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 46 out of 8,010

Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145   next


VAERS ID: 1758570 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chills, Headache
SMQs:, Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Temp 101 degrees
CDC Split Type:

Write-up: Severe headache fever chills for 36hrs day after injection


VAERS ID: 1758571 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fear, Injection site erythema, 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: 1970 systemic lupus after rubella vaccine
Other Medications: prednisone; methotrexate; Plaquenil;
Current Illness: lupus (SLE) flare
Preexisting Conditions: SLE, EDS(h), idiopathic hypersomnia
Allergies: Latex, sulfa, valtrex, quinolones
Diagnostic Lab Data:
CDC Split Type:

Write-up: The pharmacist applied the bandage first and then gave me the vaccine injection THROUGH the bandage. I have redness and swelling of the injections site. My fear is that a piece of the bandage was injected into my muscle and I will develop an abscess. I AM REPORTING THIS BECAUSE IT WOULD NOT BE BECAUSE OF THE VACCINE ITSELF, BUT BECAUSE OF THE IMPROPER INJECTION TECHNIQUE AND MAY OCCUR TO OTHERS RECEIVING AN INJECTION FROM THIS PHARMACIST. ***********Please call me for details.*********** If you see a cluster of abscesses in the area this may be the cause. (I have saved the bandage.)


VAERS ID: 1758604 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Cerebrovascular accident, Laboratory test, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (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? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: High Blood Pressure
Allergies: Statin drugs
Diagnostic Lab Data: Various Tests Ran
CDC Split Type:

Write-up: Woke up and entire left side of body was swollen and dragging. Went to the ER and was admitted and diagnosed with a stroke.


VAERS ID: 1758616 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-27
Onset:2021-10-02
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 2 RA / SC
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 1 RA / SC

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: The patient was admitted to the hospital with COVID-19 on 10/2/21.


VAERS ID: 1758619 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site rash, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient stated that on Saturday she started getting a rash on her arm around the injection site and that it was pretty itchy. Did not have any other symptoms. It started getting better on Sunday and even better on Monday. Did not have this reaction to the first dose.


VAERS ID: 1758625 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091021A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna -2nd vaccine 4/2/21 exacerbated my Myasthenia Gravis for 6 weeks
Other Medications: Mycophenolate 500 mg po bid Mestinon 60 mg po bid Turmeric 2000mg po qd Multivitamin 1 po bid Vitamin D3 5000u po qd Elavil 25 mg po qhs HCTZ 25 mg po qd Paxil 20mg po qd Acetaminophen 500mg po prn
Current Illness: Myasthenia Gravis Rheumatoid Arthritis (new)
Preexisting Conditions: Myasthenia Gravis Rheumatoid Arthritis (new)
Allergies: Azathioprine Lidocaine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left upper arm is swollen, hot and red.


VAERS ID: 1758631 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

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

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

Write-up: After event, Patient was found in alert to have already completed the series with Moderna. She did not report this at the time of the event.


VAERS ID: 1758632 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Crying, Depression, Emotional distress, Feeling abnormal, Tension
SMQs:, Dementia (broad), Depression (excl suicide and self injury) (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: Lexapro Adderall Tri-Nessa birth control Ibuprofen
Current Illness: none
Preexisting Conditions: ADHD depression anxiety
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: On Saturday 10/2/21 afternoon I started feeling very emotional and depressed. I could not stop crying and just wanted to be alone. I went to sleep at 1930 and woke up the following morning around 0800. I still felt very emotional, and was very tearful. Around 1230 I started feeling less depressed, but was still very tense. I felt out of character those two days 10/2-10/3. Today, 10/4, I feel back to "normal".


VAERS ID: 1758650 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 RA / IM

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: Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The Patient was given Pfizer Booster after receiving Moderna for the 1st and 2nd doses. The patient has had zero adverse affects.


VAERS ID: 1758661 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH TC3184 / 3 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Blood pressure increased, Computerised tomogram, Dizziness, Echocardiogram, Feeling abnormal, Headache, Orthostatic intolerance, Scan with contrast
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Hypertension (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations: After my 2nd dose of Pfizer, I felt sick for about three days. I was tired and weak, but it is nothing like this dose.
Other Medications: I was taking levothyroxine, lisinopril, simvastatin, Montelukast, Advair and a aspirin at night.
Current Illness: I did not have any illness at the time.
Preexisting Conditions: I have a thyroid condition, asthma, high cholesterol and high blood pressure.
Allergies: I do not have any allergies.
Diagnostic Lab Data: They checked for blood clots, an echocardiogram, two CT scans 1with/ 1 without contrast.
CDC Split Type: vsafe

Write-up: Fifteen minutes after receiving the vaccine I felt dizzy. They asked me to stay for fifteen more minutes to see if there were any changes. After the 30 minutes were up, I felt even worse. They brought another chair over for me to recline my legs. They started monitoring my blood pressure every few minutes. It was good. It raised a little, maybe up to 166. They called the doctor who told me that I need to go to the hospital. I did not want to go. They called the EMT over and when I stood up, I almost fell over. They brought me to Hospital. I have been admitted since 10/02. I have been experiencing dizziness and headaches. I''m not able to stand straight from my bed. I need to call for help to get up from the bed to go to the restroom.


VAERS ID: 1758670 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: INDERAL; SYNTHROID; LEXAPRO; VITAMIN D-3; ASPIRIN; BIOTIN.
Current Illness: NONE.
Preexisting Conditions: THYROID; MITRAL VALVE PROLAPSE.
Allergies: POLLEN ALLERGIES.
Diagnostic Lab Data:
CDC Split Type:

Write-up: THIS WAS THE COVID BOOSTER SHOT FOR INDIVIDUALS OVER 65. LYMPHNODE UNDER LEFT ARM EXTENDING DOWNWARD, AROUND THE LEFT SIDE OF NECK WERE SORE AND SWOLLEN. SWELLING IS GOING DOWN AND THE SORENESS IS ALMOST GONE.


VAERS ID: 1758677 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH #02611385-18196 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Gingival pain, Lip swelling, Pain in jaw, Peripheral swelling, Pruritus, Swollen tongue, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Gingival disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad), 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:
Other Medications: Synthroid 5mg Lisinpril 5mg Plaquenil 200mg
Current Illness: none
Preexisting Conditions: RA, Auto Immune issues
Allergies: Alaskan King Crab legs Penicillin Sulfur
Diagnostic Lab Data: None. Benadryl and prednisone and Tylenol
CDC Split Type:

Write-up: Swollen tongue, lip, gum soreness, tender jaw, joint pain, swollen finger joints and nail beds feel itchy and some hives.


VAERS ID: 1758717 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-10-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2595 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cardiac flutter, Pain in extremity
SMQs:, Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Tachyarrhythmia terms, nonspecific (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi Vitamins, Metformin
Current Illness:
Preexisting Conditions:
Allergies: Penicillin, smoke and dust
Diagnostic Lab Data: I still cannot reach my doctor by phone, I have not been able to report it to them. No one seems to care.
CDC Split Type:

Write-up: First day, no pain in the arm, second day a bit of pain in the arm. Later that second day, started feeling heart flutters. This has been my 4th day with heart flutters. Symptoms are becoming a little less. Aside from heart flutters, no other symptoms have been felt.


VAERS ID: 1758760 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-25
Onset:2021-10-02
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest wall mass, Diarrhoea, Pulmonary congestion, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Cardiac failure (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: CAD, HTN, GERD, Hypothyroidism
Allergies: No Known
Diagnostic Lab Data: Covid + 10/03/2021
CDC Split Type:

Write-up: Breakthrough Covid + 10/3/2021. 90-year-old female with a past medical history significant for irregular heartbeat and osteoporosis presents today for further evaluation and treatment of diarrhea that started a couple days ago. Partially imaged hyperattenuating structure in the right posterolateral chest wall measuring up to 5 cm, which may represent a hematoma. Congestive changes in the lung bases.


VAERS ID: 1758802 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Full blood count, Human chorionic gonadotropin, Maternal exposure before pregnancy, Metabolic function test, Ultrasound scan vagina, Urine analysis
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: In the ED on Sunday (10/3) I ran CBC, CMP, UA, Hcg, and sent her out for a transvaginal US.
CDC Split Type:

Write-up: Unknown brand of COVID vaccine as I did not order nor give it to the patient. May be correlation rather than causation as these things do happen, but patient had her second MRNA dose on Tuesday and reported miscarriage on Saturday. She did report some light spotting earlier that week prior to the miscarriage. Was seen in ED for abdominal pain and vaginal bleeding.


VAERS ID: 1758821 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 LA / IM

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

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

Write-up: Lymphadenopathy to left axilla, pain.


VAERS ID: 1758822 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-01-25
Onset:2021-10-02
   Days after vaccination:250
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: PCR collected on 10/02/2021, resulted positive on 10-3-2021
CDC Split Type:

Write-up: feverish, cough, runny nose.


VAERS ID: 1758827 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-16
Onset:2021-10-02
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Decreased appetite, Fatigue, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (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: COPD , CAD, CKD, HTN, PUD, BPH
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: increasing cough , fatigue, increased wheezing, loss of appetite for 5 days


VAERS ID: 1758829 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Underdose
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: Error: Wrong Dose of Vaccine - Too Low-


VAERS ID: 1758831 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Underdose
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: Error: Wrong Dose of Vaccine - Too Low-


VAERS ID: 1758832 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Underdose
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: Error: Wrong Dose of Vaccine - Too Low-


VAERS ID: 1758834 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 3 RA / ID

Administered by: Pharmacy       Purchased by: ?
Symptoms: Underdose
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: Error: Wrong Dose of Vaccine - Too Low-


VAERS ID: 1758836 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Underdose
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: Error: Wrong Dose of Vaccine - Too Low-


VAERS ID: 1758843 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Underdose
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: Error: Wrong Dose of Vaccine - Too Low-


VAERS ID: 1758854 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Myalgia, Nausea, Pyrexia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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), 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: prenatal vitamins
Current Illness: none known
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Note I am a healthcare provider. This was my third dose of the pfizer vaccine (the second dose was in January 2021; I also had covid 19 infection in January before second dose). I had shaking chills with significant fever (measured on forehead at 101) for about 24 hours associated with nausea and muscle aches. This was worse than my prior pfizer vaccines and actual covid.


VAERS ID: 1758855 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 LA / IM

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

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

Write-up: Lymphatic response. Severely enlarged lymph node on left collar bone with inflammation spreading all the way down to the underarm.


VAERS ID: 1758863 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 3 LL / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Underdose
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: Error: Wrong Dose of Vaccine - Too Low-


VAERS ID: 1758874 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-19
Onset:2021-10-02
   Days after vaccination:197
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Moderna on 2/18 and 3/19. Positive on 10/3


VAERS ID: 1758905 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-28
Onset:2021-10-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Agitation, Aphasia, Blood lactic acid increased, Crying, Discomfort, Fatigue, Laboratory test, Pyrexia, Respiratory tract congestion, Speech sound disorder
SMQs:, Lactic acidosis (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Keppra 500mg per 5ml (two times daily) Depakene 250mg per 5ml (7 daily) Levocarnitine 300mg per 3 ml (3 times daily) Oxcarbazepine 300mg per 5ml (9 times daily) Robinul 1mg (once daily) Famotidine 40mg per 5ml (6 times daily) VSL 3 (1 packa
Current Illness: None
Preexisting Conditions: Disabled from birth
Allergies: Lamictal
Diagnostic Lab Data: Various Test Ran
CDC Split Type:

Write-up: Fever of 102, severe distress sounds(unable to speak), uncomfortable, agitated, crying, congested and tiredness. Lactic acid was high.


VAERS ID: 1758906 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chest pain, Dizziness, Dyspnoea, Extra dose administered
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Medication errors (narrow)

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

Write-up: pt was innoculated with #3 dose of Phizer at 11:12 on Oct.2,2021. At 11:25 pt was sitting in observation when pt c/o chest pain,dizziness, weakness with slight shortness of breath- PT was A/OX3- EMS was notified by staff member - BP was 118/60 hr 68. at 11: 30 pt reported no change in s/s, BP 130/67 hr 60. at 11:34, EMS arrived on the scene- vital signs were taken:BP 133/84 hr97, 99% on RA, NSR on monitor- pt stated no change in s/s to EMS, who with pt consent. transported pt via stretcher to local hospital. Pt remained A/OX3 throughout incident.


VAERS ID: 1758907 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenopia, Blood test normal, Chest pain, Dehydration, Diarrhoea, Head discomfort, Headache, Palpitations, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Corneal disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: tetanus 2010 , age 50, extreme flu symptoms, high temperature, 2 days,
Other Medications: Synthroid, .50mg Lisinopril/Hctz 20-12.5mg
Current Illness: none
Preexisting Conditions: None
Allergies: Flexerill - muscle relaxer
Diagnostic Lab Data: they took a blood test to determine electrolyte level and kidney assessment due to the dehydration as a precaution. 10/3 all seemed fine
CDC Split Type:

Write-up: The day of the shot I was fine, Friday 10/1. The very next day, 10/2 at 7am I began throwing up and diarrhea that didn''t stop for 3 hours. I also had a fever of 100.4 along with extreme headache. My head felt like a watermelon and my eyes felt incredibly heavy/full. I had to go to the emergency room due to dehydration - that was aroun 10:15 am. I got an IV with anti-nausea. My fever of 100.4-100.5 persisted all night into the early morning hours of 10/3. I also experienced extreme heart pounding late on 10/2 and acute chest pain the evening of 10/3. I am still experiencing on/off fever and headache


VAERS ID: 1758942 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-07
Onset:2021-10-02
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccine breakthrough infection
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: Symptomatic Vaccine breakthrough. Inpatient 10/2 to present


VAERS ID: 1758963 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-02-03
Onset:2021-10-02
   Days after vaccination:241
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Eye discharge, Pulmonary congestion, Pyrexia, SARS-CoV-2 test positive, Wheezing
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: PCR collected on 10-2-2021, resulted positive on 10-3-2021
CDC Split Type:

Write-up: Feverish, wheezing, eye drainage, lung moist.


VAERS ID: 1758973 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-09
Onset:2021-10-02
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time normal, Angiogram abnormal, Blood lactic acid increased, Haematocrit normal, Haemoglobin normal, Human chorionic gonadotropin negative, International normalised ratio normal, Lipase normal, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Peripheral ischaemia, Platelet count increased, Prothrombin time normal, Radial pulse decreased, Red blood cell count normal, Red blood cell sedimentation rate normal, Red cell distribution width normal, Superficial vein thrombosis, Ultrasound Doppler abnormal, White blood cell count normal
SMQs:, Lactic acidosis (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Cardiomyopathy (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 Outpatient Medications Medication Sig Dispense Refill ? enoxaparin (LOVENOX) 100 MG/ML injection Inject entire contents of 1 syringe subcutaneously every 12 hours. 60 mL 0 ? NIFEdipine ER (PROCARDIA XL) 30 mg 24 hr tablet Take 1 tab
Current Illness: none
Preexisting Conditions: Patient Active Problem List Diagnosis ? Depressive disorder, not elsewhere classified ? Obesity, unspecified ? ADHD (attention deficit hyperactivity disorder), combined type ? Panic disorder without agoraphobia ? Generalized anxiety disorder ? Chronic post-traumatic stress disorder (PTSD) ? MDD (major depressive disorder), recurrent severe, without psychosis (HCC) ? Benzodiazepine withdrawal without complication (HCC) ? Relationship problem with family member ? Stress ? Tinea corporis ? Pain in joint, pelvic region and thigh ? Non-intractable vomiting with nausea, unspecified vomiting type ? Nicotine dependence (vaping until time of acute event) ? IBS (irritable bowel syndrome) ? Hypothyroidism ? Disease due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ? Diarrhea ? Breast pain, left ? Acute right-sided low back pain without sciatica
Allergies: Promethazine: Medium Seizures convulsions unease, nervous Clindamycin: Low Other (See Comments) C-Diff
Diagnostic Lab Data: 10/2/2021 WBC: 7.6 K/mcL RBC: 4.6 x10^6/mcL Hemoglobin: 13.8 g/dL Hematocrit: 40.8 % MCV: 88.7 fL MCH: 30 pg MCHC: 33.8 g/dL RDW SD: 46.6 fL RDW: 14.3 % Platelets: 463 K/mcL High ESR: 14 mm/hr Lactic Acid, Plasma (Venous): 2.5 mmol/L High Lipase Level: 38 unit/L HCG, Beta Quantitative: <2 Coag Prothrombin Time: 12.4 seconds International Normalized Ratio: 0.9 Partial Thromboplastin Time (aPTT): 37 seconds CT Angio Upper Extremity Left 10/02/21 15:08:00 IMPRESSION: Patent and unremarkable appearance of the arterial vasculature within the arm and forearm. As before, there does appear to be at least mildly decreased perfusion of the thumb compared to the adjacent digits, although this may be partially due to technique and mild motion artifact seen in this region. US Upper Ext Segmental Pressures (WBI) 10/02/21 15:28:00 Impression: 1. Critically reduced pulsatility, left first digit. 2. No evidence of arterial insufficiency, elsewhere in the left upper extremity. 3. No evidence of arterial insufficiency, right upper extremity at the wrist level.
CDC Split Type:

Write-up: left thumb blood clot with ischemia (confirmed via doppler and CT anger.


VAERS ID: 1758994 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Nausea, Thirst, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Dehydration (broad)

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

Write-up: Nausea, vomiting, severe fatigue, severe thirst, cold chills


VAERS ID: 1759008 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxide Rouvastatin Multi-vitamin Fish oil B12
Current Illness: N/A
Preexisting Conditions: Thyroid
Allergies: pennycilian
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Red, swollen, itchy arm started a couple of days after the shot. Better after taking Benadryl.


VAERS ID: 1759044 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-20
Onset:2021-10-02
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test 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: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series


VAERS ID: 1759048 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 3 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Injection site pain, Lymph node pain, Lymphadenopathy, Vaccine positive rechallenge
SMQs:, Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: COVID dose #1 Pfizer on 12-23-20
Other Medications: Singulair, Trelogy inhaler, Otezla, Xyzal, Protonix, Premarin
Current Illness: none
Preexisting Conditions: Asthma, Allergies
Allergies: Cephalosporins
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Dose #3: Left Subclavian swelling and palpable lymph node with pain/tenderness to site. This happened with dose 1 given in left arm as well and lasted 3 weeks.


VAERS ID: 1759070 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Feeling hot, Loss of consciousness, Throat tightness, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: throat felt like it was closing, red hot ears , vomiting, passed out


VAERS ID: 1759087 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Injection site pain, Pyrexia
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:
Current Illness: psoriasis, Received an Ilyumana injection 9/30/2021 at 1:35 pm
Preexisting Conditions: Heart attack, arthritis, spinal spondylitis, degenerative disc disease
Allergies: Flexeril, fish oil
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Fever, chills, fatigue, soreness at injection site


VAERS ID: 1759109 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-26
Onset:2021-10-02
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007M20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023M20A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anticoagulant therapy, Asthenia, Chest discomfort, Cough
SMQs:, Anaphylactic reaction (broad), Guillain-Barre syndrome (broad)

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

Write-up: PT presented with chest discomfort, coughing, and generalized weakness; Pt is on aspirin, lovonox; pancoprazole; carvedilol; Inpatient


VAERS ID: 1759119 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 - / -

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Headache, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

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

Write-up: Headaches, fatigue, elevated heart rate 94-98, oximeter -94.


VAERS ID: 1759123 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Fatigue, Loss of consciousness, Pyrexia
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), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Pt. states that after receiving the 2nd dose of Moderna 10/01/2021, started experiencing symptoms 10/02/2021 Stomach pains, fatigued, passed out 3hrs, and feverish. No noted Primary Visit.


VAERS ID: 1759128 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 7465 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3184 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site nodule, Injection site swelling, Injection site warmth, Lymphadenopathy
SMQs:, 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: Multi vitamin, vitamin d, vitamin c
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Large swollen supraclavicular lymph node. Red, swollen, hot knot at injection site.


VAERS ID: 1759173 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-10-02
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / -

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: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series


VAERS ID: 1759188 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-28
Onset:2021-10-02
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 - / IM

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

Write-up: generally felt ill


VAERS ID: 1759201 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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: generally not well after flu vaccines but recovers in 1-2days
Other Medications: prozac 20 mg daily zrytec daily baby asprin daily prenatal vitamin daily
Current Illness: no
Preexisting Conditions:
Allergies: sulfa
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 3rd pregnancy; upcoming Delivery due date December 9, 2021;


VAERS ID: 1759251 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Balance disorder, Chest pain, Cold sweat, Dizziness, Gingival pain, Hyperhidrosis, Injection site mass, Injection site swelling, Lymphadenopathy, Oral pain, Paraesthesia, Toothache
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gingival disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Tingling in Arms, Chest Pain, Mouth, Gum & Teeth Pain, Swollen Lymph Nodes, Swollen and raised lump at injection site, Hot and cold Sweats, Dizziness, loss of balance


VAERS ID: 1759285 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Confusional state, Disorientation, Fatigue, Myalgia, Pyrexia, Slow response to stimuli
SMQs:, Rhabdomyolysis/myopathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sotalol, azithryomycin, xarelto, triamterene, erythromycin,
Current Illness:
Preexisting Conditions: compromised lung function, heart arrhythmia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The morning after the booster shot, my mother experienced confusion, disorientation, and memory loss. This was in addition to the more "normal" side effects of fatigue, muscle aches, and low grade fever. From about 12 to 36 hours after the booster shot, my mother couldn''t tell me the day, the date, or who the president was. She did know my name, and after some consideration, our pets'' names, but couldn''t name her siblings. She had trouble completing everyday tasks like taking her pills and had low situational awareness. She was very vague in her verbal responses to me, and I could tell she did not have full comprehension of what I was saying or asking.


VAERS ID: 1759287 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 3 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Extra dose administered, Injection site bruising, Injection site cellulitis, Injection site discomfort, Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Medication errors (narrow)

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

Write-up: Facility clinic thru Specialty Rx pharmacy provider gave the resident a booster Pfizer vaccine in the left arm 6 inches below the acromion process, which is below the deltoid muscle. The injection went into the tissue below the deltoid resulting in pain, discomfort, redness, bruising, and warmth to area from site of injection extending past the elbow. The attending physician examined the resident and ordered Keflex 1000mg every 12 hours for 7 days, for a diagnosis of cellulitis.


VAERS ID: 1759301 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-11
Onset:2021-10-02
   Days after vaccination:264
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 2 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: ABBOTT ID NOW COVID-19 Positive
CDC Split Type:

Write-up: Patient received COVID booster shot on 9/29 started symptoms on 10/2 and when she obtained a COVID test the PCR test result was positive.


VAERS ID: 1759305 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301558A / 1 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Confusional state, Decreased appetite, Diarrhoea, Dizziness, Dyspepsia, Dysphagia, Dyspnoea, Epistaxis, Fatigue, Injection site pain, Migraine, Nausea, Oropharyngeal pain, Pain, Pyrexia, Rash, Throat tightness, Tremor
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: First shot reactions October 2nd - 3rd: Pain on the injection sight soreness. Tiredness Throat pain like I?m catching a cold/fever Difficulty swallowing Tightness in throat Body aches Diarrhea Nausea Dizziness Confusion Migraine No appetite Chills started @ 2116 Difficulty breathing @ 2145 Heartburn Stomach cramps Shaking October 4th All of the above but manageable Rash around mouth Nose bleeds


VAERS ID: 1759316 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Pain
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: Fast Acting Tylenol and Arthritis Tylenol
Current Illness: na
Preexisting Conditions: na
Allergies: na
Diagnostic Lab Data: none
CDC Split Type:

Write-up: I felt achy all over. It felt like I had been in a wreck or something. My entire body was achy. However, I did NOT have a fever or a Headache. Just was achy.


VAERS ID: 1759319 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076C21A / 3 AR / IM

Administered by: Work       Purchased by: ?
Symptoms: Dysphagia, Extra dose administered, Paraesthesia oral, Throat clearing
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), 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? Yes
Hospitalized? No
Previous Vaccinations: Described symptoms after 1st Moderna vaccination of tingling in mouth, numbness to right side of face, throat tingling-states fo
Other Medications: Self-medicated (at the direction of her PCP) with Benadryl and Prednisone
Current Illness: RA-
Preexisting Conditions: RA-takes Embrel
Allergies: Naproxyn Sulfa Oxycodone Cefdinir Preservative in ppd
Diagnostic Lab Data:
CDC Split Type:

Write-up: Presented to COVID Vaccine clinic to receive 3rd Vaccine (immunocompromised); verbalized prior history of mild-mod reaction to 1st Moderna that she self-treated with Benadryl, no Epi or ED evaluation; second vaccination, similiar sx''s slightly worse but still no Epi/ED visit; Received 3rd vaccine, being observed x 30 minutes; after 15 minutes described sx''s similar to previous moderna vaccinations--tingling feeling in mouth/tongue, throat clearing, tingling right side of face (all experienced with first dose) but she indicated they were ''worse"; 1102 indicated sx''s were worsening--airway clear/good trach sounds/sats good - administered Benadryl--some improvement of sx''s within 15 min; continued to improve x 10 minutes then described return of sx''s (mouth tingling/tongue feeling swollen, difficulty swallowing although able to take po water); VSS--at this point 911 was called so she could be brought to the hospital for further evaluation and monitoring; No EpiPen was administered


VAERS ID: 1759335 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-09-29
Onset:2021-10-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bone pain, Diplopia, Extra dose administered, Injection site pain, Myalgia, Pain in extremity, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Osteonecrosis (broad), Ocular motility disorders (broad), Tendinopathies and ligament disorders (broad), Medication errors (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: Rozerem, atorvastatin, omeprozole, generic lexapro, terfinadine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: day after injection site was VERY sore (no reaction from first two shots; this was the booster shot); that lasted for several days, along with unusual pain in muscle/bone area in right hand (shot was in right arm).; then starting sometime a couple days ago, started having problems with double vision/blurred vision, never had this problem before...


VAERS ID: 1759337 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-26
Onset:2021-10-02
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Ear discomfort, Epistaxis, Extra dose administered, Nasal congestion, Pain, Sinus congestion, Upper-airway cough syndrome
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Vitamin Cl Multivitaminl Ibandronate; Lovastatin; Losartanl Atenolol; Amlopipine; Famotine; Levothryroxine; Estradiol
Current Illness: none
Preexisting Conditions: hypothyrodism; hypertension; GERD; recurrent maxillary sinusitis
Allergies: codiene; penicillin V potassium
Diagnostic Lab Data:
CDC Split Type:

Write-up: chills, body aches, nasal congestion, sinus congestion, post nasal drainage, epistaxis, ear fullness. starting on 10/2/21. Husband recently tested positive. Received 3rd dose of Pfizer at grocery store, not at clinic


VAERS ID: 1759346 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PF2588 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Chest pain, Lymphadenopathy
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: MODERATE PAIN IN LEFT AXILLA, VISIBLE INFLAMED LYMPHATIC GANGLION LEFT AXILLA. INTENSE CHEST PAIN, LEFT SIDE.


VAERS ID: 1759357 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Axillary pain, Fatigue, Lymphadenopathy, Nausea, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Aside from fatigue and nausea on day two, I have Severe pain in my left arm - ping pong size ball was formed in my arm. I tried rubbing it. Later that night and following morning (day 3) I woke up with pain in my left armpit/lymph nodes area. It is also noticeably swollen compared to my right side.


VAERS ID: 1759358 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-19
Onset:2021-10-02
   Days after vaccination:225
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: generally felt ill, had a syncopal episode


VAERS ID: 1759427 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Eye irritation, Headache, Limb discomfort, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: tylenol
Current Illness: none
Preexisting Conditions: asthma
Allergies: none
Diagnostic Lab Data: I also got my flu vaccine at the same time
CDC Split Type:

Write-up: after few hours my left arm is heavy and experience a covid related symptom like muscle aches, chills, headache, burning sensation on my eyes


VAERS ID: 1759435 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, ibprofen, multivitamin, vitamin D
Current Illness: none
Preexisting Conditions: hypothyroidism, migraine
Allergies: Thimerosal
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Fever, cold chills, aching, headache Treatment: Tylenol, ibuprofen Outcome: resolved in less than 48 hrs


VAERS ID: 1759443 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Axillary and supraclavicular adenopathy with mild pain. Treated with Ibuprofen.


VAERS ID: 1759500 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood pressure increased, Chest discomfort, Feeling abnormal, Palpitations, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), 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:
Preexisting Conditions: Hypertension
Allergies: Guaifenesin Insect Extract
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt states, received the vaccine 10/1/2021, about 9 am, waited 15 minutes following vaccine, felt okay. Awoke the next morning 10/2/2021.about 430 am from symptoms tachycardia, bounding pulse, chest tightness/discomfort. Pt states she doesn''t describe as chest pain. No Shortness of breath. Went back to sleep. At about 11am, symptoms felt: no energy, not feeling right. Decided to check blood pressure 238/152. Took PRN medication Clonidine, in addition to relaxed, non-pharmacy interventions to bring blood pressure down. Clonidine and Baby ASA (81 mg). Denies symptoms of chest pain, jaw pain, shortness of breath. Pt reported the hypertension symptoms improved. Did not report actual numbers. Does not believe symptoms were related to anxiety of getting the vaccination. 10/4/2021: symptoms: energy is not back. checked blood pressure today, still slightly elevated but much improved. "doing what I need to do to keep it down. Denies chest pain, shortness of breath. "I manage my blood pressure without medications, my doctor works with me to manage without medication,. I made some lifestyle changes". Pt "does not feel at risk" to go to the ED or be seen at this time, wanted information documented. Taking action at home to bring blood pressure down. Clinic provider notified for review. Recommend office visit for blood pressure check. Per patient, sounds like symptoms are under control.


VAERS ID: 1759572 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Vaccination complication
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, synthroid, statin
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: No self reporting
CDC Split Type:

Write-up: Covid Arm with third dose - self reporting


VAERS ID: 1759613 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Diarrhoea, Nausea, Palpitations, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin Prozac Abilify Dicycolomine Verapamil Deplin Guanfacine ER
Current Illness: None
Preexisting Conditions: Inappropriate Sinus Tachycardia, dysautonomia, hypermobile Ehlers Danlos Syndrome, irritable bowel syndrome, depression, anxiety, neuropathic pain, Renal calculi, Mixed hyperlipidemia, thrombocytopenia, Iron deficiency anemia, abnormal vaginal bleeding
Allergies: N/A
Diagnostic Lab Data: None recieved
CDC Split Type:

Write-up: nausea, heart racing, vomiting, diarrhea, chills, hives


VAERS ID: 1759673 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Chest X-ray, Chest discomfort, Dyspnoea, Electrocardiogram, Erythema, Full blood count, Metabolic function test, Pruritus, Tachycardia, Urticaria, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), 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), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall XR, Adderall, Azelastine Nasal Spray, Onfi, Doxycycline, Metoprolol Succinate XR, Naratriptan, Vitamin D3
Current Illness:
Preexisting Conditions: Epilepsy, ADHD
Allergies: Sulfa Antibiotics, Codeine, Dilaudid, Lamotrigine, Diclofenac, Chlorhexidine, Senna, Mixed Grasses, Gramineae Pollens, Timothy Grass Pollens, Grass Pollen, Nickel
Diagnostic Lab Data: Chest Xray, EKG 12 lead, CBC w/Differential, Basic Metabolic Panel
CDC Split Type:

Write-up: Hives, Itching, Redness, Tight chest, Difficulty breathing/slight wheezing, tachycardia, elevated blood pressure. Received 1 epipen to the thigh, Solumedrol, Benadryl, Hydroxyzine, Albuterol. Monitored for 2.5 hours, transferred to hospital and monitored for another 2 hours. Discharged with RX for Prednisone x 4 days


VAERS ID: 1759691 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-27
Onset:2021-10-02
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site rash, Injection site reaction, Pain, Rash, Rash macular, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient stated they were taking Ibuprofen, acetaminophen, diphenhydramine and ice for an injection site reaction.
Current Illness: none
Preexisting Conditions: form was checked yes but did not specify what chronic health condition
Allergies: unsure of any allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had common injection site reaction from the date of vaccination until Thursday 9/30. At that point the reaction had disappeared. However, on Saturday 10/2 the patient found a rash on her arm that was in a different location that the injection site reaction. The reaction was red splotches that were reddish/pink, slightly warm and painful. The red splotches also were migrating up and down the arm. The reaction was reported to the pharmacy 10/4 by the patient. She was advised to contact her PCP.


VAERS ID: 1759702 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-09-29
Onset:2021-10-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 3 - / IM

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

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

Write-up: Dizziness


VAERS ID: 1759715 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

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

Write-up: Patient presented with redness, swelling, and itching at injections site. Pt was given antibiotics for treatment.


VAERS ID: 1759742 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-20
Onset:2021-10-02
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series


VAERS ID: 1759756 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Confusional state, Dizziness, Dyskinesia, Fatigue, Headache, Malaise, Moaning, Unresponsive to stimuli, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dyskinesia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Other ischaemic heart disease (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: -Head jerking -not responding -confusion -lost understanding of where and what was happening - I called for help, while my husband (patient) stood up and started moaning and swearing in pain -grabbed heart while groaning, ?ahhh my heart? -technician came out and instructed him to lay on ground and raise legs -said he was dizzy and sick to his stomach -raised legs for 15 min before deciding to leave and go home - while driving home, he asked me to pull over - he vomited in a parking lot -arrived home, (30 min drive) he went straight to the bathroom said he needed to vomit again -laid on bedroom floor with feet propped up as instructed -couldn?t walk much -by 8:00 pm he was well enough to move locations and crawl in bed -did not want to walk -fell asleep -woke up the next day feeling fatigued color in face was a little better -rested more than usual the next day -complained of headache and fatigue


VAERS ID: 1759757 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Cough, Dyspnoea, Headache, Oropharyngeal pain, Paranasal sinus discomfort, Rhinorrhoea, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (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: Influenza
Other Medications: N
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shortness of breath, wheezing, cough, sore throat, sinus pressure, headache, runny nose, chills


VAERS ID: 1759812 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-09-16
Onset:2021-10-02
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 2 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Generalised tonic-clonic seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: October 25, 1999 - First MMR vaccine, Pt was 9 months old, 104.1 degree fever, full body rash, weight loss.
Other Medications: Keppra (seizure medication) and Falmina (birth control)
Current Illness: Tested positive for covid 19 virus 4 weeks before receiving my first shot of the Pfizer vaccine.
Preexisting Conditions: Epilepsy
Allergies: Benadryl, latex
Diagnostic Lab Data: None at this time. Appointments are being scheduled at this time with multiple specialists.
CDC Split Type:

Write-up: Two weeks after receiving my second dose of the Pfizer vaccine I had a grand mal seizure for the first time in 8 years. With no medication changes and no major life changes I believe the only thing that could have caused the seizure was the vaccine. I received my first dose of Pfizer just 3-4 weeks after testing positive for the virus itself, which I later found out you?re supposed to wait a minimum of 90 days after testing positive for the virus to get the vaccine. After going to my nurse with the new information I found out about having COVID and waiting to get the second shot, I was advised I would be okay and should complete the series, in hindsight I wish I would not have received the vaccine when I did.


VAERS ID: 1759818 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

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

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

Write-up: Swollen area at site of injection 4 " Diameter, hot to touch, painful, ache in joints of arm , elbow, wrist.


VAERS ID: 1759835 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Lymph node pain, Lymphadenopathy, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: losartan/HCTZ xarelto 10mg
Current Illness: no
Preexisting Conditions: intermittent issues with blood clots, HTN
Allergies: nkda
Diagnostic Lab Data: note
CDC Split Type:

Write-up: swelling rash and swollen distal cervical/supraclavicular lymphadenopathy and pain 24 hr after and then lymph node presented about 72 hr after


VAERS ID: 1759837 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Confusional state, Dyspnoea, Electrocardiogram abnormal, Erythema, Feeling hot, Hyperhidrosis, Left atrial enlargement, Palpitations, Tremor
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin 40 mg Niacin 250 mg Tri-Lo-Sprintec 25 mcg
Current Illness:
Preexisting Conditions: Malignant Neurocardiogenic syncope Orthostatic Hypotension
Allergies: Advair
Diagnostic Lab Data: My heart rate was high at least 145 at one point and blood pressure 176/122. They gave me Labetalol in the IV. My bloodwork ran for a heart attack came back normal. My EKG showed a probable left atrial enlargement. Follow up appointment tomorrow with primary doctor.
CDC Split Type:

Write-up: Within seconds warm pressure/chest discomfort started in the center of my chest and grew outward rapidly. I struggled to breathe and my heart began to race and pound hard. I began to feel that something was majorly wrong. I began sweating and my hands were shaking. I was told that my face was really red. My family drove me to the local emergency room. When I arrived at the hospital I was confused and struggled to answer basic questions like my address.


VAERS ID: 1760004 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary mass, Axillary pain, Injected limb mobility decreased, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma High blood pressure Heart disease
Allergies: Latex Iodine Bupropion Shrimp
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Lump under left armpit the size of a baseball, painful arm, painful armpit. Can?t raise left arm. Treatment is rest for 2 days and Mobic.


VAERS ID: 1760009 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Diarrhoea, Fatigue, Headache, Heart rate increased, Myalgia, Nausea, Pyrexia, Throat irritation
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Alegra, Buspirone, Vyvanse
Current Illness: None
Preexisting Conditions: Hashimoto''s, hypothyroidism, solar urticaria and past history of non-Hodgkin''s lymphoma (15 years prior).
Allergies: Solar urticaria
Diagnostic Lab Data:
CDC Split Type:

Write-up: Abdominal cramping and diarrhea four hours after receiving shot. Fever gradually reached 104 degrees at 22 hours after shot (despite taking fever-reducing medication). Other symptoms persisting at 50 hours post shot: muscle and joint pain, headache, fatigue, throat irritation, increased heart rate, fatigue, fever abdominal cramping and nausea.


VAERS ID: 1760243 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-11
Onset:2021-10-02
   Days after vaccination:113
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Fall, Open reduction of fracture, Patella fracture, Radius fracture, SARS-CoV-2 test positive, Ulna fracture
SMQs:, Accidents and injuries (narrow), Osteoporosis/osteopenia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: vitamin C, atorvastatin, vitamin B complex, vitamin D3, carvedilol, clopidogrel, levothyroxine
Current Illness:
Preexisting Conditions: history of CAD, HTN, and meningioma currently on clopidogrel
Allergies: NKDA
Diagnostic Lab Data: COVID status positive on 10/2/21.
CDC Split Type:

Write-up: Patient received Pfizer COVID vaccine on 5/14/21 and 6/11/21. Patient admitted to our facility on 9/29/21 s/p a mechanical fall down 2-3 concrete steps with RIGHT distal radius and ulna styloid fracture and LEFT comminuted patella fracture. Pt underwent ORIF of the RIGHT distal radius and ulna fracture and ORIF of the LEFT patella on 9/30/21. On 10/2/21, patient tested positive for COVID but asymptomatic. As of 10/4/21, patient is still admitted in the med/surg unit post ORIF.


VAERS ID: 1760245 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-24
Onset:2021-10-02
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 061E21A / 1 LA / IM

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

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

Write-up: Red itchy and swollen area over the injection site. It started 8 days after the vaccination and has been occuring for 3 days.


VAERS ID: 1760252 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site rash, Injection site reaction, Lymphadenopathy, Muscle twitching, Neck pain, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dyskinesia (broad), Dystonia (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:
Other Medications: multi-vitamin
Current Illness: none
Preexisting Conditions: none
Allergies: penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Covid Arm at the injection site. Rash at least 6 inches in length and 5 in width. Swollen lymph nodes at the axillary and supraclavicular. Huge lump on my neck. All very painful and sore to the touch. Muscle twitching (all over my body) that lasted for 7 hours, that started 9 hours after the injection.


VAERS ID: 1760257 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blindness, Fall, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Her vision started half black then progressed to full black and then she passed out in the shower, falling. When she came back to consciousness, her vision stayed black for several seconds.


VAERS ID: 1760260 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Headache, Malaise, Nausea, Pain, Pyrexia, Somnolence, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Phentermine, synthetic thyroid taken mornong of shot and the following morning.
Current Illness: Cold/sinus
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: I was sick with body aches, fever, sleepy, weak, headaches, the first shot was worse. Started feeling change in arm within 20 min of the first shot with symptoms lasting 48 hours. Second shot symptoms didn''t start until the next morning and I had nausea and hive on my arm, still have some symptoms Monday.


VAERS ID: 1760274 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Burning sensation, Eye irritation, Swelling of eyelid
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Corneal disorders (broad), 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none reported
Current Illness: none reported
Preexisting Conditions: none reported
Allergies: none reported
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Apprx 5 hrs after vaccination, developed burning sensation in face and eyes, awoke from sleep later that evening with very swollen eyelids. No other skin sxms, resp sxms, CP, GI or neuro sxms. Swelling resolved with cool compresses and OTC Benadryl over several hrs.


VAERS ID: 1760275 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EX9231 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Back pain, Chills, Facial pain, Injection site pain, Mobility decreased, Pain, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan Potassium 50 mg PO daily Crestor 10 mg PO nightly
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: None to date - I left a message for my HC provider am awaiting a response or a call back.
CDC Split Type:

Write-up: I developed severe hip and lower back pain the 2nd day after the 2nd dose - I have seen a few chiropractors without relief. After I received the 3rd booster shot on Oct 1st, the next day, I had severe hip and lower back pain even worst than the previous shot. I couldn''t bend, or sit without difficulty (excruciating pain). In addition, I experienced severe chills, face ache and sharp stabbing pains in my arms and legs. I also had abdominal pain, soreness at the site (not severe) and a fever of 100.0. At the time of the 3rd shot I was trying to cope with the pains, still not being quite sure that this was the source. However I''m not convinced that this is the source of my hip and back pain and it''s not even worst.


VAERS ID: 1760276 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Injection site warmth, Insomnia, Rash, Rash erythematous, Rash papular, Rash pruritic
SMQs:, Anaphylactic reaction (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa and ophthalmic erythromycin each caused itching one time many years ago.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I had no immediate reaction at all to the vaccination. I awoke the next morning with only moderate pain and warmth at the injection site. However, 24 hours after the injection, I started developing isolated very small areas of itching -- these were tiny raised itchy spots, almost specks, that were either red, light pink, or colorless. The spots were very far apart from each other on my chest, abdomen, arms, legs, and scalp -- they did not cluster into any kind of rash formation. I would say that there were 10 to 20 spots at any one time, which would fade away, and then others would occur. I think the occurrence of these itchy spots may have interfered with my sleep (or maybe it was anxiety or something else from the vaccine), because I was practically sleepless the first night that this occurred. By 60 hours after the vaccination, the itchy spots were appearing with less frequency, and now 80 hours post-vaccination, there are only a few, although there are still new ones occurring. I am not reporting this as a major adverse event, but I wanted to document it for your records and because it would have been helpful and reassuring for me to find online information about such a reaction when it was at its worst.


VAERS ID: 1760289 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-04
Onset:2021-10-02
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atorvastatin 10mg daily ergocalciferol 50,000IU Famotidine 20mg BID Hydrochlorothiazide 25mg Daily Metoprolol 25mg BID Mirtazapine 15mg HS Zinc acetate 50mg
Current Illness:
Preexisting Conditions: Hypertension, dyslipidemia, gastro-esophageal reflux disease, overweight, plantar fasciitis, anxiety, urinary frequency, constipation, insomnia, obstructive sleep apnea, lymphedema, peripheral edema, vitamin d deficiency.
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient contracted COVID-19 after being fully vaccinated.


VAERS ID: 1760447 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Oral herpes, Peripheral swelling, Pyrexia, Skin warm, Speech disorder
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal infections (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: Mid-Saturday afternoon - 10/2 - Patient reports a temperature of 100F. She understands as a former nurse that a fever is part of side effects. Today she said her fever peaked on Saturday to 104 F, but temperature now normal She has fever blisters in her mouth that makes it difficult for her to talk. Also, she says her vaccinated arm is red, swelling, and hot to touch from elbow to shoulder. I counselled her to see her PCP ASAP. She said when she woke up today she took some benadryl and valacylovir for her fever blisters. Patient finally said that she''d call her PCP after speaking to me.


VAERS ID: 1760453 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC 3183 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Turmeric PRN Vitamin D PRN Alpha Lipoic Acid PRN
Current Illness: None
Preexisting Conditions: Obesity (Class I to II) Mild OSA Neurocardiogenic Syncope
Allergies: NKDA
Diagnostic Lab Data: None. Am a nurse practitioner; reporting as patient (received booster dose of Pfizer); deferring any work up for 4 weeks is plan. Likely association temporally with vaccine. Vaccine likely etiology; presuming reactionary lymphadenopathy only for now.
CDC Split Type:

Write-up: No major systemic symptoms; minor, unilateral, ipsilateral, supraclavicular lymphadenopathy; single, mobile, slightly tender, not hard or fixed; approximately a cm; more medial and somewhat more proximal (roughly parasternal line)


VAERS ID: 1760467 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Cyanosis, Headache, Heart rate increased, Pyrexia, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I take medication at night: Zoloft 25mg daily Vitamin D 50mcg daily Prenatal daily (breastfeeding)
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: August 21st positive for COVID-19 - lingering symptoms: joint pain, LUQ pain, random headaches, sore muscles in legs. September 11th first dose of Pfizer (EW0191) sore arm, headache/tired next day. Worsening joint pain. Around 11:30am October 2nd received second dose of Pfizer. By 11:45 pm rigors, blue lips/fingers, elevated heart rate. Took scorching hot shower and bundled up. Fever followed 100.8, headache, took extra strength Tylenol 1000mg total. Relieved symptoms. October 3rd around 3:00pm had same symptoms , same treatment. Relieved fever. October 4th happened again around 4:15pm same treatment.


VAERS ID: 1760470 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Discomfort, Gait disturbance, Headache, Pain, Pain in extremity, Pyrexia, Sleep disorder, Swelling, Tremor
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Unable to sleep the night of the vaccine due to sore arm and being uncomfortable. Next day whole body pain, sore arm, swelling around collar bone, chills, shaking, fever, headache, hardly able to walk around


VAERS ID: 1760475 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3013041 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Nausea, Vomiting projectile
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Saxenda 2.4mg daily, Prilosec 20mg daily, Wellbutrin xl 300mg daily
Current Illness: None
Preexisting Conditions: Prediabetes, depression
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness, nausea for 2-3hrs starting 26 hours after vaccine, then projectile vomiting approximately 28 hours after. 48hrs later still nauseated, dizzy and headache


VAERS ID: 1760673 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Condition aggravated, Gingival ulceration, Insomnia, Lyme disease, Migraine, Mouth ulceration, Pain of skin, Spinal pain, Tongue ulceration, Vaccine positive rechallenge
SMQs:, Severe cutaneous adverse reactions (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Gingival disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Arthritis (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: Had similar symptoms following first dose that were reported at the time. I was 22 and received the Pfizer vaccine first dose o
Other Medications: Sprintec, CBD + melatonin gel caps
Current Illness: None
Preexisting Conditions: Lyme Disease
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Similar to first dose, had a bad Lyme disease flare up. This time was worse and was unable to sleep or get out of bed due to horrible pain in spine, rest of back, and joints. Experienced a debilitating migraine that made my skin painful to the touch. Began to develop oral ulcers three days after the second dose on tongue and gums in the back of the mouth.


VAERS ID: 1760971 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-01
Onset:2021-10-02
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

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

Write-up: common sore arm for 1 day. Pain in my hand for 1 day. Began to have a fever by 3 pm throughout the night (99.6 F) Temperature normal in late morning.


VAERS ID: 1760979 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0037F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Mouth swelling, Palpitations, Swelling face, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Severe, Systemic: heart palpitations-Severe


VAERS ID: 1761016 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild


VAERS ID: 1761023 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect product formulation 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: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1761027 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE QUADRIVALENT) / SANOFI PASTEUR - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site pain, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lisinipril, sertraline, folic acid, fenofibrate, omeprazole, Vit B complex, Vit C, Vit D3, Fish oil, CoQ10 Botox Q3mo. Prolia Q6mo
Current Illness:
Preexisting Conditions: arthritis, hypertension, osteoporoses, chronic kidney disease, GERDs , anxiety, migraines
Allergies: Sulfa, paroxetine,codeine, vicodan, tramadol , tramidine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Mildly sore injection sites in both arms lasting 2 days Muscle aches, fatigue and Fever to 100.5 Began 16 hrs after injections. Took Tylenol and slept a lot. Normal in 24 hrs.


VAERS ID: 1761030 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-07
Onset:2021-10-02
   Days after vaccination:117
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, 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? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amiodarone 200 mg Tablet Directions: 1 tablet oral daily (Active) amLODIPine (NorvASC) 5 mg Tablet Directions: 1 tablet oral daily (Active) clopidogrel 75 mg Tablet Directions: 1 tablet oral daily (Active) famotidine (Pepcid) 20 mg
Current Illness:
Preexisting Conditions: CAD, COPD COPD, O2 dependent; Depression, Diabetes, GERD, HTN, Obesity; Other History of Polyp of Colon, Insomnia, Anxiety Disorder. CABG done at Medical Center within the past month; Tracheostomy; Other Cardiac Catheterization, Colonoscopic Polypectomy, Hx CAD w/ Stent Placement, PEG Tube Maintenance. Smoking Status Former Smoker.
Allergies: Codeine, penicillin, azithromycin.
Diagnostic Lab Data: 10/2/21, SARS-CoV-2 PCR (POSITIVE).
CDC Split Type:

Write-up: 71-year-old female with h/o COPD, CAD, HTN ,a.fib receved her 2nd dose of covid vaccine in may. started with cough sob hence brought into ED. tested postive for covid


VAERS ID: 1761033 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Diarrhoea, Headache, Nausea, Pyrexia, Seizure
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Keppra-for epilepsy Clonazepam- for epilepsy Remeron- for long haul COVID-19 to help with appetite Tylenol and Ibuprofen to hep with muscle aches and fever form vaccines.
Current Illness: Long Haul Covid-19 diagnose in April- mar 2021. Epilepsy diagnosed 9 years ago
Preexisting Conditions: Epilepsy Long Haul COvid-19
Allergies: Scallops Lidocaine
Diagnostic Lab Data:
CDC Split Type:

Write-up: High fever of 103, seizure hours after vaccine, chills, headache, nausea, diarrhea


Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=46&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