National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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 453 out of 8,010

Result pages: prev   354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 534 535 536 537 538 539 540 541 542 543 544 545 546 547 548 549 550 551 552   next


VAERS ID: 1623013 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Arkansas  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

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

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

Write-up: fatigue, stuffy nose, cough, fever, swollen lymph nodes in right armpit, swelling at injection site


VAERS ID: 1623016 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Oklahoma  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 0175 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Decreased appetite, Dissociation, Disturbance in attention, Dizziness, Fatigue, Feeling abnormal, Hypoaesthesia, Muscle spasms, Muscle twitching, Pain in extremity, Paraesthesia, Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypersensitivity (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: 1st flu shot, early 90s, reaction
Other Medications: Tylenol, when needed. Nothing the day of.
Current Illness: None
Preexisting Conditions: None
Allergies: Eggs, household chemicals, tree/grass/animal. Nothing severe.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pfizer-BioTech Covid-19 Vaccine EUA Friday after shot- weak, dizzy, itchy. Nurse gave benadryl. Waited 30 mins and sent home. Extremely tired and no appetite. Saturday- left arm sore/swollen, extremely tired, no appetite, feel foggy/disconnected, weak, can''t concentrate. Sunday- foggy/disconnected, left arm and leg have nerve twitches/numbness/pins and needles/cramps. Right arm and leg numb on and off. No appetite. Muscle spasms in left forearm and leg.


VAERS ID: 1623017 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Additional Details: patient called store on Saturday August 21 to tell me she had a reaction to the shot. She said it was hot, red and swollen


VAERS ID: 1623059 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear discomfort, 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: ZITSTIKA SKIN DIDCIPLINE SUPPLEMENT
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: RIGHT EAR FEELS/ SOUNDS CLOGGED. FEEL LIKE WATER IS CONSTANTLY IN RIGHT EAR. BELIEVED TO BE TINNITUS.


VAERS ID: 1623288 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-20
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate increased, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hearing impairment (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, Fish Oil
Current Illness:
Preexisting Conditions:
Allergies: Allergy to Penicillin and walnuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tinnitus in left ear, elevated heart rate


VAERS ID: 1623296 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Feeling hot, Pain in extremity, Peripheral swelling, Pruritus, Pyrexia, Swelling, Vision blurred
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shingryx, 2nd shot age 59, suffered with RA symptoms for 8 weeks which dissipated on its own
Other Medications: 20 mg simvastatin 81 mg aspirin Multivitamin
Current Illness: None
Preexisting Conditions: High cholesterol
Allergies: Penicillin sulphur steristrips
Diagnostic Lab Data: None taken
CDC Split Type:

Write-up: Side effects:. Hot spots traveling to various body locations, pain and short lived lumps in hands and fingers, fever, blurry vision, large swelling and itchiness not in the left armpit but under left armpit


VAERS ID: 1623321 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-10
Onset:2021-08-20
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM

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

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

Write-up: Raised red area 3 inches by 6 inches on upper arm. Warm to touch. Appeared 12 days after injection.


VAERS ID: 1623326 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-17
Onset:2021-08-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Laboratory test, Pyrexia, Rash, Rash erythematous, Rash maculo-papular, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: All labs are currently pending
CDC Split Type:

Write-up: Fever (101F) x3 days and maculopapular rash wide spread over abdomen and chest, red with small vesicle looking eruption that involves multiple dermatomes and crosses midlines on more than one dermatome.


VAERS ID: 1623352 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Virginia  
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 053E21A / 2 LA / IM

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

Write-up: Patient received received Pfizer as first dose and Moderna as second dose.


VAERS ID: 1623358 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-17
Onset:2021-08-20
   Days after vaccination:156
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: hospitalized 8/20/21, COVID positive


VAERS ID: 1623430 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Hypertension, Malaise, Throat irritation
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril-hydrochlorthiazide, omeprazole, Fish Oil
Current Illness: None
Preexisting Conditions: HTN, GERD, Allergic rhinitis, mild mitral regurgitation
Allergies: NKDA
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: 46 yo F with NKDA was vaccinated with Moderna Covid-19 vaccine in her left deltoid on 8/20/21 at ~1444. The patient was monitored 15 minutes. At 1519, patient was in the facility lobby and reported she didn''t feel well. Complained that her throat felt funny and it was hard to breath. Emergency helicopter team presented and took VS which showed patient was hypertensive 164/90 with good O2 sats and RR 16. Patient refused further offers of care by EMS and did not want to go to the ED. After drinking some ice water, she felt better and called her husband to pick her up.


VAERS ID: 1623441 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Connecticut  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Head injury, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient had a syncopal event post vaccination resulting a fall to the floor with hitting his head. Patient quickly regained consciousness. 911 was contacted and came to look over the patient. It was determined that emergency medical treatment was not needed and hospitalization not necessary.


VAERS ID: 1623451 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Florida  
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 036B21A / 2 RA / IM

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

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

Write-up: Moderna vaccine #2 given to individual who was not 18 at time of administration. Patient was 17 years and 6 months old. No adverse reaction at time of administration.


VAERS ID: 1623479 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-02-18
Onset:2021-08-20
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: History of paroxysmal atrial fibrillation, drug induced hepatitis
Allergies: Pencillins, Macrobid
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid vaccine documentation. PT presented to ED with SOB. Per History Physical patient initially positive 8/20/21, PT admitted 8/22/21, POC SARS COV2 ANTIGEN resulted positive 8/22/21. PT received both vaccinations and is hospitalized. First dose received 1/28/21 Lot# EL9261. Pfizer. Second dose received 2/18/21 Lot# EL9266.


VAERS ID: 1623483 (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: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Muscle twitching
SMQs:, Pseudomembranous colitis (broad), Dyskinesia (broad), Dystonia (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: Citalopram 40mg
Current Illness: none
Preexisting Conditions: none
Allergies: latex
Diagnostic Lab Data: none yet
CDC Split Type:

Write-up: right, upper lip twitching immediately following injection, still occurring off and on diarrhea around 8 hours after injection some fatigue


VAERS ID: 1623539 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Full blood count, Gait disturbance, Headache, Hypoaesthesia, Metabolic function test, Myalgia, Pain, Pain in extremity, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: Severe headache, muscle aches, Lower back pan across the full lower back. Pain radiated down the left leg and up the back along the spinal column. Difficulty walking was only able to shuffle gait. Left hand periodically went dumb, paraesthesia evidenced. I have never been in this amount of pain before. I went to the ED since I was not able to move barely.


VAERS ID: 1623542 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Maine  
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 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Migraine, Tremor, Vertigo
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (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: Mesalamine, multivitamin
Current Illness:
Preexisting Conditions: Colitis
Allergies: Amoxicillin, Penicillin, Ceclor, Azithromycin, Morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5 hours post vaccine severe migraine started that enveloped entire head including eyes and jaw along with strong body shakes. Migraine persisted for about 15 hours, I switched between Tylenol and Advil on Saturday. During this time I called the ER and was told this was to be expected. On Saturday afternoon I developed dizziness/vertigo. Now it is Monday morning, have not taken anything for it because not sure what I can take. Dizzy and vertigo seem to be severe, often have to hold on a wall or counter to steady myself. Currently waiting to hear back from my PCP.


VAERS ID: 1623552 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Oklahoma  
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 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

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

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

Write-up: Pt came in to have vaccine from Janssen. Pt was seen at 1540, received vaccine at 1545. At 1550, it was noticed that the Janssen vaccine expired at 1510. I requested for the patient to remain at the facility until the manufacturer was contacted. Janssen manufacturer stated that there was no research or study to indicate what to do, and that it was up to health care professionals at the facility. It was determined that the vaccine was probably stiff efficacious as it had only been 30 mins and that the vaccine vial had remained in the fridge at all times except when drawing vaccine from administration. Pt was still doing well at 1605. Pt was released from the facility after explaining that he had received the vaccine post approved expiration time. Pt was ok and said not a problem.


VAERS ID: 1623553 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Eye swelling, Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: ~ 30 hours after the shot I noticed itching. I woke up the next morning with my eyes almost swollen closed and a diffuse maculopapular rash appeared on my trunk, armpits, and groin. I took some Benadryl, Pepcid, and began a Medrol dose pack. It resolved completely ~48 hours after treatment began.


VAERS ID: 1623556 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Injection site erythema, Nausea, Pain in extremity, Pulmonary pain, Pyrexia, Swelling face, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Loss of taste and smell, still currently ongoing. Nausea and vomiting, stopped after a day. Arm pain and red elevated area where vaccine was administered, has stopped. Low grade fever, stopped after 3 days. Lung pain still ongoing. Swollen face for 2 days.


VAERS ID: 1623564 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-31
Onset:2021-08-20
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Cough, Dyspnoea, Tachycardia, Tachypnoea
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the ER on 8/20/21 for worsening shortness of breath and non-productive cough for the past week and half. Was found to be tachypneic requiring oxygen and tachycardic in the 130s. Admitted to the hospital for further work-up and evaluation.


VAERS ID: 1623574 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Kentucky  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Norgest-ethinyl estradiol, Buspar, Vit. D, Humaolg, Levemir
Current Illness: Type 1 DM, Hyperlipidemia
Preexisting Conditions: Type 1 DM
Allergies: Zithromax
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt. given 0.5 ml of COVID pfizer vaccine instead of 0.3 ml. No treatment necessary, monitored for adverse effects. CDC was called for guidance.


VAERS ID: 1623580 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Georgia  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fall, Headache, Hypoaesthesia, Nausea, Paraesthesia, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: none
Allergies: Amoxicillin, erythromycin
Diagnostic Lab Data: Going back in to get tested today. as they were closed over the weekend.
CDC Split Type:

Write-up: Felt a fire tingling sensation up legs and neck, stood up to get a wash cloth, fell down, starting feeling very nauseas, tongue swelled. hands and feet became numb. severe head ache. thought I was having a heart attack or panic attack or maybe reaction to vaccine. . It lasted 12-15 minutes..


VAERS ID: 1623583 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Ohio  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / SYR

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

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

Write-up: 0.5 ml of COVID pfizer vaccine given instead of 0.3 ml. No treatment necessary, no advers effects. CDC was called for guidance.


VAERS ID: 1623598 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-03-18
Onset:2021-08-20
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Amnesia, Blood culture, Blood potassium decreased, C-reactive protein increased, COVID-19, Chest X-ray abnormal, Confusional state, Fall, Intentional dose omission, Malaise, Pneumonia, Procalcitonin, SARS-CoV-2 test positive, Skin laceration, Substance use, Tobacco user, Urine analysis, White blood cell count normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Drug abuse and dependence (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Hypokalaemia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: History of Present Illness Patient is a 61 year old man who was found laying on the sidewalk outside the gas station. He remembers driving to the gas station this morning to get a pop. He remembers buying the pop but has no memory thereafter until EMS arrived to check him out. He had an unwitnessed fall which caused a small scalp laceration. According to the ED doctor, he was a bit confused when EMS arrived but he was oriented x3 upon arrival to the ED. He tells me that he has not felt well the past several days but can not specify what feels bad. Denies pain. Denies cough, nausea, body aches, fever, dizziness, weakness. He stopped taking his meds a few days ago "because I wasn''t feeling well. He stopped chewing tobacco and stopped smoking marijuana a few days ago as well for the same reason. Again, he cannot tell me what feels bad. He took the COVID vaccine in March. He has tested positive for COVID today. He denies being in any large groups. He wears his mask in the grocery stores. Patient is on disability. He has Klinefelter''s syndrome. His CXR shows PNA. WBC is normal. Potassium low. CRP high. Procal pending. Blood cultures were drawn. Rocephin and zithromax were started. Fluid boluses started in the ED. Urine studies pending.


VAERS ID: 1623610 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-26
Onset:2021-08-20
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 1 LA / IM

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

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

Write-up: hospitalization (non-ICU)


VAERS ID: 1623620 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Michigan  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Mass, Oropharyngeal discomfort
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unkmown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: Morphine, nsaids, sulfa, amox, trimethoprim, bupremopmone
Diagnostic Lab Data: none
CDC Split Type:

Write-up: throat mass, difficulty breathing ED vidit , epi, steroids and benadryl given


VAERS ID: 1623623 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-18
Onset:2021-08-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Cluster headache, Migraine
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Coumadin, prednisone, singular, proair, procardia
Current Illness: Complications due to asthma and high blood pressure
Preexisting Conditions: Asthma High blood pressure History of deep vein thrombosis and intubations
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have been experiencing cluster migraines since the injection. I do not have a history of migraines or severe headaches.


VAERS ID: 1623631 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ibuprofen 600mg
Current Illness: unk
Preexisting Conditions: none known
Allergies: no known allergies
Diagnostic Lab Data: na
CDC Split Type:

Write-up: Pt c/o subjective fever, muscle aches, chills, fatigue, and nausea which started the day after injection.


VAERS ID: 1623636 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chest pain (left side), High heart rate, shortness of breath


VAERS ID: 1623665 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-12
Onset:2021-08-20
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Tested positive for Covid-19 on 8/20/2021


VAERS ID: 1623667 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-12
Onset:2021-08-20
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Injection site rash, Injection site swelling, Injection site warmth, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: On Friday August 20, 2021 I developed 2 round red bumps on my left arm/injection site. They were about an inch or two apart and both were red, swollen, itching, warm to touch, and both were hard. On Saturday August 21, 2021 the redness started to spread around both spots and had an irregular shape but remained red, slightly raised, slightly warm to touch. On Sunday August 22, 2021 the redness from the two spots formed together to make a large, irregular shaped red area with a very noticeable red outline in an irregular shape and was moderately red and slightly warm to touch. On Monday August 23, 2021 same as Sunday except it was more red and felt like a sunburn and slightly warm to touch


VAERS ID: 1623670 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-26
Onset:2021-08-20
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0431A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anticoagulant therapy, Deep vein thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: No
Preexisting Conditions: HPV-2
Allergies: No
Diagnostic Lab Data: BLOOD CLOT ON RIGHT LEG .
CDC Split Type:

Write-up: DVT DEEP VEIN THROMBOSIS; BLOOD THINNERS AND FOLLOW UP CARE WITH PHYSICIAN. OUTCOME, PISAED OFF AND READY TO SUE.


VAERS ID: 1623679 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-02-05
Onset:2021-08-20
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Computerised tomogram thorax abnormal, Intensive care, Lung opacity, Respiratory failure, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unclear - this was 6 months ago. Has been maintained on amlodipine, spiriva, potassium, hydrochlorothiazide, losartan, and breo-ellipta
Current Illness:
Preexisting Conditions: hypertension, copd
Allergies: nkda
Diagnostic Lab Data: covid + 8-20; ct+ for ground glass opacities
CDC Split Type:

Write-up: breakthrough covid infection with admission to ICU for respiratory failure


VAERS ID: 1623702 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Arizona  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood glucose increased, Dizziness, Nervousness, Presyncope
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: bs 109, no other tests done
CDC Split Type:

Write-up: HPI: Patient presents for a near syncopal episode when getting covid vaccine today. Mother states he was feeling nervous before the shot and during the incident he felt faint but did not pass out. No LOC or head injury. He denies any CP, heart palpitations, SOB or difficulty breathing currently. BS 109.


VAERS ID: 1623729 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Missouri  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / IM

Administered by: Private       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: none
Current Illness: none
Preexisting Conditions: Hypertension, diabetes, sleep apnea, hyperlipidemia
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: patient was inadvertently given 0.5 ml instead of 0.3 ml.


VAERS ID: 1623740 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-23
Onset:2021-08-20
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / -

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: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: 08/20/2021 he went to Pharmacy and received a Pfizer(FC3181) vaccine by mistake


VAERS ID: 1623755 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Heavy menstrual bleeding, Irritability, Menstruation irregular
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Fertility 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: 25mg sertraline Quercetin Multivitamin
Current Illness: None
Preexisting Conditions: None known other than seasonal allergies
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Period started two weeks early and is heavier than I have ever experienced. Hormonal a new breakout Extreme fatigue and irritability similar to PMS symptoms


VAERS ID: 1623760 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Tennessee  
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 021C21A / 1 LA / SYR

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

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

Write-up: Arm swelled became red. Rash appeared on body and now s itching


VAERS ID: 1623778 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Tennessee  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Body temperature increased, Dyspnoea, Heart rate increased, Menstruation irregular, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Fertility disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Rapid heart beat Raising temperature Could not cool down Problems breathing Rash Period was came back on.


VAERS ID: 1623780 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: North Carolina  
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 OS4C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Gout
SMQs:, Arthritis (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: Jardiance, Tradjenta, Metformin, Pravastatin, Fenofibrate, Losartan
Current Illness: Diabetes, High Cholesterol
Preexisting Conditions: Susceptible to Gout
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Acute Gout Flair up


VAERS ID: 1623796 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chills, Injected limb mobility decreased, Injection site erythema, Injection site induration, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth, Oedema peripheral, Pain, Rash macular, Tenderness, Vaccine positive rechallenge
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Covid 19 modern dose 1 same adverse effects for second dose
Other Medications: Lamictal Keppra Hydroxyzine Buspar Vitamin D Omeprazole
Current Illness: Epilepsy Anxiety
Preexisting Conditions: Epilepsy Anxiety
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The injection site: Tender Large red spot splotchy Hot to touch Swollen Hard Itchy Other: Fever of 100.1 Chills Tenderness and swelling in left arm pit Pain in joints painful to lift arm


VAERS ID: 1623805 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Georgia  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Erythema, Pruritus, Swelling, Throat irritation, Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Vital Signs: 2:40 pm-117/77, 103, 2:47 pm-121/87, 99, 98% 2:51 pm- 125/83, 93, 98% 2:53 pm-121/81, 90, 98% 2:58 pm-120/78, 78 3:00 pm-113/77, 79, 97% 3:08 pm-113/82, 77, 98%
CDC Split Type:

Write-up: Approx. 12 minutes after vaccination, the patient reported to me with itching of the whole left arm, what appears to be a red bump/whelp on the pt''s outer chest, near left axillary area was present and itchy. With in a few minutes the pt''s began to state that her throat was itchy and was progressing to feeling tight. EMS was called @2:46pm, Benadryl 50mg orally administered @ 2:46 pm. EMS arrived and evaluated the patient at 2:53 pm. Over time patient stated she began to feel better, her throat didn''t feel as bad as it did initially. The redness of her left arm and the whelp on her chest has began to look less aggravated, the redness had began to fade. The patient and her mother declined ER attention when offered by EMS and the staff here. The EMS workers gave the patient and pt''s mother instructions on what to do, EMS then departed at 3pm. The staff here observed the patient until approximately around 3:10pm with furthered discharge instructions.


VAERS ID: 1623822 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Haematemesis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (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 D, Fish Oil
Current Illness: N/A
Preexisting Conditions: Fibromyalgia
Allergies: Zithromax
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I woke up around 1am and there was blood in my vomit. I vomited several times.


VAERS ID: 1623837 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Alabama  
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 939902 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: Not an adverse event. It was a vaccine error. The vaccinator accidentally got a Moderna Covid vaccine from the refrigerator instead of a Pfizer for the patient''s second shot. No adverse events as of this time.


VAERS ID: 1623867 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Feeling hot, Vertigo, Visual impairment
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (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: tDAPT, same exact thing happened around 24 hours after the vaccination. 25 years old, female,
Other Medications: lexapro
Current Illness:
Preexisting Conditions: amenic, factor 5 (blood clotting disorder)
Allergies: milk
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extremely dizzy, got extremely hot, saw stars in my vision, couldn''t breath was able to get to the ground and get a fan/cold washcloth to my head so I didn''t black out. This was 23 hours after I received the first dose of the vaccine. It was over an hour of feeling like I couldn''t breath, stars in my vison, extremely hot. I was extremely dizzy from 12pm-6pm that day (everything was spinning)


VAERS ID: 1623879 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-20
Onset:2021-08-20
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 2 RA / IM

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

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

Write-up: Tested PCR positive for COVID 8/20/21 after being fully vaccinated.


VAERS ID: 1623895 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Fatigue, Head discomfort, Headache, Migraine, Muscle fatigue, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: zoloft (50mg) ativan (0.5mg)
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: extreme tiredness and muscle fatigue. headache that turns into a migraine. these symptoms occurred Friday evening and have been more prevalent over the weekend. This morning i woke up nauseous and vomited. I also have developed a cough that is painful and rattles my head.


VAERS ID: 1623897 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-18
Onset:2021-08-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site swelling, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acyclovir, Jakafi
Current Illness: NA
Preexisting Conditions: Myelofibrosis and PCV
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Axillary swelling at the site of injection


VAERS ID: 1623923 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Louisiana  
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 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood magnesium, COVID-19 screening, Chest X-ray, Computerised tomogram head, Dizziness, Fall, Full blood count, Influenza virus test, Metabolic function test, Muscular weakness, Urine analysis, X-ray of pelvis and hip
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Vestibular disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvastatin Calcium 20MG Oral Tablet , Cholestyramine 4GM/5GM Oral Powder for Suspension , Esomeprazole Magnesium 40MG Oral Capsule, Delayed Release, Hyoscyamine Sulfate 0.125MG Oral Tablet, Disintegrating , Lisinopril 20MG Oral Tablet ,
Current Illness:
Preexisting Conditions: Hypertension, depression, hyperlipidemia
Allergies: None
Diagnostic Lab Data: CBC, CMP, MAGNESIUM, URINALYSIS, FLU SCREEN, CHEST XRAY, CT HEAD, XRAY PELVIS, XRAY R HIP, RAPID COVID-19 SCREEN
CDC Split Type:

Write-up: Dizziness, right lower extremity weakness, fall


VAERS ID: 1623934 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-19
Onset:2021-08-20
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: PATIENT TESTED POSITIVE TO COVID ON 8/19/21


VAERS ID: 1623941 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-02
Onset:2021-08-20
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Balance disorder, COVID-19, Cough, Decreased appetite, Diarrhoea, Disorientation, Exposure to SARS-CoV-2, Fall, Fatigue, Head injury, Nasopharyngitis, Pyrexia, SARS-CoV-2 test positive, Skin abrasion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes mellitus Heartburn Hypertension Ovarian cancer, stage 3 Left bundle branch block
Allergies: Promethazine Sulfa (Sulfonamide Antibiotics)
Diagnostic Lab Data: Positive for SARS-CoV-2 RNA by PCR Abnormal E Gene Ct cycles 24.6 Comment: Cycle threshold (Ct) values are not comparable between tests and may not be comparable between different lots of the same test. Currently there is no consensus as to whether or not particular Ct values correlate with a person being or not being infectious or risk level for disease severity. So, appropriate care should be taken with interpretation of Ct values. N2 Gene Ct cycles 26.0 Comment: Cycle threshold (Ct) values are not comparable between tests and may not be comparable between different lots of the same test. Currently there is no consensus as to whether or not particular Ct values correlate with a person being or not being infectious or risk level for disease severity. So, appropriate care should be taken with interpretation of Ct values. Resulting Agency Specimen Collected: 08/20/21 10:41 Last Resulted: 08/20/21 12:18
CDC Split Type:

Write-up: Patient is a 77 y.o. female with a history of diabetes and ovarian cancer, last chemo 08/15/21, who presents to the emergency department with son for evaluation after a fall. Patient reports for the last week she has had balance issues and weakness, with more frequent falls. She denies any injuries, but early this morning fell and hit her head. She denies loss of consciousness but had to be helped up by her husband. She also notes 5 days ago she developed cold symptoms with a cough, fever, more fatigue, and loss of appetite. Over the weekend she was around her daughter who is positive for Covid. Patient is fully vaccinated. She denies chest pain or shortness of breath. Today the son saw her and she was more disoriented. She has a small abrasion to her head, which was covered with a Band-Aid at home. She denies urinary issues. She does have diarrhea.


VAERS ID: 1623951 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-18
Onset:2021-08-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Swelling of eyelid
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: swelling of lower eyelid.


VAERS ID: 1623964 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-09
Onset:2021-08-20
   Days after vaccination:192
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Respiratory tract congestion, Rhinorrhoea
SMQs:

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

Write-up: Congestion, runny nose, starting on 8/20/21


VAERS ID: 1623977 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO173 / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Cough, Headache, Myalgia, Respiratory tract congestion
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Toprol XL 25mg 2xday,Synthroid175mg daily,Prempro 0.625-5mg, Venlafaxine ER 75mg, Alprazolam 0.25mg, Vitamen D3 5000iu 2capsules, Tylenol 1000mg, OsteoBi-Flex 1 capsule 2xday
Current Illness: N/A
Preexisting Conditions: Thyroid disease, HTN
Allergies: NKA
Diagnostic Lab Data: None yet- maybe Covid test
CDC Split Type:

Write-up: Head ache , muscle aches, chest congestion cough


VAERS ID: 1623983 (history)  
Form: Version 2.0  
Age: 97.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-31
Onset:2021-08-20
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Oxygen saturation decreased, Pneumonia, SARS-CoV-2 test positive
SMQs:, Acute central respiratory depression (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: TAMULOSIN, POTASSIUM CHOLORIDE, LEVOTHYROXINE, ASA, DULCOLAX, FUROSEMIDE, GLIPIZIDE, ACETAMINOPHEN-HYDROCODONE, HYDROXYZINE, MOM, MVI, ROSUVASTATIN, TRIAMCINOLONE
Current Illness: A-FIB RVR
Preexisting Conditions: HTN, HIP REPLACEMENT, COPD, A-FIB, HC, BPH, COLON CANCER, DM
Allergies: NKA
Diagnostic Lab Data: POSITIVE COVID-19 TEST 08/20/2021 @2357
CDC Split Type:

Write-up: patient arrived via ems from nursing facility with complaints of low oxygen saturation. Patient was recently diagnosed with pneumonia. Patient is currently taking a zpack and received a rocephin shot tonight at facility.


VAERS ID: 1623989 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-18
Onset:2021-08-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 02F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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: Singular Gabapentin sometimes Pantoprazole Albuterol Fluticasone salmetrol
Current Illness:
Preexisting Conditions: GERD Aspiration in lungs
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Both hands are extremely sore in the morning till afternoon, and then they get better slowly. Then the next day it starts again


VAERS ID: 1624006 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Headache, Injection site erythema, Injection site pain, 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: BCP
Current Illness: None
Preexisting Conditions: None
Allergies: amoxicillin
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Headache, no treatment, from approximately 18-48hrs Redness, swelling, pain near (not at) injection site for at least 5 days, no treatment


VAERS ID: 1624026 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-18
Onset:2021-08-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 10/19/18 Had Gotten the flu shot, Tdap and pheumorax all on same day so I had two put in left arm and one in the right arm. The
Other Medications: multi vitamin osteo biflex baby aspirin cozaar 50 mg 1 daily
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Woke up to a very sore left hot to touch and swollen about 4 inches under the injection site. Later that day intense itching at the swollen site until Monday. Swelling is going down and itching is starting to go away.


VAERS ID: 1624054 (history)  
Form: Version 2.0  
Age: 18.0  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: THE PATIENT HAD 2 DOSES OF MODERNA, WAS GIVEN PFIZER AS A 3RD DOSE INSTEAD OF MODERNA. THE PATIENT EXPERIENCED NO ADVERSE EFFECTS.


VAERS ID: 1624071 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-11
Onset:2021-08-20
   Days after vaccination:221
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 2 LA / IM

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

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

Write-up: Tested PCR positive for COVID 8/20/21 after being fully vaccinated.


VAERS ID: 1624087 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-14
Onset:2021-08-20
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-Vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Hydrocodon
Diagnostic Lab Data: Antigen Test Positive on 08/21/2021
CDC Split Type:

Write-up: Contracted COVID-19 on 08/20/2021


VAERS ID: 1624091 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-08-20
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Headache, Oropharyngeal pain, Pain, Respiratory tract congestion
SMQs:, Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Immune-mediated/autoimmune disorders (broad)

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

Write-up: loss of taste and smell; sore throat, congestion, headache, bodyaches, starting on 8/20/21


VAERS ID: 1624107 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-02-10
Onset:2021-08-20
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 2 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023M20A / 2 - / IM

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

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

Write-up: POSITIVE COVID TEST


VAERS ID: 1624114 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-26
Onset:2021-08-20
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 - / IM

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

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

Write-up: POSITIVE COVID TEST


VAERS ID: 1624116 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Jersey  
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 049C / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chills, Erythema, Hypoaesthesia, Muscular weakness, Pain, Peripheral swelling, Pyrexia, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Prior history of COVID19 December 2020 with persistent symptoms
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: L arm swelling, redness, and numbness traveling up neck and L face. L facial numbness, weakness, and swelling. L arm and L leg weakness. Aching, fever, chills, joint pains, body aches. can''t move L face well.


VAERS ID: 1624124 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 3 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Medication errors (narrow)

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

Write-up: Patient received 3rd covid dose. The first two were Moderna. The third was Moderna. Pfizer was used due to Moderna being unavailable in the local market. The wording of the CDC was the 3rd dose was "encouraged" rather than mandated to match the first two doses. The patient had severe nausea and aches. Encourage patient to reach out to PCP for nausea meds.


VAERS ID: 1624128 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Pennsylvania  
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 - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Influenza like illness, Injection site pain, Pyrexia, Skin sensitisation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: zoloft 100mg. , prilosec 20mg.
Current Illness: None
Preexisting Conditions: lung cancer, sinus drip
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Flu-like symptoms, extreme fatigue, skin sensitivity, fever-like symptoms, pain on arm at injection site. Symptoms lasted 2.5 days.


VAERS ID: 1624129 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-16
Onset:2021-08-20
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 RA / IM

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

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

Write-up: Tested PCR positive for COVID 8/20/21 after being fully vaccinated.


VAERS ID: 1624138 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-25
Onset:2021-08-20
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 - / IM

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

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

Write-up: POSITIVE COVID TEST


VAERS ID: 1624154 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-02
Onset:2021-08-20
   Days after vaccination:140
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Anosmia, COVID-19, Malaise, Nasal congestion, Pyrexia, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none known
Current Illness: none known
Preexisting Conditions: none known
Allergies: none known
Diagnostic Lab Data: rapid test for Covid 8/22/2021
CDC Split Type:

Write-up: Client had Pfizer vaccines for Covid on April 2 and April 30, 2021 at Hospital. Developed Covid symptoms (fever, nasal congestion, loss of smell) on 8/20. Tested rapid positive for Covid 8/22. Reported as a breakthrough Covid case in fully vaccinated person.


VAERS ID: 1624177 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-13
Onset:2021-08-20
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Irritability, Pruritus, Rash papular
SMQs:, Anaphylactic reaction (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro, vitamins D, B-12, Fish oil, calcium, magnesium, zinc, C
Current Illness: none
Preexisting Conditions: none
Allergies: no known
Diagnostic Lab Data:
CDC Split Type:

Write-up: A raised, red patch appeared on the same arm and spot where the vaccine was administered. Only explanation I can think of is the vaccine. It was there for about 48 hours. It was only slightly itchy and irritating. Now at day 3 it isn''t raised, but still slightly red. It''s about a 2 inch x 4 inch oval. No other symptoms were experienced.


VAERS ID: 1624179 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Wyoming  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chills, Headache, Injection site paraesthesia, Lymph node pain, Lymphadenopathy, Muscle spasms, Nausea, Neuralgia, Pyrexia, Spinal pain, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Tingling in arm after injection, like arm fell asleep, lasted a couple of hours. Later on night of injection, had severely swollen and painful lymph nodes under arm on side of vaccination. Vomiting, nausea, headache all over head next day. Nerve pain/sensitivity in back, all along spine. Fever/chills, muscle spasms in back, hip joints ache. All lasted approx. 48 hours except lymph node swelling and pain, headache and nerve sensitivity of which are all ongoing.


VAERS ID: 1624183 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling hot, Head discomfort
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: Pt. called clinic stating that ~ 2 hours after receiving her vaccine her head felt like it was being squeezed. Pt reports eating and feeling better but symptoms returning. Pt also reports feeling hot. Pt instructed to take Tylenol or Ibuprofen and go to ED with worsening or concerning symptoms.


VAERS ID: 1624188 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Iowa  
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 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

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

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

Write-up: Vaccine recipient completed vaccine screening form and indicated he had never received a dose of Covid 19 vaccine, when entering information into system, noted he was fully vaccinated with Pfizer.


VAERS ID: 1624193 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
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 (JANSSEN)) / JANSSEN 206AZ1A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Headache, Pain, Pain in extremity, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: thyroid meds and water pill
Current Illness: no
Preexisting Conditions: asthma, fibromyalgia, disc disease
Allergies: latex and peanuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: developed hives, headache, painful shoot down her left arm


VAERS ID: 1624264 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-02
Onset:2021-08-20
   Days after vaccination:140
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048A21A / UNK - / -

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

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

Write-up: Positive COVID case had contact with a positive mild symptoms has had infusion treatment.


VAERS ID: 1624267 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
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 053E21A / 1 LA / IM

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

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

Write-up: pt received first dose of vaccine 10 days after testing positive. pt has chills and febrile for 48 hrs post vaccination. Told pt does not need vaccine until 90 days post vaccination.


VAERS ID: 1624312 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Unknown  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate decreased, Loss of consciousness, Pallor, Peripheral coldness, Seizure, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received Pfizer vaccine. 5 minutes later, patient started convulsing, experiencing syncope like reactions. He was cold, pale, heart beat was ~ 10-15 bpm. The patient was laid on the floor on his side as he was shaking for approximately 10 seconds. After a few minutes, regained consciousness and remembered details about his name, location, time, etc. Paramedics came and took patient to the hospital.


VAERS ID: 1624315 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
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 - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Wrong product administered
SMQs:, Medication errors (narrow)

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

Write-up: Wrong vaccine was given


VAERS ID: 1624321 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Florida  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Cough, Dysphonia, Fatigue, Headache, Nausea, Oropharyngeal pain, Pain in extremity, Pyrexia, SARS-CoV-2 test negative, Sinus operation
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nothing
Current Illness: No
Preexisting Conditions: No
Allergies: NO
Diagnostic Lab Data: 8/23/21 went to urgent care. Took Covid test and it was negative. Was advised to take Tylenol and ibuprofen in addition to Robitussin Cough Medicine.
CDC Split Type:

Write-up: ACHES AND PAINS ESPECIALLY IN THE LEGS Extreme Fatigue Lost taste and ability to smell anything Very hoarse cough low grade fever nausea headaches sinus drainage sore throat


VAERS ID: 1624341 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-07
Onset:2021-08-20
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018B21A / UNK - / -

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

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

Write-up: Positive COIVD case unknown exposure moderate symptoms has had infusion treatment.


VAERS ID: 1624356 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Hypotensive event that required emergency room visit 12 hours after vaccine. Patient administered fluids and reported systolic BP of 60. Patient has recovered with current BP readings of about 100/60.


VAERS ID: 1624534 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dyspnoea, Dysstasia, Feeling cold, Speech disorder, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (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: None
Current Illness: None
Preexisting Conditions: None at this time
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I received my second dose of the fiber vaccine at 9 in the morning felt fine all day and night and around 3 in the morning I started breathing like I was running a marathon out of nowhere I had cold chills and my body was like basically shaking like I was had a serious hypothermia shock I was shaking so much I could not even stand I had to get dressed laying on the ground called out before someone and no one was home had to crawl down my stairs and go outside an try to find help since I could not speak. I didnt call 911 but should have so i would have had documentation. I regret taking this vaccine but had to as my employer strongly suggested i do so if i want to work without using n95 every day and get tested weekly.


VAERS ID: 1624827 (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: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027D21A / 1 LA / IM

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

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

Write-up: Patient received his first dose of pfizer COVID-19 vaccine on 7/28/2021. Patient decided he wanted moderna COVID-19 vaccine for his second dose instead of pfizer COVID-19 vaccine. Patient denied receiving any dose of COVID-19 vaccine prior to receiving moderna COVID-19 vaccine on 8/20/21. Pharmacist found out about the first dose of pfizer COVID-19 vaccine while documenting the vaccine administration.


VAERS ID: 1624833 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-06
Onset:2021-08-20
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Blood test normal, Computerised tomogram head, Computerised tomogram normal, Crying, Disorientation, Drug screen negative, Dyskinesia, Electrocardiogram normal, Emotional distress, Feeling abnormal, Full blood count normal, Headache, Loss of consciousness, Metabolic function test, Muscle swelling, Muscle tightness, Nausea, Respiration abnormal, SARS-CoV-2 test negative, Unresponsive to stimuli, Urine analysis, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dyskinesia (narrow), Dystonia (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad), COVID-19 (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: Lisinopril 10 mg daily
Current Illness: none
Preexisting Conditions: high blood pressure obesity
Allergies: Meat allergy. vomits
Diagnostic Lab Data: CT of head w/o Contrast, EKG, CBC, CMP, UA, UDS, and combo rapid flu/SARS antigen panel. Given Dilaudid and zofran IV which helped relieve the headache and nausea temporarily. We were told all the tests came back normal and that they didn?t know why he passed out. They asked if he had a history of seizures which he did not. I?m an RN of 26 years and it was difficult to say if it was a petit mal seizure or simple syncope. He did not fall limp and remained upright in the seat during each episode but was unresponsive and had no recall so that sounds more like a seizure.
CDC Split Type:

Write-up: Initially had a baseball sized painful swelling of the deltoid muscle which resolved after 5 days. On Friday August 20th pt. complained of a headache on his left side of his head. On Saturday morning he woke me up at 530am stating he needed to go to an ER for severe headache. En route to the rural ER that I am an RN at, he asked me to pull over so he could vomit a small amount. That was the last thing he rememberd for a 15 minute period. On resuming travel, he asked, "what does it feel like when you are about to have a seizure? because my muscles feel tense, my body feels weird and my brain is foggy. he lost consciousness 3 times over the next 15 minutes. The first time his left arm jerked once, he stopped talking and answering me for about a minute. A few minutes later he did it again. This time his respirations became fast and loud like a panting. He did not slump over like an unconscious person. I checked his pulse and kept my fingers on his wrist and called his name. He did not respond at all for about 2 minutes this time. On waking he was disoriented and emotional which is very out of character. He said, "where are we going?" When I told him we were going to the hospital and why, he began to sob and cry stating, "I can''t remember! I can''t remember!" About a mile before the hosptial, maybe 6-8 minutes later he lost consciousness one more time with the panting breathing for about 30 seconds. On waking he was normal again aside from the headache and nausea. He did not exhibit this again after arrival at the ED. He continued to have a headache throughout Sunday 8/22/21 and still has mild headache on Monday 8/23/21


VAERS ID: 1624840 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Maryland  
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 - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Chills, Ear pain, Fatigue, Headache, Influenza like illness, Injection site pain, Injection site swelling, Insomnia, Myalgia, Oedema peripheral, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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:
Current Illness:
Preexisting Conditions: Hypothyroidism
Allergies: Demeral
Diagnostic Lab Data:
CDC Split Type:

Write-up: Flu-like, fever, muscle pain, headache, fatigue, ear ache, swollen and painful arm at injection (swollen to baseball size), swollen and painful arm pit, insomnia, chills


VAERS ID: 1624845 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Michigan  
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 049E21A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site pruritus, Nausea, Palpitations, Pruritus
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: Topamax, Sucralafate, Synthroid, Linzess,Zyrtec, Proton, Ativan ,Claritin, Magnesium , Lactaid, Gas X
Current Illness: N/a
Preexisting Conditions: Asthma
Allergies: Latex, Banana, Strawberries, Wheat, Avocado, Celery, Pineapple, Apples Almonds,
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Around 6 :45 injection area very itchy. By 7 extreme itchiness, By 7:45 shoulder to elbow extreme itch debated if I should contact pharmacy. Around 8 p.m. I noticed heart palpitations along with the itchiness going up along my neck now. And down the left trunk of my body. I''m feeling nausea at this point. I decide to lay down. By 8:45 my left arm, left neck, trunk , stomach area are itching beyond comfort levels , nausea is bad and heart palpitations are intense but no difficulty breathing. So I lay here thinking how absurd this is. My husband also had his second dose at the same time he was doing fine. So I take a Zofran for nausea and an antihistamine for the itch and a Ativan. I advise my husband of the situation so he''s aware . In case of something worse prevails. I wake up in the morning feeling fine.


VAERS ID: 1625023 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Nevada  
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 053E21A / UNK - / IM

Administered by: Private       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: none
Preexisting Conditions: none
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient received 1st dose and a VAERS report was created. I notified the child''s parents and they wanted their child to receive the second dose. This is the second dose given with approval from the health department and the patient''s parents. Patient did not have any adverse reactions to either vaccine.


VAERS ID: 1625026 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Nevada  
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 053E21A / UNK - / IM

Administered by: Private       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: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient received 1st dose and a VAERS report was created. I notified the child''s parents and they wanted their child to receive the second dose. This is the second dose given with approval from the health department and the patient''s parents. Patient did not have any adverse reactions to either vaccine.


VAERS ID: 1625040 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-02
Onset:2021-08-20
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Fatigue, Headache, Lymphadenopathy, Myalgia, Pain in extremity, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall xr Hydroxychloroquine
Current Illness: None
Preexisting Conditions: Mixed connective tissue disorder
Allergies: Alpha gal
Diagnostic Lab Data: Havent seen a doctor. The nerve symptoms came on quite suddenly.
CDC Split Type:

Write-up: First swollen lymph mode in armpit of left arm. Week later swollen lymph node near elbow and tingling. The tingling spread down my arm, then to my lower legs and other arm. Sore muscles for no reason, particularly leg muscles. Generalized weakness and fatigue with some intermittent headaches that are atypical. Left arm is also very sore and painful. I had no real side effects in the first week. Although symptoms arose 3 weeks after, i cant think of any other cause and havent changed anything else.


VAERS ID: 1625042 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-17
Onset:2021-08-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / IM

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

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

Write-up: Day 3: Hives on hands and arms. Day 4: Hives on hands, arms and legs Day 5: Hive on Hands, arms, legs, torso, and buttocks.


VAERS ID: 1625057 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-19
Onset:2021-08-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Headache, Lacrimation increased, Rhinorrhoea, Sneezing
SMQs:, Anaphylactic reaction (broad), Lacrimal disorders (narrow), Hypersensitivity (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: Adderall lisinopril Amitriptyline Metformin Topamax Butalbital acetaminophen caffeine
Current Illness: None
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache Sneezing Runny nose Watery eyes ALLERGY SYMPTOMS THAT LASTED ONE DAY


VAERS ID: 1625060 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Georgia  
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 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Headache, Spinal pain
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Arthritis (broad)

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

Write-up: Headache the night of and entire next day. The Day following T and L spinal pain, flowed by organ pain, mainly what felt like kidneys, and slight shortness of breath.


VAERS ID: 1625271 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-30
Onset:2021-08-20
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EV0584 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Injection site pain, Injection site reaction, Pyrexia, Rash, Skin reaction
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic 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: Levothyroxine Cytomel Vitamin D Vitamin C Omega 3
Current Illness: None
Preexisting Conditions: Hashimoto?s thyroiditis Myeloproliferative Neoplasm - Essential Thrombocythemia
Allergies: Penicillin Sulfa Iodine Latex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pain at injection site Fatigue Headache Rash (COVID arm) after first and 2nd dose Fever (102) Chills


VAERS ID: 1625428 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Louisiana  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Blood test normal, Chest X-ray normal, Echocardiogram normal, Electrocardiogram normal, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthorid 50mg, vitamin D, Amoxicillin 875 mg x2 day,
Current Illness: Tooth infection
Preexisting Conditions: Hypothyroidism
Allergies: None
Diagnostic Lab Data: Blood pressure checked at quick care, they sent me to ER. ER did blood wrk, ekg, chest X-ray and all came back ok. Referred me to follow up with my Cardiologist and primary doctor. Followed up with cardio, echo came back good blood work pending and prescribed matoparole 25mg at night.
CDC Split Type:

Write-up: About 20 minutes after the shot my blood pressure increased very fast along with my heart rate.


VAERS ID: 1625435 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-20
Onset:2021-08-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A, / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Malaise, Skin discolouration, Skin warm
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none reported by client.
Current Illness: none reported by client.
Preexisting Conditions: none reported by client.
Allergies: none reported by client.
Diagnostic Lab Data: not provided at clinic
CDC Split Type:

Write-up: On Saturday, August 20, 2021, client received the COVID vaccine (Janssen, dose 1, lot# 205A21A, exp: 9/21/21) in to his left deltoid at approximately 1:40pm. After vaccine was administered, client was to wait in the Observation Area for 15 minutes. At 1:46pm, Vaccinator RN, noted that the patient dropped some forms on to the floor. Vaccinator, RN and Vaccine Monitor, RN, walked over to client who stated he was not feeling well. Vaccine Monitor, RN informed Co-Lead RN. Co-Lead RN responded. Client was assisted to sit in the anti-gravity chair. Upon assessment by Co-Lead RN, client''s skin was diaphoretic, warm, and pink. Client reports he felt dizzy for about 10 seconds and then he felt sweaty. Client reports last meal was at 10:00am. At 1:49pm vitals were taken: BP: 118/62, HR: 58, RR: 16. Client denied shortness of breath, palpitations, chest pain, itchiness, rash, or throat swelling. At approximately 1:52pm , client stated his symptoms completely subsided. Patient was alert and oriented x4 during entire interaction. Client states he fainted one time x 10 years ago while receiving a blood draw. At 1:59pm vitals were taken: BP: 122/78, HR: 55, RR: 16. The client skin was warm, dry and pink. Co-Lead RN educated client on ED precautions and advised to follow up with PCP. Client verbalized understanding. Client walked out of observation area with a steady gait at approximately at approximately 2:13pm.


VAERS ID: 1625948 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-20
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Bone pain, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210842971

Write-up: PAIN ON ENTIRE RIGHT-SIDE (FROM RIGHT SHOULDER TO RIGHT ARM, RIGHT HIP AND ALL THE WAY DOWN TO RIGHT FOOT); BONES HURTING; MUSCLES HURTING; This spontaneous report received from a patient concerned an adult female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 19-AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 20-AUG-2021, the patient experienced pain on entire right-side (from right shoulder to right arm, right hip and all the way down to right foot). On 20-AUG-2021, the patient experienced bones hurting. On 20-AUG-2021, the patient experienced muscles hurting. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from pain on entire right-side (from right shoulder to right arm, right hip and all the way down to right foot), muscles hurting, and bones hurting. This report was non-serious.


VAERS ID: 1625952 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-20
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Incorrect route of product administration
SMQs:, Drug abuse and dependence (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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210843007

Write-up: INCORRECT ROUTE OF ADMINISTRATION; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, subcutaneous, batch number was not reported) dose was not reported, administered on 20-AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 20-AUG-2021, the patient experienced incorrect route of administration. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of incorrect route of administration was not reported. This report was non-serious.


VAERS ID: 1625958 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-08-20
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Diarrhoea
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:
Current Illness: Abstains from alcohol; Asthma; Bipolar disorder (Patient has bipolar disorder and has been taking benzodiazepines for 20 years); Food allergy; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: Dog bite (Patient was recently bitten by a dog and was treated with antibiotics); Comments: The patient not experiencing any soreness in arm.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210843072

Write-up: DIARRHEA; This spontaneous report received from a patient concerned a 78 year old female. The patient''s weight was 120 pounds, and height was 65 inches. The patient''s past medical history included: dog bite, and concurrent conditions included: bipolar disorder, asthma, apples, eggs, chicken, wheat, all fruits (except carrots, potatoes, asparagus), lima beans, abstains from alcohol, and non-smoker, and other pre-existing medical conditions included: The patient not experiencing any soreness in arm. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 19-AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 20-AUG-2021, the patient experienced diarrhea. Treatment medications (dates unspecified) included: electrolytes nos/glucose. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from diarrhea. This report was non-serious.


Result pages: prev   354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 534 535 536 537 538 539 540 541 542 543 544 545 546 547 548 549 550 551 552   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=453&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166