, Chest X-ray normal, Chest discomfort, Chills, Computerised tomogram thorax normal, Creatine urine increased, Dyspnoea, Electrocardiogram, Fatigue, Headache, Pyrexia, Urine analysis abnormal
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: 05/05/2021, COVID 19, Moderna, age 49, adverse reactions were: fever/ chills one day after the 2nd dose. Headache and fatigue st
Other Medications:
Current Illness:
Preexisting Conditions: RA, Hidradenitis Suppurativa, high blood pressure
Allergies: Penicillin
Diagnostic Lab Data: 8/23: urine test, blood work showing normal kidney function. urine test showed no infection/ bacterial growth but blood in urine. 9/3: urine test: gross level of blood in urine, slightly elevated creatine levels, cat scan showed possible PE, sent to ER. ER did EKG, cat scan with contrast of lungs, chest x-ray - all clear. no PE. No explanation for shortness of breathe, blood in urine, headache.
CDC Split Type:

Write-up: 8/21/2021: fever/ chills started at midnight and lasted for the next 36 hours. headache /fatigue started later in the day on the 21st, closer to 12 hours after the dose was given. 8/23/2021: blood in urine, very dark brown urine. fatigue, headache, chills/ fever resolved after about 3 days. dark urine lasted for 4 -5 days post vaccination. 9/1: fever and chills restarted 9/2: headache/ fatigue/ tightness in chest/ shortness of breathe started. 9/3: blood in urine started again 9/4: fever is resolved. Headache, fatigue and blood in urine remain.


VAERS ID: 1674755 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-01
Onset:2021-08-21
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Antinuclear antibody positive, Arthralgia, Autoimmune disorder, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad), Immune-mediated/autoimmune disorders (narrow)

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: NA
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: Positive ANA titer
CDC Split Type:

Write-up: Joint pain, muscle weakness, onset of autoimmune disease 5 months post vaccination


VAERS ID: 1675068 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-21
Onset:2021-08-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dysphagia, Hyperhidrosis, Nausea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Listed in previous VAERs reports filed today
Other Medications: claritin, rhinocort aqua, singulair, arnuity inhaler, synthroid, vit b-6, vit c, calcium, vit d, biotin, glucosamine chondroitin, vit e, topomax, vitamin b12, meclizine
Current Illness:
Preexisting Conditions: breast cancer, hypothyroidism, asthma, migraine, vertigo
Allergies: sulfa, percoset, codeine, tramadol
Diagnostic Lab Data: The EMT''s took my blood pressure and it was 150+/99.
CDC Split Type:

Write-up: 10 Minutes after received the vaccine, felt like my throat was going to close, like it was hard to swallow. I started to feel lightheaded and nausea as well. I broke out in a sweat as well.


VAERS ID: 1675291 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Decreased appetite, Fatigue, Influenza like illness, Nausea, Pain, Tenderness, Vomiting
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: mildly achey for a day or two
Other Medications: Nature-Throid, Bupropion, Montelukast, Progesterone pill, blend cream of estrogen/testosterone/progesterone, weekly allergy shots (not taken within a week of the booster vaccine shot), Supplements: Adapten, Nuadapt, cortisol manager, osteop
Current Illness:
Preexisting Conditions: Hoshimoto''s Disease
Allergies: latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: The first weekend - flu-like aches and pains along with fatigue. (had lab work for an upcoming unrelated doctor''s appointment and found out that numbers elevated indicating inflammation). The second weekend - Friday, August 27, became nauseous, throwing up around 7pm, reduced appetite the next 2 days, tender stomach, weak, fatigued, by Monday, August 30 - continued weak & fatigued, nausea mostly gone, appetite had returned.


VAERS ID: 1675615 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-19
Onset:2021-08-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN Z07AZIA / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Full blood count normal, Vertigo
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin ER, Atorvastatin, Glimepiride, Baby Aspirin, Methimazole, Vitamin D3, Trulicity
Current Illness:
Preexisting Conditions: Type 2 diabetes, Hyper Thyroid
Allergies: Compazine
Diagnostic Lab Data: CBC on 8/31/21was all within normal limits
CDC Split Type:

Write-up: I woke up two days later with Vertigo. I could not turn fast or bend forward without Vertigo. I tried my chiropractor first, times two different sessions. I then found myself dizzy even during sleep Aug 30th into the 31st. On the 31st of August I sought the help from my Doctor. Doctor B was unavailable, so I saw Doctor T. She placed me on a new medication Meclizine for my Verito


VAERS ID: 1675635 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-01
Onset:2021-08-21
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Condition aggravated, Fatigue, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa Multi vitamin ACV
Current Illness: Fever. Chills. Fatigue. Vomiting
Preexisting Conditions:
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vomiting. Fever. Chills. Fatigue


VAERS ID: 1675681 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA U53E21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Dizziness, Fatigue, Headache, Night sweats
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data: 8/25/2021 Covid test given with negative results. Went to primary care doctor 8/30/21 received medicine for headaches (Butalbital/Acetaminophen)and dizziness (Meclizine 25mg) with instructions to take every 8 hours or as needed. Returned to primary care physician on 9/2/2021 and the headaches and dizziness stopped briefly. Severe headaches returned(9/4/2021) and are still currently persistent. Severe headaches will not go away even with meds.
CDC Split Type:

Write-up: Severe headache, fatigue, dizziness, off balance, and severe night sweats. Started the day after vaccine was given (8/20/2021)and is still happening.


VAERS ID: 1675723 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-01-28
Onset:2021-08-21
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Senior Living       Purchased by: ?
Symptoms: Bronchitis
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: Bronchitis symptoms and diagnosis, resulting in a positive test from Dr


VAERS ID: 1676467 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Headache, Induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Daily headache lasting until 9/3/21. Bug lump with red outline starting on 8/29 until 9/3/21


VAERS ID: 1677154 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-24
Onset:2021-08-21
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 1 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Adhesive tape allergy (tape); Allergy to antibiotic (Amoxicillin)
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy to antibiotic (Erythromycin)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Gave a vaccine to two patients that was past the 12hr window; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Gave a vaccine to two patients that was past the 12hr window) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 017E21A and 091D21A) for COVID-19 vaccination. Concurrent medical conditions included Adhesive tape allergy (tape), Allergy to antibiotic (Amoxicillin) and Allergy to antibiotic (Erythromycin). On 24-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 21-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Gave a vaccine to two patients that was past the 12hr window). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Gave a vaccine to two patients that was past the 12hr window) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication were provided by the reporter No treatment medication were provided by the reporter Most recent FOLLOW-UP information incorporated above includes: On 23-Aug-2021: Follow up received on 23 Aug 2021 include reporter first name updated. On 25-Aug-2021: Follow up received on 25 Aug 2021 include no new information. On 25-Aug-2021: Follow-up received on 25 Aug 2021 include patient demographics.


VAERS ID: 1677213 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, COVID-19, Chills, Facial pain, Headache, Myalgia, Nasopharyngitis
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Patient experienced covid like symptoms after receiving 1st dose; cold; face ache; Stomach ache; Next day, she started with headaches; body aches; chills; This spontaneous case was reported by a consumer and describes the occurrence of NASOPHARYNGITIS (cold), FACIAL PAIN (face ache), ABDOMINAL PAIN UPPER (Stomach ache), HEADACHE (Next day, she started with headaches) and MYALGIA (body aches) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medication history information was provided. Concomitant products included TERBINAFINE for Fungal infection, ESCITALOPRAM for an unknown indication. On 20-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Aug-2021, the patient experienced NASOPHARYNGITIS (cold), FACIAL PAIN (face ache), ABDOMINAL PAIN UPPER (Stomach ache), HEADACHE (Next day, she started with headaches), MYALGIA (body aches) and CHILLS (chills). On an unknown date, the patient experienced COVID-19 (Patient experienced covid like symptoms after receiving 1st dose). The patient was treated with IBUPROFEN for Adverse event, at an unspecified dose and frequency. At the time of the report, NASOPHARYNGITIS (cold), FACIAL PAIN (face ache), ABDOMINAL PAIN UPPER (Stomach ache), HEADACHE (Next day, she started with headaches), MYALGIA (body aches), CHILLS (chills) and COVID-19 (Patient experienced covid like symptoms after receiving 1st dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications also include supplements.


VAERS ID: 1677455 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-20
Onset:2021-08-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Heart rate, Heart rate increased, Palpitations, Supraventricular tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OMEPRAZOLE; CLARITINE; MONTELUKAST
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: heart rate; Result Unstructured Data: Test Result:High; Comments: Sudden high heart rate 64-153 taking several minutes to subside
CDC Split Type: USPFIZER INC202101082676

Write-up: Sudden high heart rate 64-153 taking several minutes to subside, chest pounding; Sudden high heart rate 64-153 taking several minutes to subside, chest pounding; lightheaded; appears to be an episode of SVT; This is a spontaneous report from a contactable other hcp. A 39-years-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot Number and Expiration date was not reported), via an unspecified route of administration, administered in Arm Left on 20Aug2021 13:30 (at the age of 39-years-old) as DOSE 1, SINGLE for covid-19 immunisation at other facility. Patient was not pregnant at the time of vaccination. The patient medical history was not reported. Concomitant medications included omeprazole (OMEPRAZOLE); loratadine (CLARITINE); montelukast (MONTELUKAST) taken for an unspecified indication, start and stop date were not reported. The patient previously took Sulfa and experienced allergies. Other vaccine in four weeks included none. No COVID prior vaccination and COVID was not tested post vaccination. The patient experienced sudden high heart rate 64-153 taking several minutes to subside, chest pounding, lightheaded, gradually subsided, appeared to be an episode of SVT on 21Aug2021 21:15. The patient underwent lab tests and procedures which included heart rate: high on an unspecified date. No treatment was received for the events. The event appeared to be an episode of SVT was recovered with sequel on an unspecified date, while the other events were recovering at the time of this report. Information on the lot/batch number has been requested.


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