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From the 10/15/2021 release of VAERS data:

Found 800,916 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 452 out of 8,010

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VAERS ID: 1602656 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-18
Onset:2021-08-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

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

Write-up: Increased heart rate 145, 132 and more. I have the Kardia ekg to verify. Chest pain and breathing hard.


VAERS ID: 1602665 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Fatigue, Feeling hot, Headache, Malaise, Rash, Therapy non-responder, Vasculitis
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Vasculitis (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mycophenolate Sodium (Myfortic), Wellbutrin, Estradiol, Progesterone, B12 shots
Current Illness:
Preexisting Conditions: Hypocomploment Urticarial Vasculitis, MS (Abnormal MRI), iron deficiency, stage 3b ckd
Allergies: Antihistamines, Bacolfen
Diagnostic Lab Data: Nehprologist did a lab test and discovered I had no antibodies after two Moderna shots. Therefore I took the third. Still on Myfortic while receiving vaccine.
CDC Split Type:

Write-up: Received a third shot due to immunosuppression. Began to feel unwell by that evening (headache, feeling hot, fatigue). I woke up the next morning with a significant flare of my vasculitis, the first one I have had in four months. The rash was very hot and spread more than usual covering my trunk, thighs, arms and chest. Today is day two of this flare. It is still red and hot but not spreading any further. My rheumatologist prescribed 10mg of prednisone if needed, but trying to not take to allow immune response.


VAERS ID: 1602677 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 - / IM

Administered by: Military       Purchased by: ?
Symptoms: Brain natriuretic peptide normal, C-reactive protein increased, Chest X-ray normal, Chest pain, Echocardiogram normal, Electrocardiogram ST-T change, Full blood count normal, Metabolic function test normal, Myocarditis, Pericarditis, Red blood cell sedimentation rate normal, SARS-CoV-2 test positive, Troponin
SMQs:, Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: hydroxyzine, bupropion, duloxetine, trazadone
Current Illness: Covid 19
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Covid 19 positive 8/17/2021 8/21/2021 CBC, ESR, CMP, BNP, and CXR were normal. ECG showed diffuse ST changes, NSR. CRP 5.22, Troponin 9.55
CDC Split Type:

Write-up: Tested positive for Covid 19 (8/17/2021) the day before receiving the second dose of the Pfizer vaccine (8/18/2021). He presented to the ED on 8/21/2021 with positional chest pain (worse while supine and better while sitting). No fever, chills, muscle aches, body aches, runny nose, trouble breathing. ECG was consistent with pericarditis with normal sinus rhythm, troponin was 9.5, and CRP was 5.22. Bedside echo showed no pericardial effusion and normal chest x ray. Pt was transferred to Hospital for further management of myopericarditis.


VAERS ID: 1602679 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-08-17
Onset:2021-08-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Hives, red itchy all over body


VAERS ID: 1602682 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-18
Onset:2021-08-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: Flu shot at one time and got the flu pretty badly.
Other Medications: No medications, I take daily B12, D3, DIM, Excedrin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None at this time.
CDC Split Type:

Write-up: I received the Janssen vaccine on Wednesday 8-18-2021 and started having tingling sensation on my left lower leg, hands and forearms.


VAERS ID: 1602699 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-16
Onset:2021-08-20
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Allergy to vaccine, Erythema, Infection, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec tablets and I put calamine lotion on body.
Current Illness: No illness at the time of vaccination and up to one month prior.
Preexisting Conditions: None.
Allergies: No known allergies.
Diagnostic Lab Data: No test recommended by doctor.
CDC Split Type:

Write-up: I have skin rashes all in my body and they are increasing exponentially. I had phone call with the doctor and I have provided him with the photos of my body (hands, chest, back, face etc.) places where I have skin rashes, redness, infection, allergy due to vaccine.


VAERS ID: 1602702 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Body temperature increased, Dysphagia, Feeling abnormal, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: per patient tongue swelling after receiving influenza vaccine previously
Other Medications: nothing on file
Current Illness: not known
Preexisting Conditions: nothing on file
Allergies: per patient allergy to influenza vaccine
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: 1740: Patient received the first dose of the Pfizer vaccine Lot #EW0168 at approximately 1725. At 1740 pt states "my throat and tongue feel weird. Its hard to swallow and my tongue feels bigger than it normally is". Pt taken to the observation area to lay down. Pt has previous history of severe allergic reaction to flu vaccine that required epinephrine and admission to the emergency room. Allergic reaction symptoms for flu vaccine were throat tightening and tongue swelling. Vital signs at 1742 BP: 150/103 HR: 121 SPO2: 100% RA RR: 22 Temp: 99.6 F Pain: 0/10 Doctor called in the emergency department and explained patients symptoms. Doctor advised to call 911. Vital signs at 1748 BP: 145/94 HR: 121 SPO2: 100% RA RR: 24 Pain: 0/10 1755 911 called and advised to administer patients own epinephrine. Pt''s own epinephrine administered IM into left vastus lateralis. Vital signs at 1755 BP: 152/90 HR: 115 SPO2: 100% RA RR: 24 Pain: 0/10 1758 Paramedics arrived and patient was taken to the emergency room.


VAERS ID: 1602730 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-08-16
Onset:2021-08-20
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pain in extremity, Rash macular, Vaccination site bruising, Vaccination site pain, Vaccination site reaction
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: none reported
Allergies: nka (none reported)
Diagnostic Lab Data: unknown. patient was referred to her MD for diagnosis and followup. It is unknown if she ever did follow up.
CDC Split Type:

Write-up: Patient stated that her arm was sore and a little red after the vaccine on Monday 8/16/21. However by the end of the week on 8/20/21, she said there was a large red splotch around the vaccination site that had a bruise and was very sore.


VAERS ID: 1602733 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Pfizer was left out to thaw for more than 2 hours(1pm - 4pm), mixed at 4pm, then administered dose.


VAERS ID: 1602736 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Pfizer was left out to thaw for more than 2 hours(1pm - 4pm), mixed at 4pm, then administered dose.


VAERS ID: 1602737 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Pfizer was left out to thaw for more than 2 hours(1pm - 4pm), mixed at 4pm, then administered dose.


VAERS ID: 1602740 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 066D21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily Vitamin, Allopurinol for gout.
Current Illness: None
Preexisting Conditions: Gout and pericarditis
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pericarditis is the inflamtion of the peridium. I''ve had mild inflamtion in the past. It maybe just a coincidence but unlikely that an attack is taking place two days after the second dose and this attack is directly related to the covid vaccine.


VAERS ID: 1602759 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac flutter, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metropolol Prevacid Losartin Sertraline Xarelto
Current Illness:
Preexisting Conditions: Afib, hypersensitivity pneumonitis
Allergies: Mold
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shortness of breath. O2 reading 76 when walking across room. Reading returns to normal upon sitiing, laying down. Fluttering heart also.


VAERS ID: 1602767 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-18
Onset:2021-08-20
   Days after vaccination:94
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Angle closure glaucoma
SMQs:, Glaucoma (narrow)

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

Write-up: Acute angle closure glaucoma


VAERS ID: 1602774 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Hypoacusis, Nausea, Pyrexia, Tremor, Unresponsive to stimuli
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hearing loss- I use hearing aids
Allergies: Inapsine-Dystonic reaction February 1996 Cats and Dogs Unknown allergens that caused severe eczema from 2010 until 2020.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: I woke up just after midnight. I needed to use the bathroom. I got up slowly and got to the end of my bed and felt weak. I layed down on the end of my bed and told my husband to help me. I remember feeling like I was going to pass out and then I couldn?t remember anything. My husband noticed my breathing pattern changed and I wouldn?t respond. He lowered me to the floor and kept saying my name and I was unresponsive. He said that it was about a minute that I wouldn?t respond to him. I removed waking up to him saying my name repeatedly and being very concerned and I couldn?t figure out why he sounded so upset. I finally responded to him. I was very weak and dizzy and nauseated. I got back in bed and immediately drank as much fluid as I could but felt nauseated. I took 1000mg Tylenol. I started having slaking chills. I still felt unsafe to fall asleep because I felt like I would quit breathing. It took an hour for the Tylenol to help a little but the fever remained 101. Even with Tylenol. Since then I have had a fever and felt weak. I have been resting in bed and focusing on drinking. I have used some Tylenol and Ibuprofen on and off. I do notice that my hearing in my left ear has worsened and even turning up my hearing aid to full capacity isn?t helping. I am planning to see my Audiologist as soon as they are available next week. It is currently the weekend.


VAERS ID: 1602779 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chills, Eye pain, Headache, Hypersomnia, Hypoaesthesia, Pain in extremity, Pyrexia, Somnolence
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: Start after 4 hours Pain in arm and numb in arm in morning when I woke up feel weak and sleepy, chill, headache, fever, eye mussels pain all they slept till now at 3:00 PM Saturday


VAERS ID: 1602780 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Work       Purchased by: ?
Symptoms: Influenza like illness
SMQs:

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

Write-up: Like flu symptoms


VAERS ID: 1602784 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Itching all over body


VAERS ID: 1602792 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Headache, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Intense fever, chills, headache, soreness at injection site and immediate loss of strength once symptoms started. Onset of symptoms was quick, without warning. I was actually feeling very good in the hours immediately after injection.


VAERS ID: 1602812 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 2 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939676 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diplopia, Ophthalmological examination, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Ocular motility 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: Ibuprofen, tylenol occasionally for headaches
Current Illness: Slight cold symptoms, headaches in month prior
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: August 10th eye exam, clinic, city, state
CDC Split Type:

Write-up: About two weeks after the first shot on July 22, I noticed my vision was blurry, visited an eye doctor, received an updated prescription and new glasses. The new glasses worked great and I did not make any connection between this change and the vaccine. However, after receiving the second dose of the vaccine my new glasses no longer seem to be the right prescription. I have slight double vision and it feels like I''m wearing someone else''s glasses. I''m traveling internationally now and cannot visit my eye doctor to check my prescription again.


VAERS ID: 1602818 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cold sweat, Headache, Musculoskeletal stiffness, Pain
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: Less than 12 hours afterward, I developed cold sweats, body aches, neck stiffness, and headache.


VAERS ID: 1602822 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lyrica flexerial oxycodone Tylenol NEXIUM
Current Illness: N/a
Preexisting Conditions: Rumatoud arthritis, reg arthritis, nerve damage from neck to my right hip from car accident , chronic pain, fibromyalgia, DDD, si joint damage, gerd acid reflux
Allergies: Anateiotuline terbutaline methadone Wellbutrin adhesive
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe muscle pain which is also causing severe headache joint pain


VAERS ID: 1602830 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

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

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

Write-up: Severe pain the left armpit, moderate joint pain


VAERS ID: 1602835 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: Fever, headache, muscle pain, tiredness.


VAERS ID: 1602845 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-10
Onset:2021-08-20
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 5mg AHCC NAC Multivitamin Magnesium
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: Penicillin & sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm red and hot to touch. First noticed 8/21/2021


VAERS ID: 1602847 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-05
Onset:2021-08-20
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aneurysm ruptured, Intensive care
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Armour thyroid, vit c, zyrtec,
Current Illness: None
Preexisting Conditions: Hashimotos
Allergies: Cortisoprin, iodine
Diagnostic Lab Data: Still in icu,
CDC Split Type:

Write-up: Ruptured anuerysm


VAERS ID: 1602849 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-17
Onset:2021-08-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 - / SYR

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

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

Write-up: Sever headache


VAERS ID: 1602864 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pfizer covid vaccine on 03/24/2021 (1st dose) and 04/14/2021 (2nd dose). Patient age: 51 at time of vaccination. Reaction was he
Other Medications: Zoloft, methotrexate, Xeljanz
Current Illness:
Preexisting Conditions: Depression, rheumatoid arthritis, heart palpitations
Allergies: Imitrex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Client reported heart palpitations approximately 30 minutes after vaccination. These symptoms resolved about 30 minutes after they started.


VAERS ID: 1602867 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Bone pain, Dizziness, Fatigue, Headache, Injection site pain, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Covid 19 Vax #1 on 1/21/2021: Injection site pain, and fatigue. Covid 19 Vax #2 on 2/11/2021: Injection site pain only.
Other Medications: Taken about 4 hours prior to vaccination: Hydroxychloroquine, Folic Acid, Amlodipine, Atorvastatin, Sertraline, Omeprazole, Fexofenadine, Vitamin D3, Fish Oil, Magnesium, Multivitamin, Taken about 6 hours prior to vaccination: Levothyroxin
Current Illness: None
Preexisting Conditions: Lupus, Sjogren''s Syndrome, Antiphospholipid Syndrome, Chronic Kidney Disease Stage 2; Hypertension; High Cholesterol; GERD, Depression; Thyroid Disorder, Allergic Rhinitis, Vitamin D3 deficiency
Allergies: Seasonal Allergies - Ragweed
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Approximately 8-9 hours after injection: Extreme fatigue, Headache, Body Aches. Approximately 20 hours after Injection: Extreme Fatigue, Headache, Body Aches, Injection site pain, muscle and bone pain, dizzy/off balance. Approximately 24 hours after injection: Extreme Fatigue, Headache, Body Aches, Injection site pain, muscle and bone pain, dizzy/off balance, and Fever.


VAERS ID: 1602875 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 LA / IM

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

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: bnonnone
Preexisting Conditions: immunocompromised patient
Allergies: none
Diagnostic Lab Data: no test required
CDC Split Type:

Write-up: no adverse events


VAERS ID: 1602882 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Eyelid ptosis, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient presented to pharmacy the morning following vaccination (8/21/21) and said she had swelling around her eyes (mainly around eyebrow area with dropping) when she went to bed the night of the vaccination (8/20/21). When patient presented she stated that the reaction had improved since the previous night and the swelling was no longer prominently visible. No other reaction was reported upon questioning.


VAERS ID: 1602894 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-17
Onset:2021-08-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 RL / IM

Administered by: Private       Purchased by: ?
Symptoms: Head discomfort, Sleep disorder, Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin d3, vitamin C, elderberry, fish oil, vitamin E, aphasia
Current Illness: None
Preexisting Conditions: Adhd, anxiety, depression
Allergies: Biaxin-rash
Diagnostic Lab Data:
CDC Split Type:

Write-up: Woken from sleep with tinnitus and head pressure. Went back to sleep after 3 hours of being awake with tinnitus. Tinnitus resolved upon waking. Head pressure remains.


VAERS ID: 1602917 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site mass, 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillin, morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itchy, Red swollen lump at injection site. Slight pain as well.


VAERS ID: 1602936 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Attendee complained about anxiety and being lightheaded. So was retained at the site. 1 hour after vaccination the attendee fainted, aroused within 5 seconds and was awake alert and oriented x 4. Attendee was retained at the site for another 25 minutes. She refused to have anyone come get her and she left the site independently.


VAERS ID: 1602942 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Tenderness
SMQs:, Pseudomembranous colitis (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: Saxenda, Zoloft, Zyrtec, Diamox, Armour Thyroid
Current Illness: None
Preexisting Conditions: Pseudo tumor cerebri, hypothyroidism
Allergies: Penicillin, tetracycline, doxycycline, cephlacor
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme Fatigue, Diarrhea, Arm Tenderness


VAERS ID: 1602944 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cyanosis, Dyspnoea, Migraine, Muscular weakness, Myalgia, Nausea, Pyrexia, Renal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Migraine, fever, chills, extreme muscle weakness, shortness of breath intense muscle pain, kidney pain, blue lips, nausea


VAERS ID: 1602951 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (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: Cyclosporine, Mycophenolate, prednisone, hydralazine, atenolol, clonidine, euthyrox, astorvastatin, magnesium, sodium bicarbonate, low dose aspirin, oyster shell calcium, women?s one daily multivitamin, vitamin d3, vitamin b12, slow iron, S
Current Illness:
Preexisting Conditions: Chronic kidney disease, kidney transplant, type 1 diabetes, anemia, hypertension, asthma, hyperthyroidism, high cholesterol, osteoarthritis,
Allergies: Phenobarbital, Tegretol, fluerosciene dye
Diagnostic Lab Data:
CDC Split Type:

Write-up: Elevated blood pressure despite taking blood pressure medication


VAERS ID: 1602967 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 LA / IM

Administered by: Pharmacy       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: Zoloft, Levothyroxine, lisinopril
Current Illness: N/A
Preexisting Conditions: CANCER
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt recieved Moderna for 1st 2 doses of vaccine. Pfizer was administered and upon examination of pt card, She had recieved Moderna for first 2 doses.


VAERS ID: 1602968 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Influenza like illness, Malaise, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pantoprazole 40mg daily
Current Illness: none reported
Preexisting Conditions: none reported
Allergies: Rizatriptan 10mg tab
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient called the pharmacy on 8/20/21 with complaint of fever, flu-like symptoms, pain, and nausea. She was instructed to take Tylenol or ibuprofen but stated she vomited the ibuprofen back up and did not feel well. Patient was recommended to follow up in the ER if her symptoms did not improve. She went to the emergency room and was given an IV and was prescribed an antibiotic, nausea medication, and itching medication. Patient was discharged from the ER in the same day.


VAERS ID: 1602971 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3101 / 2 - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Angina pectoris, Chest pain, Insomnia
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow)

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

Write-up: Stabbing pains in heart all night / anytime I lay down. Cannot get into hospital as they are full of Covid patients in my area but called my doctor. I have never had stabbing chest pains in my entire life, it kept me awake all night and is still occurring during the day.


VAERS ID: 1602974 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 RA / IM

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

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

Write-up: Patient received the second dose 16 days after the first dose. Patient stated he had a headache from the shot.


VAERS ID: 1603063 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Emotional distress
SMQs:, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Emotional distress


VAERS ID: 1603076 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Hypoaesthesia oral, Lip swelling, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Headache, Full body hives, itching, mouth numbness with top lip swelling. Hives still present as of this date 08/21/21. Lip swelling resolved with Benadryl. Urgent care visit- recommended Benadryl every 4 hrs, go directly to ED if mouth numbness or lip swelling occur again.


VAERS ID: 1603077 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arrhythmia, Heart rate increased, Injection site erythema, Injection site induration, Injection site swelling, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Dehydration (broad)

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

Write-up: Injection site on left arm hard red swollen. Heart has been fast & having frequent palpitations/ uneven rhythm


VAERS ID: 1603821 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-25
Onset:2021-08-20
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Pfizer on 2/25 and 3/18. Positive on 8/20 admitted 8/20-current


VAERS ID: 1603831 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-20
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

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

Write-up: Firmness, redness, itching around injection site.


VAERS ID: 1604561 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstrual disorder, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Spotting, possible early menstrual period. Began on cycle day 11, so far has continued through cycle day 12.


VAERS ID: 1605729 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Fatigue, Headache, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, Tylenol, ibuprofen, vit d
Current Illness: No illnesses. Had surgery in July
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: With my first shot I was just extremely tired and exhausted. With my second shot I was tired the next morning. I had a rash momentarily on my face. As the day progressed I had cramping and tummy pain. I had excessive diarrhea starting at 4 until about 11 on and off. Headache as well. Today woke up and felt better. Got to work. Had a small case of diarrhea again. Went home. Rested. Had another 2 bouts of diarrhea. Headache has lingered on and off.


VAERS ID: 1605732 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fall, Fatigue, Headache, Immediate post-injection reaction, Loss of consciousness, Pallor, Syncope, Tension
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: The patient mentioned having slight light-headedness immediately after the vaccination was given, which was followed by temporary loss of consciousness about 2 minutes after administration. He regained consciousness within a minute. He had fallen to the floor, where we laid him out with his head slightly elevated on a bag of rice. His pulse was detected during the initial response following syncope. His face had a pale complexion and his body had tensed up before he became responsive again. We allowed the patient to continue to lie down until he felt better. We slowly sat him up on the floor and slowly helped him to a nearby chair, which was about 15 minutes following syncope. Within a couple of minutes, patient stated feeling light-headed again, so we slowly moved him back down to the floor to lie down again. He rested there for approximately 20 minutes, then we helped him to the chair to sit again. The patient was offered water and a snack bar. He sipped on the water a couple of times while seated in the chair. The patient was stable enough to leave the pharmacy about an hour after vaccination administration. EMS was called when the incident occurred, but the patient refused to have them come to the pharmacy to check on him. The day after the incident, the patient stated having a headache and feeling a little tired. But, overall, he is doing fine.


VAERS ID: 1606578 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not known
Current Illness:
Preexisting Conditions:
Allergies: not known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt was supposed to receive 2nd dose of pfizer covid-19 vaccine. However, pt received moderna covid-19.


VAERS ID: 1609855 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Hyperhidrosis, Panic attack
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Additional Details: Patient was very nervous about receiving the vaccine. He had a panic attack afterwards, while being monitored closely in the store. He has had them in the past. He was fine once he calmed down, after 20 minutes or so.


VAERS ID: 1609861 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Headache, Injection site swelling
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

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

Write-up: Site: Swelling at Injection Site-Mild, Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Headache-Mild, Additional Details: Patient called day after recieving vaccine that has been experiencing headache, swelling at site, and trouble breahting since tha vaccine. We recommended for her to go to ER immediately for the trouble breathing. Tylenol for headache, and benadryl for swelling. We told her to let the ER doctor know about all of these reactions


VAERS ID: 1609868 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 05XC21A / 1 LA / SYR

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

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

Write-up: Tinnitus, Vertigo


VAERS ID: 1609872 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 2 LA / IM

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

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

Write-up: Error: Wrong Dose of Vaccine - Too Low-


VAERS ID: 1617370 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trintellix 20 mg, Wellbutrin 300 mg, vitamin d, biotin, b complex
Current Illness: No
Preexisting Conditions: No
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills, body aches, headache, stomach ache, fever 102. Lasted over 24 hours


VAERS ID: 1617378 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Condition aggravated, Diarrhoea, Dizziness, Extra dose administered, Headache, Injection site pain, Injection site swelling, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), 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: Sore arm and headache, received Moderna second shot 4-1-21
Other Medications: Lisinopril 10 -12 mcg hcr, Levothroxine 125 mcg, Vitamin D, Centrum Multivitamin, Tumeric Curcumin pills
Current Illness: Complications breathing non COVID related. Went to ER got chest X-ray everything clear.
Preexisting Conditions: Hashimoto?s disease, hypertension and obese bmi 38
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 2 hours after receiving my Moderna Booster shot I was severely hit with Diarrhea for 28 hours. I took Imodium to help slow it down. It?s been about 40 hours now and my stomach is still upset. Also I still have pain at the injection site with a golf ball size lump that seems to be getting smaller now. During the second day my pain in the arm was really bad. It was a whole lot worse then when I received my second dose of Moderna. In fact it was almost triple the pain. I also experienced being a little dizzy and loopy the first day. These two symptoms were mild. I also have a faint headache that started about 20 hours after the Injection


VAERS ID: 1617393 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Injection site bruising, Pain in extremity
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Dicyclomine 10mg; Birth control (generic for Yaz), Losartan 100mg
Current Illness: None
Preexisting Conditions: Fibromyalgia, nummular eczema, scalp dermatitis, high blood pressue, arthritis
Allergies: Sulfa based medications (Augmentin & Bactrum); Some penicillins, Neosporin; I have Allergic Contact Dermatitis and am allergic to all of these: Bacitracin, Benzalkonium Chloride, Cetyl Stearyl Alcohol, Cobalt Dichloride, Cocamidopropyl Betaine, Glutaraldehyde, Neomycin Sulfate, Oleamidopropyl Dimethylamine, Paraphenlenediamine, Potassium Dichromate.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue, intense bruising on and around the injection site in my upper arm. Bruising is very dark, purple, red and black. Pain also spread down to my forearm starting the next day. Diahrrea.


VAERS ID: 1617398 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dizziness, Muscular weakness, Tinnitus, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Dizziness, constant ringing in both ears, chest pains, weakness in shoulder muscles, and uncontrollable shaking of both arms and hands.


VAERS ID: 1617405 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Pain, SARS-CoV-2 test negative
SMQs:, 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: Prolia (Xgeva) shot 6 months Tyvaso inhalation 1.74 mg; 4 x daily Azithromycin Tablets 250 mg; daily Bactrim DS 800- 160 UF; 1 tablet Mon/Wed/Fri Adcirca 20mg; 2 tablets daily Mycophenolat 500 mg; 2 tabs 2 x daily Prednisone 10mg tablet
Current Illness:
Preexisting Conditions: Interstitial Lung Disease Pulmonary Fibrosis Pulmonary Hypertension Sjogren syndrome Raynaud syndrome Sleep Apnea Reflux/Gerd Osteoporosis
Allergies: None
Diagnostic Lab Data: COVID test at Primary Care with negative results
CDC Split Type:

Write-up: Headache Upper body ache Fatigue


VAERS ID: 1617409 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 2O4A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye pain, Eye swelling, Headache, Lymphadenopathy, Ocular hyperaemia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Glaucoma (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Friday started a bad headache that started behind his left eye. Saturday woke up with a blood shot and swollen eye that gradually got worse throughout the day. Moving left eye causes sharp pain. Lymph notes are very swollen on the side of injection.


VAERS ID: 1617412 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-14
Onset:2021-08-20
   Days after vaccination:98
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: White blood cell count decreased
SMQs:, Haematopoietic leukopenia (narrow), Systemic lupus erythematosus (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: Lisinopril
Current Illness: None
Preexisting Conditions: High bp
Allergies: None
Diagnostic Lab Data: As above wbc 3.3 8/20/21 previously 8.5 in 12/2018
CDC Split Type:

Write-up: Low wbc 3.3


VAERS ID: 1617423 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphagia, Throat irritation
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Estradiol, calcium, zinc, magnesium, b2, turmeric, fish oil, spirulina, melatonin, Zyrtec
Current Illness: None
Preexisting Conditions:
Allergies: Codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 30 min after shot, I was driving home and started having trouble swallowing. It felt like something was stuck in my throat. The next day, the feeling wasnt quite as bad, but my throat was burning really bad


VAERS ID: 1617429 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anal incontinence, Dyspnoea, Feeling abnormal, Hyperhidrosis, Hypotonia, Musculoskeletal stiffness, Pallor, Pulse absent, Respiratory failure, Resuscitation, Unresponsive to stimuli, Urinary incontinence
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), 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), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (narrow), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Arthritis (broad), Noninfectious diarrhoea (broad), Respiratory failure (narrow), Hypoglycaemia (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Not Known
Current Illness: not known
Preexisting Conditions: not known
Allergies: Allery to bee stings - carries EPI Pen
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 10 min post vaccination, patient c/o "not feeling right". Stated she was "burning in chest". Upon hearing this c/o, the RN immediately approached patient and repeated "you are burning in your chest". Pt. immediately became unresponsive. Limbs were tonic No pulse or resp. detected. Color became ashen and limbs were then limp. Patient was immediately moved to the floor by RN and 3 male patients in the observation area. No response to verbal and physical sti,uli. Again, no pulse or Resp were detected by RN and off duty officer who was accompanying a family member to receive Covid vaccine. Approximately 20-30 seconds elapsed. Patient was also noted to be incontinent of B&B. RN immediately positioned beside patient to start chest compressions when the patient gasped for air and opened eyes. Patient was very diaphoretic. Pulse rate immediately detected. Pulse- 78 R BP- 114/70 Resp - 14 - R 02 Sat - 99%. O2 applied. EMS summonsed. Patient was transported to local hospital. ALert and oriented.


VAERS ID: 1617431 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032120A / UNK RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / UNK LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Eye irritation, Foreign body sensation in eyes, Headache, Hypoaesthesia, Ocular hyperaemia, Pain, Pulmonary pain
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Corneal disorders (broad), Arthritis (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: B12, D3, Sulindac, Losartan,Hyrdochlorathiazide, Thyroid med,
Current Illness: taking Penicillin for 7 days for root canal prior to vaccine
Preexisting Conditions: Chronic back pain, HBP, Hyperthroidism, Deg Disc disease, hx of malign. Melanoma
Allergies: grass, weeds, melons, trees, Morphine, Sporanox
Diagnostic Lab Data:
CDC Split Type:

Write-up: 9:30 pm lungs started hurting & then felt numbness in left brain area that continued into my face near nose. Subsided about 10:30 pm Woke up with severe pain between shoulder blades & right hip area, slight headache. Right eye felt like pebbles in it & couldn''t hold it open til I got to bathroom to put in Alaway eye drops Extremely red & Left eye was irritated & put drops in as well. 4:30 pain was really bad & put Menthol linament on it, applied ice packs to shoulder blade. Took Tylenol on & off all day as pain persisted until Sunday.


VAERS ID: 1617450 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

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

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

Write-up: Sore arm, headache


VAERS ID: 1617456 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

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

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

Write-up: Chills, headache, fever, muscle aches, sore arm, nausea, fatigue lasting for 3 days


VAERS ID: 1617471 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / SC

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, 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: None
Preexisting Conditions: None
Allergies: Sulpha
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, pain, chills


VAERS ID: 1617487 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-17
Onset:2021-08-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Headache, Nausea, Pain in extremity, Peripheral swelling, Vision blurred
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (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: 5-htp Stinging Nettle Echinacea Elderberry
Current Illness: None
Preexisting Conditions: None
Allergies: Dairy
Diagnostic Lab Data: I did not go to the doctor for the adverse effects.
CDC Split Type:

Write-up: Within minutes of my first pfizer-biontech covid-19 vaccine eua, my arm began to swell and was very painful to touch and movement that lasted for two days. Within an hour I felt dizzy, with blurred vision. That only lasted for few hours. Two days after my Second pfizer-biontech covid-19 vaccine eua, I started to experience extreme fatigue around 1pm. The fatigue continued for a total of three days. On the third day after my second pfizer-biontech covid-19 vaccine eua, I had severe headache across the front, sides and back of my head. As well as feeling Nauseated. The headache and Nausea lasted for 2 days.


VAERS ID: 1617501 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 2 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 3 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Extra dose administered, Fatigue, Injection site erythema, Injection site inflammation, Injection site pain, Injection site swelling, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Valsartan 320mg tablet Hydroxyurea 500mg capsule 81mg low dose aspirin Vitamin D 1000mg
Current Illness: NONE
Preexisting Conditions: High Blood Pressure (2012) Polycythemia Vera (2012)
Allergies: Clindamycin HCL Sulfamethoxazole TMP DS Amox-Clav 875mg Lisinopril Amlodipine Besylate Bystolic
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Chills, low grade fever starting day after injection , pain at injection site and injection site hot to touch and swollen starting day of injection in evening, fatigue starting day after injection, As of today only symptoms are still swollen injection site, pain in arm and injection hot to touch and red and inflamed looking.


VAERS ID: 1617503 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Fatigue, Immediate post-injection reaction, Injection site pain, Injection site pruritus, Injection site rash, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydroxychloroquine; Rosuvastatin; Amlodipine; 81 mg ASA; Levocitirizine; Montelukast; B12; Bioastin; Spirulina
Current Illness: None
Preexisting Conditions: Lupus; Heart Disease(stent); High Blood Pressure;
Allergies: None known
Diagnostic Lab Data: None to date
CDC Split Type:

Write-up: I received the shot on a Thur afternoon, next morning-extreme fatigue; Friday Afternoon/4:00 onset of fever, which reached to 103.1; I started taking Aleve at 101 degrees, no change within an hour, so took a Tylenol Extra Strength; began using an ice pack behind my neck at 102 degrees; fever started to lower by 8:00 that evening; Saturday was a very fatigue filled day, no energy, sat or layer around all day; Sunday AM, woke up with a rash on my L Arm, site of injection, warm to touch, itchy; soreness increased?had it from just immediately after the injection


VAERS ID: 1617514 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-01
Onset:2021-08-20
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu shot in 2019
Other Medications: amiodipine, atorvastan, Vitamin D12, Finasteride, quercetin, zinc, tamsulosin, zolpidem,low dosage bayer aspirin
Current Illness: None
Preexisting Conditions: None
Allergies: No allergies to medication. Allergic to crustacean and mollusk
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Increased tinnitus


VAERS ID: 1617521 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate decreased, Hypotension, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Severe, Additional Details: LOW BLOOD PRESSURE, RAPID DECREASE IN HEART RATE


VAERS ID: 1617522 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Flushing, Hyperhidrosis, Lethargy, Nausea, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Chills-Mild, Systemic: Exhaustion / Lethargy-Mild, Systemic: Fever-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Nausea-Medium, Systemic: Vomiting-Medium


VAERS ID: 1617535 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure decreased, Confusional state, Dizziness, Hypotension, Nausea, Near death experience, Presyncope
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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: Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: patient almost fainted bp66/40-Medium, Systemic: Headache-Mild, Systemic: Hypotension-Medium, Systemic: Nausea-Medium


VAERS ID: 1617543 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Neurological examination, Paraesthesia, Sensory loss
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad)

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

Write-up: Left facial and neck tingling and decreased sensation in face. Went to emergency department for ct scan and blood work and had an evaluation by a neurologist


VAERS ID: 1617544 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-18
Onset:2021-08-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NingXia Red supplement before and after vaccine, plus my normal medications.
Current Illness: None, just my normal medical conditions like type one diabetes, etc.
Preexisting Conditions: Type one diabetes - uncontrolled Turner Syndrome Chronic kidney disease Non alcoholic fatty liver Chronic pain and migraines Blood pressure too low and too high Hashimotos hypothyroidism Diabetic retinopathy Dry eye macular degeneration Probably more that I?m forgetting.
Allergies: Benadryl and Reglan (spelling???)
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: The vaccine has made me have vaginal bleeding even though my period stopped about two weeks ago.


VAERS ID: 1617556 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

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

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

Write-up: Patient stated she was very nervous and had bad anxiety but had to get the vaccine for work. Patient felt dizzy and lightheaded, drank cold water, started sweating and eventually vomited. She stated she felt much better afterwards. She stated she had been drinking and had not eaten. She was taken to treatment area.


VAERS ID: 1617557 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Dyspnoea, Feeling hot, Nausea, Throat tightness, Tremor, Vision blurred
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Around 14-15 Years of age I received a flu vaccine and my throat felt like it was closing so I immediately took benadryl and fel
Other Medications: none
Current Illness: broken 4th metatarsal on right foot
Preexisting Conditions: allergies (receiving allergy injections 2016); have a pacemaker since 2015; eustachian tube dysfunction
Allergies: Influbenza Virus Vaccine prior to 3 years ago (can have influenza vaccine starting 3 years ago; Protonix, Keflex, sulfa drugs, morphoneb
Diagnostic Lab Data: /At the hospital I received benadryl and a steroid via IV. I was just monitored from time of entering hospital to discharge on 8/21/2021 52:00EDT. I was not checked for Covid. Doctor on duty cancelled orders for chest x-ray and IV fluids. I was at hospital for close to 6 hours.
CDC Split Type:

Write-up: About 2-5 minutes after vaccine, I felt clammy and hot, vision, blurry, throat felt tight, nausea, and dizzy, hard to breath. I carry 2 EPI pens with me so I administered both right away. Started shaking uncontrollably immediately. The pharmacist on duty called emergency number to take me across the street to Medical Center ER. I did not need any oxygen.


VAERS ID: 1617584 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-18
Onset:2021-08-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059CZ1A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prednisone Hydroclorothiazine Lovastatin Probiotics Aspirin Potassium Coq 10 Calcium
Current Illness: Polymyalgia Rhuematica Giant Cell Arteritis
Preexisting Conditions: Overweight HighCholesterol High Blood Pressure
Allergies: Lactose Intolerant
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling, redness, and heat, five inches long and three inches wide between the shoulder and the elbow on the left arm for four days. The injection site was above that and had a slight amount of bruising. There was bleeding when the shot was administered. I am on a very low dose of aspirin 81mg so it should not have caused the bleeding.


VAERS ID: 1617606 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 00ZF21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cough, Diarrhoea, Headache, Hyperhidrosis, Immediate post-injection reaction, Injection site erythema, Injection site pain, Pain, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PATIENT REPORTS ONLY TAKING OTC ANALGESICS POST VACCINE.
Current Illness: NONE REPORTED
Preexisting Conditions: NONE REPORTED. PATIENT REPORTS H/O ANEMIA-RESOLVED. PATIENT REPORTS H/O HTN-RESOLVED. PATIENT REPORTS ANEMIA AND HTN WERE PREGNANCY RELATED. PATIENT REPORTS PRE-ECLAMPSIA WITH PREGNANCY.
Allergies: CINNAMON ANALOGUES
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: PATIENT REPORTS EXPERIENCING BODY ACHES, FEVER AS HIGH AS 101.7, SWEATS, DIARRHEA, VOMITING, HEADACHE, COUGH AND SORENESS/REDNESS AT INJECTION SITE. SYMPTOMS REPORTEDLY STARTED IMMEDIATELY POST VACCINATION. ALL SYMPTOMS RESOLVED BY 8/21/2021 EXCEPT FOR SORENESS/REDNESS AT INJECION SITE.


VAERS ID: 1617610 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nasacort nasal spray, Montelukast, Astelin nasal spray, multivitamin
Current Illness:
Preexisting Conditions: asthma, seasonal allergies
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tinnitus in my left ear has not resolved as of 8/22/21.


VAERS ID: 1617636 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-18
Onset:2021-08-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Decreased appetite, Dyspnoea, Fatigue, Headache, Hypersomnia, Pain, Peripheral coldness, Weight decreased
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? No
Hospitalized? No
Previous Vaccinations: Felt very tired for 3 weeks after 1st shot.
Other Medications: N.A.
Current Illness: The one I am reporting here is my 2nd shot of Moderna vaccine (8/18/21). Actually after my first shot on 7/17/21, I was constantly felling tired for 3 weeks. Only the 4th week felt a bit normal.
Preexisting Conditions: No.
Allergies: I did allergy test half year ago. The result shows that I am allergic to all the 40 environmental factors, but not allergic to any food that were tested. I kind of suspect this test because I knew I am allergic to some food, e.g. gluten, some type of peaches, etc.
Diagnostic Lab Data: N.A.
CDC Split Type:

Write-up: I started to fell whole body side effect from 8/20/2021 around noon time. Symptoms are: headache, body ache, extremely tired, short breath, cold hands, no appetite, uncomfortable stomach. The symptoms got worse in the night. I slept about 15 hours and immediately lost 3 lbs. When I wake up at 10am on 8/21/2021, I had to take ibuprofen 2 pills and ionic zinc and forced myself to eat pasta + butter + fresh ginger to prevent further losing weight, and then I slept 3 hrs more. I gradually got better and better. I took another ibuprofen at maybe 3pm, in addition to Nettles, gingers, ionic zinc, green tea pills, etc. In the evening I felt a lot better so I did not take ibuprofen, but then I got almost all the symptoms back on 8/22 morning after slept almost 13 hours. Now I realize that I likely have to keep taking ibuprofen or Tylenol regularly to keep my symptoms controlled.


VAERS ID: 1617647 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Back pain, Haemorrhage, Heavy menstrual bleeding, Menstrual disorder, Muscle spasms
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Dystonia (broad), Arthritis (broad)

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

Write-up: The vaccine caused my menstrual cycle to start or, if you would prefer not to say it caused me to have my period, we can say that it caused me to hemorrhage. This cannot be considered to be my normal period because I just finished my period about 1.5 weeks prior to receiving the vaccine. Further, my cycles are regular every 28 days, have been for years, and as noted previously, I was well within the 28 day time frame. It should also be noted that the bleeding I am experiencing is heavier than my periods have ever been. I have also had back pain consistent with cramping, which is something I haven''t had in many years. Since I want to list all symptoms, soreness in my shoulder started today and I''ve had fever-like symptoms.


VAERS ID: 1617652 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Extra dose administered, Feeling cold, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Medication errors (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: same as previously listed 69 yoa 04/06/2021 Covid 19 Moderna
Other Medications: Aspirin - 81 mg Ezetimibe - 10 mg Atorvastatin - 20 mg Calcium (500 + D)-Vitamin D Brilinta - 60 mg Colchicine - 0.6 mg Folic Acid - 1 mg Lisinopril - 5 mg Methotrexate 2.5 mg Metoprolol - 25 mg Mycophenolate Mofetil - 500 mg Pantoprazole -
Current Illness: none
Preexisting Conditions: relapsing polychondritis diabetes prior open heart surgery (three by-passes) blind in right eye
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: cold chills and sweats incontrollable shaking these symptoms were resolved within 48 hours of injection


VAERS ID: 1617660 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Nausea, SARS-CoV-2 test, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Hospital performed a Covid-19 test 8/22/21 and patient should receive results on 8/24/21
CDC Split Type:

Write-up: patient received her Covid-19 vaccination (Janssen) on 8/20/21 around 1:30pm and at around 10:30pm began experiencing nausea, vomiting, headache, and fatigue. Vomiting ended on 8/20-8/21 however other symptoms continued until she went to Hospital on 8/22/21. Hospital prescribed toradol for her headache and ondansetron for the nausea.


VAERS ID: 1617663 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Decreased appetite, Fatigue, Headache, Loss of personal independence in daily activities, Pain
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (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: Hydrochlorothyazide 12.5mg daily Hydralazine 10mg three times daily Lisinopril 40mg daily Omeprazole 30mg daily
Current Illness: None known
Preexisting Conditions: Hypertension Acid Indigestion
Allergies: None known
Diagnostic Lab Data: None performed
CDC Split Type:

Write-up: Patient developed symptoms following vaccination late in the evening of the same day but did not specify exactly when. Symptoms continued through the following day and began to subside the second day following vaccination (Sunday the 22nd). Patient had body aches and pain, headache, loss of apatite, fatigue which interfered with ADL, and a body temperature of 103 F at highest measured point. They did not seek clinical care.


VAERS ID: 1617667 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

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

Write-up: Patient felt faint after the dose.


VAERS ID: 1617676 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Mobility decreased, Nausea, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Headache, nausea, chills, fever, left arm hurting and i couldn''t get out of bed for 2 days


VAERS ID: 1617699 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Condition aggravated, Erythema, Groin pain, Muscle spasms, Neck pain, Pain, Pain in extremity, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Balance of Nature, 2 one a day vitamins, 2 calcium. Blood pressure, cholesterol and glaucoma meds
Current Illness: None
Preexisting Conditions: Glaucoma
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA. Second Injection -Within 4 hours of injection, large red, swollen, painful lump appeared on left arm. This was followed by a 101F fever all night. This morning, slight fever is still evident. No energy. Fever caused entire body to be in unusual pain. Spasm shooting pains in left groin area and right neck area. First injection there was no problem until 7 days after injection and then it was the large red swollen itchy bump on left arm. This went away after about 4 days. No fever.


VAERS ID: 1617712 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Hypotension, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Dehydration (broad), Hypokalaemia (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: Flecanide Rosuvastatin Tamsulosin Aspirin 81mg Magnesium Quinol Vitamin D3 Omega Krill Multi Vitamin
Current Illness: Paroxysmal Afib
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tachicardia Afib Hypotension 93 / 69


VAERS ID: 1617821 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-23
Onset:2021-08-20
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Acute myocardial infarction, Electrocardiogram ST-T change, Myocardial necrosis marker increased, Pericarditis, Troponin
SMQs:, Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: HS trop 1 hr 98, 3 hr 73 and delta change 33. Also nonspecific st changes on ekg at admission 8/20/2021
CDC Split Type:

Write-up: poss NSTEMI/pericarditis elevated cardiac enzymes


VAERS ID: 1617826 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EC3180 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dysphagia, Electrocardiogram normal, Heart rate increased, Injection site pain, Muscle twitching, Ocular discomfort, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (broad), Dystonia (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 (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cimzia injection monthly; 100 mg spironolactone daily; daily birth control; gabapentin nightly;
Current Illness: none;
Preexisting Conditions: rheumatoid arthritis; sjogrens;
Allergies: hydroxychloroquine;
Diagnostic Lab Data: ECG and metabolic panel 8/20/21
CDC Split Type:

Write-up: Intense soreness in left arm after 2 hours; at 8 hours my head began tingling and felt numb. I went to check my heart rate because I felt dizzy and it began escalating. At that time, the tingling sensation moved from the small of my back all the way up to my head. I felt like my brain was on fire and there were pressure behind my eyes. My body was twitchy and I felt like I would faint. We called 911 and I went to the ER. I was given lorazepam and an anti-inflammatory. ECG was "good". The following night I had the same tingling sensation with difficulty breathing and swallowing. The second night was less intense.


VAERS ID: 1617836 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Sexual dysfunction (broad)

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

Write-up: Patient received vaccine on Friday and she called Sunday morning stating that her arm was sore at the injection site but not red or swollen; however, she has had a tingling/numbing sensation going down her arm to her pinky. She stated this started right after she received the vaccine. I told her this wasn''t normal and to seek care at an urgent care or with her pcp


VAERS ID: 1619164 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-08-18
Onset:2021-08-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Balance disorder, Cold sweat, Confusional state, Delirium, Differential white blood cell count normal, Dyspnoea, Electrocardiogram normal, Fatigue, Fear, Full blood count normal, Metabolic function test normal, Nausea, Pain, Pyrexia, Swelling, Syncope, Troponin I normal, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nothing, protein powder.
Current Illness: None.
Preexisting Conditions: Heart murmur/arrhythmia, not fully diagnosed, currently waiting for followup appointment. Doctors seen think it''s most likely not a problem.
Allergies: None, except maybe avocado.
Diagnostic Lab Data: At the ER they performed (~7:00-7:30am): - CBC with differential - Comprehensive Metabolic Panel - Extra Gold Top Tube - Extra Green Top Tube - Extra Lavender Top Tube - Troponin 1 - ECG 12 Lead
CDC Split Type:

Write-up: Extreme tiredness, fever and cold sweats during the night. I got up to use the bathroom (~5:30am), had lots of nausea. After using, I stood and started to make way to bedroom. Nausea became intense, pain and tightness swelled through my torso as well. Breathing became tight, vision was fading, and I was losing balance. My wife heard a thud from the bedroom and came out to find me collapsed against the wall, covered in cold sweat, and delirious. I don''t remember falling or passing out, I remember her concerned voice and her dabbing my face with a wet cloth. I was very confused, frightened. After getting me seated okay couch and talking through what happened, my symptoms were very similar to a heart attack, which is a personal concern of mine, so she took me to the ER (~6:15am). At the ER they performed (~7:00-7:30am): - CBC with differential - Comprehensive Metabolic Panel - Extra Gold Top Tube - Extra Green Top Tube - Extra Lavender Top Tube - Troponin 1 - ECG 12 Lead All tests came back within normal limits. Doctor believes it was Vasovagal syncope. Current outcome is near full recovery (as of 7:00pm 8/22).


VAERS ID: 1619169 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Nausea, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Metoprolol succinate Xyzal Junel
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Evening of same day dose given: Chills with intense shaking 11:00 pm -3:15 am Nausea 11:30 pm-3:15 am Vomiting 1:15 am-3:15 am Headache 1:30 am 8/21/2020 to present; treated with ibuprofen and excedrin


VAERS ID: 1619176 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Chest discomfort, Dyspnoea, Fatigue, Malaise, Oropharyngeal pain, Oxygen saturation decreased, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Negative COVID result. X-Ray showed no signs of lung issues.
CDC Split Type:

Write-up: COVID symptoms while still maintaining negative test result for COVID. Fatigue, sore throat, congestion, runny nose, difficulty breathing, low blood oxygen levels, chest tightness. X-Ray showed clear lungs, send home with albuteral which made chest tightness and breathing worse. Trying to get appointment for cardiac monitoring and checking for heart issues.


VAERS ID: 1619177 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Feeling abnormal, Headache, Pain, Paraesthesia, Pyrexia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: High fever, chills, headache, body ache, brain fog, sensation of havimg neddles all over, stomach pain...


VAERS ID: 1620487 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

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

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

Write-up: Ringing in the ears that was noticed at 5:00 am the next morning and has persisted continuously.


VAERS ID: 1620490 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

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

Write-up: Nausea, extreme fatigue, chills, occasional fever. Migraine


VAERS ID: 1620512 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053ER1A / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Heart rate increased, Palpitations, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Heart Palpitations, increased heart rate greater than 20 bpm of baseline, chills within 30 minutes post administration. Benadryl taken within 30 minutes of symptom onset. Weakness and chills 12 hours after administration. Fever of 100.6 and chills 24-36 hours post administration.


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