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From the 7/23/2021 release of VAERS data:

Found 506,830 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 45 out of 5,069

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VAERS ID: 1457193 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-30
Onset:2021-07-07
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid Labetolol Wellbutrin Vit E Omega 3 Wheatgrass
Current Illness: None
Preexisting Conditions: High blood pressure Hypothyroidism
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: ?COVID-Arm? Exactly 1 week later (7days) my left arm became itchy and red and swollen. I have a large red spot about 3-4invhes in diameter and it feels warm to the touch.


VAERS ID: 1457221 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Body temperature increased, Headache, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant 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: None
Current Illness: Sinus infection two weeks prior, took DayQuil day and night as treatment.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Headache, 102.2 temp, body aches, vomiting, nausea


VAERS ID: 1457224 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-02-08
Onset:2021-07-07
   Days after vaccination:149
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, Cough, Nasal congestion, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), 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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: PCR Covid 19 Vaccination
CDC Split Type:

Write-up: Fully vaccinated individual developed COVID 19 symptoms of fever, cough, nasal congestion on 7/7/21


VAERS ID: 1457227 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-16
Onset:2021-07-07
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 - / IM

Administered by: Work       Purchased by: ?
Symptoms: Interchange of vaccine products
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: None known
Current Illness: None known
Preexisting Conditions: none known
Allergies: None known
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient presented to receive 2nd dose of Pfizer, did not have vaccine card. We used a database to verify the apparent 1st dose. This is when it was discovered that the patient had received Johnson and Johnson in March 2021 and Pfizer from 6/16/2021 (which we did administer). We did not proceed with another dose.


VAERS ID: 1457228 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Hypoaesthesia, Pain in extremity
SMQs:, Peripheral neuropathy (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: NONE
Current Illness:
Preexisting Conditions:
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated that after he received his vaccine he had headaches, and arm pain. Patient also said that his right jaw is numb. Patient didn''t seek medical attention yet, Patient stated that he is still having Adverse Event.


VAERS ID: 1457229 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-05-11
Onset:2021-07-07
   Days after vaccination:57
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan 50mg daily
Current Illness: None
Preexisting Conditions: Hypertension, Prediabetes, intermittent asthma, hyperlipidemia
Allergies: None
Diagnostic Lab Data: Component 7/7/2021 SARS-COV-2 NAA (COVID-19) Detected (A)
CDC Split Type:

Write-up: +COVID infection after completing vaccine series


VAERS ID: 1457244 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-20
Onset:2021-07-07
   Days after vaccination:109
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Pt hospitalized with COVID 19 post vaccination.


VAERS ID: 1457246 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Dehydration (broad)

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

Write-up: Patient called today (7/8/21) complaining of shortness of breath and rapid heart rate


VAERS ID: 1457281 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 LA / IM

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

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

Write-up: Patient was given first dose of COVID Vaccine on 6/23/2021 and administered the second dose of COVID Vaccine 14 days later on 7/7/2021


VAERS ID: 1457296 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 LA / IM

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

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

Write-up: Patient was given first dose of COVID Vaccination on 6/23/2021 and was given second dose of COVID Vaccine 14 days later on 07/07/2021


VAERS ID: 1457310 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypotension, Pallor, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: After receiving vaccination, approximately 2 minutes after - patient lost color, fainted, and began to seize. 911 was called, EMT took vitals and blood pressure was low. Patient refused to go to emergency room. Patient sat for about 20 minutes after shot, he was asked multiple times if he was okay to drive and he said yes.


VAERS ID: 1457336 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

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

Write-up: Right arm swelling and redness


VAERS ID: 1457342 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198-STATE / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pallor, Peripheral coldness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Mom states pt fainted for the first time yesterday morning (07/07/2021). Pt stated she woke up thirsty but did not feel dizzy. Pt asked mom for water and as she was going to the kitchen she fainted. Mom states pt looked pale and her hands were cold. Pt states she does drink lots of liquids everyday. Pt states she does not have any stressors at this time and actually feels really happy. The only thing is pt did receieve the first dose of the Covid-19 vaccine on Tuesday (07/06/2021). Today pt states she feels much better. No other symptoms or concerns at this time.


VAERS ID: 1457349 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head, Dizziness, Fall, Head injury
SMQs:, Anticholinergic syndrome (broad), Accidents and injuries (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: patient reported only being on supplements and regularly low blood pressure to the paramedics
Current Illness: nka
Preexisting Conditions: nka
Allergies: nka
Diagnostic Lab Data: patient reported at the hospital her 1. blood pressure, heart rate was monitored 2. ct scan of the head was clear 3. heart was monitored.
CDC Split Type:

Write-up: after 5-6 minutes post vaccination while sitting in waiting / monitoring area, patient got very dizzy and fell off her chair on to the ground. she immediately got up with help from staff and sat back on the chair. paramedics were called on her request and after monitoring and running diagnostics patient asked to be taken to emergency room to be further monitored because she felt dizzy and had bumped her head when she fell off the chair. she returned a few hours later on her own after getting discharged from the hospital to get her vaccination card.


VAERS ID: 1457357 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 1 LA / IM

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

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

Write-up: Patient received Moderna vaccine IM to LD. No signs or symptoms of adverse reaction at this time. Patient can move extremity without difficulty. Mom was given handout and advised to monitor for signs and symptoms of adverse reaction. Mom voiced understanding.


VAERS ID: 1457367 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Face oedema, Lip swelling, Oedema peripheral, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: HIVES, GENERALIZED EDEMA OF FACE AND HANDS, LIP SWELLING ONSET 3 HOURS POST VACCINATION. TX: PO BENADRYL AND PREDNISOLON GIVEN IN OFFICE TODAY (07/08/2021). DISCHARGED HOME WITH RX: PREDNISONE AND HYDROXIZINE. RECHECK IN 24 HOURS.


VAERS ID: 1457375 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

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

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

Write-up: Swelling of Tongue and headache after receiving the vaccine, patient was given Benadryl 50mg PO BID x 3days and Prednisone 60 mg PO daily x 3 days


VAERS ID: 1457381 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FW0181 / 1 RA / IM

Administered by: Private       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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Hepatitis B, estimated 1980''s, experienced temp-paralysis
Other Medications: Crestor, HCtv, Olphaneim, Multi-Vitamins, Vitamin B + C, Supplements, Tylenol, Fiber pill
Current Illness: N/A
Preexisting Conditions: Arthritis, HBP, High-Cholesterol
Allergies: Seafood, Thymercal, Flu-Vaccine (preservative free), Eye drops, Insted, Morphine, Sulfa, Aspirin, Gel-Caps, Red-Dye, Iodine, Beta dine, Arithamicine, Percocet, Calcium, Motrin, Zofran, Ibuprofen
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt. states received Phizer 07/06/2021 and 07/07/2021 started experiencing a rash developing on both hands and continuing up the arms. No primary visit but with Cardiologist who recommended Benadryl and calamine lotion. Plans to schedule visit with Primary in the near future.


VAERS ID: 1457392 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-02
Onset:2021-07-07
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction, Chest discomfort, Chest pain, Echocardiogram, Electrocardiogram PR interval, Electrocardiogram QRS complex shortened, Electrocardiogram QT interval, Electrocardiogram ST segment elevation, Electrocardiogram T wave abnormal, Electrocardiogram abnormal, Electrocardiogram repolarisation abnormality, Limb discomfort, Myocardial infarction, Myocarditis, Pain, Sinus bradycardia, Troponin increased, Vaccination complication
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (narrow), Disorders of sinus node function (narrow), Conduction defects (narrow), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: doxycycline 20mg po bid multivitamin chewable daily melatonin 2.5mg po daily
Current Illness: none
Preexisting Conditions: none
Allergies: cefdinir (nausea)
Diagnostic Lab Data: JULY 7th, 2021 troponin 7.66 EKG-sinus bradycardia, Vent. Rate : 059 BPM Atrial Rate : 059 BPM P-R Int : 128 ms QRS Dur : 088 ms QT Int : 382 ms P-R-T Axes : 022 084 047 degrees QTc Int : 378 ms Sinus bradycardia Septal infarct , age undetermined ST elevation, consider early repolarization, pericarditis, or injury Abnormal ECG No previous ECGs available Nonspecific T wave abnormality
CDC Split Type:

Write-up: History of Present Illness 17-year-old male who denies any major medical problems presents to the ER concern for chest pain. The patient states that he stayed up all night and he woke up this morning around 12:30 p.m., around 1 hour prior to arrival and he was having a tightness in his chest. The tightness is constant, seems to go down his left arm. He has never had this happen before. He received his Pfizer vaccination for COVID-19 on Friday of last week and he feels like he has had some aches since that time. He has been taking Motrin for this and this morning he also took Motrin but there is no significant relief. He has no significant shortness of breath, no nausea vomiting, no diaphoresis. I spoke with him privately and he denies any history of cocaine abuse. Per his mother he has healthy, no major medical problems. He has not recently had any other concerns or recent review systems. No history of having blood clots or DVTs. Medical Decision Making: History examination as above. Patient presents our concern for tightness in his chest with some radiation to his left arm over the past 1 hour. His EKG does show J-point elevation but he has no risk factors, he is hemodynamically stable well-appearing on examination. He has no shortness of breath, nausea, diaphoresis. Differential includes myopericarditis, early repolarization. Feel that the likelihood of STEMI, ACS is low. Will obtain a troponin as a part of his workup, chest x-ray for evaluation of cardiac silhouette size, bedside ultrasound. I do not suspect that he has a PE. He has no tachycardia tachypnea hypoxia. No external findings of suggest a DVT on examination. I do not suspect that he has cardiac tamponade, CHF, pulmonary process such as pneumothorax, pneumonia based on his history. Do not suspect a GI etiology. Will monitor closely here in the ER and re-evaluate. Time 2:30 p.m.. The patient''s troponin is elevated at 7. I consult with Cardiology and I spoke with Dr- we reviewed the patient''s EKG, his presentation, his history. He feels this is secondary to myocarditis from likely the COVID-19 vaccination. I have added a viral PCR as well as a part of his workup. He does not recommend activation the cath lab, he does not feel this is a STEMI. I do agree based on the history and the patient''s appears this time. He recommended a formal echocardiogram as well. -I spoke with the ultrasound technician at bedside and there is no evidence of wall motion abnormality. This is consistent with my examination. -given the patient''s elevated troponin we do not have capabilities of caring for him here. Not have Pediatric Cardiology, we do not have a PICU if the patient''s condition were to worsen. There for the patient requires transfer to tertiary center. -will consult with another hospital for transfer. Time 3:22 p.m.. I spoke with Dr, he accepts for transfer. No recommendations for medications at this time. The patient is chest pain-free, hemodynamically stable. Spoke with the ultrasound technician there is no evidence of cardiac wall abnormality, pending official interpretation with our cardiologist. -asked for emergent transfer because I do not want the pain to be waiting here in the ER with possible worsening condition, worsening troponin elevation without cardiology consultation at a pediatric specific hospital. I do not want him to have the chance of deteriorating at this facility and therefore I do feel that he warrants emergent transfer as opposed to routine where he could wait here in the ER for hours. I do feel that benefits outweigh the risk and I spoke with the patient and his family about this and they agree. Critical Care: 55 minutes. Emergent evaluation on presentation given his EKG showing STEMI per computer interpretation. Time spent for multiple re-evaluations, discussion with Cardiology and outside hospital consultants, time spent with documentation. Time spent with family. Complex medical decision making. Serious life threatening disease process. Potential for death and increased morbidity. Exclusive of procedure time.


VAERS ID: 1457399 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-23
Onset:2021-07-07
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9263 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / UNK - / -

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

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

Write-up: COVID-19


VAERS ID: 1457408 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-28
Onset:2021-07-07
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cardio-respiratory arrest, Catheterisation cardiac abnormal, Chest pain, Coronary arterial stent insertion, Coronary artery occlusion, Electrocardiogram ST segment elevation, Intensive care, Nausea, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Respiratory failure (broad)

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

Write-up: 50 years old female with past medical history of hypertension. Patient presented with chief complaint of chest pain associated with nausea and vomiting. She was found to have a inferior ST elevation. Code heart was called. Patient was taken to Cath Lab. Mid RCA was occluded and one drug-eluting stent was placed. Patient tolerated procedure well. She was transferred to the ICU for the further management.


VAERS ID: 1457423 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Pain under arm mild swelling.


VAERS ID: 1457475 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-02
Onset:2021-07-07
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Neck pain
SMQs:, Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lexapro 10mg
Current Illness: migraines
Preexisting Conditions: no
Allergies: no allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: extreme neck pain for at least 48 hours


VAERS ID: 1457476 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chills, Gait inability, Hypoaesthesia, Influenza like illness, Mobility decreased, Neck pain, Pain in extremity, Pyrexia, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu shot, 25 years ago, all of my "baby shots"
Other Medications: Nortryptilene Singulair Losartan Zyrtec Vitamin D Lexapro
Current Illness: reaction to vaccine #1
Preexisting Conditions: Chronic Fatigue and Immune Dysfunction Syndrome
Allergies: sulfa drugs
Diagnostic Lab Data: none, but I''m thinking of going to the ER
CDC Split Type:

Write-up: Extreme arm pain, including shoulder, neck, back, no use of arm, numbness of hands, Flu-like symptoms, including fever, chills shakiness of legs, to the point that I can''t walk


VAERS ID: 1457479 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Angiogram cerebral normal, Arteriogram carotid normal, Blood pressure increased, Cerebral small vessel ischaemic disease, Computerised tomogram head normal, Condition aggravated, Dizziness, Formication, Headache, Injection site paraesthesia, Magnetic resonance imaging head abnormal, Paraesthesia, Visual impairment
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Hypertension (narrow), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (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? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nexium
Current Illness: none
Preexisting Conditions: obesity, HTN, dyslipidemia, migraines, GERD, fatigue, arthritis, Vit B12 deficiency, Vit D deficiency
Allergies: none
Diagnostic Lab Data: CT head showed no intracranial abnormality 7/7/21. CT angiograph head and neck were negative 7/7/21. MRI brain 7/8/21 showed no acute infarct but mild chronic ischemic microvascular changes.
CDC Split Type:

Write-up: Within 10min of administration, patient began to complain of a tingling, "crawling" feeling in her right arm where she received the shot. I had her try to move her arm a bit to distribute the dose. Then the tingling/crawling feeling spread to her right scapula, then the entire right arm and right face. Her blood pressure was elevated 156/87. She admittedly has not taken her HTN meds in a year. Patient was sitting in an office chair and began to feel dizzy, lightheaded and onset of a headache. When she said that her vision was starting to get black, I layed her to the floor and called EMS. Then her right leg also started to feel tingling. Patient was sent to the ED via ambulance and admitted to the hospital for code stroke.


VAERS ID: 1457482 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 1 LA / IM

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

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

Write-up: We accidently gave a 17 year, 11 month, 12 day old male the Moderna vaccine - it is not approved for anyone under the age of 18. Reported it and told to fill out a VAERS. I tried calling patient however was not able to talk personally with him. I left a detailed message asking him to call me on my direct line.


VAERS ID: 1457491 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-17
Onset:2021-07-07
   Days after vaccination:112
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Postmenopausal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Ringing in ears after covid vaccine
Other Medications: Cytomel, Synthroid, Atenolol, Claritin, multivitamin
Current Illness: seasonal allergies
Preexisting Conditions: hypothyroid; tachycardia
Allergies: cipro, peanuts
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: surprise period - in menopause


VAERS ID: 1457508 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

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

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

Write-up: Petechiae , Facial rash and swollen lips. Still the same after hydration, Tylenol and Benadryl.


VAERS ID: 1457516 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-26
Onset:2021-07-07
   Days after vaccination:193
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

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

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

Write-up: This patient tested positive for COVID on 7/7/2021. Received dose #1 Moderna 12/26/2020, dose #2 Moderna 1/20/2021


VAERS ID: 1457531 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO183-H / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose increased, General physical condition abnormal, Hyporesponsive to stimuli, Hypotension, Pallor
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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: Reports no regular medication use
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CBG= 163
CDC Split Type:

Write-up: Adverse Event PT received 2nd dose of Pfizer at 1604, presented with pallor and decreased responsiveness at 1608. PT was sitting slumped in chair, supported by staff. PT was assisted to elevate feet. Aid was called at 1608 and arrived at 1609. PT was assisted to floor and reported feeling ?much better? on floor. VS were taken at 1610 (BP laying 70/40, HR 50, SPO2 98% on RA, BP at 1612 80/P). PT denies medical history, allergies, routine medication use, or previous vaccine/injection reaction. PT stated that she had ?too much anxiety? before vaccine and had begun to feel dizzy, PT was unsure if she completely lost awareness of surroundings during initial event. Pt also reports that she had just woken up and had not eaten or taken in any fluids before her vaccine appointment. PT was prompted to sit up at 1614 and did so without difficulty or requiring offered assistance, juice was provided. PT?s color was improved and PT said ?Now I?m much better.? At 1615, PT was assisted to chair (again, without difficulty) and VS were taken. BP was 78/42 sitting, HR was 67, SPO2 was 99%. VS at 1620 were 72/38 sitting, 72 HR. PT was responsive, responding to questions appropriately. PT reported that she did not know her baseline BP. At 1623, PT was assisted to stand (educated beforehand to sit in chair if she felt dizzy). PT denied dizziness, BP was 60/42 standing, HR 75. PT assisted back to chair, provided and consumed water, and ate a snack that she had brought along with her. PT was educated on safety/danger of falls, hypotension, and advised that a trip to the ER was recommended. PT verbalized understanding, but reported that she wished to wait a little longer at this time. BP at 1628 sitting was 72/44 and at 1637 BP was 70/40 sitting. CBG at 1652 was 163. BP at 1656 was 78/44 sitting. PT was again encouraged to take ambulance to ER and educated on hypotension and safety. PT verbalized understanding, declined ambulance transfer, and signed AMA paperwork. PT was advised to go to ER and educated on what to report to ER staff when she presented for services. At 1659, PT was assisted to wheelchair and exited facility in the presence of family in private vehicle. Treatment: Assessment and treatment by EMTS, CBG taken Outcome: PT exited facility in wheelchair, accompanied by family. Education provided, declined ambulance. Advised to present to ER for further TX, verbalized understanding. HCP Responding:


VAERS ID: 1457601 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Vaccine temperature excursion. Vial was beyond use date. Vial should have been removed from freezer on 7/1/2021 and placed in refrigerator. Vial was removed from freezer on 7/5/2021.


VAERS ID: 1457609 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO1811 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Vial was beyond use date. Vial should have been removed from freezer on 7/1/2021 and placed in refrigerator. Vial was removed from freezer on 7/5/2021.


VAERS ID: 1457613 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Hypersomnia, Nausea, Product preparation issue
SMQs:, Acute pancreatitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Outpatient Medications Quantity Refills Start End Ascorbic Acid (VITAMIN C) 500 MG tablet Sig: Take 500 mg by mouth daily. Route: Oral Class: Historical Med fluticasone NASAL (FLONASE) 50 MCG/ACT nasal spray 3 Bottle 3 3/3
Current Illness: Questioning today did reveal that she is back using methamphetamines.
Preexisting Conditions: Problem List Date Reviewed: 7/7/2021 as of 7/8/2021 ICD-10-CM Priority Class Noted - Resolved Depression (Chronic) F32.9 8/8/2017 - Present DUB (dysfunctional uterine bleeding) (Chronic) N93.8 2/22/2019 - Present Hx Polysubstance abuse) (Chronic) F19.10 10/7/2019 - Present Allergic rhinitis (Chronic) J30.9 11/23/2020 - Present
Allergies: No Known Allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The patient did receive the correct amount of vaccine of 0.3ml of the vaccine once reconstituted. It is likely that the pt received a more concentrated dose of the vaccine. This was discovered after trying to draw up the correct number of vaccines from the vial and the vial was short. It appears that too much diluent was left in the diluent bottle and thus it was deduced that the amount of diluent used was 0.8ml instead of 1.8ml. Based on deduction, the vaccine was most likely in a stronger concentration than it was supposed to be. The vaccine was likely not reconstituted/diluted properly. There was no adverse reaction noted at the 15 minutes the pt stayed for supervision after the dose was administered. The issue was reported to her PCP. The pt was notified later in the day at approximately 3:20pm and still not having any adverse reaction. I also did a f/u call to her the morning after the vaccine was given. She was fatigued and slept alot and was having some nausea. These are some of the expected side effects of getting the vaccine. She stated she was doing fine however.


VAERS ID: 1457615 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Vial was beyond use date. Vial should have been removed from freezer on 7/1/2021 and placed in refrigerator. Vial was removed from freezer on 7/5/2021.


VAERS ID: 1457636 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-05
Onset:2021-07-07
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 LA / IM

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

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

Write-up: unknown


VAERS ID: 1457648 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-30
Onset:2021-07-07
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Single supraclavicular LAD on side of vaccine


VAERS ID: 1457653 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-01-28
Onset:2021-07-07
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL32471342 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Influenza A virus test negative, Influenza B virus test, 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ergocalciferol, Diclofenac top gel, Omeprazole, Cyclobenzaprine
Current Illness: none
Preexisting Conditions: Alcoholic cirrhosis, Atrial Fibrillation, Chronic low back pain, Chronic neck pain, Hearing loss Bilateral, Chronic gastric ulcer, EGD, Arthritis of knee
Allergies: Motrin, Gadolinium
Diagnostic Lab Data: Jul 07, 2021@15:09:05 _FLU A (CEPHEID) NEGATIVE , _FLU B (CEPHEID) NEGATIVE , _RSV (CEPHEID) NEGATIVE _COVID-19 (CEPHEID) POSITIVEA*
CDC Split Type:

Write-up: 64 year with Covid-19 viral infection, has mild symptoms fully vaccinated. He is maintaining normal saturation on room air and lungs auscultation normal, no x-ray taken.


VAERS ID: 1457667 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821281 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Cold sweat, Erythema, Fatigue, Feeling abnormal, Injection site pain
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Arthritis (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: None
Preexisting Conditions: None
Allergies: Sulfa, contact dermatitis
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue, joint pain, injection site pain, redness of skin, brain fog, clammy


VAERS ID: 1457681 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, No adverse event
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: None
Preexisting Conditions: Insomnia, Prediabetes
Allergies: No Known Allergies
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient received second dose Covid Vaccine 15 days after her first Covid Vaccine. Staff oversaw the date in which patient received first dose. No adverse reaction shown at the time of injection. Provider notified patient vacine was given too early.


VAERS ID: 1457893 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 RA / SYR

Administered by: Senior Living       Purchased by: ?
Symptoms: Asthenopia, Dizziness, Eyelid ptosis
SMQs:, Anticholinergic syndrome (broad), Corneal disorders (broad), Vestibular disorders (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)

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

Write-up: Dizziness, "tired/droopy" eyes. Administered Benedryl waited 20 mins, Patient left for 15 minutes, came back with significant other and were advised to go to urgent care. Significant other drove patient to urgent care.


VAERS ID: 1457898 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939676 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough
SMQs:, Anaphylactic reaction (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: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2 hours after the 2nd dose of the vaccine patient stated that they developed a cough and felt as if their throat was closing, they did not seek medical attention. 24 hours later patient still had a linger cough.


VAERS ID: 1457909 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chills, Pain
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: UNK
Current Illness: N/A
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: pt reports bodyaches chills rigors today after receiving 2nd dose of moderna yesterday. requesting qrtrs.


VAERS ID: 1458131 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / 2 LA / IM

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

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

Write-up: Pt had red circle develop on her arm.


VAERS ID: 1458371 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-01
Onset:2021-07-07
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Limb discomfort, Muscle tightness, Pain in extremity, Pruritus, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dystonia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Apri birth control pills, vita fusion prenatal vitamin gummies, CoQ10 600mg, vitamin D 2,000iu, escitalopram 10mg
Current Illness: None
Preexisting Conditions: Immediate Severe reaction to insect bites.
Allergies: Lactose intolerance
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: 7 days after first injection - left arm felt heavy and sore. Hot to the touch. Painful. Next day, iced it continuously. Red Swelling visible and spreading around and down upper half of left arm. Tight. Itchy.


VAERS ID: 1458468 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Montelukast - 10 MG ; Loratadine - 10 MG ; Bupropion - 150 MG ; Levothyroxine - 25 mcg ; Vitamin D3
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Seasonal
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine Swelling, Itching, Redness, Soreness, injection site warm to touch. OTC Benadryl


VAERS ID: 1458471 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Chills, Dyspnoea, Fatigue, Feeling cold, Headache
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Other ischaemic heart disease (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: Tylenol
Current Illness: Nope
Preexisting Conditions: Nope
Allergies: Milk
Diagnostic Lab Data:
CDC Split Type:

Write-up: Short of breath, heart hurts, tired, chill and cold, headache,


VAERS ID: 1458477 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-05
Onset:2021-07-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

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

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

Write-up: About 52 hours after vaccine (2 days and a few hours) his neck started to ache. About 6:30 pm the evening of the 7th. The next morning ( July 8th) his neck still ached and we used a heating pad. No fever at this point. Then about 7:30 p.m. the evening of the 8th he complained of a headache, neck still aching and had a fever of 101.5 (this is the first fever we''ve recorded/known of).


VAERS ID: 1459474 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-07-03
Onset:2021-07-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allopurinol, Men''s One a Day, Prilosec, Lisinopril
Current Illness: None
Preexisting Conditions: Gout, high blood pressure, obesity
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed rash on the tops of both feet. Small blisters, painful. Treating with calamine lotion and foot powder. So far the rash appears to be clearing on it''s own.


VAERS ID: 1459480 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1459487 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1459489 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1459643 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1459644 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1459651 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1459653 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1459656 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1459712 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

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

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

Write-up: Generalized maculopapular rash.


VAERS ID: 1459714 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1459719 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

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

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

Write-up: Patient given Pfizer as the second dose of the covid vaccine instead of Moderna as was the first dose. No signs or symptoms of adverse reaction. Patient states she feels good.


VAERS ID: 1459740 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Decreased appetite, Dysgeusia, Skin exfoliation, Somnolence, Taste disorder
SMQs:, Severe cutaneous adverse reactions (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (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: None
Current Illness: None
Preexisting Conditions: IgA deficiency
Allergies: Penicillin and sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Previously report metallic taste in mouth/altered sense of taste. Additionally reactions to report: sharp chest pain (resolved after several hours), skin peeling, loss of appetite, drowsiness


VAERS ID: 1459792 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-06
Onset:2021-07-07
   Days after vaccination:62
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 7/7/2021- SARS Coronavirus-2, PCR detected
CDC Split Type:

Write-up: Tested positive for COVID 7/7/2021. No additional information is available.


VAERS ID: 1459803 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-15
Onset:2021-07-07
   Days after vaccination:114
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Exposure to SARS-CoV-2
SMQs:, Anaphylactic reaction (broad), COVID-19 (narrow)

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

Write-up: Patient has medical history of chronic kidney disease; Traveled out of sate three weeks prior to 7/7/2021 Developed cough two week later C19 outbreak at her church and her Mother tested positive Currenlty hospitalized since 7/7/2021


VAERS ID: 1459831 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO183 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Burning sensation, Dizziness, Feeling hot, Flushing, Hyperhidrosis, Immediate post-injection reaction, Pallor, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Airborne supplement/immune system tablet (OTC)
Current Illness: None
Preexisting Conditions: Spinal stenosis
Allergies: No known allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Immediately felt burning down arm and into shoulder after vaccine was administered; went to sit down in observation area felt like she was light-headed and going to pass out, hot, sweaty, pale, flushed, vomited x1 while observed. EMS on site responded with cool packs, elevated feet, gave water to drink.


VAERS ID: 1459832 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Ear pain, Headache, Oropharyngeal pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular 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: Flu vaccine
Other Medications: Midodrine 10mg Singular
Current Illness:
Preexisting Conditions: Low blood pressure Covid long hauler.
Allergies: Penicillin Latex Flu vaccine (anaphylactic reaction)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness, headache, sore throat, body aches, ear pain (bilateral), fever (up to 102.5)


VAERS ID: 1459851 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-01-09
Onset:2021-07-07
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Valtrex
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: Covid 19 PCR test positive
CDC Split Type:

Write-up: Diagnosed with COVID 19 per PCR test on 7/8/21


VAERS ID: 1459853 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Body temperature increased, Disturbance in attention, Dizziness, Dyspnoea exertional, Fatigue, Hot flush, Nausea, Oral herpes, Pain, Pain in extremity, Psychomotor hyperactivity, Sleep disorder
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Akathisia (broad), Oropharyngeal infections (narrow), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, gabapentin, omeprazole, cialis, lexapro, zyrtec, asprin, vitamin B, vitamin D, MVI, senna, - all daily PRN ibuprofen, PRN valium, PRN norco 10/325, PRN valcyclovir
Current Illness: gastritis
Preexisting Conditions: GERD, ADHD, BPH, idiopathic neuropathy, idiopathic polydipsia, vitamin D deficiency,
Allergies: morphine, cipro, statins, sulfa drugs, oral Toradol, melatonin,
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Starting about 14 hours after vaccine administration, patient experienced difficulty concentrating with periods of hyperactivity, pain/soreness in bilateral hands with extreme pain at times with movement, soreness in bilateral feet, soreness across the back in the area of the kidneys, occasional mild dizziness, fatigue, mild nausea, hot flashes, a cold sore, poor sleep quality since vaccine, mild dyspnea on exertion, and increased temperature of about 0.5-1 degree F.


VAERS ID: 1459860 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-01
Onset:2021-07-07
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Hyperhidrosis, Injection site pain, Pain
SMQs:, Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypoglycaemia (broad)

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

Write-up: Body aches, body weakness, chills, sweating, severe injection site pain


VAERS ID: 1459861 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

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

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

Write-up: Feeling lightheaded, also disconnected


VAERS ID: 1459866 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Injection site mass, Injection site pain, Pruritus, Skin warm
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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injection site has a hard knot in it, is very hot to the touch, burns and is red and itchy


VAERS ID: 1459903 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cardiac flutter, Chest pain, Feeling abnormal, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Depression w/ Anxiety
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt Called c/o of sternal CP and "feeling kind of fluttery" which began Wednesday night, but she was able to "brush it off". (Pt had 2nd dose of Moderna COVID Vaccine Tuesday late afternoon). CP continues into Thursday and is to the point she can "no longer ignore it." Denies hx of gastric reflux. Denies any radiation of pain. Describes CP as a "constant soreness" . When asked if she continues to have palpations or "fluttering" she stated "yes, my chest feels unstable." Pt advised to go to ER to be assessed for cardiac concerns. Pt stated she would do so and express gratitude for the advise.


VAERS ID: 1459991 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest pain, Dyspepsia, Electrocardiogram normal
SMQs:, Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Kallman syndrome
Allergies: None
Diagnostic Lab Data: 7/9/2021 had EKG done. EKG showed heart is fine. Waiting for bloodwork results
CDC Split Type:

Write-up: Mild Chest pain. Sore pectoral muscle also Plus Heartburn Have had on and off twinge of chest pain started next day in pectoral muscle area


VAERS ID: 1460002 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site swelling, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, headache, body aches, armpit swollen at sight of injection , exhaustion


VAERS ID: 1460049 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-05
Onset:2021-07-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Body temperature increased, Lymphadenopathy
SMQs:, Neuroleptic malignant 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: None
Preexisting Conditions: None
Allergies: Sulfa and eggs
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe swelling, pain and fever in right armpit. Ice pack and Ibuprofen per doctors office. Still painful and swollen but has gone down some. Temp. check on 07/06/2021 was 99.1 for next 2 days.


VAERS ID: 1460061 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 OT / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benedryl
Current Illness: Fibromayalgia, third stage kidney failure
Preexisting Conditions: Fibromayalgia, third stage kidney failure
Allergies: Trees, Grass, Corn pollen, house dust.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Breaking out in hives


VAERS ID: 1460075 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Bradycardia, Dizziness, Flushing, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: "Pt c/o flushing/sweating and dizziness 3mins after vaccination. Vitals significant for bradycardia. @13:08 BP 100/58, HR 39, RR 12, SPO2 99% -- $g @ 13:12 83/40, 41, 100% -- $g @13:22 87/43, 50, 100% -- $g @13:23 107/67, 61, 100%. 911 Called at 13:15 and paramedics arrived 13:20. At 15:15 pt elected to leave vaccination site . form signed. Pt driven home. Unknown PMH or current medications."


VAERS ID: 1460107 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: desyrell ,ativan, pozac, pepcid
Current Illness: none
Preexisting Conditions: none
Allergies: apples ans honet
Diagnostic Lab Data: epi X 2
CDC Split Type:

Write-up: throat itching and cough


VAERS ID: 1460138 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PATIENT INDICATED THAT SHE WAS ON A STATIN DRUG FOR HIGH CHOLESTEROL.
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: DARVOCET
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: I GOT TIMED OUT WITH ALL THE DETAILS I GAVE ON MY FIRST ATTEMPT. THEREFORE, I WILL GET STRAIGHT TO THE POINT. PATIENT WAS FOUND AFTER 15 MINUTES OF ADMINISTERING THE VACCINE TO BE PALE , COLD SWEAT AND NOT DOING WELL. I GAVE HER SOME WATER AND AT THAT POINT SHE LOST CONSCIOUSNESS FOR APPROX 30 SECONDS. 911 WAS CALLED. SHE COMPLAINED OF HAVING BLURRY VISION AND FEELING MALASE. EMTS AND FIRE DEPT. ARRIVED. HOOKED HER UP TO SEVERAL MONITORS. THE ONLY ONE THAT WAS OF CONCERN WAS HER BLOOD PRESSURE OF ABOUT 84/43. IT WAS RECOMMEDED THAT SHE BE TRANSPORTED AS SHE LIVES ALONE. SHE HAD ONLY EATEN EGGS AND POTATOES AT 11AM AND WAS FOSTERING 3 KITTENS. RAN ERRANDS ON A HOT DAY AND SAID SHE WAS HYDRATED.


VAERS ID: 1460148 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Injection site pain
SMQs:, Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu shot gave flu like symptoms 2017
Other Medications: irbesartan and hydrochlorothiazide tables 150mg/12.5mg d3 25mcg fish oil 1000mg one a day mens potassium 99mg magnesium 400mg
Current Illness: ear infection 3 weeks before
Preexisting Conditions: high blood pressure
Allergies: hydrocodine
Diagnostic Lab Data:
CDC Split Type:

Write-up: pain in injection site explosive diarrhea tiredness


VAERS ID: 1460186 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-13
Onset:2021-07-07
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Chest X-ray normal, Computerised tomogram head normal, Confusional state, Dizziness, Fall, Mental status changes, SARS-CoV-2 test positive, Urinary tract infection, X-ray of pelvis and hip normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Patient received both doses of COVID Moderna vaccine (2/13/21 and 3/13/21). She presented to the ER on 7/7/21 after a fall at home. She was noted to have altered mental status/confusion and claimed she was dizzy. CT brain was negative, as well as chest X-ray and pelvic X-rays (also negative). Pt was tested for COVID per protocol, and was found to be positive on 7/7/21, despite being fully vaccinated and being asymptomatic. Patient was admitted for Neuro work-up and was started on ceftriaxone for presumed UTI. COVID treatment has not bee started since pt is asymptomatic and is not hypoxic.


VAERS ID: 1460187 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-02
Onset:2021-07-07
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 AR / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: melatonin
Current Illness:
Preexisting Conditions: Had COVID-19 prior infection in December 2020.
Allergies: cefdinir--rash
Diagnostic Lab Data: Peak Troponin I 11522 on 7/7/21, ECHO normal, Troponin I 5681 at discharge
CDC Split Type:

Write-up: Myocarditis with peak Troponin I 11,522, Patient had chest pain as primary symptom. Improved with NSAID therapy, hospitalized for 2 days. Troponin I 5681 at time of discharge, f/u with outpatient cardiology at our hospital scheduled.


VAERS ID: 1460207 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-02-14
Onset:2021-07-07
   Days after vaccination:143
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Anticoagulant therapy, Asymptomatic COVID-19, Bladder catheterisation, Chest X-ray normal, Deep vein thrombosis, Haematuria, Pulmonary embolism, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? 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 the ER on 7/7/21 with hematuria and was found to have acute kidney injury. Patient was recently diagnosed with a PE and bilateral DVT 4 weeks PTA and was on Eliquis for these. Patient also has a history of lung cancer and COPD and is chronically on 4L O2 at home. A foley was placed by Urology in the ER and Eliquis was held due hematuria and changed to heparin drip upon admission. In the ER, patient was tested for COVID per policy, and was found to be positive on 7/7/21 despite being fully vaccinated (1/24/21 and 2/14/21). Patient was admitted for further work-up and has not been started on COVID treatment due to patient being asymptomatic for COVID. Pt''s chest X-ray was negative for pneumonia.


VAERS ID: 1460216 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Arkansas  
Vaccinated:0000-00-00
Onset:2021-07-07
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Hyperglycaemia, Respiratory tract congestion, SARS-CoV-2 test positive, Type 2 diabetes mellitus
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: POSITIVE COVID TEST 7/6/2021
CDC Split Type:

Write-up: VACCINATION DATE NOT DOCUMENTED ADMITTED TO HOSPITAL 7/7/2021 WITH CONGESTION AND COUGH AND HYPERGLYCEMIA TYPE 2 DIABETES


VAERS ID: 1460297 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Dizziness, Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)

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

Write-up: Patient experienced dizziness, weakness, nausea, and pale skin after receiving her 1st COVID vaccine.


VAERS ID: 1460300 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-07-05
Onset:2021-07-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood creatine phosphokinase MB, Blood culture, Brain natriuretic peptide, Chest discomfort, Chills, Culture stool, Cytomegalovirus test negative, Decreased appetite, Electrocardiogram ST-T segment abnormal, Enterovirus test negative, Fatigue, HIV test negative, Myalgia, Oropharyngeal discomfort, Pyrexia, Respiratory viral panel, Throat tightness, Treponema test negative, Troponin increased, Varicella virus test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Other ischaemic heart disease (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fluticasone 50mcg/inh nasal spray Montelukast 5mg chewable tablets once daily ReliOn Ventolin HFA PRN Triamcinolone 0.1% topical ointment Zyrtec 10mg PO daily
Current Illness: None
Preexisting Conditions: Asthma, eczema, allergic rhinitis, mild mast cell activation syndrome
Allergies: Dairy allergies. Seasonal allergies
Diagnostic Lab Data: EKG 7/8 with non-specific ST and T wave abnormality 7/8 notable labs: CKMB 23.5, troponin 5.69, BNP 11. Troponins over the next several days have been 5.26 $g 5.5 $g 7.76 $g 4.85 Myocarditis work-up includes the following tests which have been negative: viral respiratory panel, CMV, enterovirus serum PCR, HIV, RPR/syphilis, VZV. Enterovirus stool culture is in process as are blood cultures. For additional medical records/results of pending labs please contact the Hospital Release of Information Department
CDC Split Type:

Write-up: Pt. reports that a few hours after the vaccine, he felt that his throat and chest were tight and uncomfortable and then he developed fever, chills, myalgias after vaccination that resolved after about 48 hours. Last documented fever was Tuesday (7/6) morning. In general, he has been feeling tired with decreased appetite but maintained adequate hydration and has had normal urine output. Over the past 24 hours, he has developed chest discomfort that has progressed to chest pain; it peaked this morning (7/8) when he woke up and he woke his parents up because the pain was so bad. Due to chest pain, he presented to the ED for evaluation where he was found to have non-specific ST segment changes on his EKG, elevated troponin to 5.69. He was admitted to the hospital and treated with NSAIDs where he has been improving.


VAERS ID: 1460315 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Chest pain, Electrocardiogram, Headache, Streptococcus test, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: ASTHMA, SEASONAL AND ENVIROMENTAL ALLERGIES
Allergies: NONE
Diagnostic Lab Data: EKG (7/7/2021) RAPID STREP (7/9/2021)
CDC Split Type:

Write-up: 7/7/21 @ 9 AM: ONSET OF HEADACHE FOLLOWED BY VOMITING. CHILDRENS TYLENOL GIVEN. 7/7/2021 @ 8PM: ONSET OF LOWER CHEST/ UPPER ABDOMINAL PAIN AND VOMITED 3 TIMES. WENT TO ER @ HOSPITAL @ 9 PM-11 PM HAD EKG & ZOFRAN GIVEN


VAERS ID: 1460342 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature increased, Discomfort, Headache, Injection site pain, Nausea, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: First my left arm where the vaccine was done starts hurting badly, then at night on July 7, 2021 when I went to bed, my head was severe headaches. I kept drinking water as I was advised to do. On July 8, 2020, during day time all my body was hurting, it looked like someone who worked 12 hours a day for one one week. I was not able to go out. I stayed home drinking more water . I was having severe headache. I thought about going to hospital, n=but I did not because I did not want to be prescribed some pills. The whole night of july 8 through july 9, in the morning, my body temperature went way up,very high,it was a severe fever. I was having severe pain everywhere . my body became heavy. One part of my head felt like I got severe punch, then the pain went to my right leg. I had some nausea in the morning of July 9, 2021.The heavy pressure I''m having on the right side of my head is not fading. I do Not want to go see a doctor for fear of prescription drug.


VAERS ID: 1460355 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-04-29
Onset:2021-07-07
   Days after vaccination:69
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: busPIRone , LEXAPRO,RETIN-A, CLEOCIN SOLU, JUNEL
Current Illness:
Preexisting Conditions: SCOLIOSIS, ANOREXIA, ANXIETY, MAJOR DEPRESSIVE DISORDER
Allergies: Erythromycin Base(Rash, Hives)
Diagnostic Lab Data:
CDC Split Type:

Write-up: tested positive for covid on - this was a pretravel swab. She had symptoms of congestion which have resolved. Pfizer vaccination completed outside of our clinic but we have dates listed as 4/8/21 and 4/29/21. 4/29/2021 Given ER8736 4/8/2021 Given EW0158


VAERS ID: 1460368 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-06-15
Onset:2021-07-07
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Pain, Pain in extremity
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: There is a small, weak, shooting pain in my chest around the area of my heart. It lasts for about half a minute to a full minute before dispersing. It rarely happens and so far, it has been about once daily. My left arm is also experiencing a weak, dull pain on the outer side of my bicep. It starts in the middle and goes down to the elbow. It sticks around for a while but it did not start until 07/09/2021.


VAERS ID: 1460379 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-29
Onset:2021-07-07
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram head normal, Drug screen negative, Electroencephalogram abnormal, Intensive care, Laboratory test normal, Loss of consciousness, Magnetic resonance imaging head normal, Postictal state, Seizure
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), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (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: none
Current Illness: Fractured right wrist on May 18, 2016
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: MRI, CT and EEG. Also labs such as drug screens. Everything negative except EEg which showed increase activity in right midtemporal lobe
CDC Split Type:

Write-up: Late in the evening on July 7 patient began having multiple seizures. EMTs were called and patient was transferred to local hospital while seizing. Patient stabilized in ER with injections. But since patient was unconscious (postIcatal) he was transferred to ICU until stabilized on oral medication. Patient in hospital for 36 hours.


VAERS ID: 1460381 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain lower, Discomfort, Erythema, Headache, Nausea, Oropharyngeal pain, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Temazepam Aspirin
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin Opiate Morphine Niacin Adhesive tape
Diagnostic Lab Data: Physical observation
CDC Split Type: vsafe

Write-up: I was having side effects during the vaccine a headache and then nausea, throat soreness, face redness, neck redness, rash on chest. Pain in lower abdomen. Pressure around left ankle.


VAERS ID: 1460386 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-01-14
Onset:2021-07-07
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: symptoms started on 7/7, tested positive on 7/9


VAERS ID: 1460393 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2020-12-28
Onset:2021-07-07
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 LA / IM

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

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

Write-up: +covid test 7/7/2021 after being fully covid 19 vaccinated


VAERS ID: 1460401 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Myalgia, Nausea, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever Chills Arm muscle pain Nausea Fatigue Headache


VAERS ID: 1460421 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Dyspnoea, Eye movement disorder, Glassy eyes, Panic reaction, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient called pharmacist attention at 6:55pm. Patient''s eyes glossy and rolled into back of head, patient then fainted. When patient awoke she started having difficulty breathing, started coughing and seemed panic. She had a rapid acting albuterol inhaler with her - she took 2 puffs immediately, breathing did not improve. Pharmacist grabbed emergency kit and administered epinephrine (right IM leg) and benadryl (right IM arm). Patient refused EMS or AMR service many times. Follow up phone call on 7/9/2021 - patient has recovered and no other side effects at this time.


VAERS ID: 1460428 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trazodone 50 mg at bedtime, sertraline 50 mg daily, Fish oil 1000 mg twice daily, norethindrone 10 mg daily, vitamin D3 2000 units daily
Current Illness: None reported.
Preexisting Conditions: Depression, anxiety.
Allergies: None reported
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient fainted after vaccine was administered. No injury reported due to the fainting episode. Per patient mother, patient exhibits a history of fainting, for example after blood draws. Pharmacy staff was notified of incident after the patient had regained consciousness .


VAERS ID: 1461673 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5 minutes after receiving vaccine , patient experienced sweating and dizziness, gave patient water and had patient keep head upright, patient was fine after 5 more minutes.


VAERS ID: 1461680 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

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

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

Write-up: Patient was fine receiving vaccine as well as during the 15 minute mandatory waiting period, however later that evening upon going home she complained of headache and leg pain. Patient was instructed to contact PCP as soon as possible.


VAERS ID: 1461712 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Full blood count, Joint swelling, Lip swelling, Metabolic function test, Pain in extremity, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: not known
Preexisting Conditions: none
Allergies: not known
Diagnostic Lab Data: CBC and complete metabolic panel
CDC Split Type:

Write-up: Developed rash and joint swelling the next day. Also with swelling of the lips. No fever. Rash was itchy and on arms and legs. No joint swelling resolved after 48 hours. Still with pain of feet with walking on 7/9/21


VAERS ID: 1461713 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / UNK LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Arthralgia, Chills, Headache, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (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: Losartan; Norethindrone
Current Illness:
Preexisting Conditions: HTN
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, muscle and joint aches/pains, chills, nausea


VAERS ID: 1461750 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 7+ LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Injection site pain, Lymphadenopathy, Pain, Sleep disorder, Somnolence
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (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: Nature Thyroid, Metronidazole, Omeprazole, Vitamin D,
Current Illness: Sinus infection approximately 4 weeks prior.
Preexisting Conditions:
Allergies: tomatoes
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injection site was so sore I couldn''t sleep. Woke up the next morning and my entire body hurt, I also had difficulty breathing. I was extremely sleepy. Shot was Wednesday, by Friday morning I had painful swollen lymph nodes under my left arm. Still having difficulty breathing. Body still hurts.


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