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

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



Case Details (Reverse Sorted by Onset Date)

This is page 47 out of 8,010

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VAERS ID: 1761193 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-13
Onset:2021-10-02
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, COVID-19, Cardiac flutter, Electrocardiogram abnormal, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ascorbate sod-zinc-echinacea (Zinc with Vit C and Echinacea) Lozenge (Active) ascorbic acid (vitamin C) (Vitamin C) 500 mg Tablet Directions: 1 tablet oral daily (Active) cholecalciferol (vitamin D3) 1,000 unit Capsule Directions: 1 c
Current Illness:
Preexisting Conditions: HTN. Appendectomy, Addt''l Surgical History Partial thyroidectomy. Smoking Status Never Smoker.
Allergies: NKDA
Diagnostic Lab Data: SARS-CoV-2 Antigen (+) 10/1/2021
CDC Split Type:

Write-up: 57 year-old male with no known prior cardiac hx, with hx of HTN off BP rx, admitted with Covid19+ and atrial fibrillation, unclear if new. He had fevers 4 days ago and the next day had a covid19 + test. He was started on 8 medications by an Urgent care center, one of which is Prednisone. He states states that after taking the first dose of Prednisone, he started to have fluttering in his chest which seemed to be more persistent than usual. He was scheduled to come to the ED today for monoclonal antibody infusion and when he had his EKG taken, he was noted to be in atrial fibrillation w/ controlled VR, for which he was admitted to the Observation Unit.


VAERS ID: 1761207 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Tennessee  
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 - / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Chills, Cough, Dizziness, Feeling abnormal, Headache, Hyperhidrosis, Malaise, Muscle spasms, Oropharyngeal pain, Respiratory tract congestion, Somnolence, Throat irritation
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (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 (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amox-clav, meloxicam, omeprazole, Test C, ibuprofen, Tylenol, Anastrozole
Current Illness: Tested negative for Covid on 9/13/21 however was told I have a Sinus infection, as being treated for this with the amox-clav.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None yet, will be getting a covid test today 10/5/21
CDC Split Type:

Write-up: Shot was received around 2pm, by 4pm on Oct 2,2021 is when I started to feel ill. 10/2/21 I couldn''t stay awake I slept to 7pm woke up for 2 hours and slept till the following morning. I currently am still having all the following issues as of 10/5/21. Headache, dizziness, foggy feeling in head, All of my muscles are cramping, all of my joints hurt, chills, sweating, throat hurts/ burns bad, now have really bad cough, chest hurts to take deep breathes, Very congested


VAERS ID: 1761219 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: D.C.  
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 EW0170 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Condition aggravated, Lethargy, Migraine, Muscle fatigue, Nausea, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute pancreatitis (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), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Fever/chills, nausea, migraine, muscle fatigue. Age: 37. Jan 2021. 2nd dose of Pfizer Covid vaccine
Other Medications: Zoloft, Synthroid, Armodafinil
Current Illness: None
Preexisting Conditions: Depression, Hypothyroidism, High cholesterol, Narcolepsy
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 10/2/21: Fever/chills, nausea, migraine, extreme muscle fatigue, lethargy This led to an episode of Vasovagal syncope in which the patient needed to be taken to the ED. Fluids were given (Normal saline, then Lactated ringers) and Metoclopramide for the nausea and migraine.


VAERS ID: 1761220 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-13
Onset:2021-10-02
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Atrial fibrillation, Chest pain, Cough, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen,albuterol HFA inhaler 2 Puff ,apixaban, dextrose diltiazem
Current Illness:
Preexisting Conditions:
Allergies: Metoprolol Succinate
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized 81 y.o male with a history of COPD, CAD, CKD stage III, aorta dilation, type II DM, HTN, OSA and restrictive lung dz with chronic respiratory failure on O2 that presents with chest pain today and some shortness of breath for the past few days. He was noted to have A fib RVR with rates in the 140s and was started on a dilt gtt. He feels his SOB and chest pain is improved since his heart rate is improved. He denies any jaw pain or arm pain. The pain was mostly in the left chest. He is on 4L O2 at baseline, though his O2 orders say 2L at rest and 4L with activity. He said he has had some coughing, but doesn''t feel it''s worse than baseline.


VAERS ID: 1761231 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-23
Onset:2021-10-02
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B2A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site rash, Rash erythematous
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish oil, Multi vitamins
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 24 Sep 2021- Day after shot, fatigued and severe headache. 2nd Oct 2021 - A week later noticed red spotty rash on inoculated Arm, rash has since subsided as of 5 Oct 2021


VAERS ID: 1761233 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Washington  
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 - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Headache, Injection site pain, Injection site swelling, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, mucsle and joint pain, injection site swelling and soreness, headache, all lasting 2days.


VAERS ID: 1761240 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary 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: alendronate (FOSAMAX) 70 mg Oral Tablet CALCIUM GLUCONATE ORAL famotidine (PEPCID) 20 mg Oral Tablet multivitamin Oral Tablet sennosides-docusate sodium (SENOKOT-S) 8.6-50 mg Oral Tablet vitamin A (AQUASOL A) 10,000 unit Oral Capsule vitami
Current Illness: None
Preexisting Conditions: Mastalgia Constipation Acute GI bleeding Osteoporosis Osteopenia Arthritis Hot flashes
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Armpit on the vaccine arm became swollen and painful.


VAERS ID: 1761242 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
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 - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Arthralgia, Chills, Decreased appetite, Fatigue, Headache, Injection site erythema, Injection site pain, Injection site swelling, Malaise, Myalgia, Nasal congestion, Nausea, Pain, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Day of vaccine, experienced burning sensation in my torso along with the pain, redness and swelling at injection site. That evening went to sleep with the chills. Woke up at 0600 on 10/02, bad headache, nasal congestion and generally feeling unwell. Took Tylenol and went back to sleep. Woke up around 0900, extreme muscle and joint soreness. No desire to eat. Drank fluids for most of the morning. Ate toast and soup. Later in the evening I began to experience severe nausea. Vomited three times. Sunday morning woke up again with a headache and body pains continuing. Experienced nausea on and off the rest of the day. Generally fatigued all day again. Monday 10/04, symptoms of muscle pains and fatigue persist.


VAERS ID: 1761256 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Tennessee  
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 FF8839 / 1 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Chest pain, Injection site erythema, Injection site pruritus, Injection site rash, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, Ibuprofen, Zyrtec, Flonase, Macrobid 100mg
Current Illness:
Preexisting Conditions: High cholesterol, frequent UTI
Allergies: Z-pack
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash, redness, swelling, and itching at injection site (2" diameter) within 2 hours after injection and continues 3 days after. Chest pains within 1 hour of injection and continued for 1 day.


VAERS ID: 1761267 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Indiana  
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 / 2 RA / SYR

Administered by: Senior Living       Purchased by: ?
Symptoms: Arthralgia, Pain
SMQs:, Arthritis (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: Bioxen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Body / bone joint aches


VAERS ID: 1761269 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

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

Write-up: Herpes Zoster


VAERS ID: 1761272 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-28
Onset:2021-10-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Musculoskeletal stiffness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 75 mcg, spironolactone 50 mg,, losartan 200mg, q-var,Tylenol, fish oil, vit d, baby aspirin, rosuvastin 5 mg, magnesium citrate 200 mg,
Current Illness: Recent back surgery
Preexisting Conditions: Asthma, blood pressure and diabetes (both well controlled). High cholesterol well controlled back issuEs
Allergies: Amoxicillin-pot clavulavte, codeine, ezetimibe, gluten,dust mite,lactose,opioids, penicillin, some perfumes, most statins, tobrsmycin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme muscle soreness and stiffness


VAERS ID: 1761290 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-05
Onset:2021-10-02
   Days after vaccination:58
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

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

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

Write-up: hospitalization (non-ICU)


VAERS ID: 1761296 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Maryland  
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 (MODERNA)) / MODERNA 039D21A / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Persistent vomiting. Phenergan given by MD, symptoms still persist


VAERS ID: 1761306 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-12
Onset:2021-10-02
   Days after vaccination:232
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 LA / IM

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

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

Write-up: hospitalization (non-ICU)


VAERS ID: 1761310 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-22
Onset:2021-10-02
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA NA / 2 UN / UN

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

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

Write-up: hospitalization (non-ICU)


VAERS ID: 1761327 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-25
Onset:2021-10-02
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Intensive care
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: hospitalized (ICU)


VAERS ID: 1761365 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: New York  
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 301308A / 2 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Chills, Diarrhoea, Headache, Heart rate increased, Oropharyngeal pain, Pain, Pain of skin, Pyrexia, Renal pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Fever, chills, headache, body aches, sore throat, diarrhea, top of head hurts to touch, pain in kidney, elevated HR all lasting for days


VAERS ID: 1761380 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-25
Onset:2021-10-02
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ERR2613 / 2 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 AR / IM

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

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

Write-up: Dose 1 COVID vaccine on 3/4/21, dose 2 on 3/25/21, patient admitted and tested positive for COVID in the hospital on 10/4/21


VAERS ID: 1761451 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-17
Onset:2021-10-02
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Exposure to SARS-CoV-2, Headache, Malaise, Nausea, SARS-CoV-2 test positive, Vaccine breakthrough infection, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: HTN, DM Type II, HLD, CKD, Hypothyroidism, Neuropathy
Allergies: No Known
Diagnostic Lab Data: Covid + 10/02/2021
CDC Split Type:

Write-up: Breakthrough Covid + male presents to the ED with general malaise about 10 days ago and that over the past 2 days he has had a HA associated with N/V, unrelieved by taking tylenol around the clock. Pt states his sister tested positive for COVID-19 a few days ago and he was recently in contact with her.


VAERS ID: 1761544 (history)  
Form: Version 2.0  
Age: 11.0  
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 FF2587 / 2 RA / IM

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

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

Write-up: There was no adverse event at all reported. Vaccine was administered to an 11 year old minor who was not eligible ye to receive the vaccine under pharmacy protocol/standing order guidelines. Wrong birthday was provided by the parents intentionally to get the vaccine sooner than his actual age of 11. Wrong birth year of 2009 was given instead of his actual birth year of 2010. Month and date wad give correctly. Pfizer vaccine is currently approved for 12 years and older.


VAERS ID: 1761549 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: California  
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 - / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Feeling hot, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine Acyclovir Venlafaxine Folic acid Vitamin B12
Current Illness: none
Preexisting Conditions: Mild hypothyroidism
Allergies: Augmentin Doxycycline
Diagnostic Lab Data: none
CDC Split Type:

Write-up: intense pain over total body, waves of more intense pain. nausea chills, feeling hot, temp 98.6 duration 8 hours, subsided to lower level pain for 24 hr nausea continued for 48 hrs no treatment


VAERS ID: 1761565 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-31
Onset:2021-10-02
   Days after vaccination:244
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / UNK - / -

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

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

Write-up: Covid positive contact unknown


VAERS ID: 1761583 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-05
Onset:2021-10-02
   Days after vaccination:211
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Respiratory tract congestion, Rhinorrhoea, 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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID-19 is positive which is likely the underlying cause of his acute worsening of his cough, dyspnea, and his new rhinorrhea and congestion. We will admit the patient to the Cardiology service for further evaluation and management.


VAERS ID: 1761589 (history)  
Form: Version 2.0  
Age: 96.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-31
Onset:2021-10-02
   Days after vaccination:244
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: Shortness of Breath (Increased work of breathing today. Covid positive 10/2. )


VAERS ID: 1761592 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-15
Onset:2021-10-02
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Hyperhidrosis, Incisional drainage, Spinal cord abscess, Spinal cord infection
SMQs:, Neuroleptic malignant syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: ED and based on symptoms of diaphoresis and increased drainage from incisional site, he was deemed appropriate for admission to neurosurgery service to rule out abscess/spinal infection vs COVID


VAERS ID: 1761604 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: New York  
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 FE3592 / 3 LA / IM

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

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

Write-up: Fever 30 hours after injection Nausea and epigastric pain - severe by 36 hours, vomiting, not responsive to OTC medications


VAERS ID: 1761628 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-09-20
Onset:2021-10-02
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Echocardiogram, Hypoaesthesia, Magnetic resonance imaging, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT Scan - 10/2 MRI - 10/3 Echo - 10/3
CDC Split Type:

Write-up: Weakness and numbness in right side extremities around 8pm on 10/2, lasting approximately 2 hours Emergency room visit. Admitted to hospital around 9:30pm.


VAERS ID: 1761640 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mulit-minerals, magnesium, abilify, wellbutrin, ginko biloba
Current Illness:
Preexisting Conditions: Bi-polar disorder
Allergies: Neosporin, lamictal, demerol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash, fatigue, fever (101) lasting 4 days


VAERS ID: 1761661 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-09-21
Onset:2021-10-02
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Hyperaesthesia, Pemphigoid, Pruritus, Rash, Skin burning sensation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lipitor, mepron, cardizem, lasix, neurotin, remeron, protonix, mycophenolate, prednisone, tacrolimus, xarelto
Current Illness:
Preexisting Conditions: ILD; a fib; dermatomyositis; steriod induced hyperglycemia; depression
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: rash all over body suspect bullous pemphigoid worst under and around left arm ; started about a week after shot and is rapidly progressing; burning and itching especially sensitive to any contact, steriod cream adn doxy given; already taking oral steriods


VAERS ID: 1761714 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Washington  
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 (JANSSEN)) / JANSSEN 212A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Dyspnoea, Hypopnoea, Respiratory rate increased, Throat clearing, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (narrow), Hypoglycaemia (broad)

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

Write-up: ~ 1300 notified that patient, was experiencing a scratchy and itchy throat. Patient had just prior received a J&J vaccine in her right deltoid. First BP attempt was unsuccessful. Anterior oropharynx and tongue had no swelling noted on exam. Pt having increased anxiety. Second attempt BP 180/120 HR ~110. No difficulty breathing, diaphoresis, pallor or urticaria noted. Oropharynx and tongue remained unchanged. Patient was clearing throat with increased frequency and breathing shallowly and fast. Anxiety present. No stridor noted, LS clear bilaterally, no urticaria noted. Notified pt that 911 was being called for evaluation. ~1306 BP 180/125 HR 110?s. Pt reporting increased difficulty breathing. I discussed the use of epinephrine and the risks with an elevated BP and HR. Pt stated ?do you want to use mine or yours.? Pt carries an epi pen for anaphylaxis from food allergies and has had to use it in the past. I asked the pt if she was sure she wanted epi and she stated ?yes?. No stridor noted, LS clear bilaterally, no urticaria noted, no diaphoresis, A&O, still clearing throat and taking shallow breaths. 0.3mg of epinephrine administered by RN via pt?s own pen in the left lateral thigh. EMS arrived ~ 3 minutes after administration of epinephrine. EMS evaluated patient and discharged her at the location. Patient remained at location for ~ 15 more minutes with RN at her side. She stated her throat was starting to feel better. Throat clearing decreased. Smiling and conversing with no distress noted. She walked out of the location in stable condition.


VAERS ID: 1761757 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Louisiana  
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 (MODERNA)) / MODERNA 019F21A / 1 LA / IM

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

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

Write-up: developed fever, chills, nausea


VAERS ID: 1761862 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-02-23
Onset:2021-10-02
   Days after vaccination:221
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022M20A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 10-2-2021, resulted positive
CDC Split Type:

Write-up: unknown


VAERS ID: 1761873 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Blood test, Chest pain, Dyspepsia, Echocardiogram normal, Electrocardiogram abnormal, Fatigue, Fibrin D dimer increased, Headache, Heart rate increased, Pain
SMQs:, Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG, blood work, CTA of lungs. The EKG was a little bit abnormal, blood work- dimer was elevated, CTA was normal. echocardiogram- normal
CDC Split Type: vsafe

Write-up: I had a headache like 30 minutes afterwards. I had body aches and fatigue. On Saturday I started having chest pain and trouble breathing. I went to urgent care on Sunday. They did an EKG, blood work, CTA of lungs. The EKG was a little bit abnormal, blood work- dimer was elevated, CTA was normal. They prescribed Ibuprofen and Colchicine. I saw a cardiologist on Wednesday. I still have some chest pain from time to time. My heart rate is a little bit elevated from its baseline. They did an echocardiogram on Wednesday and it was normal.


VAERS ID: 1761878 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-19
Onset:2021-10-02
   Days after vaccination:256
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 10/4 SARS/COV-2, NAAT positive
CDC Split Type:

Write-up: Breakthrough COVID


VAERS ID: 1761911 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-22
Onset:2021-10-02
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Confusional state, Disorientation, Electrocardiogram, Fatigue, Full blood count, Headache, Jaundice, Pallor, Petit mal epilepsy
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no prescriptions. daily multivitamin. 1000mg fish oil, 1500mg glucosamine, 1200mg chondroitin, 100mg MSM, 10mg Cetirizine
Current Illness: none
Preexisting Conditions: none
Allergies: Aspirin, Penicillin, Azithromycin
Diagnostic Lab Data: CT scan, EKG, CBC (10/02/2021)
CDC Split Type:

Write-up: Rapid onset confusion (lasting less than 5 minutes). Followed an hour later by silent (absent) seizure lasting @ 3 minutes. mental disorientation (@30 minutes)Jaundiced coloration of skin. Lips absent of color. (@20 minutes) 911 emergency services dispatched to patient''s home. Patient transported to ER via ambulance Extreme fatigue (continuing ). Headaches for several days following day of event and continuing.


VAERS ID: 1761960 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
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 30130BA / UNK LA / IM

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

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

Write-up: At 6:00 pm day of vaccination 10/02/21 I developed severe left arm pain 9/10, i thought I tore my rotator cuff, I administered 2 tabs po. On 10/03/21 @ 1:30 am I was awoken with severe chills w/ uncontrollable teeth chattering, severe myalgia, severe joint & bone pain 10/10. I felt like I was receiving chemo or was poisoned. I took Ibuprofen & Diphenhydramine po & fell asleep @ 4:30am. 10/03/21 all day was on & off muscle & joint pain 5-6/10 w/ fever 100.1 @ 6:00 pm, administered Tylenol 2 tabs po fever decreased to 99.1. 10/05/21 continue with joint pain 3/10, left deltoid discomfort & tenderness decreased to 1/10


VAERS ID: 1761973 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Tennessee  
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: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever Chills Nausea Fatigue


VAERS ID: 1762044 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-31
Onset:2021-10-02
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Amenorrhoea, Pregnancy test negative
SMQs:, Fertility 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:
Preexisting Conditions: alopecia areata
Allergies: Notrofurantoin
Diagnostic Lab Data: 3 negative pregnancy tests (10/2/21, 10/3/2021, 10/5/2021)
CDC Split Type:

Write-up: Absent period


VAERS ID: 1762048 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-18
Onset:2021-10-02
   Days after vaccination:257
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 2 LA / IM

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

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

Write-up: Tested positive for COVID 10/2/21 after being fully vaccinated.


VAERS ID: 1762060 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-24
Onset:2021-10-02
   Days after vaccination:192
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Adverse event, 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: 1762063 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: North Carolina  
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 (MODERNA)) / MODERNA 076C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose abnormal, Blood glucose increased, Chills, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ALEVE
Current Illness: PATIENT IS DIABETIC
Preexisting Conditions: DIABETES
Allergies: NONE
Diagnostic Lab Data: MULTIPLE BLOOD SUGAR CHECKS SINCE THE DATE
CDC Split Type:

Write-up: PATIENT EXPIERENCED SEVERE CHILLS, MUSCLE PAIN AND VERY HIGH BLOOD SUGAR (300+)


VAERS ID: 1762066 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Illinois  
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 EN6202 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Discomfort, Extra dose administered, Lip swelling, Oral discomfort, Scalloped tongue, Swollen tongue, Tongue coated, Tongue discomfort
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Taste and smell disorders (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, Levothyroxine, Liothyroxine, Bupropion, Spirolactone,
Current Illness: None
Preexisting Conditions: PCOS, Hypothyroid
Allergies: None
Diagnostic Lab Data: None - not life threatening, just wanted to share the information with the CDC
CDC Split Type:

Write-up: After the third injection - the next evening, tongue and mouth felt funny. Can''t taste anything, inside of lips feel swollen, tongue feels swollen and coated. Ridges along sides of tongue. Very uncomfortable.


VAERS ID: 1762068 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 3 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Injection site erythema, Injection site mass, Injection site swelling, Pain
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: Hx of Hepatitis C
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: on 10/02/21 Noticed redness, swelling lump size of tennis ball at injection site. Had fatigue and body aches


VAERS ID: 1762076 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-07
Onset:2021-10-02
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 10/1/2021 SARS/COV-2, NAAT Positive
CDC Split Type:

Write-up: Breakthrough COVID


VAERS ID: 1762104 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-04
Onset:2021-10-02
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Adverse event, 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: 1762127 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-03-05
Onset:2021-10-02
   Days after vaccination:211
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029A21A / 2 LL / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Aortic aneurysm, Biopsy lung normal, Blood glucose decreased, COVID-19, COVID-19 pneumonia, Dyspnoea, Intensive care, Oedema peripheral, Oxygen saturation decreased, Peripheral swelling, Positive airway pressure therapy, Pulmonary mass, Restrictive pulmonary disease
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Interstitial lung disease (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Hypoglycaemia (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: PMHx of DM II, hypertension, hyperlipidemia, hypothyroidism, non-hodgkin lymphoma in remission, thoracic aortic aneurysm.
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Date of Admission 10/02/2021 Date of Discharge 10/05/2021 Reason for Hospitalization usually only wears O2 at night, has been having SOB and low sats for a week. currently on 5 L NC Hospital Course Patient is a 70 year old male admitted to the ICU on 10/2 for acute hypoxic respiratory failure 2/2 COVID. PMHx of DM II, hypertension, hyperlipidemia, hypothyroidism, non-hodgkin lymphoma in remission, thoracic aortic aneurysm. Patient is vaccinated against COVID-19. The patient started feeling more short of breath about one week prior to presentation. He wears 5L O2 every night and occasionally during the day. Patient was admitted to ICU as he required BiPAP. Patient was started on remdesivir, dexamethasone, and baricitinib. Patient was transitioned to HFNC evening of 10/2 then transitioned to green tube NC at 8L on 10/3. Patient was stable for transfer to the PCU. Improved to home O2 (5L) quickly. Pt stayed on O2 at rest and with walking, did not need more than 5L. Pt did have low sugars throughout stay despite significant decrease in Insulin. Discussed diet at length with pt and plans to slowly titrate back up as needed in the outpatient setting. Discharge Diagnoses SOB (shortness of breath) Ordered: Sleep Study Home Sleep Apnea Watch PAT Orders: insulin glargine, 30 units, Subcutaneous, At Bedtime, # 10 mL, Refill(s) 5, Pharmacy: Pharmacy 25, 177.5, cm, 10/03/21 3:21:00 CDT, Height (cm), kg, 10/02/21 15:52:00 CDT, Weight (kg), 129 insulin lispro, 1-15 units, Subcutaneous, tid w/Meals, << Sliding Scale Comments $g$g 150 - 174 1 units Call if less than 80 175 - 199 2 units 200 - 224 3 units 225 - 249 4 units 250 - 274 5 units 275 - 299 6 units 300 - 324 7 units 325 - 34... Discharge Patient Follow Up Appt Medicine Endocrinology Follow Up Appt Medicine Pulmonary Adult #AHRF 2/2 COVID 19 PNA, on precautions, vaccinated Date of + test: 10/2 (symptom onset 1w/a) #OHS #OSA, does not use CPAP - Sleep study ordered for outpatient - 5L O2 throguhout the day and at night - FU with PCP on 10/22 - FU with pulm placed for worsening of restrictive disease (prior to COVID dx) #DM2 Home regimen: Metformin, pioglitazone, jardiance, Trulicity, 95u Lantus bid, up to 71u tid AC - Home with 30u q''evening, SSI 1:25, 1-15u - Restarted PO meds - Will contact PCP to titrate back up to home dose as diet changes - Message sent to Endo provider who is aware #HTN #LEE (2/2 chemo) Home Regimen: HCTZ 25mg qday, lisinopril 20mg, metoprolol 50 bid, Lasix 20mg qday PRN - Hold HCTZ, restarted Lisinopril at discharge - Continue to take Lasix #Pulmonary Nodule - Discussed with Radiology that it has improved in size from Biopsy in January, same area that was Bx and negative for neoplasm - FU with CT in 6mo-1y Other Diagnoses Ongoing Aortic root aneurysm Diabetes mellitus, type 2 Hyperlipidemia Hypertension Hypothyroidism Lower extremity edema Non-Hodgkin lymphoma Obesity Historical Diabetes mellitus type 2 in obese Discharge Disposition Home Medications New, Changed, or Refilled Medications insulin glargine (Lantus insulin Vial 100 units/mL 30 units, Subcutaneous, At Bedtime, for 30 day(s), 10 mL, 5 Refill(s) insulin lispro (insulin lispro 100 units/mL injecta 1-15 units, Subcutaneous, tid w/Meals, << Sliding Scale Comments $g$g 150 - 174 1 units Call if less than 80 175 - 199 2 units 200 - 224 3 units 225 - 249 4 units 250 - 274 5 units 275 - 299 6 units 300 - 324 7 units 325 - 349 8 Instructions:<< Sliding Scale Comments $g$g150 - 174 1 units Call if less than 80175 - 199 2 u Medications to be Continued Misc. Medication 0 Refill(s) Misc. Medication (BD UF II SHORT 1cc 8mm SYRINGE) See Instructions, USE 3x/DAY, 300 Each, 1 Refill(s) Instructions:USE 3x/DAY Misc. Medication (DEXCOM G6 RECEIVER) See Instructions, DEXCOM G6 RECEIVER UAD E11.9, 1 Each, 0 Refill(s) Instructions:DEXCOM G6 RECEIVERUADE11.9 Misc. Medication (DEXCOM G6 SENSOR) See Instructions, DEXCOM G6 SENSOR UAD--CHANGE Q10 DAYS E11.9, 3 Each, 2 Refill(s) Instructions:DEXCOM G6 SENSORUAD--CHANGE Q10 DAYSE11.9 Misc. Medication (DEXCOM G6 TRANSMITTER) See Instructions, DEXCOM G6 TRANSMITTER UAD--CHANGE Q90 DAYS E11.9, 1 Each, 2 Refill(s) Instructions:DEXCOM G6 TRANSMITTERUAD--CHANGE Q90 DAYSE11.9 aspirin (aspirin 81 mg oral delayed release tablet) 81 mg, 1 Tablet(s), Oral, Daily atorvastatin (atorvastatin 40 mg) See Instructions, Take 1 tablet by mouth once daily, 90 Tablet(s), 6 Refill(s) Instructions:Take 1 tablet by mouth once daily dulaglutide (Trulicity Pen 3 mg/0.5 mL subcutaneous 3 mg, Subcutaneous, qWeek, 12 Each, 11 Refill(s) empagliflozin (Jardiance 25 mg) 25 mg, 1 Tablet(s), Oral, qAM, E11.65, 90 Tablet(s), 3 Refill(s) Instructions:E11.65 furosemide (Lasix 20 mg) 20 mg, 1 Tablet(s), Oral, Daily, daily as needed for leg swelling, 30 Tablet(s), 0 Refill(s) Instructions:daily as needed for leg swelling insulin aspart (NovoLOG insulin Vial 100 units/mL i See Instructions, up to 71 units tid with meals E11.65, 180 mL, 11 Refill(s) Instructions:up to 71 units tid with meals E11.65 levothyroxine (levothyroxine 100 mcg (0.1 mg)) See Instructions, Take 1 tablet by mouth once daily, 90 Tablet(s), 7 Refill(s) Instructions:Take 1 tablet by mouth once daily lisinopril (lisinopril 20 mg) 20 mg, 1 Tablet(s), Oral, Daily, 90 Tablet(s), 2 Refill(s) metFORMIN (metFORMIN 1000 mg) 1 Tablet(s), Oral, bid, 180 Tablet(s), 3 Refill(s) metoprolol (Metoprolol Tartrate 50 mg) 50 mg, 1 Tablet(s), Oral, bid, for 30 day(s), 60 Tablet(s), 12 Refill(s) omega-3 polyunsaturated fatty acids (omega-3 polyun 2,000 mg, 2 capsule(s), Oral, bid ondansetron (ondansetron 8 mg) 0 Refill(s) pioglitazone (pioglitazone 15 mg) 15 mg, 1 Tablet(s), Oral, Daily, for 90 day(s), 90 Tablet(s), 11 Refill(s) Discontinued Medications hydrochlorothiazide (hydroCHLOROthiazide 25 mg) See Instructions, Take 1 tablet by mouth once daily, 90 Tablet(s), 9 Refill(s) Physical Exam at Discharge Vitals & Measurements T: 36.6 ?C TMIN: 36.6 ?C TMAX: 36.9 ?C HR: 77 RR: 18 BP: 129/82 SpO2: 92% GEN: no acute distress, EYE: normal conjunctiva, EOMI HENT: nose and ears atraumatic, lips normal RESP: NC in place, respirations non-labored CARDIO: Regular rate, +2 peripheral edema b/l GASTRO: abdomen soft and non-tender, no organomegaly MUSCULO: no digital cyanosis, no gross deformity SKIN: no rash, normal turgor PSYCH: appropriate mood and affect, normal judgement


VAERS ID: 1762133 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan Potassium, Complete Multivitamin
Current Illness: None
Preexisting Conditions: Lichen planus, dry eye disease, high blood pressure
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I have a 3-inch bruise at the injection site; a large red itchy rash; soreness in the arm; a bad headache; body aches.


VAERS ID: 1762149 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-02
Onset:2021-10-02
   Days after vaccination:242
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 10/5 SARS/COV-2, NAAT, Positive
CDC Split Type:

Write-up: Breakthrough COVID


VAERS ID: 1762159 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
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

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chills, Hypoaesthesia, Lymphadenopathy, Malaise, Myalgia, Oedema peripheral, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: On 10/2 the next day after receiving my pfizer booster vaccine, I experienced muscle pain, chills, joint pain, feeling unwell, swollen lymph nodes under my left arm (arm pit), left arm pain followed by numbness. It is now 10/5 and the left under arm swelling has not resolved and I continue to experience numbness in my left arm. I notified my doctor and I am waiting for a response.


VAERS ID: 1762170 (history)  
Form: Version 2.0  
Age: 28.0  
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 FF2589 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Strep throat prescribed penicillin on 9/14/21
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Menstrual cycle much heavier than usual


VAERS ID: 1762205 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: D.C.  
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 FC3184 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Injection site erythema, Injection site swelling, Interchange of vaccine products, Loss of personal independence in daily activities, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (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: Pfizer shots 1 and 2 in March and April 2021. Similar reaction. Age. 43.
Other Medications: Pulmicort Inhaler Allegra Flonase Systane Moisturizing Eye Drops Vitafusion Women''s Multivitamin
Current Illness: None
Preexisting Conditions: Recently diagnosed with Asthma
Allergies: Shrimp Almonds
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Had chills/fever and was very, very tired all day on 10/2...unable to perform regular activities. Headache and slight tiredness (no fever/chills) on 10/3. Redness and swelling of injection started 10/3 and continue...but redness and swelling is typical for me with most shots. Notable that I received the flu shot on the same day, in opposite arm.


VAERS ID: 1762221 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-30
Onset:2021-10-02
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 RA / IM

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

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

Write-up: Tested positive for COVID 10/2/21 after being fully vaccinated.


VAERS ID: 1762268 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Colorado  
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 - / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Discomfort, Erythema, Injection site pain, Lymphadenopathy
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: B-12 Multi-Vitamin
Current Illness:
Preexisting Conditions: Multiple Sclerosis
Allergies: Lactose Latex Penicillin Ciprofloxacin
Diagnostic Lab Data:
CDC Split Type:

Write-up: The lymph node in the armpit of the arm I received the shot in became significantly swollen. I first noticed this on Saturday 10/2 when I woke up around 7 am. The size of the lymph node was about the same as a golf ball. The area was red and very tender. I have taken Tylenol and/or Advil regularly to help with the discomfort. I also applied a warm compress to the site. As of today (10/5/2021), the swelling has reduced, but the tenderness is still present.


VAERS ID: 1762276 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Nebraska  
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 FF2587 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspepsia, Dyspnoea, Fatigue, Lymphadenopathy, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific dysfunction (narrow), Cardiomyopathy (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: Plavix, Elaquix, Zedia, Clamonadien, Hydrolozien, Leveloxien, Renexa, Crestor, Fish Oil, Calcium D3, B12, Progestrone
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Losartan, Bacterium, Contrast Dye
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt. states that after receiving the 3rd dose Booster of Phizer 10/01/2021, started experiencing symptoms 10/02/2021 of Severe chills, shortness of breath, fatigued, swollen lymphoids, indigestion, and low-grade fever (99.3). No noted Primary visit. Symptoms have symptoms.


VAERS ID: 1762331 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Chest discomfort, Diarrhoea, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (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: Unknown
Current Illness: None
Preexisting Conditions: None
Allergies: Unknown
Diagnostic Lab Data: None at this time.
CDC Split Type:

Write-up: Pt c/o sore arm developing on Friday following vaccine. Saturday experiencing diarrhea, muscle pain and chest discomfort. Monday following vaccine advised to do a covid test. Contacted nurse Tuesday and having left sided chest discomfort with movement and taking deep breaths. Appt for follow up booked on Wednesday and pt advised if chest pain worsens, becomes sob, pain radiates to arm/jaw must follow up at nearest ED.


VAERS ID: 1762365 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: California  
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 - / 3 LA / IM

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

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

Write-up: Flushed head, Ichiness to face, ears, head, and arms. Treatment Zyrtec Lasted for 3 days.


VAERS ID: 1762371 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Washington  
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 - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Discomfort, Dysstasia, Intermenstrual bleeding, Menstruation irregular, Muscle twitching, Myalgia, Paraesthesia, Sitting disability
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Fertility disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Antibiotics
Diagnostic Lab Data: I will be going to my primary care provider tomorrow to get to the bottom of what?s going on.
CDC Split Type:

Write-up: The next day after receiving my first dose of the Pfizer covid vaccine I started feeling server joint and muscle pain throughout my legs and arms as well as my back. It has been difficult to sit or stand for periods of time due to the feeling of being uncomfortable. I have also been suffering from tingling in my hands and feet as well as facial twitching. I also have started my menstrual cycle after just finishing it 3 days before my covid vaccine. I have been spot bleeding ever since getting the covid vaccine.


VAERS ID: 1762378 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-29
Onset:2021-10-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

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

Write-up: I have been experiencing severe hives and body rash 3 days after my second Covid vaccination. I had no symptoms to my first dose.


VAERS ID: 1762482 (history)  
Form: Version 2.0  
Age: 65.0  
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 FF2597 / 3 LA / SYR
FLU4: INFLUENZA (SEASONAL) (AFLURIA QUADRIVALENT) / SEQIRUS, INC. UNKNOWN FLU SHO / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Myalgia, Pyrexia, SARS-CoV-2 test negative, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Penicillin at age 5; vomiting and fever
Other Medications: Metformin; Benicar; Levemir; Singular; Zetia; Celebrix; sertraline
Current Illness: None
Preexisting Conditions: Diabetes
Allergies: Penicillin
Diagnostic Lab Data: COVID-19 test with negative result
CDC Split Type:

Write-up: Extreme fatigue; fever of 101.8 degrees; overall muscle aches; headache; vomiting


VAERS ID: 1763982 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Tennessee  
Vaccinated:0000-00-00
Onset:2021-10-02
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211006569

Write-up: CHEST PAIN; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 02-OCT-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 02-OCT-2021, the patient experienced chest pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from chest pain. This report was non-serious.


VAERS ID: 1764565 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary mass, Fatigue, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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: 03/15/2021, Pfizer
Other Medications: vitamin B12, Women''s multi vitamin, Immunity plus vitamin, collagen supplement, probiotic, apple cider vinegar supplement
Current Illness: none
Preexisting Conditions: osteoarthritis
Allergies: gluten allergy , milk allergy
Diagnostic Lab Data: none
CDC Split Type:

Write-up: uncontrollable shakes that lasted approximately an hour, followed by a fever for over 24 hours and extreme tiredness for 48 hours, lump in the arm pit area


VAERS ID: 1764596 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mobility decreased, Pain in extremity
SMQs:, Parkinson-like events (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: received booster. started having sorness in left arm. could not lift arm for 2 days .


VAERS ID: 1764602 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-10
Onset:2021-10-02
   Days after vaccination:234
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 RA / IM

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

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

Write-up: Tested PCR positive for COVID 10/2/21 after being fully vaccinated.


VAERS ID: 1764641 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-10
Onset:2021-10-02
   Days after vaccination:53
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

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

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

Write-up: Tested positive for COVID 10/2/21 after being fully vaccinated.


VAERS ID: 1764659 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS 2579B / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Pain, Presyncope, Pyrexia, Vertigo
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Felt extremely lightheaded as if I was going to pass out about 5 minutes in. That initially passed and then I just had the normal low grade temp and body aches for about 12 hours. On Monday 10/4/21 I started with Vertigo sensation and almost fainted at work. The vertigo has not yet gone away.


VAERS ID: 1764684 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Maternal exposure during breast feeding, Nausea, Pain in extremity, Suppressed lactation
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Functional lactation disorders (narrow), Neonatal exposures via breast milk (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pre- natal Vitamin Sunflower Lecithin
Current Illness: None
Preexisting Conditions: None
Allergies: Diflucan Macrobid Bactrim
Diagnostic Lab Data:
CDC Split Type:

Write-up: Starting the Thursday night of the date of administration I started feeling normal side effects reported such as headache, arm pain, and nauesa. However, starting on the Saturday after administration, my milk supply while breastfeeding my child began to decrease and has continued to do so since then. Nothing else has changed besides receiving the vaccine.


VAERS ID: 1764753 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Breast mass, Breast pain, Erythema, Pain, Paraesthesia, Skin warm
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Lipodystrophy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 1) small orange-sized mass in left breast with redness, warmth, pain 2) Tingling pain radiating across back from waist to shoulders


VAERS ID: 1764831 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-04
Onset:2021-10-02
   Days after vaccination:240
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Tested 10/3/21
CDC Split Type:

Write-up: Fully vaccinated employee developed symptoms and tested positive for Covid 19.


VAERS ID: 1764845 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-31
Onset:2021-10-02
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Dysgeusia, Haematemesis, Haemoglobin, Melaena, Myalgia, Oropharyngeal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Taste and smell disorders (narrow), Gastrointestinal haemorrhage (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: naltrexone, nortriptyline, Omeprazole, polyethylene glycol, propranolol, sulfamethoxazole-trimethoprim
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 62 y.o. male hx etoh cirrhosis and prior varices has been sober for several months who presents with melena. This started last night. In the ER had one episode of coffee ground emesis. Denies chest pain. He is vaccinated for covid, was diagnosed w/ covid 9/26. Has been having myalgias, sore throat, dysgeusia, cough. Denies dyspnea. In the ER he was not hypoxic. Hgb 9.3 which is essentially at his recent baseline. No tachycardia, one BP of 83/51 but subsequently 119/55. Afebrile.


VAERS ID: 1764850 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

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

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

Write-up: Intense pain and swelling of armpit and neck.


VAERS ID: 1764859 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-12
Onset:2021-10-02
   Days after vaccination:232
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / UNK LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Atelectasis, COVID-19, Chest X-ray abnormal, Hypoxia, Immunodeficiency, Pneumonitis, Pulmonary fibrosis
SMQs:, Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Hypersensitivity (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? 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 is an immunocompromised host with multiple comorbidities, being admitted with COVID infection. He has mild hypoxia and a portable chest x-ray consistent with pneumonitis superimposed on scarring. Right middle lobe collapse could not be excluded, so will obtain a PA lateral and start remdesivir with dexamethasone and consult Transplant Infectious Disease for further recommendations


VAERS ID: 1764860 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-08
Onset:2021-10-02
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Dyspnoea, Ear discomfort, Ear pain, Headache, Pain, Pulmonary congestion, Sinus congestion, Upper-airway cough syndrome
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (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: Atorvastatin; Sildenafil; Tadalafil; Gabapentin; Propecia; Xanax; Cyclobenzaprine; Sertraline; Albuterol; Doxyclycline
Current Illness: none
Preexisting Conditions: GERD; hyperlipidemia; rosacea; history of prostate cancer, single episode major depressive disorder; reactive airway disease
Allergies: penicillin; sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: headache, nonproductive cough, chills, shortness of breath, body aches, ear pain, sinus congestion, post nasal drainage, chest congestion, ear fullness, starting on 10/2/21, recent travel


VAERS ID: 1764863 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-12
Onset:2021-10-02
   Days after vaccination:232
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / UNK LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest X-ray abnormal, Hypoxia, Pneumonitis, Scar
SMQs:, Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Hypersensitivity (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: The patient is an immunocompromised host with multiple comorbidities, being admitted with COVID infection. He has mild hypoxia and a portable chest x-ray consistent with pneumonitis superimposed on scarring. Right middle lobe collapse could not be excluded, so will obtain a PA lateral and start remdesivir with dexamethasone and consult Transplant Infectious Disease for further recommendations


VAERS ID: 1764899 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Extra dose administered, Musculoskeletal stiffness
SMQs:, Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad), Medication errors (narrow)

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

Write-up: Pt. states that after receiving the 3rd Booster of Phizer 10/01/2021, started experiencing symptoms 10/02/2021 started experiencing symptoms of stiff neck (right side) and low back pain. 3 days subsided, No noted Primary visit.


VAERS ID: 1764970 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-02-05
Onset:2021-10-02
   Days after vaccination:239
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Influenza A virus test negative, Influenza virus test negative, Oropharyngeal pain, Respiratory syncytial virus test negative, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Diabetes mellitus, hyperlipidemia, spinal stenosis, thyroid disease, hypertension.
Allergies: Patient has an allergy to iodinated contrast media (reports throat swelling).
Diagnostic Lab Data: FLUVID test: Positive for COVID-19 on 10/3/2021 (negative for influenza A, influenza B, and RSV on test panel).
CDC Split Type:

Write-up: Patient required inpatient admission to hospital with COVID-19 on 10/2/2021 (presented with cough, shortness of breath, and sore throat for the past week per provider notes). As of 10/6/2021, the patient remains admitted to the hospital for treatment of COVID-19 infection.


VAERS ID: 1764979 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-15
Onset:2021-10-02
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 3 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Computerised tomogram head, Drug screen negative, Full blood count normal, Headache, Hemiparesis, Immunisation, Tremor, Troponin decreased
SMQs:, Neuroleptic malignant syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flomax, Levemir, Albuterol, Prednisone, Flexeril
Current Illness: Had not felt well since initial C19 shots
Preexisting Conditions: Lichen simplex chronicum, Kidney stones, Type 2 DM insulin dependent, Asthma, Obesity, Smoker
Allergies: PCN, Bee stings, Amlodipine, epinephrine, Latex and Reglan
Diagnostic Lab Data: Troponin 0.05 (upper end of normal), CBC normal, CRP 14.5 (mildly elevated), Panel 12 mostly normal. CT of the head without contrast pending results.
CDC Split Type:

Write-up: Severe headache and now today a tremor of the left hand and arm associated with weakness


VAERS ID: 1764983 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Headache, Pain in extremity, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 20mg
Current Illness: none
Preexisting Conditions: hyper tension
Allergies: penicillin
Diagnostic Lab Data: none yet
CDC Split Type:

Write-up: Arm felt like it had been punched lasted 4 days. Left side of chest hurt unable to isolate lasted 3 days. Severe headache lasted 2 days. Vision blurred started clearing on 5th day. E.D. still on going.


VAERS ID: 1765046 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Headache, Injected limb mobility decreased, Injection site swelling, Mobility decreased, Musculoskeletal discomfort
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Employee calling to report a reaction after receiving a COVID-19 vaccine. Vaccine Name - Pfizer Vaccine Date - ? 10/1/2021 Is this your first or second dose- 2nd dose Date of symptom onset - ? 10/2/2021 Symptoms - ? Severe headache that felt like being "stabbed in the head", swollen left arm at injection site, couldn''t move head, neck, and left arm x 3 days, pressure in chest and back above and below breast. Last day of work and shift - ? NA Home remedies-Tylenol 4000mg a day and 600mg of Ibuprofen Any improvement-headache is gone, sweeling improving, can move head, neck, and left arm now, chest pain gone, still has back pain but has improved Recommendation-since employee stated she doesn''t feel like she needs to be seen, advised to continue taking ibuprofen per package instructions until tomorrow and see if improved since improving each day. Employee voiced understanding Employee of information ? Yes Employee voiced any concerns ? No Employee?s questions answered to employee?s satisfaction -Yes


VAERS ID: 1765111 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 LA / SYR
FLU4: INFLUENZA (SEASONAL) (AFLURIA QUADRIVALENT) / SEQIRUS, INC. P100350381 / 1 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Extra dose administered, Injection site erythema, Injection site swelling, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 01/09/21 COVID Vaccine Phizer
Other Medications: Pepcid (40) MG and BComplex Oral
Current Illness: No
Preexisting Conditions: No
Allergies: Codeine and Sulfa
Diagnostic Lab Data: Put on steroids for 12 days for injection site infection and swollen left lymph node
CDC Split Type:

Write-up: Left lymph node swelled up to size of orange under left arm. Swelling (3 to 4 inches) round red area round injection site going down arm.


VAERS ID: 1765169 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-27
Onset:2021-10-02
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Pruritus, Rash
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? 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: Site: Pain at Injection Site-Medium, Systemic: Allergic: Itch (specify: facial area, extremeties)-Severe, Systemic: Allergic: Itch Generalized-Severe, Systemic: Allergic: Rash (specify: facial area, extremeties)-Severe, Systemic: Allergic: Rash Generalized-Severe


VAERS ID: 1765203 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Lymphadenopathy, Sleep disorder
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, Vitamin D
Current Illness:
Preexisting Conditions: Asthma
Allergies: Penicillin, Sulfa, Celery, Pistachios
Diagnostic Lab Data:
CDC Split Type:

Write-up: My right lymph node in my arm pit became extremely swollen and sore to the point that I could not sleep.


VAERS ID: 1765244 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood disorder, Cardiac disorder, Chest discomfort, Chest pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Haematopoietic cytopenias affecting more than one type of blood cell (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Blood Disorder (diagnosed by MD)-Medium, Systemic: Cardiac Disorder (diagnosed by MD)-Medium, Systemic: Chest Tightness / Heaviness / Pain-Medium, Systemic: Fever-Medium


VAERS ID: 1765245 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-30
Onset:2021-10-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymph node pain, Lymphadenopathy, Mobility decreased
SMQs:, Parkinson-like events (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: Omeprazole DR capsule, Cetirizine tablet, Sertaline 20mg tablet
Current Illness: Rhinovirus
Preexisting Conditions: GERD
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Swelling, tenderness and pain of lymph nodes in shot arm (R) that started on full day 2 with spread to upper and lower armpit nodes over the course of 5 days. Moderate pain causing immobility. Of note- this is a booster shot administered approx 7mo after 2nd dose of same vaccine. This is not a symptom experienced with first or second vaccine.


VAERS ID: 1765258 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: New York  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 AR / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Immunisation, 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: Humalog insulin, Fluoxetine, Welbutrin, Basaglar insulin, Gabapentin.
Current Illness:
Preexisting Conditions: Diabetes Type 1 Depression High cholesterol
Allergies: Erythromycin and Meloxicam
Diagnostic Lab Data:
CDC Split Type:

Write-up: Body aches, fever 102, chills


VAERS ID: 1765274 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-02-17
Onset:2021-10-02
   Days after vaccination:227
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Polymerase chain reaction
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: Cycle threshold of 19.5 on 10/2/21
CDC Split Type:

Write-up: Hospitalization due to COVID-19 Reported per Moderna COVID-19 Vaccine EUA


VAERS ID: 1765327 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-12
Onset:2021-10-02
   Days after vaccination:263
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Fully Vaccinated employee began symptoms and tested positive for Covid-19.


VAERS ID: 1765384 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-17
Onset:2021-10-02
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 RA / IM

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

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

Write-up: Tested Positive for Covid.


VAERS ID: 1765397 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-21
Onset:2021-10-02
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 2 LA / IM

Administered by: Public       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:
CDC Split Type:

Write-up: Tested Positive for Covid


VAERS ID: 1765410 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Lymphadenopathy, Oral pruritus, Salivary gland enlargement
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Swollen glands in neck area and swollen glands under tongue. Itching of the roof of my mouth.


VAERS ID: 1765412 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Fatigue, Language disorder, Limb discomfort, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalopathy/delirium (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unkown
Current Illness: unknown
Preexisting Conditions: unkown
Allergies: unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called today, which is 4 days after her vaccination. For the first 2 - 3 days after her vaccine, she experienced language impairment, "rubber legs", fever, short term memory loss, and fatigue. Patient is feeling better and following up with her PCP.


VAERS ID: 1765427 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-10-02
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cerebral haemorrhage, SARS-CoV-2 test positive
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Pt received Pfizer x2. Pt tested COVID + on 9/29/21 and admitted to hospital for COVID on 10/2/2021. Pt receiving remdesivir and dexamethasone. During admission, had ICH.


VAERS ID: 1765434 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-25
Onset:2021-10-02
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 2 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Anion gap, Aspartate aminotransferase increased, Atrial fibrillation, Bacteraemia, Basophil count decreased, Blood albumin decreased, Blood alkaline phosphatase normal, Blood bicarbonate normal, Blood bilirubin normal, Blood calcium decreased, Blood chloride decreased, Blood creatinine increased, Blood culture positive, Blood glucose increased, Blood potassium normal, Blood sodium decreased, Blood urea increased, C-reactive protein increased, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chills, Creatinine renal clearance decreased, Culture urine negative, Differential white blood cell count abnormal, Dyspnoea, Electrocardiogram abnormal, Eosinophil count decreased, Fatigue, Fibrin D dimer increased, Glomerular filtration rate decreased, Haematocrit normal, Haemoglobin decreased, Haemolysis, Hypoxia, Immature granulocyte count, Klebsiella infection, Klebsiella test positive, Lymphocyte count, Lymphocyte count decreased, Mean cell haemoglobin concentration decreased, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume increased, Metabolic function test, Monocyte count increased, N-terminal prohormone brain natriuretic peptide increased, Nausea, Neutrophil count increased, Platelet count normal, Productive cough, Protein total normal, Pyrexia, Red blood cell count normal, Red blood cell nucleated morphology, Red cell distribution width normal, SARS-CoV-2 test positive, Tachycardia, Tachypnoea, Troponin, Urine analysis, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Haemolytic disorders (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Myelodysplastic syndrome (broad), Tumour lysis syndrome (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (narrow), Dehydration (broad), Sepsis (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: Allergies as of 10/6/2021 Pneumococcal 13-val Conj Vacc Not Specified 02/13/2015 Swelling
Other Medications: Outpatient Medications B-D ULTRA-FINE 33 LANCETS MISC CARTIA XT 120 MG 24 hr capsule ciprofloxacin (CIPRO) 500 MG tablet dexamethasone (DECADRON) 6 MG tablet glimepiride (AMARYL) 4 MG tablet glucose blood in vitro test strips (FREESTYLE LIT
Current Illness:
Preexisting Conditions: Respiratory DOE (dyspnea on exertion) Pneumonia due to COVID-19 virus Circulatory Hypertension associated with diabetes Atrial fibrillation, persistent Thoracic aortic ectasia Digestive Diverticulosis Genitourinary CRF (chronic renal failure), stage 3 (moderate) Endocrine/Metabolic Hypercholesterolemia Controlled type 2 diabetes mellitus without complication, without long-term current use of insulin Other Hx of bladder cancer Benign recurrent vertigo Proteinuria secondary to diabetes Presence of urostomy
Allergies: Pneumococcal 13-val Conj Vacc Swelling
Diagnostic Lab Data: Procedure Component Value Ref Range Date/Time Peripheral Blood Culture Collected: 10/03/21 1914 Order Status: Completed Specimen: Blood, Venous Updated: 10/05/21 2201 Cult Blood Peripheral No Growth 48 hours Peripheral Blood Culture Collected: 10/03/21 1907 Order Status: Completed Specimen: Blood, Venous Updated: 10/05/21 2201 Cult Blood Peripheral No Growth 48 hours POCT GLUCOSE NOVA METER AUTO (Abnormal) Collected: 10/05/21 1057 Order Status: Completed Specimen: Blood, Capillary Updated: 10/05/21 1100 Glucose, POC 151 High 70 - 99 mg/dL Narrative: Comprehensive Metabolic Panel (CMP) (Abnormal) Collected: 10/05/21 0643 Order Status: Completed Specimen: Blood, Venous Updated: 10/05/21 0824 Sodium Level 133 Low 134 - 146 mmol/L Potassium Level 4.8 3.4 - 5.0 mmol/L Chloride 98 98 - 112 mmol/L HCO3 21 21 - 29 mmol/L Anion Gap 14 9 - 18 mmol/L Glucose Level 153 High 70 - 99 mg/dL Blood Urea Nitrogen 61 High 8 - 20 mg/dL Creatinine 1.50 High 0.60 - 1.30 mg/dL MDRD eGFR 45 Low $g=60 mL/min/1.73 m2 Comment: MDRD GFR calculation is based on the 4 value MDRD equation. K/DOQI Clinical Practice Guidelines for chronic kidney disease. MDRD estimated GFR (eGFR) is best used for detection of chronic kidney disease in clinically stable patients. DO NOT USE VALUES FROM THIS EQUATION FOR DRUG DOSING. It has not yet been validated for drug dosing or for patients with rapidly changing clinical situations (inpatient care). CG eCrCl 39 mL/min/1.73 m2 Calcium Level Total 9.4 8.6 - 10.4 mg/dL Protein Total 7.3 6.0 - 8.0 g/dL Albumin Level 3.2 Low 3.5 - 5.0 g/dL Bilirubin Total 0.3 0.2 - 1.0 mg/dL Alkaline Phosphatase 74 40 - 129 IU/L Alanine Aminotransferase 53 High 10 - 40 IU/L Aspartate Aminotransferase 43 High 10 - 40 IU/L Hemolysis -- Comment: Interpret results with caution. Slight specimen hemolysis. Hemolysis can affect laboratory results for the listed analytes; however, the degree of hemolysis in this specimen may not be high enough to cause significant change. Analytes that may be affected are: Ammonia, AST, Bilirubin Direct, Folate, Haptoglobin, Insulin, LDH, Osteocalcin, and Potassium. C Reactive Protein (CRP), Blood Level (Abnormal) Collected: 10/05/21 0643 Order Status: Completed Specimen: Blood, Venous Updated: 10/05/21 0824 C-Reactive Protein 46.4 High <=5.0 mg/L D-Dimer (Normal) Collected: 10/05/21 0643 Order Status: Completed Specimen: Blood, Venous Updated: 10/05/21 0812 D-Dimer Quant 310 0 - 500 ng/mL FEU Comment: It should be noted that the published studies evaluating this assay have included only Emergency Room or other outpatients presenting with new symptoms suggestive of thromboembolic disease. This assay has not been evaluated for this purpose in hospital inpatients, postoperative patients, or other patient types than those indicated. Elevated D-Dimers may be seen in activation states of coagulation. Elevated states of D-Dimer levels may be associated with the following: DVT, DIC, hemorrhages, fibrinolysis, post-operative periods, cancer, and severe infections. D-Dimer levels may be falsely elevated in underlying, non-thrombotic conditions common in hospitalized patients. Cut-off value for D-dimer use in evaluation of VTE is 500 ng/mL FEU. The measurement of D-Dimer should not be used as an aid in the diagnosis of VTE in patients with: - Therapeutic dose anticoagulant therapy for $g24 hours - Fibrinolytic therapy within previous 7 days - Trauma or surgery within previous 4 weeks - Aortic aneurysm - Sepsis, severe infections, pneumonia, severe skin infections - Liver cirrhosis - Renal Failure - Pregnancy Three regulatory authorities recommend that in patients older than 50 years with low-to-intermediate pretest probability for acute pulmonary embolism, an age-adjusted D-dimer cutoff of age x 10 (FEU units) can be used to exclude a diagnosis of PE without need for further imaging. Complete Blood Count w/Differential (Abnormal) Collected: 10/05/21 0643 Order Status: Completed Specimen: Blood, Venous Updated: 10/05/21 0802 White Blood Cell 12.84 High 4.00 - 10.80 x10*3/uL Red Blood Cell 5.05 4.60 - 6.00 x10*6/uL Hemoglobin 14.4 14.0 - 18.0 g/dL Hematocrit 46.0 42.0 - 52.0 % Mean Cell Volume 91.1 80.0 - 100.0 fL Mean Cell Hemoglobin 28.5 27.0 - 33.0 pg Mean Cell Hemoglobin Concentration 31.3 Low 32.0 - 37.0 g/dL Red Cell Diameter Width 14.3 11.0 - 16.0 % NRBC Absolute Count 0.00 0.00 - 0.01 x10*3/uL NRBC Automated 0.0 0.0 - 0.1 %WBC Platelet 306 140 - 400 x10*3/uL Mean Platelet Volume 10.5 7.4 - 11 fL Neutrophil Automated 82.5 High 35.0 - 80.0 % Immature Granulocyte Automated 0.8 High 0.0 - 0.6 % Lymphocyte Automated 8.3 Low 20.0 - 50.0 % Monocytes Automated 8.2 2.0 - 12.0 % Eosinophil Automated 0.1 0.0 - 6.0 % Basophil Automated 0.1 0.0 - 2.0 % Neutrophil Absolute Count 10.61 High 1.80 - 7.80 x10*3/uL Immature Granulocyte Absolute Count 0.10 High 0.00 - 0.05 x10*3/uL Lymphocyte Absolute Count 1.06 1.00 - 4.00 x10*3/uL Monocyte Absolute Count 1.05 High 0.00 - 0.90 x10*3/uL Eosinophil Absolute Count 0.01 0.00 - 0.50 x10*3/uL Basophil Absolute Count 0.01 0.00 - 0.20 x10*3/uL POCT GLUCOSE NOVA METER AUTO (Abnormal) Collected: 10/05/21 0415 Order Status: Completed Specimen: Blood, Capillary Updated: 10/05/21 0420 Glucose, POC 202 High 70 - 99 mg/dL Narrative: POCT GLUCOSE NOVA METER AUTO (Abnormal) Collected: 10/04/21 2344 Order Status: Completed Specimen: Blood, Capillary Updated: 10/05/21 0415 Glucose, POC 276 High 70 - 99 mg/dL Narrative: POCT GLUCOSE NOVA METER AUTO (Abnormal) Collected: 10/04/21 1814 Order Status: Completed Specimen: Blood, Capillary Updated: 10/04/21 1815 Glucose, POC 301 High 70 - 99 mg/dL Narrative: POCT GLUCOSE NOVA METER AUTO (Abnormal) Collected: 10/04/21 1328 Order Status: Completed Specimen: Blood, Capillary Updated: 10/04/21 1330 Glucose, POC 249 High 70 - 99 mg/dL Narrative: Comprehensive Metabolic Panel (CMP) (Abnormal) Collected: 10/04/21 1054 Order Status: Completed Specimen: Blood, Venous Updated: 10/04/21 1154 Sodium Level 134 134 - 146 mmol/L Potassium Level 4.8 3.4 - 5.0 mmol/L Chloride 97 Low 98 - 112 mmol/L HCO3 22 21 - 29 mmol/L Anion Gap 15 9 - 18 mmol/L Glucose Level 180 High 70 - 99 mg/dL Blood Urea Nitrogen 62 High 8 - 20 mg/dL Creatinine 1.58 High 0.60 - 1.30 mg/dL MDRD eGFR 43 Low $g=60 mL/min/1.73 m2 Comment: MDRD GFR calculation is based on the 4 value MDRD equation. MDRD estimated GFR (eGFR) is best used for detection of chronic kidney disease in clinically stable patients. DO NOT USE VALUES FROM THIS EQUATION FOR DRUG DOSING. It has not yet been validated for drug dosing or for patients with rapidly changing clinical situations (inpatient care). CG eCrCl 37 mL/min/1.73 m2 Calcium Level Total 8.9 8.6 - 10.4 mg/dL Protein Total 6.8 6.0 - 8.0 g/dL Albumin Level 3.0 Low 3.5 - 5.0 g/dL Bilirubin Total 0.3 0.2 - 1.0 mg/dL Alkaline Phosphatase 69 40 - 129 IU/L Alanine Aminotransferase 38 10 - 40 IU/L Aspartate Aminotransferase 41 High 10 - 40 IU/L C Reactive Protein (CRP), Blood Level (Abnormal) Collected: 10/04/21 1054 Order Status: Completed Specimen: Blood, Venous Updated: 10/04/21 1154 C-Reactive Protein 74.0 High <=5.0 mg/L D-Dimer (Normal) Collected: 10/04/21 1054 Order Status: Completed Specimen: Blood, Venous Updated: 10/04/21 1152 D-Dimer Quant 390 0 - 500 ng/mL FEU Comment: It should be noted that the published studies evaluating this assay have included only Emergency Room or other outpatients presenting with new symptoms suggestive of thromboembolic disease. This assay has not been evaluated for this purpose in hospital inpatients, postoperative patients, or other patient types than those indicated. Elevated D-Dimers may be seen in activation states of coagulation. Elevated states of D-Dimer levels may be associated with the following: DVT, DIC, hemorrhages, fibrinolysis, post-operative periods, cancer, and severe infections. D-Dimer levels may be falsely elevated in underlying, non-thrombotic conditions common in hospitalized patients. Cut-off value for D-dimer use in evaluation of VTE is 500 ng/mL FEU. The measurement of D-Dimer should not be used as an aid in the diagnosis of VTE in patients with: - Therapeutic dose anticoagulant therapy for $g24 hours - Fibrinolytic therapy within previous 7 days - Trauma or surgery within previous 4 weeks - Aortic aneurysm - Sepsis, severe infections, pneumonia, severe skin infections - Liver cirrhosis - Renal Failure - Pregnancy Three different regulatory authorities recommend that in patients older than 50 years with low-to-intermediate pretest probability for acute pulmonary embolism, an age-adjusted D-dimer cutoff of age x 10 (FEU units) can be used to exclude a diagnosis of PE without need for further imaging. Complete Blood Count w/Differential (Abnormal) Collected: 10/04/21 1054 Order Status: Completed Specimen: Blood, Venous Updated: 10/04/21 1119 White Blood Cell 13.81 High 4.00 - 10.80 x10*3/uL Red Blood Cell 4.79 4.60 - 6.00 x10*6/uL Hemoglobin 13.6 Low 14.0 - 18.0 g/dL Hematocrit 43.2 42.0 - 52.0 % Mean Cell Volume 90.2 80.0 - 100.0 fL Mean Cell Hemoglobin 28.4 27.0 - 33.0 pg Mean Cell Hemoglobin Concentration 31.5 Low 32.0 - 37.0 g/dL Red Cell Diameter Width 14.3 11.0 - 16.0 % NRBC Absolute Count 0.00 0.00 - 0.01 x10*3/uL NRBC Automated 0.0 0.0 - 0.1 %WBC Platelet 248 140 - 400 x10*3/uL Mean Platelet Volume 10.5 7.4 - 11 fL Neutrophil Automated 79.2 35.0 - 80.0 % Immature Granulocyte Automated 0.7 High 0.0 - 0.6 % Lymphocyte Automated 8.5 Low 20.0 - 50.0 % Monocytes Automated 10.7 2.0 - 12.0 % Eosinophil Automated 0.7 0.0 - 6.0 % Basophil Automated 0.2 0.0 - 2.0 % Neutrophil Absolute Count 10.94 High 1.80 - 7.80 x10*3/uL Immature Granulocyte Absolute Count 0.09 High 0.00 - 0.05 x10*3/uL Lymphocyte Absolute Count 1.18 1.00 - 4.00 x10*3/uL Monocyte Absolute Count 1.48 High 0.00 - 0.90 x10*3/uL Eosinophil Absolute Count 0.09 0.00 - 0.50 x10*3/uL Basophil Absolute Count 0.03 0.00 - 0.20 x10*3/uL POCT GLUCOSE NOVA METER AUTO (Abnormal) Collected: 10/04/21 1028 Order Status: Completed Specimen: Blood, Capillary Updated: 10/04/21 1035 Glucose, POC 194 High 70 - 99 mg/dL Narrative: POCT GLUCOSE NOVA METER AUTO (Abnormal) Collected: 10/04/21 0956 Order Status: Completed Specimen: Blood, Capillary Updated: 10/04/21 1000 Glucose, POC 195 High 70 - 99 mg/dL Narrative: POCT GLUCOSE NOVA METER AUTO (Abnormal) Collected: 10/04/21 0347 Order Status: Completed Specimen: Blood, Capillary Updated: 10/04/21 0400 Glucose, POC 193 High 70 - 99 mg/dL Narrative: POCT GLUCOSE NOVA METER AUTO (Abnormal) Collected: 10/03/21 2318 Order Status: Completed Specimen: Blood, Capillary Updated: 10/03/21 2320 Glucose, POC 196 High 70 - 99 mg/dL Narrative: POCT GLUCOSE NOVA METER AUTO (Abnormal) Collected: 10/03/21 1906 Order Status: Completed Specimen: Blood, Capillary Updated: 10/03/21 1910 Glucose, POC 230 High 70 - 99 mg/dL Narrative: POCT GLUCOSE NOVA METER AUTO (Abnormal) Collected: 10/03/21 1353 Order Status: Completed Specimen: Blood, Capillary Updated: 10/03/21 1405 Glucose, POC 264 High 70 - 99 mg/dL Narrative: POCT GLUCOSE NOVA METER AUTO (Normal) Collected: 10/03/21 1027 Order Status: Completed Specimen: Blood, Capillary Updated: 10/03/21 1030 Glucose, POC 85 70 - 99 mg/dL Narrative: Comprehensive Metabolic Panel (CMP) (Abnormal) Collected: 10/03/21 0800 Order Status: Completed Specimen: Blood, Venous Updated: 10/03/21 0844 Sodium Level 133 Low 134 - 146 mmol/L Potassium Level 4.8 3.4 - 5.0 mmol/L Chloride 99 98 - 112 mmol/L HCO3 22 21 - 29 mmol/L Anion Gap 12 9 - 18 mmol/L Glucose Level 77 70 - 99 mg/dL Blood Urea Nitrogen 43 High 8 - 20 mg/dL Creatinine 1.43 High 0.60 - 1.30 mg/dL MDRD eGFR 48 Low $g=60 mL/min/1.73 m2 Comment: MDRD GFR calculation is based on the 4 value MDRD equation. MDRD estimated GFR (eGFR) is best used for detection of chronic kidney disease in clinically stable patients. DO NOT USE VALUES FROM THIS EQUATION FOR DRUG DOSING. It has not yet been validated for drug dosing or for patients with rapidly changing clinical situations (inpatient care). CG eCrCl 41 mL/min/1.73 m2 Calcium Level Total 9.4 8.6 - 10.4 mg/dL Protein Total 7.1 6.0 - 8.0 g/dL Albumin Level 3.3 Low 3.5 - 5.0 g/dL Bilirubin Total 0.3 0.2 - 1.0 mg/dL Alkaline Phosphatase 72 40 - 129 IU/L Alanine Aminotransferase 29 10 - 40 IU/L Aspartate Aminotransferase 26 10 - 40 IU/L C Reactive Protein (CRP), Blood Level (Abnormal) Collected: 10/03/21 0800 Order Status: Completed Specimen: Blood, Venous Updated: 10/03/21 0844 C-Reactive Protein 144.5 High <=5.0 mg/L D-Dimer (Normal) Collected: 10/03/21 0808 Order Status: Completed Specimen: Blood, Venous Updated: 10/03/21 0833 D-Dimer Quant 410 0 - 500 ng/mL FEU Comment: It should be noted that the published studies evaluating this assay have included only Emergency Room or other outpatients presenting with new symptoms suggestive of thromboembolic disease. This assay has not been evaluated for this purpose in hospital inpatients, postoperative patients, or other patient types than those indicated. Elevated D-Dimers may be seen in activation states of coagulation. Elevated states of D-Dimer levels may be associated with the following: DVT, DIC, hemorrhages, fibrinolysis, post-operative periods, cancer, and severe infections. D-Dimer levels may be falsely elevated in underlying, non-thrombotic conditions common in hospitalized patients. Cut-off value for D-dimer use in evaluation of VTE is 500 ng/mL FEU. The measurement of D-Dimer should not be used as an aid in the diagnosis of VTE in patients with: - Therapeutic dose anticoagulant therapy for $g24 hours - Fibrinolytic therapy within previous 7 days - Trauma or surgery within previous 4 weeks - Aortic aneurysm - Sepsis, severe infections, pneumonia, severe skin infections - Liver cirrhosis - Renal Failure - Pregnancy Three different regulatory authorities recommend that in patients older than 50 years with low-to-intermediate pretest probability for acute pulmonary embolism, an age-adjusted D-dimer cutoff of age x 10 (FEU units) can be used to exclude a diagnosis of PE without need for further imaging. Complete Blood Count w/Differential (Abnormal) Collected: 10/03/21 0808 Order Status: Completed Specimen: Blood, Venous Updated: 10/03/21 0817 White Blood Cell 13.29 High 4.00 - 10.80 x10*3/uL Red Blood Cell 4.88 4.60 - 6.00 x10*6/uL Hemoglobin 13.7 Low 14.0 - 18.0 g/dL Hematocrit 43.8 42.0 - 52.0 % Mean Cell Volume 89.8 80.0 - 100.0 fL Mean Cell Hemoglobin 28.1 27.0 - 33.0 pg Mean Cell Hemoglobin Concentration 31.3 Low 32.0 - 37.0 g/dL Red Cell Diameter Width 14.3 11.0 - 16.0 % NRBC Absolute Count 0.00 0.00 - 0.01 x10*3/uL NRBC Automated 0.0 0.0 - 0.1 %WBC Platelet 220 140 - 400 x10*3/uL Mean Platelet Volume 10.0 7.4 - 11 fL Neutrophil Automated 86.9 High 35.0 - 80.0 % Immature Granulocyte Automated 0.4 0.0 - 0.6 % Lymphocyte Automated 4.3 Low 20.0 - 50.0 % Monocytes Automated 8.0 2.0 - 12.0 % Eosinophil Automated 0.2 0.0 - 6.0 % Basophil Automated 0.2 0.0 - 2.0 % Neutrophil Absolute Count 11.56 High 1.80 - 7.80 x10*3/uL Immature Granulocyte Absolute Count 0.05 0.00 - 0.05 x10*3/uL Lymphocyte Absolute Count 0.57 Low 1.00 - 4.00 x10*3/uL Monocyte Absolute Count 1.06 High 0.00 - 0.90 x10*3/uL Eosinophil Absolute Count 0.03 0.00 - 0.50 x10*3/uL Basophil Absolute Count 0.02 0.00 - 0.20 x10*3/uL POCT GLUCOSE NOVA METER AUTO (Abnormal) Collected: 10/03/21 0301 Order Status: Completed Specimen: Blood, Capillary Updated: 10/03/21 0305 Glucose, POC 139 High 70 - 99 mg/dL Narrative: POCT GLUCOSE NOVA METER AUTO (Abnormal) Collected: 10/02/21 2224 Order Status: Completed Specimen: Blood, Capillary Updated: 10/02/21 2225 Glucose, POC 268 High 70 - 99 mg/dL Narrative: Procalcitonin (Abnormal) Collected: 10/02/21 1936 Order Status: Completed Specimen: Blood, Venous Updated: 10/02/21 2031 Procalcitonin 0.84 High <=0.25 ng/mL Comment: <0.05 ng/mL = Negative Between 0.05 - 0.25 ng/mL = Low, bacterial infection is possible but unlikely. Between 0.25 and 0.50 ng/mL = Intermediate; bacterial infection is likely. $g0.50 ng/mL = High; bacterial infection is very likely. POCT GLUCOSE NOVA METER AUTO (Abnormal) Collected: 10/02/21 1834 Order Status: Completed Specimen: Blood, Capillary Updated: 10/02/21 1835 Glucose, POC 230 High 70 - 99 mg/dL
CDC Split Type:

Write-up: Patient is a 78 y.o. male with past medical history of persistent AFib, diabetes, bladder cancer and prostate cancer s/p cystectomy with urostomy and prostatectomy, hyperlipidemia, CKD stage 3 who presented to the ED on 10/2 with complaints of fatigue, fevers, chills, dyspnea, productive cough, and nausea. Symptoms started about three days prior to presentation. Pt is fully vaccinated against COVID-19 with Moderna. Upon arrival to the ED, patient was noted to be hypoxic requiring 2L of supplemental oxygen. He was also noted to be tachypneic and tachycardic. Labs were obtained and notable for Na-132, Cr-1.38, WBC-13.09, pro-bnp of 2471, troponins of 22 followed by 21. COVID PCR was positive. UA also showed evidence of possible infection. EKG demonstrated Afib with no acute ischemic changes. CXR demonstrated evidence of COVID PNA. Patient was given a dose of Decadron as well as Rocephin for possible UTI. He was then transferred to SH Blodgett for further care due to lack of bed availability. Following admission, patient was continued on decadron and also started on remdesivir. He was diuresed to maintain net negative fluid balance. He was otherwise managed conservatively with improvement in his COVID symptoms. He was not felt to be a candidate for monoclonal Ab infusion given his initial hypoxia. Oxygen was able to be weaned to room air. Patient will discharge on oral decadron to complete 10 days of steroid therapy. Patient was otherwise continued on Rocephin for possible UTI. Blood cultures and urine culture were obtained. 1/2 blood cultures drawn on 10/2 did return positive for Klebsiella pneumoniae. Repeat blood cultures obtained 10/3 remained NTD. Urine culture showed no growth of bacteria. Given bacteremia presumed to urinary source however, patient will discharge on ciprofloxacin to complete a 10-day course. He was discharged home in stable and improved condition


VAERS ID: 1765438 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-28
Onset:2021-10-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest pain, Computerised tomogram, Electrocardiogram, Ultrasound scan
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: apixaban, colace finasteride, flomax , lisinopril, meclizine, melatonin, metoprolol, nifedipine, omeprazole, prozac, albuterol
Current Illness: anxiety, htn, pulmonary hypertension, copd, systemic sclerosis, stage 3 kidney disease, a fib, chf, sleep apnea, emphysema, hearing loss,
Preexisting Conditions: item 11
Allergies: sulfa drugs
Diagnostic Lab Data: ekg, cat scan, sonogram, blood work
CDC Split Type:

Write-up: extreme chest pains worse on deep breathing. called 911 hospitalized for chest pain


VAERS ID: 1765446 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: fever (max 102), body aches, chills, headache from 2nd Pfizer COVID vaccine
Other Medications: estrogen patch, Lexapro, Wellbutrin, furosemide, Synthroid
Current Illness: none
Preexisting Conditions: GERD, NASH, hiatal hernia, h/o ovarian cancer (2002)
Allergies: IV contrast
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Approximately 20 hours from administration of vaccine I developed a low grade fever of 100.3, body aches, headache, abdominal pain, and chills. At approximately 26 hours from administration my temperature (verified on 2 thermometers with my husband acting as control) my tympanic temperature was 105.4. Despite alternating Tylenol and ibuprofen, my fever continued to rise and peaked at 107.1 at approximately 30 hours from administration. Again, this was verified on 2 tympanic thermometers and my husband, who did not receive a vaccine, registered in the normal range with the same thermometers. I am a nurse and would not have believed it if I''d not seen it with my own eyes. I was alert and oriented throughout the night. I experienced severe chills and body aches and severe headache. Fever went down to 104 after a cool bath and cold compresses and the following day, 10/2, it stayed at 101-102. I continued to experience the same symptoms, just reduced, for the following 2 days, with a temp max of 100.3. Today, on day 5, my temperature is 99.5. I no longer have chills or body aches but do continue to have abdominal pain and fatigue.


VAERS ID: 1765496 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-11
Onset:2021-10-02
   Days after vaccination:113
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO187 / 2 - / IM

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

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

Write-up: Developed symptoms of Covid-19 and tested positive on PCR test on 10/4/21


VAERS ID: 1765515 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Chills, Computerised tomogram, Electrocardiogram, Fibrin D dimer, Full blood count, Heart rate increased, Metabolic function test, Pain, Palpitations, Pyrexia, Sinus tachycardia, Troponin T
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Potassium & magnesium supplement
Current Illness: None
Preexisting Conditions: Migraines approximately once every two months lasting 2-3 days
Allergies: Sulfa
Diagnostic Lab Data: ECG, CT Scan, EKG, Chest X-ray, Basic metabolic panel, Troponin T, D-Dimer, Complete blood count with differential.... All tests performed on 10/3/21
CDC Split Type:

Write-up: On 10/2/21, I began with the normal reported symptoms of chills, fever, body aches. I wear a constantly and noticed that my heart rate was elevated. It became very elevated and stayed so all day...my heart rate varied from 105 to over 138 throughout the day. I took a cold shower, drank cold water, did deep breathing exercises and held my breath for a beat before exhaling as attempts to lower the heart rate. These attempts would work just for a very few moments (the time of the breath and approximately 5 minutes after getting out of the shower). However, none of these methods kept my heart rate down. I went to bed with the intention that if my heart rate did not slow by 10/3/21, I would go to the hospital to be checked out. My heart rate stayed high overnight from 10/2/21 to 10/3/21. I spoke with the nurse hotline for my insurance and she advised that I go to the emergency room as, when at rest, my heart was at 105 to 110 bpm and when walking around the house it would rise to over 120. I went to the Medical Center Emergency Room on 10/3/21 where tests were conducted and I was released with a diagnosis of sinus tachycardia. As a baseline for the heart rate, my normal resting heart rate is between 73 and 75 bpm. On a normal day, I will register only approximately 70 to 120 exercise zone minutes and that is with specifically trying to exercise. On 10/2/21, when my heart was racing, I was not able to do anything but lie down.. registered 458 exercise zone minutes. Additionally, my normal daily calorie burn is between 1900 to 2500 calories with exercise. On 10/2/21 with no exercise and just lying down, my calorie burn was 3,525.


VAERS ID: 1765562 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-27
Onset:2021-10-02
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Condition aggravated, Electrocardiogram normal, Hypertension, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: norvasc 5 mg
Current Illness: high blood pressure
Preexisting Conditions: high blood pressure
Allergies: none
Diagnostic Lab Data: Oct 3 Chest Xray Oct 3 Blood Tests Oct 3 EKG
CDC Split Type:

Write-up: Very high blood pressure, heart palpitations. Visited ER was tested (EKG, Blood tests, chest Xray) no major issues identified. Following up with my cardiologist


VAERS ID: 1765623 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-10-01
Onset:2021-10-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

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

Write-up: GOT A CALL TODAY FROM THE NURSE AT A LOCAL NURSING HOME REPORTING THAT PATIENT HAD A HEART ATTACK ON 10/2/2021 A DAY AFTER GETTING THE COVID VACCINE


VAERS ID: 1765656 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-02
Onset:2021-10-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse reaction
SMQs:

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

Write-up: Adverse reaction is to the Prizer booster number 301558A given on 10/02/2021 I had no reaction to the first two shots, only the booster


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