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From the 11/12/2021 release of VAERS data:

Found 875,292 cases where Vaccine is COVID19 and Patient Did Not Die

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

This is page 45 out of 8,753

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VAERS ID: 1848149 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-11-02
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Expired product administered
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: USJNJFOC20211112239

Write-up: ADMINISTERED EXPIRED VACCINE; This spontaneous report received from a health care professional concerned a 36 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, expiry: UNKNOWN) dose was not reported, administered on 02-NOV-2021 for prophylactic vaccination. No concomitant medications were reported. On 02-NOV-2021, the patient experienced administered expired vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of administered expired vaccine was not reported. This report was non-serious.


VAERS ID: 1848210 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 077C21B / 3 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Uveitis, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ocular infections (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mesalamine Lo-loestrin Adderall
Current Illness: Ulcerative colitis Idiopathic hypersomnia
Preexisting Conditions: Ulcerative colitis Idiopathic hypersomnia
Allergies: Clindamycin
Diagnostic Lab Data: Uveitis treated with corticosteroid eye drops
CDC Split Type:

Write-up: Vomiting Uveitis


VAERS ID: 1848221 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest pain, Dizziness, Dyspnoea, Electrocardiogram
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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:
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: Chest X-ray Bloodwork EKG
CDC Split Type:

Write-up: Severe chest pain 12 hours post vaccine, shortness of breath, and dizziness.


VAERS ID: 1848639 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Electrocardiogram ambulatory, Feeling hot, Laboratory test, Palpitations, Paraesthesia, Tinnitus
SMQs:, Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hearing impairment (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: Minor flu like symptoms after 2nd Covid vaccine. Do not recall if I had palpitations, if did they were minor
Other Medications: Zyrtec, flintstone chewable, fish oil, biotin
Current Illness: NA
Preexisting Conditions: Seasonal allergies
Allergies: Codeine, zythromycin, erythromycin
Diagnostic Lab Data: Wore heart minitor Wednesday-Friday, lab tests done. I return next week for results. I have not yet reported the whooshing in ear or hands and feet yet as I did not realize that was significant when I spoke to Dr on wednesday
CDC Split Type:

Write-up: Experienced heart palpatations that evening, several per minute. I have had minor palpatations before, but they were the worst I ever had. They continued heavily the following day. They subsided mostly by Thursday. Also experienced sound of blood rushing/whooshing/pulsing in my right ear Wednesday night and again Friday night. This had never happened to me before. Also beginning Wednesday evening my hands and feet at times feel hot and tingly. That comes and go. This is my booster shot.


VAERS ID: 1848764 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-03-03
Onset:2021-11-02
   Days after vaccination:244
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Respiratory failure, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Positive covid test by PCR 11/02/2021
CDC Split Type:

Write-up: Positive covid-19 infection with sever respiratory failure requiring hospitalization


VAERS ID: 1848795 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939906 / 3 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Bone pain, Chills, Decreased appetite, Headache, Hyperhidrosis, Nausea, Pain, Pain in extremity, Paraesthesia, Photopsia, Pyrexia, Retching
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Retinal disorders (narrow), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: liquid multi-vitamin supplement, liquid mineral supplement, salmon oil, Lutein, vitamin C, pro-biotic every day
Current Illness: NONE
Preexisting Conditions: smoker
Allergies: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Felt tingling up my neck to face within 15 minutes of injection - 12 hours later, fever, chills, sweats, nausea, REALLY sore left arm, deep bone aches. 21 hours - dry heaves, strobing vision, headache, body aches, more fever, chills, sweat. Anorexic 48 hours.


VAERS ID: 1848808 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-22
Onset:2021-11-02
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 061E21A / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Blood alkaline phosphatase, Blood magnesium, Blood test, Brain natriuretic peptide, Cardiac stress test, Chest X-ray, Differential white blood cell count, Echocardiogram, Electrocardiogram, Full blood count, Metabolic function test, Mobility decreased, Musculoskeletal chest pain, Pain, Troponin
SMQs:, Parkinson-like events (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 10/29/2021: ECG -Lead Troponin CBC & Differential BNP Basic Metabolic Profile ALT/SGPT Alkaline Phosphatase XR Chest Echocardiogram Stress Test Blood Test - Magnesium
CDC Split Type:

Write-up: Chest tenderness (left side) progressing to stabbing pain. Unable to lie down. This happened over a 3-4 day period.


VAERS ID: 1848818 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-21
Onset:2021-11-02
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / UN

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Pregnancy test, Ultrasound scan, Urine analysis
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)

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

Write-up: I had a miscarriage, I was 6 weeks.


VAERS ID: 1848864 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Headache, Insomnia, Pain, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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: D3 5k iu daily Athletic greens Fish oil Zinc Magnesium Threonate Psyllium husk (fiber) Acetyl L-Carnitine 500mg Ashwagandha Creatine (5mg) Red Yeast rice L-Theanine Apigenin
Current Illness: None.
Preexisting Conditions: Multiple Sclerosis
Allergies: No known allergies.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache Body ache Shivering/Body trembling Insomnia


VAERS ID: 1848906 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1611 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Aphasia, Back pain, Body temperature increased, Deafness unilateral, Disturbance in attention, Ear discomfort, Eye discharge, Headache, Impaired driving ability, Neck pain, Pain in jaw, Toothache
SMQs:, Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Hearing impairment (narrow), Osteonecrosis (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: Vitamin D - 2000iu, Zinc 25mg
Current Illness: None
Preexisting Conditions:
Allergies: Heparin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe Spinal Aches - Mid Back to Hips - 3days HeadAche - 3days Elevated temperature - 2days (101.4, 101.2) Left Ear pressure and loss of hearing - 3days Left Collar Bones Ache - 3days Memory Loss - ongoing - couldn''t remember personal phone number, names of shellfish eating, loss of being able to complete sentences because couldn''t remember words to complete thought, loss of focus while driving forgetting destination point Left side of Jaw ache and lower teeth ache Eye tear ducts - sappy sticky fluid at tear ducts


VAERS ID: 1848908 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New York  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Muscle spasms
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: The first and second dose of Pfizer COVID-19 vaccination
Other Medications: Vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had extreme abdominal pain that lasted about 5 hours. It felt like every muscle in my abdomen was having the most intense Charlie horse I?ve ever had. The pain was worse than when I dislocated my knee or fractured my ankle. It was by far some of the worst pain I?ve ever experienced. I considered going to the hospital but by the time I was able to move it started getting better.


VAERS ID: 1848917 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 1 LA / IM
FLUA4: INFLUENZA (SEASONAL) (FLUAD QUADRIVALENT) / SEQIRUS, INC. 312870 / 1 RA / IM

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

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

Write-up: Patient experienced dizziness on 11/2/21, 11/3/21 and 11/4/21. Dizziness resolved by 11/5/21


VAERS ID: 1848918 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 3 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR UT7384JA / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Breast swelling, Discomfort, Erythema, Lymphadenopathy, Pain in extremity, Rash, Skin irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Retroperitoneal fibrosis (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient had left underarm swelling and redness (near lymph node area). Swelling traveled to left breast and a visible rash with irritation appeared. Patient also had left leg pain, inner thigh pain, some back pain and discomfort.


VAERS ID: 1848929 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939904 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inflammation
SMQs:

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

Write-up: Inflammation of the Face on the same side of injection.


VAERS ID: 1848965 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2020-12-01
Onset:2021-11-02
   Days after vaccination:336
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Cough, Headache, Nasal congestion, Oropharyngeal pain, Pain, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

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

Write-up: Covid symptoms including cough, congestion, runny nose, sore throat, body aches, headache, loss of taste and smell


VAERS ID: 1849001 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939904 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Antidepressants; thyroid meds; sleeping aids
Current Illness:
Preexisting Conditions: Renal insufficiency; depression
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling; pain; redness itching at injection site. Red, itchy oval became 2" by 2 ?." Continued to itch after pain ceased. Still a little itchy 11/6/2021. Redness almost gone.


VAERS ID: 1849002 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: New York  
Vaccinated:2021-10-31
Onset:2021-11-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Vitreous floaters
SMQs:, Retinal disorders (narrow)

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

Write-up: Large amount of floaters in vision, both eyes. Noticeable when looking at clear sky, night time.


VAERS ID: 1849053 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-10-22
Onset:2021-11-02
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033021A / 3 LA / SYR

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

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

Write-up: Hives


VAERS ID: 1849127 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-10-27
Onset:2021-11-02
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: The lymph node near my left collar bone swelled up a week after my COVID vaccine. (It moves around if I push it). It is 1 cm in size.


VAERS ID: 1849236 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Pain
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: aches and pain
Other Medications: Olmesarton, Levothyroxine, Atorvastin, Paroxotine
Current Illness: none
Preexisting Conditions: High Chol, Thyroid, blood pressure
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: The next day after the booster, I developed strong dizziness, and ache and pains. The aches and pain and gone and I am now 6 days out and I still have the dizziness, it is a bit less.Everytime I look up or down I become very dizzy


VAERS ID: 1849298 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-10-26
Onset:2021-11-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immediate post-injection reaction, Nervousness, Sleep disorder, Tremor, Vertigo
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), 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: Hydrochlorthrizde
Current Illness: None
Preexisting Conditions: Seasonal allergies
Allergies: Penicillin
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Vertigo immediately following shot. One week letter nerve shakes in upper body. Unable to fall into a deep sleep. Still experiencing vertigo daily. Nerves feel extremely shaky during REM sleep.


VAERS ID: 1849355 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Chills, Headache, Hypoaesthesia, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Localized rash at injection site following flu vaccine in 2018
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 5 hours after vaccine, began experiencing severe chills, fever, and muscle pains all over body. Fever reached 101F with ibuprofen taken every 6 hours. Fever, chills, and muscle pain continued for entirety of following day. Numbness in legs and arms on and off for hours for 4 days after vaccination. Pain/headache behind eyes for 24 hrs after vaccination.


VAERS ID: 1849358 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-01
Onset:2021-11-02
   Days after vaccination:246
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none known
Current Illness: none known
Preexisting Conditions: none known
Allergies: none known
Diagnostic Lab Data: PCR + for Covid on 11/2
CDC Split Type:

Write-up: Client was vaccinated with Moderna vaccine for Covid x 2 in March 2021. Developed symptoms (mild- nasal congestion) on 11/2 and tested + on 11/2, 11/3, and 11/4. Received antibody infusion on 11/4.


VAERS ID: 1849393 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Lymphadenopathy, Pain in extremity, Pyrexia, Rash macular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: I once almost passed out (someone was walking me around but I could only see blackness, although I could hear her. This occurre
Other Medications: Only vitamins: Calcium (1,000 mg)/Magnesium (500 mg)/Phosphorus (500 mg)/Vitamin D (10 mcg) combination pill and Vitamin B Complex. Also one tumeric pill (450 mg). Occasional use of Claritan PRN. I had not taken it for weeks.
Current Illness: None
Preexisting Conditions: None
Allergies: Just mold and sensitivity to bleach and strong fragrances (from years of working in sick buildings)
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I recieved my shot at 12:15 p.m. Sore arm within hours. Chills began within 9-10 hours. Fever that went as high as 102.1 degrees after appoximately 24 hours (so, midday on the following day). Fever lasted approximately 12 hours and was gone when I woke up on the 3rd day following the shot. It should be noted I had taken Tylenol and it responded to that by going down, but it came back up and required a 2nd dose of Tylenol. By then, I was just tired from the previous day, but was fine and felt completely betterby the 4th day. I also experienced significant swelling of the glands to the right of my right breast; in the armpit area. This came on during the second day, when I had the fever. The skin of both armpits also had reddish/purplish splotches. I performed slow, gentle lymphatic drainage massage to the area periodically for a couple of days and it resolved almost completely by the 3rd day of onset of those particular symptoms. At present, if I press my right arm closely against my body, I can tell that the glands have not 100% returned to normal, but they do not bother me.


VAERS ID: 1849585 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-31
Onset:2021-11-02
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vision blurred, Visual field defect
SMQs:, Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Back and neck pain from ruptured and herniated discs
Allergies: Penicillin
Diagnostic Lab Data: Eye exam
CDC Split Type:

Write-up: Blind spots and blurred vision in right eye


VAERS ID: 1849622 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 2 RA / IM
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 013420A / 1 RA / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 048F21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Appendicectomy, Appendicitis, Computerised tomogram abdomen abnormal
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Acute appendicitis resulting in the removal of my appendix . 3rd booster given at 10 am Monday November 1st. Tuesday November 2nd around 3 pm my stomach started hurting. By Wednesday night I was in the ER. Surgery was Thursday afternoon. I have never had a stomach issue at all prior to this.


VAERS ID: 1849874 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test, Headache, Injection site pain, Joint swelling, Laboratory test, Pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair HFA, Flonase
Current Illness: Asthma
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data: Still waiting for the lab test results.
CDC Split Type:

Write-up: In the morning of 11/02/21, started to feel a headache and joint pains. Then noticed that my left elbow started to swell and so painful to bend. Have to take Tylenol to subside the pain and headache. The swelling gradually spreading towards my wrist. On 11/04/21, decided to have it checked with my doctor and prescribed me with Amoxicillin and Ibuprofen. Was also taken a blood sample for further lab tests. Currently (11/07/21 around 9pm), swelling still continues to spread and have now reached my wrist.


VAERS ID: 1849894 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Headache
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: Zoloft, spriolactone, probiotics
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None at this time
CDC Split Type:

Write-up: Lightheaded, dizzy, headaches


VAERS ID: 1850059 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-11-02
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dysphagia, Fatigue, Injection site pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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:
Other Medications:
Current Illness: Alcohol use (rarely and not during Covid); Allergy to grains; Cancer; Celiac disease; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: Lymphadenectomy; Mastectomy; Comments: No drug abuse or illicit drug usage
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211110157

Write-up: TROUBLE SWALLOWING; CHILLS; TIREDNESS/FATIGUE; DIARRHEA; TINGLING THROUGHOUT BODY/TINGLING FEELING IN HEAD; PAIN AT INJECTION SITE; This spontaneous report received from a patient concerned a 53 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included: right mastectomy, and lymph nodes removed under right arm and neck, and concurrent conditions included: cancer, celiac disease, alcohol user, non-smoker, and gluten allergy, and other pre-existing medical conditions included: No drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 02-NOV-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 02-NOV-2021, the patient experienced trouble swallowing. On 02-NOV-2021, the patient experienced chills. On 02-NOV-2021, the patient experienced tiredness/fatigue. On 02-NOV-2021, the patient experienced diarrhea. On 02-NOV-2021, the patient experienced tingling throughout body/tingling feeling in head. On 02-NOV-2021, the patient experienced pain at injection site. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from pain at injection site, chills, tiredness/fatigue, diarrhea, tingling throughout body/tingling feeling in head, and trouble swallowing. This report was non-serious.


VAERS ID: 1850126 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-15
Onset:2021-11-02
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, COVID-19, Dizziness, Dizziness postural, Headache, Palpitations, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID-19 PCR test ran on 11/5/2021 and was positive.
CDC Split Type:

Write-up: Patient presented to facility with dizziness, palpitations, frontal headache and elevated BP readings x 1 week. Patient complained dizziness is worse with movement and when standing.


VAERS ID: 1850151 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-10-31
Onset:2021-11-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 3 RA / IM

Administered by: Private       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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: apixaban, furosemide, lisinopril, metoprolol
Current Illness: none
Preexisting Conditions: Asymptomatic LV dysfunction Leg edema NICM (nonischemic cardiomyopathy) History of NSVT (nonsustained ventricular tachycardia) Paroxysmal atrial fibrillation S/p ablation of atrial flutter Hemorrhoids
Allergies: NKDA
Diagnostic Lab Data: CBC ordered 11-2-21
CDC Split Type:

Write-up: 3rd dose of Pfizer vaccine given. Swelling under the right armpit. Not consistent with lymphadenopathy specifically. Temporally associated with the vaccine booster in the ipsilateral arm. Started about 2 days afterward. Given some knowledge of subsequent abnormal mammograms after Covid vaccines, question whether this is some inflammatory response from the vaccine versus something different. Does not have other alarm features of malignancy. Will obtain CBC, also note that he is on Eliquis, so would make sense to get CBC from that perspective 2. Patient will email me his vaccine card so we can fill out the vaers.


VAERS ID: 1850422 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-10-26
Onset:2021-11-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Muscle spasms, Ultrasound scan, Ultrasound uterus, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins and levothyroxine
Current Illness: I was not experiencing any illness.
Preexisting Conditions: I have hypothyroidism.
Allergies: I do not have any allergies.
Diagnostic Lab Data: I had an ultrasound and a vaginal ultrasound when I went in for my visit. The test showed that they gestational sac was showing at 6 weeks, but it should have been at 8 weeks.
CDC Split Type: vsafe

Write-up: On 11/02, I started to have vaginal bleeding. I called my provider and they said that it can be normal. On 11/04, I was still bleeding and had cramping as well. They did an ultrasound and told me that the gestational length was showing 6 weeks, but it should have been at 8 weeks. We went over options about the possibilities of what could be happening. I was supposed to have my HCG blood levels checked on 11/06 and 11/08. I did not have this test performed because on 11/05, I passed a lot more blood and the gestational sac. I ended up having a miscarriage. The baby was due 06/16/2022. I have one daughter, who was a healthy birth and is now 1 1/2 years old. I did not have any issues during my pregnancy with her.


VAERS ID: 1850426 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Chills, Fatigue, Headache, Influenza like illness, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Taste and smell disorders (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Patient stated today 11/08/2021 had flu like symptoms starting evening of 11/2/21 of vaccination. Stated had muscle aches, sore, fatigue, chills, headache, loss of smell/taste. Also reported caretaker had similiar


VAERS ID: 1850432 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bone pain, Chills, Chromaturia, Extra dose administered, Headache, Hypersomnia, Myalgia, Nervousness
SMQs:, Rhabdomyolysis/myopathy (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna shot 2
Other Medications: Synthroid, potassium, dyazide, Brio inhaler
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Shaking chills, rigors, headache, muscle and bone pain. Day 3 post vaccine cherry cola urine upon awakening. Po hydration cleared urine on next void. Slept 18 hours day 2 post vaccine. Today Day 6 post vaccine still feel shaky.


VAERS ID: 1850462 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 3 LA / IM

Administered by: Private       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: Patient provided expired product (vial punctured and dose given after expiration time after withdrawal)


VAERS ID: 1850501 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-30
Onset:2021-11-02
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Cough, Headache, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ?Stool Softener 100 MG Capsule 1 capsule as needed Orally Once a day ?Vitamin D 1000 UNIT Tablet 2 tablets Orally once a day, Notes: occasionally ?Tums 500 MG Tablet Chewable 1 tablet Orally Once a day ?traMADol HCl 50 MG Tablet (S
Current Illness: none
Preexisting Conditions: RENAUDS PHENOMENA. Hx of palpitations, - Holter, CEM in 1990''s was negative. . gross hematuria, + Prob. infections: CT scan negative except nonobstructing stone 2 mm left kidney. Negative cystoscope 2008. OSTEOPOROSIS: not a candidate for meds (6/21) due for medical reasons. . VITAMIN D DEFICIENCY 6/13 level 9: recommend starting vitamin D3 50,000IU weekly fo r12 weeks. PRESBYESOPHAGUS : 2016 EGD also history of small hiatal hernia and Schatzki ringSchatzki''s ring, esophagitis. LUMBAR DEGENERATIVE DISC DISEASE: MRI 2014. KIDNEY STONE; NEG URETAL LESION AND NEG PATH FOR TCC/FISH 4/16. DEGENERATIVE JOINT DISEASE: Left hip. CATARACTS:.
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: headache, sore throat, nonproductive cough, "low grade" fever, body aches, loss of taste, runny nose, congestion. starting on 11/2/21


VAERS ID: 1850591 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017F21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Dehydration, Face injury, Fall, Fatigue, Feeling cold, Headache, Hyperhidrosis, Joint injury, Nasal injury, Pain, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (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: Ezetimibe 10mg, Motegrity 2mg, multivitamin, vitE, Garlic, Fish oil 2150mg, MoveFree Joint Health, Caltrate 600 + D3, Biotin, D3 50mcg, Red Yeast Rice 1200mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Began to feel mild to moderate symptoms (headache, tiredness, feeling cold) before retiring for bed around 11:00pm on 11/1/21. Around 3:00am 11/2/21 went to bathroom (urinated) felt achey and went back to bed. Around 6:00am got up to go to the bathroom and fainted upon walking into the bathroom. Was on the floor profusely sweating. Bruised my knee, bridge of nose (later developed skinned knee with pain, bruised bridge of nose and under eyes). Contacted my GP and was on a virtual call at 4:00 that afternoon. Related to him the events of adverse reaction. He checked my blood pressure on the call (with my home blood pressure monitor), dehydration - all normal. Concluded that my blood pressure may have dropped upon get. ting up (maybe too fast?) in combination with maybe a fast heartbeat and told to rest and monitor blood pressure, eat and hydrate. The rest of that day and the next I continued to feel body aches, headache. Took Tylenol. As of today knee remains stiff, mild soreness around eyes and nose.


VAERS ID: 1850635 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / IM

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

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

Write-up: Medication Beyond Use Date 10/30/21. Medication Expire Date 12/21. Medication administered on 11/1/21. No adverse reactions noted.


VAERS ID: 1850642 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered, Exposure during pregnancy, Immunodeficiency, No adverse event
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), 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: Claritin, Euthyrox, Omega 3, Prenatal Plus, Vitamin D3
Current Illness: None
Preexisting Conditions: Asthma, Hypothyroidism, Obesity
Allergies: Erythromycin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Medication Beyond Use Date 10/30/21. Medication Expire Date 12/21. Medication administered on 11/1/21. No adverse reactions noted. Pt was confirmed pregnant on 10/28/21


VAERS ID: 1850645 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 3 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Disturbance in attention, Loss of personal independence in daily activities, Pain, Pain in extremity
SMQs:, Dementia (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (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: Metformin, Prostate Control, Selenium, Xarelto, Tamsulosin HCL, Viril, High Impact Endurance, N-Acetyl L-Cysteine (NAC), Biote A.D. K, Bystolic, Digoxin, MetaGlycemX, PhytoMulti, Pomegranate Plus, Stress B Plus, Vitamin D, Anastrozole, Vita
Current Illness: None
Preexisting Conditions: Stroke in 2014
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Excruciating pain down my left arm. From the shoulder to my wrist. Feels like fire. Worst pain I''ve ever felt. It is constant. I cannot function or concentrate.


VAERS ID: 1850665 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered, Exposure during pregnancy, No adverse event
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), 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: None
Current Illness: Gestational Diabetes
Preexisting Conditions: Obestiy
Allergies: NKDA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Medication Beyond Use Date 10/30/21. Medication Expire Date 12/21. Medication administered on 11/1/21. No adverse reactions noted. Pt is 28 weeks gestation


VAERS ID: 1850674 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 3 LA / IM

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

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

Write-up: Medication Beyond Use Date 10/30/21. Medication Expire Date 12/21. Medication administered on 11/1/21. No adverse reactions noted.


VAERS ID: 1850773 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-31
Onset:2021-11-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939905 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect route of product administration, Product administration error, Skin discolouration, Skin oedema
SMQs:, Angioedema (broad), Drug abuse and dependence (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazolex, vitamin, iron, atorvuastatin, amp Lodi pine, asperin, calgitriol, irbesartan, vitamin d3, timodor, hydrophilil, hydroorothpazide, Arcadia study (may be aspirin or blood thinner)
Current Illness: None
Preexisting Conditions: High blood pressure, stroke
Allergies: Scallops and cephalexin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Discoloration and and liquid under the skin. The pharmacist said that the technician placed the shot too low. There is a doubt as to whether the booster was applied correctly and if it will be effective.


VAERS ID: 1850776 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-27
Onset:2021-11-02
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 01YF21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Erythema, Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth, Pruritus, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Allergies, history of anaphylaxis
Allergies: bee and wasp stings, coconut, macadamia nuts, raspberries, gold, p-phenylenediamine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received first Moderna COVID vaccine on 27 October. On 02 November, left deltoid swelled at injection site; it was a large red whelp 2 inches across and 4 inches long. Experienced burning, itching and fever - injection site was 104.8, forehead temperature was 98.2. As of 08 November, the site is still a red whelp, itches and fever of 100.8.


VAERS ID: 1850795 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076C21A / 3 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Headache, Migraine, Pain, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna Vaccine Dose 1 - 36 hours of mild fever and body aches; on 12/28/2021.
Other Medications: Blood pressure medication - Lisinopril
Current Illness: No
Preexisting Conditions: Hypertension
Allergies: Sulfa based medications
Diagnostic Lab Data: No.
CDC Split Type: vsafe

Write-up: I did have a sore arm - for 24 hours. I had a headache - migraine. That I got 9 hours later after the vaccine. I took Rizatriptan 10 mg - orally dissolves in mouth. I got relief within 30 minutes. The next morning, 3rd, I woke up with that migraine again. I took the same medication - Rizatriptan - 10 mg with the same relief in about 30 minutes. I woke up the next morning, the 4th, with the same headache and took it again - Rizatriptan 10 mg. I had relief in 30 minutes again. On the 5th, it was quite severe when I woke up and I did not take medication because I feared I was causing headache to rebound. By late afternoon - 02:00 pm, I was having a lot of pain; I was vomiting. My medical clinic came out to my house for home visit- and started an IV - Finnegan and Toradol in the IV. I fell asleep and slept all night. Woke up the next morning, with aching on back of head. By Sunday morning, I felt fine.


VAERS ID: 1850799 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-24
Onset:2021-11-02
   Days after vaccination:223
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA NA / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Hypoxia, Myalgia, Nausea, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: diabetes, Congestive heart failure, diabetic foot ulcer, osteomyelitis, peripheral artery disease
Allergies:
Diagnostic Lab Data: SARS-CoV-2 (COVID-19) Micro detected on 11/6/21
CDC Split Type:

Write-up: symptom onset about 11/2/21: include fever, cough, shortness of breath, chills, myalgias, nausea., hypoxia. Possible exposure prior week at a nursing home rehab center


VAERS ID: 1850813 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-07
Onset:2021-11-02
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19 pneumonia, Respiratory failure, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Admitted with acute mixed respiratory failure with hypercapnia and hypoxia. COVID-19 pneumonia, she is fully vaccinated. She swabbed negative at outside hospital 2 weeks ago and is now positive on 11/2/21.


VAERS ID: 1850829 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-11-02
   Days after vaccination:76
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Interchange of vaccine products, Myocarditis, Respiratory syncytial virus infection, Respiratory syncytial virus test positive, Viral test positive
SMQs:, Cardiomyopathy (broad), Medication errors (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Received Moderna vaccinations in Jan/Feb, then received Pfizer booster in August (8/18/21); admitted 11/2/2021 with new myocarditis, also dx with RSV; unclear etiology. Probably viral. Presentation with RSV positive culture ?RSV myocarditis in adults is rare.


VAERS ID: 1850830 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-25
Onset:2021-11-02
   Days after vaccination:250
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: GABAPENTIN, ROPINIROLE, VENLAFAXINE, LISINOPRIL, GLIPIZIDE, ATORVASTATIN, DDAVP
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: POSITIVE COVID TEST 11/2/2021
CDC Split Type:

Write-up: SHORTNESS OF BREATH, FATIGUE, WEAKNESS, CHILLS


VAERS ID: 1850838 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-10-15
Onset:2021-11-02
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Mobility decreased
SMQs:, Retroperitoneal fibrosis (broad), Parkinson-like events (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: D-amphetamine salt combo (30mg), bupropion XL (150mg), clonazepam (0.5mg), vitamin D3 (25mcg)
Current Illness: none
Preexisting Conditions: detached retina; overweight
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: An ache in the area of the left shoulder/left side of back started late Nov. 2/early Nov. 3. It was really bad to the point that it made it hard to move for about the first three days. It started improving on Nov. 6. As of the time of this report, it''s barely noticeable.


VAERS ID: 1850840 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 1 LA / IM

Administered by: Senior Living       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1850844 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-26
Onset:2021-11-02
   Days after vaccination:249
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Cough, Dyspnoea, Productive cough, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Infective pneumonia (broad)

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

Write-up: Admitted with progressive SOA/Cough/congestion//weakness. Clear/white sputum only. Weak. No change in taste/smell/appetite.


VAERS ID: 1850895 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Muscle twitching, Myalgia, Nausea, Neuralgia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Dyskinesia (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Plavix, Lipitor, Lisinopril, Mobic, Gabapentin, Metoprolol, Wellbutrin, Valtrex, Prozac, Pantaprozole
Current Illness: None
Preexisting Conditions:
Allergies: Adhesives (rash)
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Stabbing nerve pain all over, muscle twitching and pain; nausea, loss of appetite, fatigue x2 days


VAERS ID: 1850911 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-10-25
Onset:2021-11-02
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Headache; chills/fever; upset stomach; lymph node tenderness after second Moderna vaccine on 2/6/21
Other Medications: Meloxicam (15 mg) Vitamin D Fish Oil
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Swelling in and tenderness in lymph node under right arm for 4 days proceeding Moderna booster vaccine. The swelling gradually abated on it''s own without medical intervention.


VAERS ID: 1850941 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185-H / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed hives approximately 6 hours after injection. Hives present on both upper thighs near bikini line and underside of both arms. No reaction at injection site. Hives still present on 11/2


VAERS ID: 1851050 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Cerebrovascular accident, Dizziness, Feeling drunk
SMQs:, Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports after receiving the vaccine she feels "whoozy" when she walks. Denies dizziness. Blood pressure 136/71 HR 80. Patient reports not eating or drinking this morning. Patient was given PB crackers and water. She reports wooziness continues, "maybe dizzy". Reports she feels like she is drunk. Patient does not have anyone to drive her home and she is not safe to drive self. Reviewed with plans to get better. Patient agrees.Pt diagnosed with a stroke and was administered tenecteplase


VAERS ID: 1851083 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-10
Onset:2021-11-02
   Days after vaccination:265
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: 11/5 SARS/COV-2, NAAT Positive
CDC Split Type:

Write-up: Breakthrough COVID


VAERS ID: 1851105 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-10-01
Onset:2021-11-02
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Delivery, Exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily prenatal vitamin, Vitamin D3 5,000IU daily, Magnesium supplement.
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: No specific testing or labs have been drawn in relation to mom''s COVID vaccine. Multiple tests and labs have been done in caring for the baby.
CDC Split Type:

Write-up: Healthy pregnancy with no complications. Received COVID booster shot at 33 weeks pregnant. No side effects or symptoms for myself (mom) after booster. Baby was born about 4.5 weeks later at 37 weeks, 6 days. Normal uncomplicated labor and delivery, but baby was found immediately to have a prematurely closed ductus arteriosus with subsequent pulmonary hypertension and right ventricular hypertrophy. Cardiologists taking care of her suspect that the PDA closed a few weeks before birth, possibly corresponding with the timing of the COVID booster. To date, there has been no known other cause of the PDA closure (no maternal medication contraindications, etc). Baby''s due date was 11/17/21, born on 11/2/21. Birth weight was 8lbs 6oz. Baby is still hospitalized in the ICU, ventilated and struggling cardiovascularly.


VAERS ID: 1851106 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-15
Onset:2021-11-02
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH #EW0172, #EW017 / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Activated partial thromboplastin time normal, Alanine aminotransferase decreased, Anion gap normal, Aspartate aminotransferase normal, Basophil percentage, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood creatinine increased, Blood glucose normal, Blood lactate dehydrogenase increased, Blood phosphorus normal, Blood potassium normal, Blood sodium normal, Blood urea increased, Brain natriuretic peptide increased, Carbon dioxide normal, Chest X-ray, Chest discomfort, Cough, Differential white blood cell count abnormal, Dyspnoea, Electrocardiogram, Eosinophil percentage decreased, Full blood count, Glomerular filtration rate decreased, Haematocrit normal, Haemoglobin normal, Laboratory test, Lymphocyte count, Lymphocyte percentage, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume normal, Monocyte count, Monocyte percentage increased, Neutrophil count, Neutrophil percentage, Platelet count normal, Protein total normal, Red blood cell count normal, Red cell distribution width increased, Troponin I increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Haematopoietic leukopenia (broad), Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Myelodysplastic syndrome (broad), Tumour lysis 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: A. fib and CHF, COPD, Hypertension, CVA
Allergies: Lovenox, Levaquin, Sulfa drugs, tape
Diagnostic Lab Data: Lab Results: Other Chemistry: 04-Nov-21 21:40, Brain Natriuretic Peptide Brain Natriuretic Peptide 460 [10 - 100 pg/ml] A cutoff of 100 pg/mL has been demonstrated to provide the maximal combination of sensitivity, specificity, and negative predictive value for contributing to the diagnosis of congestive heart failure (CHF). A BNP value greater than 100 pg/mL is consistent with a diagnosis of CHF in the appropriate clinical setting. Blood concentrations of natriuretic peptides may also be elevated in patients with myocardial infarction and in patients who are candidates for or are undergoing renal dialysis. 04-Nov-21 21:40, Chemistry 14 Profile Estimated GFR African American 46.66 [60.00 - 130. ml/ min] Estimated Glomerular Filtration Rate 38.56 [60.00 - 130. ml/ min] Estimated GFR Value <60 ml/min/1.73 sq meters is indicative of chronic kidney disease <15 ml/min/1.73 sq meters is indicative of kidney failure The Estimated GFR is calculated by the four variable MDRD equation. Limitations of this calculation include: Decreased accuracy for values $g60 Decreased accuracy in the hospitalized/severely ill patient populations Disregard EGFR values for infants and children (should not be applied to this age group) 04-Nov-21 21:40, Troponin I Troponin I 0.05 [0.00 - 0.03 ng/mL] Normal: <= 0.03 ng/mL Indeterminate: 0.04-0.29 ng/mL Suggestive of Myocardial Damage: $g= 0.30 ng/mL 05-Nov-21 05:18, Troponin I Troponin I 0.03 [0.00 - 0.03 ng/mL] Normal: <= 0.03 ng/mL Indeterminate: 0.04-0.29 ng/mL Suggestive of Myocardial Damage: $g= 0.30 ng/mL Coagulation: 04-Nov-21 21:40, PTT PTT 38 [26 - 39 sec] CBC-Differential-Morphology: 04-Nov-21 21:40, CBC White Blood Cell Count 6.9 [4.5 - 11.0 K/cmm] Red Blood Cell Count 4.35 [3.30 - 5.30 M/cmm] Hemoglobin 12.7 [11.0 - 16.2 g/dL] Hematocrit 39.8 [36.0 - 46.0 %] Mean Corpuscular Volume 91.7 [80.0 - 100.0 fl] Mean Corpuscular Hemoglobin 29.3 [26.0 - 34.0 PG] Mean Corpuscular Hemoglobin Concn 32.0 [31.0 - 37.0 %] Red Cell Distribution Width 17.0 [11.5 - 14.5 %] *Platelet Count 152 [140 - 440 K/cmm] Mean Platelet Volume 8.7 [7.4 - 10.4 FL] Automated Neutrophils % 67 [ %] Automated Lymphocytes % 22 [ %] Automated Monocytes % 10 [ %] Automated Eosinophils % 0 [ %] Automated Basophils % 0 [ %] Absolute Neutrophil Count 4.7 [1.0 - 8.0 K/cmm] Absolute Lymphocyte Count 1.5 [1.0 - 5.0 K/cmm] Absolute Monocyte Count 0.7 [0.1 - 0.8 K/cmm] Chemistry Panels & Profiles: 04-Nov-21 21:40, Chemistry 14 Profile Sodium Level, Serum 144 [136 - 144 mmol/L] Potassium Level, Serum 3.7 [3.6 - 5.1 mmol/L] Chloride Level, Serum 110 [101 - 111 mmol/L] Total Carbon Dioxide, Serum 22 [20 - 30 mmol/L] Blood Urea Nitrogen, Serum 29 [8 - 26 mg/dL] Creatinine Level, Serum 1.34 [0.44 - 1.00 mg/dL] Anion Gap 12 [8 - 16 mmol/L] Glucose, Serum 105 [70 - 99 mg/dL] The above reference range for glucose is appropriate for the fasting state. For random specimens, values up to 140 mg/dL are considered normal. Calcium Level, Serum 9.1 [8.4 - 10.2 mg/dL] Albumin Level, Serum 3.8 [3.5 - 5.0 g/dL] Phosphorus Level, Serum 3.8 [2.3 - 4.7 mg/dL] Bilirubin, Total 0.4 [0.3 - 1.0 mg/dL] Protein Total Level, Serum 7.4 [6.5 - 8.1 g/dL] Aspartate Aminotransferase (SGOT) 31 [15 - 41 U/L] Alanine Aminotransferase (SGPT) 10 [14 - 54 U/L] Alkaline Phosphatase, Serum 111 [41 - 150 U/L] Lactic Dehydrogenase (LDH), Serum 311 [125 - 220 IU/L] Chest Xray 1 view EKG
CDC Split Type:

Write-up: central chest pressure, shortness of breath, mild dry cough.


VAERS ID: 1851155 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / IM

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

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

Write-up: multiple seizures leading to hospitalization


VAERS ID: 1851292 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939905 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vaccination site pain, Vaccination site pruritus, Vaccination site rash, Vaccination site swelling
SMQs:, Hypersensitivity (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: I was taking Vyvanse 60 mg
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Any penicillin drug
Diagnostic Lab Data: N/A
CDC Split Type: vsafe

Write-up: I reach out to a nurse practitioner/friend to look at my arm, due to cellulitis, there was a rash, swelling and pain around the vaccine site. It grew about a half an inch by November 4th, 2021. I took Benadryl and it is completely back to normal with mild itching and a slight red color.


VAERS ID: 1851354 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076C21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Computerised tomogram thorax abnormal, Extra dose administered, Insomnia, Pain, Pulmonary mass, Urine analysis normal, Vaccination site pain, Vaccination site swelling, Vaccination site warmth
SMQs:, Retroperitoneal fibrosis (broad), Cardiomyopathy (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: diclofenac 75mg once daily metformin ER 500mg once daily levothyroxine .100mcg once daily glimepiride 4mg once daily atenolol 25mg once daily womens multivitamin once daily vitamin b once daily vitamin d 5000 IU once daily turmeric 4 capsul
Current Illness: none
Preexisting Conditions: Type 2 diabetes arthritis only have half a thyroid
Allergies: contrast dye for CT scans sulfa drugs
Diagnostic Lab Data: CT scan- 11/05/2021- pulmonary nodules Urinalysis- 11/05/2021- normal
CDC Split Type: vsafe

Write-up: The day after the shot, the vaccine site was swollen, hot and very painful. My husband and i both experienced swore upper bodies to our necks. I never had a fever. A few days after I started to notice sharp stabbing pains up the right side of my back. The pain kept me up all night. It was like someone stabbed me in the back periodically. I woke up the next morning and contacted my doctor. By the time I got to her office the pain had stopped. She did not believe the back pain was from the shot. She thought I had kidney stones and set me up with an CT scan. While I was waiting for the scan, the pain started again. From the scan, they found I had no kidney stones but I do have pulmonary nodules. My doctor''s office told me they would test me again in 6 months. I had a CT scan about 4 years ago and nothing was found. The pain stopped later that evening. My arm is still red but it is not swollen or painful. I think I have developed a sensitivity to the vaccine and I will not be getting another booster.


VAERS ID: 1851357 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 004F21A / 3 LA / IM

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

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

Write-up: Patient contacted pharmacy 24 hours after vaccination reporting itchy feet. When queried about swelling, patient says there is some swelling. Recommended that patient contact PCP & seek medical help immediately if symptoms worsened. Follow up phone call with patient on 11/8 (6 days after vaccination) showed improvement (90% per patient) with daily cold pack & elevation of feet. Patient did not seek help from PCP, just from a friend that worked at a vaccination clinic. Recommended patient notify PCP. Patient also reporting via VSAFE.


VAERS ID: 1851385 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-29
Onset:2021-11-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shingles - fever and general achy feeling, Covid-19 #2 - fever
Other Medications: Vitamin D, multivitamin, metoprolol succinate, HCTZ, gabapentin, atorvastatin, meloxicam, Hydrocodone (PRN)
Current Illness: common cold (Covid ruled out by PCR test)
Preexisting Conditions: Hypertension, Mitral Valve Disorder, Lumbago, Cervicalgia, Sleep Apnea, Hyperlipidemia, Aortic Calcification, Basel Cell Carcinoma
Allergies: Walnuts and cat dander
Diagnostic Lab Data: neurological exam - normal 11/3/21
CDC Split Type:

Write-up: Sudden onset dizziness. Continued light headedness through 11/6/21 - now resolved


VAERS ID: 1851407 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Aphasia, Blood test, Dyspnoea, Electrocardiogram, Feeling abnormal, Headache, Joint range of motion decreased, Laboratory test, Nausea, Neck pain, Pain, Pain in extremity, Palpitations, Throat irritation
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: codeine, sulfa drugs, augmentin , amitriptyline, ibuprofen, melatonin, nitrofurantoin, fluoxetine, trazodone,
Diagnostic Lab Data: yes blood work, lab, ekg
CDC Split Type:

Write-up: An hour after taking the vaccine she started having a mental fogginess, she had difficulty forming words. About 4hrs later she had severe arm pain where she couldn''t lift her arm. 8 to 10 hrs later she started to get a racing heart rate and shortness of breath. She developed severe post neck pain that radiate to the top of her head. She had nausea and a linger in her throat. She went to the ER on Nov 3rd.


VAERS ID: 1851414 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chest pain, Diarrhoea, Headache, Oxygen saturation decreased, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

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

Write-up: fever 103,5 F during 5 days, weakness, low oxygen blood level, headache, chest pain, diarrhoea headache still continue after one week after the jab


VAERS ID: 1851777 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939905 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear pain, Eye disorder, Pain in extremity
SMQs:, Corneal disorders (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: constant ear ache described as "ice picks" that happened as soon as she received vaccine. Her arm was extremely sore for couple days and eyes felt like she "couldn''t open wide enough".


VAERS ID: 1852058 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 213D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Bedridden, Chest discomfort, Fatigue, Headache, Heart rate increased, Hypoaesthesia, Myalgia, Nausea, Pruritus, Rash, Throat tightness, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 11 Sep 21 - GlaxoSmithKline influenz vaccine, age 43; muscle and joint pain and soreness, extreme fatigue, and nausea for 24 hou
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: None to date.
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA Headache within 45 minutes-treated with OTC medications; headaches have continued unresolved, intermittent as recently as today. Accelerated heartrate within 45 minutes-no treatment; symptoms have continued intermittently as recently as today. Weakness and nausea within 1 hour, vomited x1-no treatment; nausea continued for 2 days. Extreme fatigue within 1 hour-confined to bed; symptoms lasted 3 days. Tightness in chest and throat and fine rash to arms and generalized itching within 1.5 hours-2 Benadryl at onset followed by Benadryl twice a day for next 3 days; continued for 3 days. Numbness in both arms within 1.5 hours-no treatment; continued intermittently for 3 days. Muscle and joint soreness/pain within 2 hours-no treatment; continued for 3 days.


VAERS ID: 1853430 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 320308D / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anosmia, Chills, Decreased appetite, Fatigue, Headache, Malaise, Pain, Pain in extremity, Pyrexia, Taste disorder
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Demarol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, chills, headache, body ache, lack of apetite, impaired sense of smell and taste, extremely sore arm, significant fatigue. It''s been more than one week, arm is still sore and still suffer from significant fatigue and overall lower feeling of wellbeing. Also sense of taste and smell still impaired.


VAERS ID: 1853310 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / UNK RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature, Body temperature increased, Chills, Dehydration, Fluid intake reduced, Headache, Immunisation, Pain in extremity
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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: Medical History/Concurrent Conditions: Blood pressure high (High blood pressure)
Allergies:
Diagnostic Lab Data: Test Date: 20211102; Test Name: Body temperature; Result Unstructured Data: Test Result:100.6; Comments: Time: 21:30, temperature of 100.6 for several hours
CDC Split Type: USPFIZER INC202101505670

Write-up: Pain in right arm; Headache; Chills; Temperature of 100.6 for several hours 11/3/2021; Could not get enough water down; Experiencing dehydration; The patient received the third/booster dose of BNT162b2; This is a spontaneous report from a contactable consumer, the patient. A 69-year-old non-pregnant female patient received BNT162b2 (booster) (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FG3527) via an unspecified route of administration in the right arm on 02Nov2021 (at the age of 69-years-old) as a single dose for COVID-19 immunisation. Medical history included high blood pressure. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient received other vaccines within four weeks prior to vaccination which included influenza vaccine (flu shot) (MANUFACTURER UNKNOWN) on 28Oct2021 for immunization. The patient did not receive any medication within two weeks of vaccination. The patient had no problem until 02Nov2021 at 21:30 and from then onwards she experienced pain in right arm, headache, chills and temperature of 100.6 for several hours 03Nov2021. She could not get enough water down and experienced dehydration. The events did not result in a visit to the doctors or other healthcare professional office/clinic, and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. On 02Nov2021, the patient underwent body temperature test and the result was 100.6 (unspecified units). Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of temperature of 100.6 which lasted for several hours was resolved on 03Nov2021 however the clinical outcome of the events pain in right arm, headache, chills, could not get enough water down and experienced dehydration were resolving at the time of this report.


VAERS ID: 1853312 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 2 RA / OT

Administered by: Work       Purchased by: ?
Symptoms: Chills, Malaise, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101505738

Write-up: Developed malaise; Chills; Body aches; Fever; This is a spontaneous report from a contactable pharmacist. A 51-year-old male patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FF2589) via intramuscular route of administration in the right arm on 02Nov2021 at 10:45 (at the age of 51-years-old) as a single dose for COVID-19 immunisation. The patient did not have any medical history. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medications were not reported. The patient did not receive any other vaccines within four weeks prior to the COVID-19 vaccine. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0217) via intramuscular route of administration in the right arm on 12Oct2021 at 10:00 (at the age of 51-years-old) as a single dose for COVID-19 immunisation. On 02Nov2021 at 22:30, about 12 hours after receiving vaccine dose, the patient developed malaise, chills, body aches and fever. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were taken as a result of the events which included treatment with paracetamol (TYLENOL). Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events developed malaise, chills, body aches and fever were resolving at the time of this report.


VAERS ID: 1853323 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Immunisation, Migraine
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101512168

Write-up: Migraine; Extreme fatigue; The patient received third/booster dose of BNT162b2; This is a spontaneous report from a contactable consumer, the patient. A 33-year-old non-pregnant female patient received the third (booster) dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 02Nov2021 at 19:30 (at the age of 33-years-old) as a single dose for COVID-19 immunisation. The patient had no relevant medical history. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient received other vaccine within four weeks of vaccination which included tetanus vaccine (MANUFACTURER UNKNOWN) on an unknown date in 2021 for immunization. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on an unknown date and also received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on an unknown date as a single dose for COVID-19 immunisation. On 03Nov2021, the patient experienced migraine and extreme fatigue. The events did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events migraine and extreme fatigue were unknown at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1853515 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939904 / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site bruising
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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: 2 hours after the dose today she noticed a bruise at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE BRUISING (2 hours after the dose today she noticed a bruise at the injection site) in an 81-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939904) for COVID-19 vaccination. Previously administered products included for an unreported indication: INFLUENZA VACCINE in October 2021. On 02-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Nov-2021, the patient experienced INJECTION SITE BRUISING (2 hours after the dose today she noticed a bruise at the injection site). At the time of the report, INJECTION SITE BRUISING (2 hours after the dose today she noticed a bruise at the injection site) outcome was unknown. Patient experienced Bruise with flu shot taken a couple of weeks ago and patient also stated she had not taken any treatments. No concomitant medications were reported. This case was linked to MOD-2021-372938 (Patient Link).


VAERS ID: 1853633 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939904 / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Cough, Disorientation, Disturbance in attention, Dizziness, Dysarthria, Fatigue, Feeling abnormal, Hypoaesthesia, Hypoaesthesia oral, Impaired work ability, Tinnitus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Hearing impairment (narrow), Vestibular disorders (broad), Arthritis (broad), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (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: Wellbutrin; Lexapro.
Current Illness: Season allergies, post nasal drip.
Preexisting Conditions: None.
Allergies: Sulfa.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Started to feel dizzy with ringing in my ears and trouble focusing on work around 10am around 10:45 my face started to feel numb and I felt like I was going to pass out. Laid my head down for a bit and then called my PCP''s office. While talking to the nurse, my speech was slurred and my tongue and the roof of my mouth started to feel numb. she advised me to take Benadryl and call 911. I took Benadryl called 911 they sent out EMS and they advised me that I was just injected with a live virus and this was the side effect of having COVID. That made no sense to me, she then instructed me to take DayQuil for the effects of having COVID. I told the EMT that I was not feeling like I had the flu I felt out of it and numb. She checked my vitals and lungs and said everything was good and that they could transport me to the Hospital ED but they were full and I would just be sitting there and it would be best to rest in my home. That if the Benadryl wore off or if things got worse, to go to urgent care. I slept and when I woke up the facial numbness was less and my tongue and mouth no longer felt numb. I was dizzy and my ears were still ringing and disoriented the entire day. The next day I was extremely tired and started to having coughing with chest pain when I would cough and by that evening I was having joint pain everywhere. Today I feel better, still have the coughing with chest pain. Following up with my PCP at 9:20am 11/04/21.


VAERS ID: 1853654 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 LA / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER I DON''T KNOW / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chills, Feeling hot, Headache, Hypertension, Hypoaesthesia, Immunodeficiency, Pain, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Armour Thyroid, Methylphenidate, Rosuvistatin, Amitriptyline, Escitalopram, Ferrous Gluconate
Current Illness: none
Preexisting Conditions: sinusitis, depression/anxiety, endometriosis
Allergies: amoxicillin, prednisone
Diagnostic Lab Data: Simply the vitals taken in the nurse''s office on 03NOV2021. Temp 99.9, BP 135/95, Pulse 111. No other tests were taken.
CDC Split Type:

Write-up: Tuesday evening - severe headache and body aches. Wednesday morning better - then complete numbness in left upper leg quadricep area, pain in mid back on the left side, but no headache. Went to nurse at employer just to check things out. Took vitals - I had a fever of 99.9 degrees F, my BP was very high for me at 135/95, and my pulse was 111. Took some deep breaths and drank some water, rested for ~ 5 minutes. Retook vitals and the results were nearly the same (slightly lower but not by much.) That evening after traveling home I went to bed at 6:15 pm. I had the chills and felt very feverish (my neck, face and forehead were VERY hot, while the rest of me was very cold.) I do not have a thermometer at home so could not take temperature. The next morning when I woke up I felt much better. Then only remaining pain in my left arm for two more days. Now I''m feeling myself again.


VAERS ID: 1853702 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-13
Onset:2021-11-02
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, 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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Breakthrough COVID-19 infection


VAERS ID: 1853724 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019F21A / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Incorrect dose administered
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 0.5ml dose, instead of 0.25ml booster dose


VAERS ID: 1853802 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-10-25
Onset:2021-11-02
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 3 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Condition aggravated, Oedema peripheral, Psoriasis, Rash, Sensitive skin, Skin exfoliation
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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: ? acetaminophen (TYLENOL) 500 mg tablet Take 2 tablets (1,000 mg total) by mouth 4 (four) times a day. ? aspirin 81 mg chewable tablet Chew 1 tablet daily. ? blood-glucose meter misc Test as directed for diabetes control. ? insulin aspart U
Current Illness:
Preexisting Conditions: DM2 with retinopathy, ASCVD, CHF, psoriasis
Allergies: acetazolamide (itching), rosuvastatin (myalgia)
Diagnostic Lab Data: none
CDC Split Type:

Write-up: rash started 11/2/21, improving by 11/7/21, after peeling, feeling burned and sensitive, and having significant R$gL leg edema. Patient has history of psoriasis on feet and this was reminiscent of flare of that, but resolved quickly with just emollients


VAERS ID: 1853867 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Headache, Pyrexia, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: Moderna Side Effects Received Vaccine on Tuesday November 2nd, 2021 at approximately 5pm. No immediate side effects . Same day at approximately 9pm I experienced the following side effects: My resting heart rate was between 115-120 bpm. It lasted throughout the night on and off. I also started wheezing and had trouble breathing all night. I also had the mild fever and headach. I have a history of asthma so I got through the trouble breathing by using breathing exercises and remaining calm. Next day Wednesday November 3rd, 2021. My resting heart rate was 100-105 bpm. Also still had trouble breathing, but kept calm and did the breathing exercises. Thursday November 4th, 2021. My resting heart rate was at 80-90 bpm. Other side effects were gone as well.


VAERS ID: 1853906 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Apathy, Asthenia, Blood test, Burning sensation, Decreased appetite, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (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: flu
Other Medications: allergy meds, nasal spray, Chiral
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: strawberry
Diagnostic Lab Data: blood work
CDC Split Type: vsafe

Write-up: I having pain, tingling, weakness, burning all over my body. I having motive issues. I have lack of aplite. These symptom has been going on for about week. It has gotten worst since the shot. I went to the ER. They did blood work. They told me to follow up with my primary care doctor.


VAERS ID: 1853946 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-24
Onset:2021-11-02
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN #043A21A / 1 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Anion gap normal, Aspartate aminotransferase increased, Basophil percentage decreased, Blood albumin decreased, Blood alkaline phosphatase normal, Blood bilirubin decreased, Blood calcium decreased, Blood chloride increased, Blood creatine phosphokinase increased, Blood creatinine increased, Blood glucose decreased, Blood lactate dehydrogenase increased, Blood lactic acid, Blood magnesium normal, Blood phosphorus, Blood potassium decreased, Blood sodium normal, Blood urea increased, Carbon dioxide normal, Chest X-ray, Differential white blood cell count, Eosinophil percentage decreased, Fall, Full blood count, Glomerular filtration rate decreased, Haematocrit decreased, Haemoglobin decreased, Hypoglycaemia, Lymphocyte count decreased, Lymphocyte count normal, Lymphocyte percentage decreased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume normal, Monocyte count normal, Monocyte percentage, Muscular weakness, Neutrophil count normal, Neutrophil percentage increased, Pain in extremity, Platelet count normal, Protein total decreased, Red blood cell count decreased, Red cell distribution width increased, White blood cell count normal, X-ray of pelvis and hip
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (narrow), Tubulointerstitial diseases (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (narrow), Hypokalaemia (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: unknown
Current Illness: unknown
Preexisting Conditions: Diabetes, 5 vessel bypass, stroke, hypertension, hypercholesterolemia,
Allergies: Demerol HCI
Diagnostic Lab Data: Lab Results: Other Chemistry: 03-Nov-21 11:12, *Whole Blood Glucose, Glucometer *Whole Blood Glucose, Glucometer 34 [79 - 99 mg/dL] Hypoglycemia Proto Meter: UU14148580 Operator: 03-Nov-21 12:18, Chemistry 14 Profile Estimated GFR 47.87 [60.00 - 130. ml/ min] Estimated Glomerular Filtration Rate 39.56 [60.00 - 130. ml/ min] Estimated GFR Value <60 ml/min/1.73 sq meters is indicative of chronic kidney disease <15 ml/min/1.73 sq meters is indicative of kidney failure The Estimated GFR is calculated by the four variable MDRD equation. Limitations of this calculation include: Decreased accuracy for values $g60 Decreased accuracy in the hospitalized/severely ill patient populations Disregard EGFR values for infants and children (should not be applied to this age group) 03-Nov-21 12:18, Lactic Acid Lactic Acid 1.30 [0.50 - 2.20 mmol/L] 03-Nov-21 12:18, Magnesium Level, Serum Magnesium Level, Serum 1.6 [1.6 - 2.6 mg/dL] 03-Nov-21 13:31, *Whole Blood Glucose, Glucometer *Whole Blood Glucose, Glucometer 85 [79 - 99 mg/dL] Meter: UU14458925 Operator: CBC-Differential-Morphology: 03-Nov-21 12:18, CBC White Blood Cell Count 8.0 [4.5 - 11.0 K/cmm] Red Blood Cell Count 3.43 [3.90 - 5.60 M/cmm] Hemoglobin 9.9 [12.0 - 17.3 g/dL] Hematocrit 29.0 [36.0 - 53.0 %] Mean Corpuscular Volume 84.8 [80.0 - 100.0 fl] Mean Corpuscular Hemoglobin 28.8 [26.0 - 34.0 PG] Mean Corpuscular Hemoglobin Concn 34.0 [31.0 - 37.0 %] Red Cell Distribution Width 16.4 [11.5 - 14.5 %] *Platelet Count 180 [140 - 440 K/cmm] Mean Platelet Volume 7.7 [7.4 - 10.4 FL] Automated Neutrophils % 91 [ %] Automated Lymphocytes % 4 [ %] Automated Monocytes % 5 [ %] Automated Eosinophils % 0 [ %] Automated Basophils % 0 [ %] Absolute Neutrophil Count 7.3 [1.0 - 8.0 K/cmm] Absolute Lymphocyte Count 0.3 [1.0 - 5.0 K/cmm] Absolute Monocyte Count 0.4 [0.1 - 0.8 K/cmm] Chemistry Panels & Profiles: 03-Nov-21 12:18, Chemistry 14 Profile Sodium Level, Serum 143 [136 - 144 mmol/L] Potassium Level, Serum 3.3 [3.6 - 5.1 mmol/L] Chloride Level, Serum 107 [101 - 111 mmol/L] Total Carbon Dioxide, Serum 26 [20 - 30 mmol/L] Blood Urea Nitrogen, Serum 32 [8 - 26 mg/dL] Creatinine Level, Serum 1.76 [0.61 - 1.24 mg/dL] Anion Gap 10 [8 - 16 mmol/L] Glucose, Serum 47 [70 - 99 mg/dL] Telephone notification of critical result was read back and verified with: 11/3/2021 13:07:53 The above reference range for glucose is appropriate for the fasting state. For random specimens, values up to 140 mg/dL are considered normal. Calcium Level, Serum 7.4 [8.4 - 10.2 mg/dL] Albumin Level, Serum 1.9 [3.5 - 5.0 g/dL] Phosphorus Level, Serum 4.2 [2.3 - 4.7 mg/dL] Bilirubin, Total 0.2 [0.3 - 1.0 mg/dL] Protein Total Level, Serum 5.1 [6.5 - 8.1 g/dL] Aspartate Aminotransferase (SGOT) 116 [15 - 41 U/L] Alanine Aminotransferase (SGPT) 42 [17 - 63 U/L] Alkaline Phosphatase, Serum 110 [41 - 150 U/L] Lactic Dehydrogenase (LDH), Serum 590 [125 - 220 IU/L] 03-Nov-21 12:18, Creatine Kinase (CPK) Creatine Kinase (CPK) 3514 [30 - 200 IU/L] XRay trauma series Chest/Pelvis
CDC Split Type:

Write-up: Weakness and pain in extremities, multiple falls


VAERS ID: 1853997 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-29
Onset:2021-11-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA #013M20A, # 030 / 3 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Aggression, Anion gap, Basophil percentage, Bilirubin urine, Blood calcium normal, Blood chloride increased, Blood creatinine normal, Blood glucose normal, Blood potassium normal, Blood sodium normal, Blood urea normal, Blood urine present, Carbon dioxide normal, Chest X-ray, Computerised tomogram head, Confusional state, Differential white blood cell count, Eosinophil percentage, Full blood count, Glomerular filtration rate normal, Glucose urine absent, Haematocrit normal, Haemoglobin normal, Lymphocyte count, Lymphocyte percentage decreased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin increased, Mean cell volume increased, Mean platelet volume decreased, Metabolic function test, Monocyte count, Monocyte percentage increased, Neutrophil count, Neutrophil percentage increased, Nitrite urine absent, Platelet count normal, Protein urine absent, Red blood cell count decreased, Red blood cells urine positive, Red cell distribution width normal, Specific gravity urine normal, Urinary sediment present, Urine analysis abnormal, Urine ketone body absent, Urine leukocyte esterase, Urobilinogen urine, White blood cell count normal, White blood cells urine positive, pH urine increased
SMQs:, Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (narrow), Chronic kidney disease (broad), Myelodysplastic syndrome (broad), Tubulointerstitial diseases (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: dementia, hypertension
Allergies: no known allergies
Diagnostic Lab Data: Lab Results: Other Chemistry: 02-Nov-21 09:00, Basic Metabolic Panel Estimated GFR 89.74 [60.00 - 130. ml/ min] Estimated Glomerular Filtration Rate 74.16 [60.00 - 130. ml/ min] Estimated GFR Value <60 ml/min/1.73 sq meters is indicative of chronic kidney disease <15 ml/min/1.73 sq meters is indicative of kidney failure The Estimated GFR is calculated by the four variable MDRD equation. Limitations of this calculation include: Decreased accuracy for values $g60 Decreased accuracy in the hospitalized/severely ill patient populations Disregard EGFR values for infants and children (should not be applied to this age group) CBC-Differential-Morphology: 02-Nov-21 09:00, CBC White Blood Cell Count 7.8 [4.5 - 11.0 K/cmm] Red Blood Cell Count 4.16 [3.30 - 5.30 M/cmm] Hemoglobin 13.2 [11.0 - 16.2 g/dL] Hematocrit 39.9 [36.0 - 46.0 %] Mean Corpuscular Volume 96.1 [80.0 - 100.0 fl] Mean Corpuscular Hemoglobin 31.7 [26.0 - 34.0 PG] Mean Corpuscular Hemoglobin Concn 33.0 [31.0 - 37.0 %] Red Cell Distribution Width 12.8 [11.5 - 14.5 %] *Platelet Count 200 [140 - 440 K/cmm] Mean Platelet Volume 7.2 [7.4 - 10.4 FL] Automated Neutrophils % 72 [ %] Automated Lymphocytes % 16 [ %] Automated Monocytes % 9 [ %] Automated Eosinophils % 2 [ %] Automated Basophils % 1 [ %] Absolute Neutrophil Count 5.7 [1.0 - 8.0 K/cmm] Absolute Lymphocyte Count 1.3 [1.0 - 5.0 K/cmm] Absolute Monocyte Count 0.7 [0.1 - 0.8 K/cmm] Chemistry Panels & Profiles: 02-Nov-21 09:00, Basic Metabolic Panel Sodium Level, Serum 142 [136 - 144 mmol/L] Potassium Level, Serum 3.8 [3.6 - 5.1 mmol/L] Chloride Level, Serum 108 [101 - 111 mmol/L] Total Carbon Dioxide, Serum 27 [20 - 30 mmol/L] Blood Urea Nitrogen, Serum 14 [8 - 26 mg/dL] Creatinine Level, Serum 0.75 [0.44 - 1.00 mg/dL] Anion Gap 7 [8 - 16 mmol/L] Glucose, Serum 99 [70 - 99 mg/dL] The above reference range for glucose is appropriate for the fasting state. For random specimens, values up to 140 mg/dL are considered normal. Calcium Level, Serum 9.6 [8.4 - 10.2 mg/dL] Routine Urinalysis: 02-Nov-21 09:00, UA Possible UTI (PLUS preserve UA x 48 hours for possible urine culture order) Color STRAW [YELLOW] Clarity, Urine CLEAR [CLEAR] Specific Gravity, Urinalysis 1.010 [1.005 - 1.03 SGU] *Ph, Urine 9.0 [5.0 - 8.0 ph units] Protein, Urinalysis NEGATIVE [NEGATIVE mg/dL] Glucose, Urinalysis NEGATIVE [NEGATIVE mg/dL] Ketones, Urine NEGATIVE [NEGATIVE mg/dL] Bilirubin, Urinalysis NEGATIVE [NEGATIVE mg/dL] Blood, Urine 1+ (SMALL) [NEGATIVE mg/dL] Urobilinogen, Urine NEGATIVE [NEGATIVE mg/dL] Nitrite, Urine NEGATIVE [NEGATIVE] Leukocyte Esterase, Urine NEGATIVE [NEGATIVE Leu/ul] White Blood Cells, Urine 0-5 [NONE] Red Blood Cells,Urine 3-5 [0 - 2] Squamous Epithelial Cells FEW [FEW] Transitional Epithelial Cells FEW [FEW] X Ray Chest 1 view CT Brain W/O contrast
CDC Split Type:

Write-up: Increased confusion and aggression


VAERS ID: 1854017 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / UNK - / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Mental disorder, Mental status changes, Right hemisphere deficit syndrome
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvastatin, Levothyroxine, Metoprolol, Pepcid, Potassium, Aspercreme, Aspirin, Depakote, Vitamin B, Tylenol, Fenofibrate
Current Illness: Dental pain 10/8
Preexisting Conditions: UTI-E. coli; Hypokalemia; Hypomagnesemia; Hyperlipidemia; Hypertriglyceridemia Hypothyroidism; Shchizoaffective disorder; Bipolar disorder, unspecified, GERD, CKD4 HTN, Nicotine dependence, Morbid obesity, TIA
Allergies: Thiothixene, Phenothiazines
Diagnostic Lab Data: Transferred to ED, hospitalized
CDC Split Type:

Write-up: Transient altered mental status & right sided deficits.


VAERS ID: 1854033 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 1 LA / IM

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

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

Write-up: Systemic: Fever-Severe, Additional Details: I was contacted by Urgent Care to inform me that the pt presnted with 102 degree F fever on 11/02/2021. The patient returned to the same urgent care on 11/08/2021 complaining of continued high fever and referred them to the Emergency Room. I have not been able to contact the patient or family and I have left a message on their voicemail requesting them to call me. The Pfizer Covid-19 vaccine was administered into the Left Deltoid.


VAERS ID: 1854085 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Swollen and painful armpit for 6 days


VAERS ID: 1854127 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051F21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (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: Baby Aspirin, Jamunet
Current Illness: No
Preexisting Conditions: Diabetic
Allergies: Shellfish, Sulfa, Cipro
Diagnostic Lab Data: No
CDC Split Type: vsafe

Write-up: I have a bump size of a baseball at the injection site went to doctor advised to apply ice since last Wed. November 3, 2021. It doesn''t hurt just a bump coming out of my shoulder. My doctor has informed me it will subside not as of yet.


VAERS ID: 1854168 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-01
Onset:2021-11-02
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 3 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood urine present, Chest pain, Fatigue, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: follow up on 11/15/21 is scheduled
CDC Split Type:

Write-up: The first 2 days after the Moderna booster were similar to the 2nd dose of Moderna except for the extremely large bump on my arm. On the 3rd day I experienced slight chest pain. On the 4th day I had urinated small blood clots in my urine for 6 hours starting at 9a. The first hour they were the size of a quarter for 4 urines. The next 4 times I urinated they were the size of a dime and then a change to snot like blood. Then a small color of blood and then by 4p no more blood. I was tired, called my doctor and was prescribed amoxicillin. I went to bed early and slept 10 hours. I felt fine after that. I am following up with my doctor to check and see if it is bladder related.


VAERS ID: 1854246 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-25
Onset:2021-11-02
   Days after vaccination:222
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: HYDROcodone-acetaminophen, apixaban, calcium citrate PO, carVEDilol Cholecalciferol Cyanocobalamin escitalopram furosemide ramipril
Current Illness: N/A
Preexisting Conditions: Essential hypertension, Cardiomyopathy, Chronic atrial fibrillation, Depression, anxiety, gastric bypass, obesity, Atrial fibrillation with RVR degenerative joint disease
Allergies: N/A
Diagnostic Lab Data: Nucleic Acid Amplification (NAA)/Polymerase Chain Reaction (RT-PCR) Positive
CDC Split Type:

Write-up: 11/2 Patient came in for Pre-Surgical PASS appointment. COVID test result from 11/2/21 is noted to be POSITIVE. Pt asymptomatic.


VAERS ID: 1854376 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051F21A / 3 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Pyrexia, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cetirizine 10mg 1xday Lantus 25 units Lisinopril 2.5 mg 1xday metformin 850mg 3xday anastrozole 1mg 1xday Multivitamin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type: vsafe

Write-up: I started around afternoon with chills and by 5PM I started running a fever at 99.7 degrees. The chills continued through most of the night. At about 4AM my fever was up to 100.6 degrees, and the chills continued for most of the 2nd day. I was fatigued with a headache. The fever remained most of the day. It broke about midnight, and then I went back to a normal temperature. I continued to have a headache, and then the chills stopped around Wednesday. I slept most of the time. I was totally out of it on Tuesday. I didn''t even remember taking any of my medications. By Thursday, on the 3rd day, I was already back to a normal routine.


VAERS ID: 1854383 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-09
Onset:2021-11-02
   Days after vaccination:207
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 1854454 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-12
Onset:2021-11-02
   Days after vaccination:263
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 2 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Asthenia, Atrial fibrillation, Blood thyroid stimulating hormone decreased, COVID-19, COVID-19 pneumonia, Cardiac assistance device user, Chest X-ray abnormal, Glycosylated haemoglobin increased, Hypokalaemia, Lung opacity, Obesity, SARS-CoV-2 test positive, Thyroxine increased, Tri-iodothyronine increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Supraventricular tachyarrhythmias (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), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 325 MG tablet aluminum, magnesium & simethicone (MAALOX EX) 400-400-40 MG/5ML bisacodyl (DULCOLAX) 10 MG suppository clotrimazole (LOTRIMIN) 1 % cream diphenhydrAMINE (BENADRYL) 25 MG tablet Emollient (EUCERIN) lotio
Current Illness:
Preexisting Conditions: Nervous Syncope and collapse Myasthenia gravis Type 2 diabetes mellitus with diabetic neuropathy, with long-term current use of insulin Late onset Alzheimer''s disease with behavioral disturbance Genitourinary Nocturia Endocrine/Metabolic Hypophosphatemia Graves disease Other Memory impairment Weakness Living in assisted living Edema Pedal edema
Allergies: IodineHives Cortisone Erythromycin Macrolides
Diagnostic Lab Data: CHEST SINGLE VIEW Resulted: 11/02/21 1140 Order Status: Completed Updated: 11/02/21 1142 Narrative: EXAMINATION: Single View Chest EXAM DATE: 11/2/2021 11:35 AM TECHNIQUE: Single view chest INDICATION: COVID-19, weakness. COMPARISON: Chest radiograph 9/28/2020. ENCOUNTER: Not applicable FINDINGS: Left chest wall dual-lead pacemaker. The cardiomediastinal silhouette is unremarkable. Unchanged chronic elevation of the left hemidiaphragm. Mild opacity at the left lung base. No substantial pleural effusion or pneumothorax. Impression: Chronic elevation of the left hemidiaphragm with mild opacity at the left lung base that may represent atelectasis or consolidation. Procedure Component Value Ref Range Date/Time COVID-19 PCR - Rapid BL and Regionals(Abnormal) Collected: 11/02/21 1459. Order Status: Completed. Specimen: Swabbed Collection from Nasopharynx Updated: 11/02/21 1517 COVID-19 PCR Detected Abnormal.
CDC Split Type:

Write-up: Patient is a 82 y.o. female who presented to Hospital on 11/2/2021 from assisted living facility. The patient is known COVID-19 positive and presented with increased weakness and found to have AKI and hypokalemia. While hospitalized she received IVF resuscitation and her AKI resolved. She received aggressive potassium replacement during her hospitalization. Upon discharge will continue KCl 40meq daily. The patient was noted to have COVID-19 viral pneumonia. She never showed signs of respiratory distress and remained on room air throughout her hospital stay. The patient has been vaccinated, she was not a candidate for remdesivir or decadron. Given the increased weakness she was evaluated by PT/OT who recommended Rehab, unfortunately there were no available beds at rehab hospital accepting patient with COVID and the patient was unable to return to assisted living until 11/12/2021. Thus the patient will be discharging to her daughter''s home and was set-up with a lift and hospital bed. Patient will need a follow-up TSH in 6 weeks as her levothyroxine dose was reduced to 175mcg daily due to low TSH, with an elevated t3 and t4. Would also consider follow-up BMP. Recommend follow-up with PCP in 1 week for post-hospitalization follow-up and coordination of care. Other medical issues addressed this hospitalization: Late onset Alzheimer''s disease with behavioral disturbance.- At baseline Type 2 diabetes mellitus with diabetic neuropathy, with long-term current use of insulin - Repeat A1C 7.8 - Reduced home lantus and novolog dose to prevent hypoglycemia, continue outpatient follow-up for management . Class 2 severe obesity with serious comorbidity in adult. - Complicating risk factor for COVID-19 - Recommend outpatient follow-up with PCP , Atrial fibrillation - Not on OAC at baseline due to high risk for falls - Rate controlled


VAERS ID: 1854501 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-11-02
Onset:2021-11-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM
FLUC4: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT) / SEQIRUS, INC. - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Extra dose administered, Fatigue, Headache, Inappropriate schedule of product administration, Injection site pain, Pain, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control, Creon, Ferretts 325mg, Vitamin C, Magnesium Oxide 400mg, Acetaminophen, Zinc 30mg, Flonase nasal spray, Vitamin D, Melatonin, Calcium Carbonate 500mg chews, multivitamin, B-100, Vitamin B-12, allergy pill as needed
Current Illness:
Preexisting Conditions: Fibromyalgia, malabsorption
Allergies: Sulfa drugs, amoxicillin, NDSAIDs, Ferric Oxide, sensitivity to milk and pork
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately five hours after receiving the COVID-19 Modern booster and flu shot, I noticed hives on both arms; however, they did not itch or bother me. As expected, my arm had some soreness at the injection spot and I was tired. During the night (10-12 hours after receiving the vaccines, I woke up with a bad case of the chills and presumably a fever. When I got up in the morning, I had a fever but most of the hives had gone away. I took OTC acetaminophen and my fever went away as well. That day (after the vaccine), I had full body aches, was tired and weak, and had a dull headache.


VAERS ID: 1854509 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-11-01
Onset:2021-11-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939905 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Headache, Inappropriate schedule of product administration, Myalgia, Nausea, 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), Arthritis (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: First Covid Dose received on September 16, 2021
Other Medications: Synthroid 150 mcg PO QD Singulair 10 mg PO QD Zyrtec 10 mg PO QD
Current Illness: None
Preexisting Conditions: Post surgical Hypothyroidism Asthma Nasal Allergies
Allergies: Sulfa''s Penicilline Iodine contrast Bethadine Latex
Diagnostic Lab Data: not performed
CDC Split Type:

Write-up: Severe arthralgias and myalgias describes as severe as the Chikunguya the patient had on 2014, fever (range from 37.3 to 38), nauseas, headache, chills, tireness that lasted 48 hrs


VAERS ID: 1854585 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-10-25
Onset:2021-11-02
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gait inability, Herpes zoster, Laboratory test, Neuralgia, Pain, Pain in extremity, Rash, Rash vesicular, Sciatica, X-ray abnormal
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: PCOS
Allergies: None
Diagnostic Lab Data: Tested for blood clots, X-ray of leg nov 3 Diagnosed with sciatic nov 4 Diagnosed with shingles causing the extreme nerve pain nov 9
CDC Split Type:

Write-up: At the onset was extreme lower right leg pain, pain was so bad walking wasn?t possible! The pain proceeded to shoot up the leg and nothing would help, heat, ice, chiro, stem all tried. One week later with pain the whole week the right foot broke out in blister like rash and went to the hospital and was diagnosed with shingles.


VAERS ID: 1854605 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-01-15
Onset:2021-11-02
   Days after vaccination:291
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Malaise, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Positive Covid-19 test of unknown type.
CDC Split Type:

Write-up: Complaint of runny nose/congestion, loss of taste/smell, and malaise.


VAERS ID: 1854615 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-01-12
Onset:2021-11-02
   Days after vaccination:294
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Headache, Nausea, SARS-CoV-2 test positive, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Complaint of headache, nausea/vomiting, and lightheaded


VAERS ID: 1854636 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-23
Onset:2021-11-02
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bronchitis, Cough, Headache, Influenza virus test negative, Nasal congestion, Oropharyngeal pain, Productive cough, Respiratory tract congestion, SARS-CoV-2 test negative, Sinus congestion, Streptococcus test negative
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol Spironolactone Vitamin D Pantoprazole
Current Illness: none
Preexisting Conditions: Mitral-valve prolapse Obesity
Allergies: Sulfa
Diagnostic Lab Data: Strep, Flu, COVID (rapid and PCR) - 11/5/21 - all negative
CDC Split Type:

Write-up: Bronchitis Started with a sore throat on the 3rd. Stuffy nose and head started on the 4th and then cough and chest congestion on Thursday night. Started as a dry cough but moved to a productive cough on Friday afternoon. Also had a bad headache. Sought medical care and was diagnosed with Bronchitis. Received a steroid shot, liquid for cough and congestion (Bromphen), Albuterol, and an antibiotic. Today, I''m feeling better but the cough is still lingering. It is fairly productive.


VAERS ID: 1854700 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-05
Onset:2021-11-02
   Days after vaccination:270
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038K20A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Dysuria, Haematuria, SARS-CoV-2 test positive
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 11/2/21 SARS-CoV-2 (COVID-19) detected
CDC Split Type:

Write-up: 11/2/21 presented as transfer from medical center "for gross hematuria and difficulty urinating for a couple of days". PMHx "of bladder cancer s/p TURBT and bovine treatments " and "prostate cancer s/p prostatectomy".


VAERS ID: 1854712 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-19
Onset:2021-11-02
   Days after vaccination:256
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007M20A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Cough, Diarrhoea, Dyspnoea, Dyspnoea exertional, Fatigue, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (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: 11/3/21 SARS-CoV-2 (COVID-19) by NAA detected
CDC Split Type:

Write-up: 11/2/21 patient presents to EC ED "with sob. Patient that 8 days ago started having fatigue, generalized weakness, diarrhea. Two days ago started having DOE, and cough". PMHx "of HTN, DM, HLD".


VAERS ID: 1854713 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-02
Onset:2021-11-02
   Days after vaccination:245
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018B21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chills, Diarrhoea, Pyrexia, Rectal haemorrhage, SARS-CoV-2 test positive
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 11/2/21 SARS-CoV-2 (COVID-19) detected
CDC Split Type:

Write-up: 11/2/21 presents "with bright red bleeding per rectum that he noticed after he started to have diarrhea about one week ago" and "some subjective fever and chills". ESRD on MWF HD, HTN"


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