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From the 1/14/2022 release of VAERS data:

Found 1,031,637 cases where Vaccine is COVID19 and Patient Did Not Die

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

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VAERS ID: 1897469 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-29
Onset:2021-11-23
   Days after vaccination:298
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 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: positive covid test


VAERS ID: 1897471 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5618 / 1 LA / IM

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

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

Write-up: We gave a Covid shot to the patient when the parents were requesting for a flu shot. No adverse reactions reported at the time of the incident.


VAERS ID: 1897475 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 3 LA / SYR

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

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

Write-up: Vial was opened at 9:02am on 11/22/2021 and the injection was given to patient on 11/23/2021 at 11:14am/ Patient had no Adverse reactions


VAERS ID: 1897479 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-13
Onset:2021-11-23
   Days after vaccination:224
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Dehydration, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Infective pneumonia (broad), Dehydration (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospital admission nausea, vomiting, and dehydration post op now with COVID on admit.


VAERS ID: 1897486 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 3 LA / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

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

Write-up: patient felt like her arm and face were being poked by pins and needles in the vaccinated arm lips and side of the face, it gradually went away as hours passed


VAERS ID: 1897497 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

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

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

Write-up: Administered vaccine to nervous patient. After the patient was standing for 5 minutes she collaped and hit her head on the wall. Patient was placed in supine postion given water and sugary snacks. Doctor came and evaluated patient. After 5 minutes patients vital were taken. Patient stated that she felt dizzy. After laying in supine postion for 10 minutes patient felt better.


VAERS ID: 1897513 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-24
Onset:2021-11-23
   Days after vaccination:244
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 - / -

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Infection, 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: Covid + on 11/23/2021
CDC Split Type:

Write-up: Breakthrough Case


VAERS ID: 1897538 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8028 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Immunisation, Pain in extremity, Underdose
SMQs:, Tendinopathies and ligament disorders (broad), Medication errors (broad)

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

Write-up: Client is a 12 year old female, scheduled for a Pfizer 12+ second dose. Client received a pediatric dose. Parent of the client has been notified of error and recommendation to revaccinate the client. Client vaccinated with Pfizer 12 + vaccine 11/23/21 @ 1618. 11/24/21 Communicate with the client''s mother via text message. Mother stated that the client has had a sore arm. Client?s mother denied the client having any other symptoms. Client?s mother denied having any questions or other concerns. Client?s mother advised to encourage client to move her arm and offer over the counter medications to alleviate the pain as needed according to package directions.


VAERS ID: 1897553 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-18
Onset:2021-11-23
   Days after vaccination:250
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: History of Lymphoma, diabetes, osteoporosis, ischemic cardiomyopathy, status post transplant on Cellcept/Tacrolimus
Allergies:
Diagnostic Lab Data: 11/23/2021 Coronovirus (PCR) positive
CDC Split Type:

Write-up: Patient brought to the hospital for evaluation due to being found on the floor, unknown amount of time. Patient has no memory of event.


VAERS ID: 1897572 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 394588 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Axillary mass, Chills, Condition aggravated, Joint swelling, Mass, Neck mass, Oedema, Oedema peripheral, Pain, Pyrexia, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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: 1st and 2nd Dose of Phizer 03/11/2021, 04/01/2021 (muscle aches, joint pain, and fatigue lasting 36hrs)
Other Medications: Tylenol
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 11/22/2021, started experiencing symptoms 11/23/2021 of swelling of a lump located on the (right-side) neck, under the (right) armpit, and around the (right) elbow. Body aches, chills, slight fever, and joint pain (self-treated with Tylenol). Pt. still experiencing the swelling of the neck, armpit, and elbow area. No noted Primary visit/communications.


VAERS ID: 1897608 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1161 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Musculoskeletal stiffness, Nausea, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: pt had anxiety over getting the shot but felt forced by her employer since she is a nurse. pt had nause, shooting pain and stiffness in neck, headache, sore arm.


VAERS ID: 1897609 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-02
Onset:2021-11-23
   Days after vaccination:294
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003A21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: ABBOTT ID NOW COVID-19 Positive 11/23/21
CDC Split Type:

Write-up: Presented to ED with complaints of dizziness


VAERS ID: 1897614 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 3 LA / IM

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

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

Write-up: Patient reported having flu-like symptoms on the following day.


VAERS ID: 1897622 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 3 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cetirizine, Flonase, Tylenol
Current Illness: None
Preexisting Conditions: ADHD, prediabetes, seasonal allergies
Allergies: Penicillins
Diagnostic Lab Data: EKG 11/24/21 showed tachycardia to 110 but otherwise normal.
CDC Split Type:

Write-up: Isolated tachycardia up to 140s-150s approximately 24 hours after vaccination. No chest pain or discomfort, shortness of breath, or fever.


VAERS ID: 1897654 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-19
Onset:2021-11-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Electrocardiogram
SMQs:, Supraventricular tachyarrhythmias (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: amlodipine, metropolol,oxybutrin, multivitamin,luten,coq10
Current Illness: none
Preexisting Conditions: DM type 2, HTN
Allergies: PCN, cipro
Diagnostic Lab Data: EKG
CDC Split Type:

Write-up: AFIB


VAERS ID: 1897684 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-14
Onset:2021-11-23
   Days after vaccination:313
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 LA / IM

Administered by: Unknown       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: positive covid test


VAERS ID: 1897692 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Headache, Hyperhidrosis, Nausea, Neuralgia, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: 03/09/2021 2nd dose of Moderna. Symptoms similar but not as pronunced
Other Medications: Centrum Silver 50+ multivitamin. No prescription medications are being taken or prescribed.
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: After arising early to take daughter to airport, first noted symptom was a painful headache with pain centered in head above the forehead. this was also noted after the second Moderna dose 03/09/2021. Next symptom was nausea which resulted in emesis. One short burst which resulted in a small amount of bile tasting fluid. Nausea abated after emesis. Took 1 650mg tab of Tylenol for headache which attenuated but did not completely relieve pain. Also note was a neuralgia similar as the initial symptoms of influenza. Neuralgia increased during the evening. After driving daughter to airport returned home at 07:30. Both my wife and myself retired & slept in for most of the day. I did not eat but did drink ample amount of water to avoid dehydration. During the evening from 19:00 on and through the night it was noted that I had a low-grade fever and was also very diaphoretic. Diaphoresis was extreme to the point of changing night clothes 3 times and changing bedding. Today headache has abated Minor neuralgia, but still have a low-grade fever and I am still diaphoretic. Was also able to consume food with no ill effects noted.


VAERS ID: 1897696 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-14
Onset:2021-11-23
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Covid + on 11/23/2021
CDC Split Type:

Write-up: Breakthrough Case


VAERS ID: 1897701 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 067F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Underdose
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Age 8: Complications from Xylocaine, topical - Hives & Fever
Other Medications: Fluoxetine, Busiprone, Metoprolol Succinate, Triamterene-Hydrochlorothiazide
Current Illness: Heart condition - occasional fluttering/irregular heart events, on a Beta Blocker daily
Preexisting Conditions:
Allergies: Xylocaine
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Following the injection 11/23, the Pharmacist stated that a significant amount of liquid squirted back at him. I conferred with the lead Pharmacist - Pharmacy cannot legally provide another dose. We''ll need to hope the #1 & #2 Moderna doses along with the partial Moderna booster will keep Cofid-19 at bay. I called pharmacy again and was ensured he did all that was required by law. My Doctor authorized the booster because I work with Autistic, have a heart issue and care for elderly parents.


VAERS ID: 1897706 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

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

Write-up: Patient received the COVID vaccine for ages 12 and up. Not the vaccine for ages 5-11


VAERS ID: 1897713 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-17
Onset:2021-11-23
   Days after vaccination:251
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / 2 - / -

Administered by: Pharmacy       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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Covid + on 11/23/2021
CDC Split Type:

Write-up: Breakthrough Case


VAERS ID: 1897752 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-06
Onset:2021-11-23
   Days after vaccination:262
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

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

Write-up: patient hospitalized


VAERS ID: 1897768 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058H21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Malaise
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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? Yes
Hospitalized? No
Previous Vaccinations: sore arm after 1st shot, flu symptoms and no taste after 2nd dose
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Advised pt to seek medical attention at quick care or the er.
CDC Split Type:

Write-up: Patient did not feel well after his vaccine and spent the day following his vaccine in bed. Around 7pm the day after, he felt well enough to get up an play cards. At this point he discovered his left hand (specifically his thumb and index finger) were numb and he could not move those 2 fingers - immediately dropping all the cards. Pt reported to the pharmacy at 2:45pm on 11/24 reporting the reaction. He is still not able to move those fingers, they are numb, but no pain. I advised pt to seek medical attention at quick care or the er.


VAERS ID: 1897772 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5618 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Underdose
SMQs:, Medication errors (broad)

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

Write-up: pediatric dose given. should have been 12 years+ dose. parent aware.


VAERS ID: 1897798 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-12
Onset:2021-11-23
   Days after vaccination:103
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / UNK RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / UNK 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? 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


VAERS ID: 1897799 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33026 BD / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Fatigue, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Soreness in arm within 1 hour; fatigue and body aches within 5 hours and persisting at 20 hours; stomach cramps at 12 hours until 18 hours; stomach cramps and body aches diminished with 400mg of ibuprofen at 5 hours, 13 hours, and 18 hours.


VAERS ID: 1897815 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8028 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood glucose normal, Dizziness, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: No known
Preexisting Conditions: Seizures, Dementia, Hypertension
Allergies: No known drug or food allergies
Diagnostic Lab Data: Glucose on scene was 77
CDC Split Type:

Write-up: After patient received his Pfizer booster, he was sitting in observation for 15 minutes. As the team was getting ready to discharge him after the 15 minutes, the team noticed the patient was leaning to the side and asked him how he was feeling. Pt stated he was lightheaded and then lost consciousness. Team immediately called 911 and checked his vitals. Pt''s pulse was palpable, blood pressure - 160/100, glucose was 77. Pt then gained consciousness as EMS arrived (approximately 2 minutes later). Pt was transported to hospital via EMS.


VAERS ID: 1897840 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012H21B / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bursa injury, Injury, Product administration error
SMQs:, Accidents and injuries (narrow), Hostility/aggression (broad), Medication errors (narrow)

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

Write-up: Pt went to doctor to discover Bursa injury due to high administration of Moderna vaccine


VAERS ID: 1897841 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-01-25
Onset:2021-11-23
   Days after vaccination:302
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 LA / IM

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

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

Write-up: Fully vaccinated EE tested positive for covid-19


VAERS ID: 1897845 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-01-15
Onset:2021-11-23
   Days after vaccination:312
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none known
Current Illness: none known
Preexisting Conditions: none known
Allergies: none known
Diagnostic Lab Data: PCR + 11/23/2021 for Covid
CDC Split Type:

Write-up: Client vaccinated with Moderna vaccines approx Jan 15 and Feb 15, 2021. Symptom started 11/23 - fever 100.1 and nasal congestion. Reported as case of breakthrough Covid in a previously vaccinated person. Has not received booster dose.


VAERS ID: 1897846 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5618 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Underdose
SMQs:, Medication errors (broad)

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

Write-up: given a pediatric dose and should have been given an adult dose


VAERS ID: 1897862 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra dose administered, Fatigue
SMQs:, Medication errors (narrow)

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

Write-up: Nurse gave patient his 3 rd dose of Pfizer. She realized after giving the dose she gave too much. She gave 0.5ml instead of 0.3ml. Patient was informed about the dosage. Also the staff called the Health Officer about the error. Patient was upset. Dr. did call the patient to reassure. I also called the patient today to get information & see how he was doing. He stated that he was really tired. No other issues.


VAERS ID: 1897875 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 1 AR / IM

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

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

Write-up: The patient started to lean on his sister sitting next to him and then fainted, momentarily. His father helped lower him to the ground. no injuries happened as a result. He rested on a cot for approx 20 minutes, drank some juice, feeling better and leaving shortly after that. Suspect vasovagal reaction post vaccination. The patient described feeling "dizzy'' but doesn''t remember anything after that.


VAERS ID: 1897879 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / UNK RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Influenza, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (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: Extreme muscle and joint pain, fever, headache, fatigue, pain and distortion of left middle finger
Other Medications: Quinipril, Nifedipine, Modafinil, Volteran,
Current Illness: None
Preexisting Conditions: Hypertension, Bi-Polar Syndrome, ADHD
Allergies: Sulfa
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Muscle and joint pain, headache, fatigue, feeling of coming down with the flu, no fever


VAERS ID: 1897883 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-17
Onset:2021-11-23
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Blood creatinine normal, Blood glucose normal, C-reactive protein increased, COVID-19, Chest X-ray abnormal, Culture stool, Dyspnoea exertional, Fibrin D dimer, Full blood count, Laboratory test abnormal, Lung opacity, Metabolic function test, SARS-CoV-2 test positive, White blood cell count decreased
SMQs:, Anaphylactic reaction (broad), Haematopoietic leukopenia (narrow), Interstitial lung disease (narrow), Systemic lupus erythematosus (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), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amoxicillin-clavulanate (AUGMENTIN) 875-125 MG per tablet Ascorbic Acid (VITAMIN C PO) aspirin 81 MG tablet benzonatate (TESSALON) 200 MG capsule betamethasone dipropionate 0.05 % cream clonazePAM (KLONOPIN) 0.5 MG tablet clotrimazole (LOTR
Current Illness:
Preexisting Conditions: Bipolar 2 disorder DM (diabetes mellitus), type 2 with renal complications Chronic kidney disease (CKD), stage III (moderate) HTN (hypertension) Restless leg syndrome IBS (irritable bowel syndrome) Hyperlipidemia PAD (peripheral artery disease) Gastroparesis Coronary artery disease due to lipid rich plaque History of pulmonary embolism Osteoporosis Morbid obesity with BMI of 40.0-44.9, adult S/P total knee arthroplasty Binswanger''s encephalopathy Back pain Carotid artery disease Thyroid nodule Colonoscopy refused Urge incontinence of urine Impaired mobility Dyspnea on exertion Chronic diastolic heart failure
Allergies: Statins Clonidine Dyazide Norvasc Prilosec
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized 11/23/2021-still admitted currently; COVID-19 positive 11/23/2021; fully vaccinated plus booster CHIEF COMPLAINT: COVID ASSESSMENT / PLAN: Acute Respiratory Failure, secondary to COVID-19 o COVID-19 Infection - confirmed on 11/23/2021. o Vaccine Status: Fully vaccinated (Pfizer). Booster: Yes, dose on 11/17/2021 o Outpatient CXR (11/8/2021) suspicious for CAP - treated with Augmentin and Azithromycin o CTA Thorax (11/23/2021) - bilateral ground glass opacities, negative for PE o Abnormal Labs: ? Glucose - 61 � Corrected in ER ? Cr - 1.10 ? WBC - 3.94 o Plan for Admission to Blodgett ? Hold Decadron as patient is not requiring O2. Did desaturate with ambulation but otherwise normal. Start if hypoxia occurs. ? Hold ABX, secondary to questionable Cdiff. � Procalitonin ordered ? Not eligible for Remdesivir ? Trend CBC, CMP, D-Dimer, CRP ? Follow stool cultures ? Acapella, mucinex BID and Albuterol BID ? Encourage prone positioning, tessalon perles PRN, albuterol PRN ? Continuous O2 monitoring - not currently on O2. ? Respiratory Isolation


VAERS ID: 1897884 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-24
Onset:2021-11-23
   Days after vaccination:244
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER6730 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray abnormal, Confusional state, Cough, Dyspnoea, Insomnia, Mental status changes, Oedema peripheral, Pneumonia, SARS-CoV-2 test positive
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Eliquis 5 mg oral tablet, 5 mg= 1 TAB, PO, BID (2 times a day) Lipitor 10 mg oral tablet, 10 mg= 1 TAB, PO, Daily Metoprolol Succinate ER 100 mg oral tablet, extended release, 100 mg= 1 TAB, PO, Daily
Current Illness:
Preexisting Conditions: DVT, PE Hypertension
Allergies: IVP dye morphine
Diagnostic Lab Data: 11/23/2021 COVID19 PCR test positive 11/23/21 CXR suspected pneumonia, greater right lung involvement.
CDC Split Type:

Write-up: 86-year-old male past medical history hypertension, high cholesterol, CLL pulmonary embolism, pleural effusion who is here for evaluation of shortness of breath the patient had this morning and altered mental state present for the last 5 days. Patient tested positive for COVID 1 week ago he was initially started on Medrol Dosepak that was switched to dexamethasone. Patient also took couple doses of Augmentin that was discontinued after patient received monoclonal antibody infusion on Friday. Since Friday patient has had hard time sleeping at night time. Patient''s family states the patient appears to be more confused from time to time. Patient lives independently and is self-sufficient. Patient has had cough since Tuesday which has been improving. This morning patient complained of shortness of breath the patient states currently has resolved. Patient has been able to tolerate oral intake. Patient has been able to ambulate without any difficulty. Patient is on Eliquis a given pulmonary embolism 1 year ago. Patient''s family also noted increasing lower extremity edema. Patient has been compliant with all his medications. Patient has not required any oxygen. Patient received full COVID vaccinations did not receive booster.


VAERS ID: 1897892 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 3 LA / IM

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

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

Write-up: Patient was given the wrong dose. She was given 0.5ml of Pfizer instead of 0.3ml. She stayed the 15 minutes. No s/s of adverse effects from receiving the wrong dose was noted.


VAERS ID: 1897902 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-16
Onset:2021-11-23
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Injection site pain, Injection site reaction, Injection site warmth
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? 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 reaction- R deltoid localized skin erythema, warmth, and tenderness 1 week after vaccination


VAERS ID: 1897921 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 3 LA / SYR

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

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

Write-up: Patient was given Pfizer COVID-19 vaccination that expired one day prior to administration.


VAERS ID: 1897928 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / SYR

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

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

Write-up: Patient was given Pfizer COVID-19 vaccination that expired one day prior to administration.


VAERS ID: 1897944 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / SYR

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

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

Write-up: Patient was given Pfizer COVID-19 vaccination that expired one day prior to administration.


VAERS ID: 1897994 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939909 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoacusis, Lymph node pain, Lymphadenopathy, Pain in extremity
SMQs:, Hearing impairment (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: Levothroxine
Current Illness: Na
Preexisting Conditions: Celiac disease
Allergies: cipro , sulfa
Diagnostic Lab Data: Na
CDC Split Type:

Write-up: Hearing dimming, like someone turned the volume down on life. Also arm pain and swollen lymph nodes all over but mostly painful in left axilla


VAERS ID: 1897996 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-10-25
Onset:2021-11-23
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Endotracheal intubation, Oxygen saturation decreased, SARS-CoV-2 test positive
SMQs:, Angioedema (broad), Acute central respiratory depression (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Covid positive on 11/5
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient required immediate intubation on arrival to the ED due to pulse ox in the 40?s.


VAERS ID: 1898019 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 213D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyskinesia, Fall, Fatigue, Gaze palsy, Laboratory test, Loss of consciousness, Seizure
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Dyskinesia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None reported
Preexisting Conditions: None reported
Allergies: Biaxin is the only thing reported
Diagnostic Lab Data: Tests were whatever EMT''s performed, we did check him with BP monitor and found heart rate to be 30
CDC Split Type:

Write-up: Patient was nervous about getting injection but said he wanted it and would be fine. I gave the injection and stood by patient (just in case) after 30 or 40 seconds he told me he felt funny, the next thing I see he slumped in chair, his head dropped back and his eyes rolled to back of his head, he had a mild seizure, body jerking for a few seconds then stopped, he started to come around but then passed back out and had mild seizure again. Patient came to again and stayed awake. He stated that he had a similar reaction when giving blood. EM T came and took care of him, his heart rate was 30 as he was coming to. He was advised to go to hospital but refused. Girlfriend came and picked him up. I called him today and he said he was tired but felt better and even went to the gym.


VAERS ID: 1898168 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 8030 / 3 - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Decreased appetite, Fatigue, Headache, Malaise, Pain in extremity, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (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: Feel sick, don?t want to eat, extreme chills, headache, sharp pain in left under arm, heart palpitations fatigue Has continued since day after injections


VAERS ID: 1898185 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

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

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

Write-up: High fever


VAERS ID: 1898193 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031H21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Fatigue, Haematochezia, Headache, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Guillain-Barre syndrome (broad), Ischaemic colitis (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: Aleve
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bloody stool. head and body pain, weakness and fatigue. Body pain cleared up by 11/24 but bloody stool remained. I went to a doctor who said to monitor over the next couple days and if bloody stool continues to take a steroid that was prescribed.


VAERS ID: 1898199 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5618 / 1 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS ZG474 / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immediate post-injection reaction, Inappropriate schedule of product administration, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Medication errors (narrow), Hypoglycaemia (broad)

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

Write-up: Patient fainted immediately after giving 2nd vaccine. (Fluarix). Her head went straight back over the top of the chair and she gasped 2 times. I assumed her airway was restricted. In the meantime, her mother came over and sat next to her and asked if she had a seizure. I said that I did not believe she had a seizure. Mother also said she had no history of seizures or fainting. Just about then the young lady popped up totally alert and able to answer questions from her mother. Her mother said she felt like she had a fever and wanted to sit there for a while. She asked if I could take her blood pressure and I told her I did not believe we had a monitor. They left after about 10 minutes.


VAERS ID: 1898459 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-16
Onset:2021-11-23
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 077C21B / 3 LA / SYR

Administered by: Private       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: See above regarding 1st Moderna Covid shot.
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None so far
CDC Split Type:

Write-up: Only one week after Moderna booster (3rd shot) began developing hives and rash that spread across entire body. Had a much more mild reaction localized to injection arm only one week after the 1st shot (also Moderna). No rash on 2nd shot. This 3rd shot has produced hives across entire body one week later (nothing during the intervening days though).


VAERS ID: 1898465 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1620 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Diarrhoea, Fatigue, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Propranolol 15 mg per day
Current Illness: None
Preexisting Conditions: CFS
Allergies: Steroids, tannins several food sensitivities..
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe diarrhea for hours. Also, tingling in left arm, hand and shoulder, and lower leg and foot. Tingling, burning sensation throughout left side back. All coupled with uncommon and severe, head-dropping fatigue.


VAERS ID: 1898604 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Lethargy, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pfizer initial 2 covid vaccines
Other Medications: Nortryptiline
Current Illness: None
Preexisting Conditions: No conditions
Allergies: Amoxicillin
Diagnostic Lab Data: I am a medical doctor MD
CDC Split Type:

Write-up: Severe muscle and joint pain throughout entire body, severe fatigue, lethargy, chills


VAERS ID: 1898619 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Pruritus
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient got Moderna booster and 15 minutes later she started reporting itching and difficulty in breathing. She was responsive and comunicating well. I called 911. The paramedics came in and gave her a shot of benadryl and then transported her to the hospital. Today she is doing fine


VAERS ID: 1898726 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Headache, Pain
SMQs:

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

Write-up: Headache, chills, body ache


VAERS ID: 1898730 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-18
Onset:2021-11-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit D 3
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Low Platelet count = 114
CDC Split Type:

Write-up: Sustained decreased platelet count 5 days after booster injection.


VAERS ID: 1898732 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Influenza like illness, Pulse abnormal, Somnolence, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: On 11/23/21 Patient experienced a reaction to the J & J covid-19 vaccine. At approximately 5 to 10 min after receiving vaccine complained of ringing in his ears, dizziness. Pt appeared diaphoretic and had a thready pulse. No complaints of inability breathing and when prompted to breath more deeply was able to do so. Pt was instructed to lie on floor with feet elevated by the seat of the chair. At 6:06 pm a blood pressure was taken resulting in 145/84 with a pulse of 58. pt remained on floor until he felt he could sit up and was instructed to sit up slowly. He returned to sitting in his chair and BP was taken again with a result of 127/77 with a pulse of 58. Pt felt he was stable enough to go home and was instructed to seek further medical attention if symptoms worsened. Pt stated he would do that. He was also given the phone number of the medical exchange by NP who assisted with rendering aid. 11/24/21 - A follow up call was made to patient. pt stated he was doing better than yesterday. When he returned home on 11/23/21 he ate some food and felt better. He states he slept a lot and today is experiencing flu like symptoms but feeling overall feeling better than yesterday.


VAERS ID: 1898733 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027421B / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 100mg
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA, seasonal
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Swollen, painful lymph nodes on R neck, R clavicle, R axilla, R inguinal fold. Right clavicle and underarm nodes ~5cm in diameter


VAERS ID: 1899501 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Chills, Decreased appetite, Fatigue, Headache, 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none known
Preexisting Conditions: none
Allergies: zantac
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shivers, fever (close to 100F), pounding headache, nausea/loss of appetite, fatigue All still present 31 hours after the injection.


VAERS ID: 1899502 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

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

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

Write-up: Swollen lymph nob


VAERS ID: 1899249 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-11-23
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211151926

Write-up: SWEATING MORE AT NIGHT; A BIT OF PAIN ON MY ARM; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 23-NOV-2021 for prophylactic vaccination. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 23-NOV-2021, the patient experienced sweating more at night. On 23-NOV-2021, the patient experienced a bit of pain on my arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the a bit of pain on my arm and sweating more at night was not reported. This report was non-serious.


VAERS ID: 1899695 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Senior Living       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
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient received the Moderna vaccine, first dose at 17 years old.


VAERS ID: 1899709 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8027 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Product administration error
SMQs:, Extravasation events (injections, infusions and implants) (broad), Medication errors (narrow)

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

Write-up: Site: Pain at Injection Site-Mild, Systemic: patient distracted me and quickly grabbed the vaccine off the table and injected his left arm. I did not complete in the system or fill out his card as I did not administer and did not know if he in fact got it or squirted it quickly.-Mild, Additional Details: I cannot confirm if patient received the vaccine or not. He turned his chair saying he wanted it in his right arm. He then asked if I could use the bandaid he just bought and I said sure. I was opening the box when he quickly grabbed the syringe off of the table and injected himself in the left arm lower than his deltoid. He had clicked the vanishpoint. I asked why he did that and he was laughing and said he thought it would be fun to do it himself. He watched the pharmacist do it last time.


VAERS ID: 1899714 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8027 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac disorder, Chest discomfort, Chest pain, Flushing, Hyperhidrosis, Interchange of vaccine products
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Medication errors (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Cardiac Disorder (diagnosed by MD)-Severe, Systemic: Chest Tightness / Heaviness / Pain-Severe, Systemic: Flushed / Sweating-Medium, Additional Details: pt received moderna series and pfizer booster


VAERS ID: 1899731 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012H21B / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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: Itching at Injection Site-Mild, Site: Redness at Injection Site-Mild, Systemic: Allergic: Itch Generalized-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Systemic: Per patient she had hives /rashes on leg and elbow-Mild


VAERS ID: 1899735 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 3 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injection site bruising, Injection site erythema, Injection site pain, Injection site swelling, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (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: Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-


VAERS ID: 1899931 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Malaise, Pain, Pyrexia, Respiratory tract congestion
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 19, COVID-19 pfizer, weakness and swollen lymph node
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: amoxicillin, keflex
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever of 102, weakness, malaise, body aches, congestion


VAERS ID: 1899945 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 067F21A / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect route of product administration, Injection site bruising, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Drug abuse and dependence (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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: Women?s Daily Probiotic, Xyzal, vitamin b-12 1000mcg, venlafaxine 150mg, aripiprazole 5mg, Bupropion SR 150mg BID,
Current Illness:
Preexisting Conditions:
Allergies: Tramadol
Diagnostic Lab Data:
CDC Split Type:

Write-up: My arm started to become pruritic at the injection site around 7pm, the injection site felt very warm, swollen and tender. The next day the injection site was worse- more red, swollen and hot to the touch. I asked my friend who is a pharmacist and she said it looks like the injection was given too low on the arm. By 10pm on Wednesday 24th the site was starting to look red and purple as if it is bruising. The site has remained itchy through out this time as well. I have applied numerous ice packs on the site for swelling but the swelling persists.


VAERS ID: 1899962 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Chills, Injection site lymphadenopathy, Nausea, Pain, Pyrexia, Rash, Swelling, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Similar symptoms with the previous Covid Pfizer vaccine injection, received May 12, 2021, patient was 22 yoa
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None have been performed
CDC Split Type:

Write-up: Fever: began 12 hours after injection - highest was 101.1 F - treated with acetaminophen - remains at 99.5 F Aches: began 12 hours after injection - everywhere especially left arm - treated with acetaminophen - remains slightly painful Chills: began 12 hours after injection Nausea: began 24 hours after injection Vomiting: began 24 hours after injection Rash around neck: began 48 hours after injection Swelling: began 24 hours after injection - centralized around lymph node tissue closest to injection site


VAERS ID: 1899963 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Chills, Diarrhoea, Feeling abnormal, Productive cough, Pyrexia, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Diarrhea and stomach issues for 2 weeks
Other Medications: Vitamin D3, Calcium 500 mg, Losartin HCT 40/25, Cranberry, Zinc, Vitamin C
Current Illness: None
Preexisting Conditions: Obesity and hypertension
Allergies: None
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: This was my third shot/a booster. No effects until Tuesday evening after vaccination. Chills, Fever, and low grade temperature. Also had diarrahea and stomach issues. This is day and symptoms persist. Highest fever today November 25, 2021 is 99.9. Normal temperature for me is 97.1. Cough that is productive today but had cough for 3 days. Overall feel awful. Took a home Covid test and it came back negative. Today seems to be the worse day so far.


VAERS ID: 1899965 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 069F21A / 3 LA / SYR
UNK: VACCINE NOT SPECIFIED (OTHER) / UNKNOWN MANUFACTURER - / N/A LA / SYR

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

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

Write-up: Hard, red, swollen, slightly itchy circle at injection site


VAERS ID: 1899975 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-11-16
Onset:2021-11-23
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8028 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Asthma, Condition aggravated, Diarrhoea, Fatigue, Influenza like illness, Migraine, Nausea, Pain, Poor quality sleep, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 300 mg gabapentin; .25 Mirapex; One loratadine; 15 mg folate; 1 mg lorazepam; 100mg levothyroxine; HRT Aravella FE 1/20; Vitamin B complex; Zinc; Ester C; Magnesium gluconate; Vitamin D3, two pills equals 10,000 units; Coenzyme Q10 600mg; 1
Current Illness: Hypermobile Ehlers-Danlos Syndrome, Homogenius MTHFR, COMT, Autism Spectrum disorder, ADHD, degenerative disk disease, spondolitis, Dysautonomia, Mast Cell activation Disorder, Asthma
Preexisting Conditions: Hypermobile Ehlers-Danlos Syndrome, Homogenius MTHFR, COMT, Autism Spectrum disorder, ADHD, degenerative disk disease, spondolitis, Dysautonomia, Mast Cell activation Disorder, Asthma
Allergies: ginger, clindamicin, zoloft, montelukast
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Strong reaction to vaccine. Feels like I have the flu combined with feeling like I have been in an auto accident. I have had a fever ranging from 99.0-99.6 and I normally have low body temp of 96.8 due to my connective tissue disease, EDS so a "low grade fever" for most is more significant for me. I also have had non-stop issues with my asthma and normally I only have to use it when I have a virus. I feel like this vaccine has caused system wide inflamation. Pain is not stopping, nausea, diarrhea, severe fatigue, wide spread body pain, not sleeping well, increased anxiety, 9 days post vaccine it is not letting up. Woke this morning with a migraine that did not respond to any medications. I was afraid to get this vaccine and now it seems I had good reason to be afraid of it. This needs to be studied more in those who have genetic mutation, I have MANY.


VAERS ID: 1899998 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Dyspnoea, Fatigue, Hyperhidrosis, Musculoskeletal stiffness, Nausea, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Simistatin 10mg ,preservision
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient felt nauseous, sweaty and fainted with severe stiffness. Patient stopped breathing during this event. Patient woke up with confusion and had fatigue for the rest of the day followed by a fever.


VAERS ID: 1900002 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Potassium hydroxide preparation positive, Vulvovaginal burning sensation, Vulvovaginal discomfort, Vulvovaginal mycotic infection
SMQs:, 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: flu shot over 6 years ago resulted in flu like symptoms for 24 hours
Other Medications: seroquel 75mg po QHS trazodone 50mg QHS
Current Illness: none
Preexisting Conditions: interstitial cysitis
Allergies: mango
Diagnostic Lab Data: Wet prep + yeast
CDC Split Type:

Write-up: vaginal irritation/burning; yeast infection


VAERS ID: 1900006 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33026BD / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Breast pain, Chest pain, Pain in extremity
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Lipodystrophy (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called me on 11/24/21 and informed me that she got the shot on 11/22/21 at 1 pm and she started having reaction on 11/23/21 at 9 pm. She had pain in left arm, left armpits and chest pain and pain was radiating to left arm and left side of breast, also soreness on left arm.


VAERS ID: 1900015 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Hypoaesthesia, Myocarditis, Palpitations
SMQs:, Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Chest xray
CDC Split Type:

Write-up: Left a numb, chest pain, heart palpitations, heart inflammation.


VAERS ID: 1900017 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER UNKNOWN / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Feeling abnormal
SMQs:, Anaphylactic reaction (broad), Dementia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse but was not taken day of
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chest cramps, chest tightness, and chest pressure. Brain fog for days. Chest cramps have subsided but still notice a little tightness still there


VAERS ID: 1900022 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Memory impairment, Photophobia, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (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: Norethindrone
Current Illness: -
Preexisting Conditions: Migraines
Allergies: Sulfa
Diagnostic Lab Data: Vital signs done
CDC Split Type:

Write-up: Changes in vision; my eye vision has drastically decreased its hard to focus/see words/letters. My eyes are very sensitive to light. I have became very forgetful this is not normal. This all happened within 30 minutes of receiving the vaccine.


VAERS ID: 1900024 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031H21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Headache, Insomnia, Sensation of foreign body, Throat tightness, Tinnitus
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hearing impairment (narrow), Hypersensitivity (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: Singular (nightly)
Current Illness: None
Preexisting Conditions: Seasonal allergies, mild asthma
Allergies: None
Diagnostic Lab Data: None at this time, unable to get appointment due to holidays.
CDC Split Type:

Write-up: Within 5 minutes, felt a lump in my throat and continued throat closure almost to the point of having difficulty breathing. Pharmacist provided 10mg of Benadryl. Took 1.5 hours for throat issue subsided. Did not have any reaction to the first 2 shots like this. 2 hours later, after resting for an hour significant loud high pitched ringing began in my left ear. Ringing has not stopped, now 46 hours later. Severe fatigue, moderate headaches and difficulty sleeping since the shot was administered.


VAERS ID: 1900030 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3203BD / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain
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: Depo-Provera
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain in upper armpit area on same side as injection site, left side. Onset about 8 hours after injection. Application of warm towel for relief. Still persisting, but subsiding 48 hours after injection.


VAERS ID: 1900035 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / SYR

Administered by: Senior Living       Purchased by: ?
Symptoms: Chills, Injection site erythema, Injection site induration, Injection site inflammation, Injection site mass, Injection site pain, Lymph node pain, Lymphadenopathy, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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: Oral contraceptives Adderall
Current Illness: None
Preexisting Conditions: None
Allergies: Azythromycin
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: $g102 fever for over 24 hours, short-term relief with ibuprofen and then would return. Chills, body aches. Fever finally broke and stayed gone at around 10am on 11/25/21. Hard, painful lump at injection site. Red, inflamed ring around injection site that extends out over 4 inches away from site. Swollen, painful axillary lymph node in same side as injection. Still have sore arm and pain at this moment.


VAERS ID: 1900037 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

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

Write-up: Uncomfortable tightness in chest, high resting heart rate (normal resting heart rate ~60 bpm, during this episode the resting heart rate was around ~80 bpm. This was even laying down and doing nothing for hours at a time. Even slight movement, walking could increase heart rate above 90-100 bpm. This side effect persisted until some point at night. Upon waking up, the symptom had disappeared and heart rate had returned to normal.


VAERS ID: 1900039 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Flatulence, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (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: Levothyroxine Sodium 125mcg, vitamin D, Vitamin B12
Current Illness:
Preexisting Conditions: Hypothyroidism
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm pain at injection site, started on 11/23/2021 and is still somewhat sore on 11/25/2021. Flatulence - started 11/23/2021 at about 1PM, continued 11/23/2021, and still noticable on 11/23/2021, thought it is subsiding.


VAERS ID: 1900058 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site induration, Injection site pain, Injection site pruritus, Injection site reaction, Night sweats, Oropharyngeal pain, Pain, Rash erythematous, Rash papular
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Round, raised and hard red rash at shot site on left arm, very itchy, painful and as big as a desert plate. Also, 2 days of severe body aches and one night of extreme night sweats. And a sore throat.


VAERS ID: 1900199 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / -

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Bone pain, Chest pain, Dyspnoea, Hypoaesthesia, Injection site pain, Pain
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Osteonecrosis (broad), Arthritis (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Zoloft
Diagnostic Lab Data: None. Was told there is nothing that can be done.
CDC Split Type:

Write-up: Right arm pain to hand with shooting pain two days after. Some numbness in right palm and fingers. Severe bone pain. Joint pain but this seemed like bone pain. Worse pain I''ve ever had even compared to child birth. The bone pain was like nothing I have ever experienced. Shortness of breath and some chest pain with gasping for air twice while trying to fall asleep, which has never happened to me. I''m very healthy.


VAERS ID: 1900681 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site reaction, Skin lesion
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: Synthroid
Current Illness: None
Preexisting Conditions: Hashimotos
Allergies: Percocet
Diagnostic Lab Data:
CDC Split Type:

Write-up: A lesion similar to a pox mark developed next to the injection site


VAERS ID: 1900682 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: Biotin, CBD, glucosamine, chondroitin, MSM
Current Illness:
Preexisting Conditions: Exercise induced asthma
Allergies: Niacin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe paresthesia accompanied with chills. Chills lasted about 2 hours; paresthesia got better over time but lasted about 24 hours.


VAERS ID: 1901075 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-11-23
Submitted: 0000-00-00
Entered: 2021-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211152265

Write-up: TINNITUS THROUGH THE ROOF; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 23-NOV-2021, the patient experienced tinnitus through the roof. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of tinnitus through the roof was not reported. This report was non-serious.


VAERS ID: 1901408 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Injection site pain, Interchange of vaccine products, Pain, Productive cough, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Medication errors (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

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

Write-up: First 2 shots were Pfizer. Pharmacy I went to only had Moderna for booster. Since it has been stated it''s OK to mix and match I decided to move forward with Moderna booster. I was fine for first 12 hours after the booster. Was out and about all day. Late that evening I started to get a headache and chills. Then it got progressively worse over next 24 hours. Developed low-grade fever. Body was very achy. Injection site was sore for 2+ days. Developed a wet cough day after getting booster. Chills, fever, body ache when away on 11/25 but still have the cough.


VAERS ID: 1901409 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

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

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

Write-up: High fever of 102.5 on the day after shot, muscle aches, chills. Second day after shot, high fever of 101.2, muscle aches , chills. Third day normal temperature, felt better.


VAERS ID: 1901414 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / -

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

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

Write-up: Got the booster in left arm, not sure if its in the muscle but my arm is HOT, you can feel the warmth through clothes and its red. The heat is bothering me...I iced it when I got home, tuesday and wednesday and took motrin.


VAERS ID: 1901857 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-04
Onset:2021-11-23
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Blood culture negative, Blood gases, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chronic obstructive pulmonary disease, Condition aggravated, Cough, Dyspnoea, Fatigue, Fibrin D dimer normal, Hypoxia, Lung infiltration, Lung opacity, Respiratory distress, SARS-CoV-2 test positive, Spirometry, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ADVAIR HFA 230-21 MCG/ACT inhaler albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler aspirin 81 MG EC tablet fluticasone-umeclidin-vilant (TRELEGY ELLIPTA) 100-62.5-25 MCG/INH inhaler ipratropium-albut
Current Illness: 4/27/2021- COPD with exacerbation; Acute suppurative otitis media of right ear without spontaneous rupture of tympanic membrane, recurrence not specified; Acute pansinusitis, recurrence not specified; Benign paroxymal positional vertigo, unspecific laterality; Trapezius muscle spasm
Preexisting Conditions: Hospital Pneumonia due to COVID-19 virus Acute respiratory failure with hypoxia (HCC) COPD with acute exacerbation (HCC) Hypertension Obesity Non-Hospital Benign prostatic hyperplasia, unspecified whether lower urinary tract symptoms present Seasonal allergic rhinitis due to pollen Low testosterone in male Tobacco abuse Heart failure, unspecified HF chronicity, unspecified heart failure type (HCC) Lung nodule < 6cm on CT
Allergies: No Known Allergies
Diagnostic Lab Data: Procedure Component Value Ref Range Date/Time DR CHEST SINGLE VIEW [354573878] Resulted: 11/23/21 1235 Order Status: Completed Updated: 11/23/21 1237 Narrative: EXAMINATION: Single View Chest EXAM DATE: 11/23/2021 12:31 PM TECHNIQUE: Single view chest INDICATION: dyspnea COMPARISON: 9/3/2021 ENCOUNTER: Not applicable _________________________ FINDINGS: Heart size is normal. No mediastinal pathology. The lateral aspect of the left lower lung is not included on this study. Within the visualized lungs, there has been increase in moderately prominent streaky opacification in both lungs. No pneumothorax or definite pleural effusion. _________________________ Impression: Increase in moderate streaky opacification of both lungs. This could represent either vascular congestion or pneumonia. Recommend clinical correlation. Procedure Component Value Ref Range Date/Time Peripheral Blood Culture [354573873] Collected: 11/23/21 1148 Order Status: Completed Specimen: Blood, Venous Updated: 11/25/21 1401 Cult Blood Peripheral No Growth 48 hours Peripheral Blood Culture [354573874] Collected: 11/23/21 1156 Order Status: Completed Specimen: Blood, Venous Updated: 11/25/21 1401 Cult Blood Peripheral No Growth 48 hours Narrative: Draw from a different site than draw one. COVID-19 PCR - Rapid [354573883] (Abnormal) Collected: 11/23/21 1155 Order Status: Completed Specimen: Swabbed Collection from Nasopharynx Updated: 11/23/21 1211 COVID-19 PCR Detected Abnormal
CDC Split Type:

Write-up: Patient currently admitted at (3) days inpatient stay starting at 11/23/2021. PT 56 y.o. male who presents to hospital with shortness of breath. Patient is presently vaccinated against COVID in May of this year. He states approximately 2-3 days ago he began having worsening cough shortness of breath and fatigue. Denies any GI complaints. He has been using his oxygen around the clock; normally only uses 3 L at night. Because of worsening shortness of breath he presented to the emergency department for evaluation. Oxygen saturations on room air were in the 70s. He is currently saturating 94% with 4 L of oxygen. Chest x-ray showed bilateral infiltrates and COVID testing was positive. He had significant wheezing; he did get steroids but did not get bronchodilators. D-dimer was negative. Because of his worsening hypoxemia and respiratory distress he was referred to the hospital for further evaluation and care. Acute respiratory failure with hypoxia (HCC) Assessment & Plan Patient uses 3 L of oxygen at nighttime only Concurrently saturating 94% on 4 L Plan incentive spirometry, flutter, proning as tolerated Check blood gases to rule out hypercapnia COPD with acute exacerbation (HCC) Assessment & Plan Patient with history of severe disease based on PFTs Uses trilogy at home Suspect exacerbation worsened due to underlying COVID Aggressive respiratory hygiene steroids and bronchodilators Strongly encouraged smoking cessation * Pneumonia due to COVID-19 virus Assessment & Plan Patient with symptom onset 11/21 Worsening shortness of breath cough and hypoxia Chest x-ray showing bilateral infiltrates Vaccinated in April and May of 2021 COVID positive 11/23 Plan admission, steroids, remdesivir, and aggressive supportive respiratory care Hypertension Assessment & Plan Blood pressure is currently stable Obesity Assessment & Plan Body mass index 47.6


VAERS ID: 1901865 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), 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: n/a
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called pharmacy on Friday morning . He stated that his whole arm is red , swollen and hurts him. It started Tuesday and continued till Friday morning. Patient states he is stable and concerned about his arm.


VAERS ID: 1901888 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 3 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Extra dose administered
SMQs:, Medication errors (narrow)

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

Write-up: Patient not eligible for the booster shot. It had not been 6 months. There was a miscommunication between nursing staff and pharmacy vaccinators.


VAERS ID: 1901915 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-27
Onset:2021-11-23
   Days after vaccination:241
Submitted: 0000-00-00
Entered: 2021-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN2613 / 2 - / -

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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID+ 11/23/21
CDC Split Type:

Write-up: BREAKTHROUGH CASE


VAERS ID: 1901923 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-10
Onset:2021-11-23
   Days after vaccination:136
Submitted: 0000-00-00
Entered: 2021-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 - / -

Administered by: Pharmacy       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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID+ 11/23/2021
CDC Split Type:

Write-up: BREAKTHROUGH CASE


VAERS ID: 1901932 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-11-23
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 3 LA / IM

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

Write-up: Breakthrough COVID case, fully vaccinated, with booster dose. Immunocompromised.


VAERS ID: 1901962 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Nausea
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: Mercaptapurine, Prozac, vitamin D, folic acid, black seed oil, low dose aspirin
Current Illness: None
Preexisting Conditions: Crohn?s disease, depression
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fatigue, chills, nausea. No treatment. 11am to 2 pm 11/23/2021.


VAERS ID: 1901974 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-11-21
Onset:2021-11-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8098 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram, Chest pain, Chills, Computerised tomogram abdomen, Computerised tomogram normal, Computerised tomogram pelvis, Culture urine negative, Electrocardiogram abnormal, Fibrin D dimer increased, Heart rate increased, Inflammation, Nausea, Pain, Pyrexia, Sinus tachycardia, Vomiting, White blood cell count increased
SMQs:, Acute pancreatitis (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Protonix, Vitamin D
Current Illness: No
Preexisting Conditions: Autoimmune arthritis, GERD
Allergies: Gluten
Diagnostic Lab Data: WBC 18. D-dimer elevated, CTA of chest negative. CT abdomen/pelvis negative. Covid negative. Urine culture negative. Blood culture pending as of 11/26/21. EKG showed sinus tachycardia. Received 4 bags of IV fluids and antiemetics.
CDC Split Type:

Write-up: Pfizer booster on 11/21/2021. On 11/23/2021, developed fever up to 102, vomiting, body aches, nausea, chills. By 11/25/2021, had chest pain and a heart rate in the 180s. Went to ER on 11/25/2021. Covid test negative. Diagnosed with massive inflammatory likely r/t Pfizer booster response by Patient.


VAERS ID: 1901981 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-11-22
Onset:2021-11-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Joint range of motion decreased, Pain in extremity
SMQs:, 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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: arm soreness, limited range of motion


VAERS ID: 1901982 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Condition aggravated, Diarrhoea, Headache, Hyperhidrosis, Interchange of vaccine products, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Medication errors (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: 19, rash, fever, chills, nausea, sweats, Moderna
Other Medications: Birth control
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever, vomiting, nausea, diarehia, chills, sweats, headeache


VAERS ID: 1901994 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-11-23
Onset:2021-11-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Decreased appetite, Headache, Injection site pain, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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: No e
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever (102 degrees) Uncontrollable chills Body aches Nausea Headache Loss of appetite Extreme pain at injection site Started at 9pm after injection. Lasted two days. Tylenol did not help elevate symptoms


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