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From the 11/12/2021 release of VAERS data:

Found 875,292 cases where Vaccine is COVID19 and Patient Did Not Die

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

This is page 500 out of 8,753

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VAERS ID: 1712129 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-13
Onset:2021-09-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Lymph node pain, Lymphadenopathy, Pain in extremity
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PAMPRIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergic reaction to analgesics (Known allergies: NSAIDS); Polycystic ovarian syndrome (PCOS)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101211995

Write-up: Achy first finger/ extreme pain in lower leg; Extreme pain in forearm; Tender lymph nodes in armpit and breast; Extreme pain in shoulder; Swollen lymph nodes in armpit and breast; This is a spontaneous report from a contactable consumer, the patient. A 41-year-old non-pregnant female patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0186) via an unspecified route of administration in the left arm on 13Sep2021 at 18:15 (at the age of 41-years-old) as a single dose for COVID-19 immunisation. Medical history included polycystic ovarian syndrome (PCOS) and allergies to non-steroidal anti-inflammatory drugs (NSAIDs). Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccine within four weeks prior to the COVID-19 vaccine. Concomitant medications included mepyramine maleate/pamabrom/paracetamol (PAMPRIN), for an unknown indication from an unknown date and unknown if ongoing. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0183) via an unspecified route of administration in the left arm on 18Aug2021 at 18:00 (at the age of 41-years-old) as a single dose for COVID-19 immunisation. On 15Sep2021 at 06:00, the patient experienced extreme pain in shoulder, forearm, swollen or tender lymph nodes in armpit and breast, achy first finger, extreme pain in lower leg. The events resulted in doctor or other healthcare professional office/clinic visit. Since the vaccination, the patient had not been tested for COVID-19. Therapeutic measures were not taken as a result of the reported events. The clinical outcome of the events extreme pain in shoulder; extreme pain in forearm; achy first finger/ extreme pain in lower leg; swollen lymph nodes in armpit and breast; and tender lymph nodes in armpit and breast leg were not resolved at the time of this report.


VAERS ID: 1713239 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-14
Onset:2021-09-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Fatigue, Headache, Hot flush, Nausea, Pain, Pain in extremity, Palpitations, Vomiting
SMQs:, Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Motrin
Current Illness:
Preexisting Conditions: History of SVT. Resolved with surgery.
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Dose 1 I had sore arm, fatigue 36hours. Body aches, chills, fever. Headache. Dose 2 I had sore arm, fatigue over 80hrs, body a he''s. Hot flashes, head ache, nausea. Vomiting, and palpations.


VAERS ID: 1713253 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Injected limb mobility decreased, Injection site pain, Injection site urticaria, Insomnia, Muscle spasms, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Patient reported problems with anesthesia as well as antibiotic that she took in the hospital. She said she had hives with the antibiotic.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient''s mom called on Thursday (9/16/2021) to report that she had not slept the previous night because her arm was so sore. She said that there was no rash, swelling, or heat on the arm. The mother asked if the patient could take OTC Tylenol, etc. which I told her was fine. I told her to call the doctor if event worsened. The patient called back on September 18 to report that the previous day, a hive like rash developed. The arm where shot was given down to the elbow has hives and throbbing. She said that the arm felt like a hot iron was on the arm, and she had difficulty moving it. She also said she has random spasms in the arm. She also reported that she sweated profusely and that she has a genetic condition that causes her not to sweat. The patient said she was nervous taking the shot because she is so sensitive to medication. She will contact her primary care provider and let us know what the doctor says.


VAERS ID: 1713316 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-07
Onset:2021-09-15
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Discomfort, Exposure to SARS-CoV-2, Fatigue, Headache, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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: Vitamin D; Micrette
Current Illness: none
Preexisting Conditions: Vitamin D deficiency
Allergies: Nexium
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, sore throat, pressure neck, shoulders, runny nose, congestion, fatigue starting on 9/15/21. Daughter tested positive for COVID on 9/12/21, unclear if daughter vaccinated


VAERS ID: 1713327 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-26
Onset:2021-09-15
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016B21A / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolo; Adult aspirin low strength; Gabapentin; Pantoprazole; Metformin; Clopidogrel; Simvastatin
Current Illness: none
Preexisting Conditions: migranes; GERD; hyperlipidemial glucose intolerance; hyptertension; type 2 diabetes
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had Virtual visit and at that time was asymptomatic and interested in COVID 19 PCR testing. His partner tested positive for COVID-19 on 9/14/21). Patient had PCR testing on 9/15/21, which was positive. Unclear if partner vaccinated


VAERS ID: 1713354 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-15
Onset:2021-09-15
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Eye discharge, Fatigue, Foreign body sensation in eyes, Ocular hyperaemia, Respiratory tract congestion, Rhinorrhoea
SMQs:, Anaphylactic reaction (narrow), Glaucoma (broad), Corneal 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: MiraLax; Benefiber; Synthroid; HCTZ; hyralazine; Klor-Con; Albuterol
Current Illness: none
Preexisting Conditions: hypertension; acquired hypothyroidism; colon polyps; osteopenia; osteoarthritis of right hip; lichen sclerosus
Allergies: Lisinopril; Bactrim
Diagnostic Lab Data:
CDC Split Type:

Write-up: Cough, runny nose, congestion, fatigue starting 9/15/21 ln additiion, right eye is red and has been gritty and has had discharge the past couple of days


VAERS ID: 1713368 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-28
Onset:2021-09-15
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Loss of personal independence in daily activities, Vertigo positional
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (narrow)

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: Albuterol inhaler as needed (rarely ever needed)
Current Illness: None
Preexisting Conditions: Very mild asthma
Allergies: Amoxicillin
Diagnostic Lab Data: No underlying cause.
CDC Split Type:

Write-up: Nonstop dizziness 2.5 weeks post 2nd vaccine. Sever vertigo if standing or bending over. Vitals perfect and preformed 2x daily. I am a trained CMA with no underlying health conditions. This has not only impaired my daily functions, but halted them altogether now.


VAERS ID: 1713386 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-13
Onset:2021-09-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nifedipine, Coreg, lisinopril, aspirin, atorvastatin
Current Illness: Diabetes mellitus,
Preexisting Conditions: Coronary vasospasm
Allergies: Iodine contrast
Diagnostic Lab Data: Elevated troponins.
CDC Split Type:

Write-up: Myopericarditis, chest pain. Started roughly 9/15/2021. Vaccine received on 9/13/2021. Admitted to the hospital.


VAERS ID: 1713463 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-09-12
Onset:2021-09-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 LA / SYR

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

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

Write-up: The injection site is hot to the touch. It?s red, swollen, and rash like all around. It itches a lot! It started about 4 days after the initial injection. I?ve put Neosporin and took Benadryl. I?ve spoke to the pharmacist and they referred me to this site to report it. The pharmacist also suggested topical Benadryl. It was also suggested to get a doctors opinion on getting the second dose.


VAERS ID: 1713480 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-14
Onset:2021-09-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 1 LA / IM

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

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

Write-up: Patinet called pharmacy today (18Sept21) and stated that within 24 hours of vaccine administration, patient states began itching all over body. Over the course of the next days, patient states bumps have appeared all over her arms, neck, thighs and lower back. Patient states she is itchy everywhere. States the bumps feel almost blister like. Patient states she took single dose of benadryl on the first night (Sept 15) but has not repeated the dose. Patient states she went to bed immediately after taking single dose of benadryl and does not know if it helped or not. I have advised the patient to call her primary care and to go to an urgent care facility as soon as possible for evaluation of the reaction. I informed the patient my concern would be a potential ongoing delayed reaction. Patient states she does not want to take the second dose - I advised the patient she would need to see a physician for adivse on second dose pending the evaluation of the ongoing reaction. Patient states she has not been able to go to primary care or urgent care facililty (as of 4pm on 18Sept21) but states she would get to urgent care tonight.


VAERS ID: 1713481 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B12A / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Fatigue, Hyperhidrosis, Immediate post-injection reaction, Injection site pain, Insomnia, Migraine, Muscular weakness, Myalgia, Nausea, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Wednesday 09/15/2021 1000 hours: Normal soreness as expected immediately after injection. 1500 hours: Left arm began to feel limp and heavy (weak) with pain extending from injection site distal towards elbow. 1700 hours: Previous symptoms with noticeable fatigue and muscle pain. 2200 hours: Previous symptoms with feeling of dizziness, fatigue/ general lethargy. Thursday 09/16/2021 0200 hours: Previous symptoms with insomnia, sweating, migraine headache, joint pain. Signs: Initial temperature of 100.4 (F). 0630 hours: Previous symptoms with additional chills. Signs: fever increased to 101.2 (F), visible sweating (soaking wet t-shirt). One 81 mg Aspirin taken by mouth. 1000 hours: Previous symptoms with additional nausea (no vomiting), signs: fever increased to 101.8 (F). One Acetaminophen Regular Strength 325mg taken by mouth. 1500 hours: No change in symptoms. Signs: fever reduced to 101.2 (F) Friday 09/17/2021 0400 hours: No change in symptoms, signs: fever reduced further to 100.8 (F) 1100 hours: No symptoms of pain from injection site, muscle pain, sweating, migraines, joint pain, chills, nausea (all resolved). Continued symptoms: limp/weakness of left arm, dizziness, insomnia, fatigue/ lethargy, slight headache, photosensitivity. Signs: None, Body temperature normal. Saturday 09/18/2021 0630 hours: Remaining symptoms: Lethargy, fatigue, dizziness, all other symptoms resolved. No observable signs. At no point were my lymph nodes visibly larger or noticeably larger upon palpation. No edema, discoloration, or warmth was noticeable at the injection site. Vitals outside of temperature remained normal with no observable change in BP, Pulse, or oxygen saturation. Diagnostic tools: OMRON BP MONITOR, MODEL: BP652N SANTA MEDICAL Pulse Oximeter, MODEL: SM-165 BRAUN Tympanic thermometer, MODEL: ThermoScan 5


VAERS ID: 1713518 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-01
Onset:2021-09-15
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Hyperhidrosis, Nausea, Pain, Pyrexia, Tonsillar hypertrophy
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? 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: Fever, chills, swollen tonsils, body aches, sweating, nausea, fatigue. 5 days after vaccine.


VAERS ID: 1713562 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-13
Onset:2021-09-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Catheterisation cardiac, Echocardiogram, Myocarditis, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Wellbutrin
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: Blood Work: 9/16/21 Echocardiogram: 9/17/21 Cardiac catheter: 9/17/21
CDC Split Type:

Write-up: Pericarditis/Myocarditis. Treatment still ongoing. Frequent ingestion of anti-inflammation medication


VAERS ID: 1713653 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: None
Diagnostic Lab Data: Physician was called who prescribed a 6 day prednisone pack and vistaril for itching
CDC Split Type:

Write-up: Itchy rash on trunk, underarms, groin and at and around injection site. Symptoms began 8 days after first vaccine dose.


VAERS ID: 1713727 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-14
Onset:2021-09-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Erythema, Headache, Joint swelling, Neck pain, Pain in extremity, Paraesthesia, Peripheral swelling, Pyrexia, Tremor
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: 10 hours after shot dizziness and high fever of 102 15 hours after shot - Headache and fever, severe neck pain and arm pain 24 hours after shot- Severe joint pain and redness with swelling in wrists, fingers, and ankles 2 days after shot- fever gone, swelling in joints and pain in joints (more in morning than at night), not able to look up because of neck pain 4 days after shot- Fatigue, swelling in fingers along with wrists and ankles, tingling feeling in hands, joint pain from touch and swelling, dizziness, and trembling in hands, severe neck pain ongoing


VAERS ID: 1713826 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-13
Onset:2021-09-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 2 RA / IM

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

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

Write-up: Triggered a HSV outbreak. Husband had 2nd dose of vaccine 4 days later and he ALSO had an outbreak as a result.


VAERS ID: 1713947 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-13
Onset:2021-09-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2595 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD7204 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Dyspnoea, Lymphadenopathy, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None , went back to the facility to ask about the side effects and to see if mine were normal and was told that those were some of them .
CDC Split Type:

Write-up: Fevers. chills, Lymphatic swelling under arm pit ( huge lump looked like I grew a third boob !! ) coughing shortness of breath swollen around the collar bone.


VAERS ID: 1713956 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / IM

Administered by: Unknown       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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Medication error, patient came in to get 2nd vaccine, was administered the Pfizer as a second dose, and later noted that she had already had her Janssen in March 2021. Asymptomatic from any effects.


VAERS ID: 1714008 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-24
Onset:2021-09-15
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Lymph node pain, Lymphadenopathy, Ultrasound scan
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: BioThroid, Bioadren, Biodine, K2+D3, Low dose Naltroxone, Selenium, Pre & ProBiotic,
Current Illness: Hayshimotos Throiditis
Preexisting Conditions: Thyroid disorder.
Allergies: Seasonal Allergies, some medication fillers (blue color)
Diagnostic Lab Data: Chest X Ray, Ultra Sound, and Blood Work
CDC Split Type:

Write-up: enlarged lymph-nodes in neck acute with pain.


VAERS ID: 1714218 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-14
Onset:2021-09-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Feeling hot, Hypoaesthesia, Paraesthesia
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:
Other Medications: None
Current Illness: None
Preexisting Conditions: OCD
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tingling, numbness in hands and feet. Feeling of numbness and pins and needs/heat


VAERS ID: 1714230 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-30
Onset:2021-09-15
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (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: multi vitmin
Current Illness: no
Preexisting Conditions:
Allergies: ibuprophen
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had an ablasion years ago but still have infrequesnt periods due to beginning menopause. I had cramping followed by almost two days of bleeding and then it stopped.


VAERS ID: 1714441 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 2 LA / IM

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

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

Write-up: Patient had a large, red, circular spot on her upper arm. She said this happened right after the second Moderna shot. The first shot she had no problem. She said at one point it was warm to the touch. She said it got bigger since the shot. I advised her to go to the doctor and the doctor diagnosed it as cellulitis. She was prescribed and dispensed (at our pharmacy), Bactrim DS, 1 tablet by mouth twice a day for 10 days, #20.


VAERS ID: 1714448 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-14
Onset:2021-09-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Muscle spasms, Rash macular, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Drowsiness, headache, whole body and muscle cramping 12 hours after vaccine. Blotchy rash noted 29 hours after vaccine under both arms, on both sides of axillary area, and on bilateral thighs.


VAERS ID: 1714450 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-08
Onset:2021-09-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
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: 7 days following the vaccination was diagnosed with COVID-19.


VAERS ID: 1714509 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-09-13
Onset:2021-09-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstruation irregular
SMQs:, Fertility 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: Multivitamin, zinc, vitamin D, quercetin
Current Illness: none
Preexisting Conditions: anticardiolipin antibody
Allergies: erythromycin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: The second menstrual period in 14 days. Already had a regular monthly cycle Sept 1-5. On September 15 (2 days after the second Moderna shot), another period began and it is now day 5 with no signs of stopping.


VAERS ID: 1714531 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-14
Onset:2021-09-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, 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:

Write-up: Considerable worsening of existing tinnitus. Extreme rushing sounds. Hearing music. Much much worse than before vaccine


VAERS ID: 1714710 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0050E21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Injection site swelling, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (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? 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:
CDC Split Type:

Write-up: Site: Swelling at Injection Site-Medium, Additional Details: PT RECEIVED 3RD COVID-19 MODERNA VACCINE.CALLED PHARMACY THE NEXT DAY THAT HER ARM WAS SWOLLEN AFTER SHE WENT TO VISIT HER PROVIDER.


VAERS ID: 1714866 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 RA / IM

Administered by: School       Purchased by: ?
Symptoms: Incorrect product formulation administered
SMQs:, Medication errors (narrow)

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

Write-up: After injecting Dilutent into vial - waited 15 minutes and injected 1.8cc into right arm of student. Realized it was a multidose vial.


VAERS ID: 1714894 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / UNK - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Head discomfort, Headache, Heart rate increased, Pain in extremity
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none at all
Current Illness: none
Preexisting Conditions: chronic headaches
Allergies: coedine meds and certain nuts, none of which factor into this episode
Diagnostic Lab Data: Zero, I stayed at home. I''d been examined for mind-fog-related conditions about a decade ago with nothing found.
CDC Split Type:

Write-up: Obviously this is anecdotal, I have not received medical treatment and am relating as best as I can. I got a first Moderna vaccine on the morning of Wednesday, September 15. I have a history of experiencing headaches and "brain fog" but nothing crippling. Starting in the evening and continuing for Thursday, Friday, and Saturday I had a pounding headache on the right side and in the middle of my head - this was qualitatively different than my usual chronic headaches. it was constant but the pressure kept changing, I felt as though I might have been sensitive to circulation in my head. I was ready to check into a hospital and was reading and rereading vaccine side-effects out of concern. I spent Thursday and Friday flat on my back, and tried to do as little as possible on Saturday, and Saturday night when I tried to participate in a dinner conversation I experienced such brain-fog that I''m amazed that I could function at all. Yesterday (Sunday) I was mostly back to normal. At some times during my headache my pulse was about 100 to 105. My arm was sore but not red or swollen. I understand that the reaction to a second dose is often worse. Since I have do experience chronic headaches and mind fog (though not anything like what I experienced the past several days), and since I''m in otherwise OK health, and since I''ve already received a dose of the Moderna vaccine, I wonder if a second presents more risk for me than the advantages it offers? Of course I don''t want to get COVID and COVID can be crippling even to a healthy person, but since I don''t have underlying conditions and I''ve I''ve already received one dose, perhaps I should not get a second dose? I''m extremely concerned about undergoing any similar crippling headache. Please advise if a second dose is contraindicated.


VAERS ID: 1714902 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-12
Onset:2021-09-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu vaccine, October 2nd, 2020. Left arm swelling and numbness and pain in left arm for 8 months requiring 2 epidural injections
Other Medications: Losartin 50mg qd, Metoprolol 50 mg qd, Lexapro 20 mg qd, Allegra 180mg, Prilosec 40 mg qd, Probiotics, Vitamin D 2,000 mg qd, Tylenol 650mg/Tramadol 50mg PRN.
Current Illness: N/A
Preexisting Conditions: Celiac disease
Allergies: Gluten, NSAIDS
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Large, red area with swelling and fever on right deltoid and bicep about 2 inches below injection site. Medium, painful knots along right clavicle. Both starting 4 days after vaccine.


VAERS ID: 1714977 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-08
Onset:2021-09-15
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

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

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

Write-up: Covid positive household contact


VAERS ID: 1715017 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cold sweat, Insomnia, Tinnitus
SMQs:, Hearing impairment (narrow), Hypoglycaemia (broad)

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

Write-up: ears started ringing after 30 min of injection of J&J covid 19 vaccine. At this time unable to fall asleep as I get cold sweats & clammy at night.


VAERS ID: 1715044 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fall, Hyperhidrosis, Loss of consciousness, Malaise, Pallor, Somnolence, Urinary incontinence, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Patient reported born with birth defect, "only have one lung and had heart surgery right after birth."
Allergies: Self reported history, "to all of the penicillins."
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported not feeling well and became very pale in her face and lips. Shortly after she became diaphoretic. VS taken: 121/64, P-57-61, 98% RA. Patient denied feeling short of breath. At approximately 10:35am, patient then had a large emesis x2. Moments after, patient fell over in her chair, but staff caught her preventing her from hitting the floor, she was passing out. Staff lowered her to the floor and called 911 for EMS. Patient''s appearance was still very pale and diaphoretic. Patient did have an episode of urine and possibly bowel incontinence when she fell over in the chair. Patient remained sitting upright on the floor, awake but groggy, sipping small amounts of water until EMS arrived. She continued to deny any shortness of breath, trouble swallowing, etc. Moments later, patient did appear to become more clear and alert. VS: 147/80, P-80, 98% RA. EMS arrived and evaluated patient. EMS and patient felt that she would be okay to go home and monitor once she was cleared by EMS. Patient''s husband was there and planned to driver her home. Writer attempted to reach patient the next day 9/16/21, left msg to call back. 9/20/21, writer spoke with husband on patient behalf and he reports she is doing great. No further symptoms or issues and they denied the need for further medical treatment. Advised that the patient needs to update her primary provider about episode and to discuss 2nd dose.


VAERS ID: 1715061 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-31
Onset:2021-09-15
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 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? 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: Breakthrough covid case


VAERS ID: 1715073 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 RA / -

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

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

Write-up: PATIENT''S FATHER REPORTS SEVERAL HOURS AFTER VACCINE PATIENT HAD A SEIZURE


VAERS ID: 1715081 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-10
Onset:2021-09-15
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Eye pain, Hypoaesthesia, Hypoaesthesia oral, Pain in jaw
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Osteonecrosis (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluticasone propionate, Azelastine, symbicort, singulair10mg, ventolin HFA108, meloxicam 7.5mg
Current Illness: None
Preexisting Conditions: Asthma, tension headache
Allergies: N.K.D.A
Diagnostic Lab Data: none
CDC Split Type:

Write-up: numb tip of tongue, numb, left side of face, left eye pain, jaw pain . Start prednisone 20mg 3 tablets with food for 7 days


VAERS ID: 1715147 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Hyperhidrosis, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Fairly uncomfortable, "splitting" headache in front and sides of head. Nausea, muscle aches, chills and sweats. Lasted for 1 day as moderately intense symptoms and 1 additional day at less intense symptoms. No treatments or medications used for symptoms.


VAERS ID: 1715176 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Chest discomfort, Dizziness, Malaise
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: unknown
Preexisting Conditions: Allergies, Reflux, anxiety, depression
Allergies: milk, soy, wheat
Diagnostic Lab Data: chest xray, decadron prescription on discharge
CDC Split Type:

Write-up: general malaise, dizziness, & chest tightness


VAERS ID: 1715233 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC 3183 / 1 LA / SYR

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

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

Write-up: Muscular pain


VAERS ID: 1715250 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-05
Onset:2021-09-15
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Cough, Diarrhoea, Dyspnoea, Fatigue, Malaise, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), COVID-19 (broad)

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

Write-up: admitted 9/15. pt ha had symptoms since 3 weeks prior to admit.Patient presented with symptom(s) noted the chief complaint Patient is being tested today due to having covid-19 symptoms - reports 12 days of feeling ill including symptoms of fatigue, weakness, diarrhea, dry cough and SOB"


VAERS ID: 1715277 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-31
Onset:2021-09-15
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: WEAKNESS, SHORTNESS OF BREATH


VAERS ID: 1715284 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, 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 came in for second dose of Pfizer COVID-19 vaccine which was completed on 09/15/21. The issue is that patient had received first dose 08/31/21 outside making patient too early for their second dose. Patient had no reaction to receiving second dose, but it was too early unfortunately and was not caught until after vaccination.


VAERS ID: 1715334 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic shock, Dizziness, Muscular weakness, Pharyngeal swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
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 prior to this vaccine.
Allergies: shellfish allergiey, sulfamethizole, erythromycin, cephalosporins, cefaclor
Diagnostic Lab Data: Treated in ER for anaphylactic shock to the janssen vaccine.
CDC Split Type:

Write-up: Felt fine the first ten min. I have food allergies so I waited the full 20 min. Got up and felt al ittle light headed. By the time I walked to my car I could feel my throat instantly swell. I drove my self straight to the emergamcy room. Emergancy room instanly treat me for anaphylactic shock. I recieved two EPI and was observed there after for the rest of the evening. Was also giving benadyl as well. I was dishcharged with EPI and benadryl to take home. Since I have been home I have had to throat swell everyday and have to take bendrly. I am not experiencing, muscle weakness all over my body and I''m making an apt. with my main doctor.


VAERS ID: 1715342 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-06-13
Onset:2021-09-15
   Days after vaccination:94
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204AZIA / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose increased, Chest X-ray normal, Dizziness, Electrocardiogram, Hypertension, Hypoaesthesia, Metabolic function test, Palpitations, Renal failure, Urine analysis
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (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), Guillain-Barre syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Cant remember name
Other Medications: no
Current Illness: no
Preexisting Conditions: copd and high blood pressure
Allergies: cleocin
Diagnostic Lab Data: BP - High ECG - Borderline Chest Xray -Normal Urinalyses - Metabolic, Glucose level was high at 117. Kidney failure
CDC Split Type: vsafe

Write-up: Numbness in 2 finger on the left hand. BP was high, heartbeat was pounding unusually hard, felt like I was passing out. Went to ER June 23, 2021.


VAERS ID: 1715361 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: Unknown
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 0.3 ml administered


VAERS ID: 1715378 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 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? 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: unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 0.3 ml administered


VAERS ID: 1715379 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-19
Onset:2021-09-15
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine, low-dose aspirin, vit D3, fenofibrate, lovastatin, magnesium oxide, metoprolol tartrate, mycophenolate, omega 3-dha-epa fish oil, prednisone, probiotic, pysillium husk, K-Phos neutral, tacrolimus, vit B and C complex
Current Illness:
Preexisting Conditions: ESRD s/p renal transplant, type II diabetes, hypertension, hyperlipidemia
Allergies: adhesive tape, latex
Diagnostic Lab Data: 9/15/21 Sars-CoV-2 antigen test positive
CDC Split Type:

Write-up: Patient was admitted with primary diagnosis of COVID-19 pneumonia on 9/15/21 after presenting to the ED with stable symptoms given his history of renal transplant (2017). At the time of this report, patient is still admitted receiving remdesivir, dexamethasone, and 3L oxygen through nasal cannula.


VAERS ID: 1715404 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Immunisation, 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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Wrong ml administered upon discovery of the error.


VAERS ID: 1715412 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute kidney injury, Disorientation, Feeling cold, Hyperhidrosis, Nausea, Pain in extremity, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tumour lysis syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: morprohine, hydrocordone, furosemide, ceanaplus, locenoprile, generic prilosec
Current Illness:
Preexisting Conditions: stage 4 non hobskins luphomia , lukemia
Allergies:
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: extreme cold temperature, excessive sweating, nausea, fever, disoriant , pain in left arm, vommiting and kidneys shut down


VAERS ID: 1715433 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 1 LA / IM

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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: asa, lipitor, coreg, vitamin D3, plavix, inspra, super B complex, centrum silver, lasix, iron 100 plus , magnesium, flagyl, fish oil, entresto, aldactone, vitamin A
Current Illness: Essential HTN CAD Mixed hyerlipidemia ICD Chronic Systolic Heart Failure
Preexisting Conditions: Chronic Systolic Heart Failure HTN CAD
Allergies: enalapril
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient vaccinated with expired vaccine. No adverse reactions noted


VAERS ID: 1715434 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 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? 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: Unknown
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 0.3 ml administered IM, 0.2 ml administered upon discovery


VAERS ID: 1715445 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-09
Onset:2021-09-15
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / UNK - / -

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

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

Write-up: Covid positive work


VAERS ID: 1715448 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Immunisation, 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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 0.3 ml administered IM, 0.2 ml administered upon discovery


VAERS ID: 1715463 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-09
Onset:2021-09-15
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / UNK - / -

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

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

Write-up: Covid positive unknown contact


VAERS ID: 1715514 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Hypoaesthesia oral
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gout high blood pressure potassium
Current Illness: As soon as he got in his face was numb the next day his face was OK but his lips are numb
Preexisting Conditions: Blood pressure gout
Allergies: Penicillin terra dol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Face went to sleep then his lips


VAERS ID: 1715548 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose increased, Increased insulin requirement
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Lipodystrophy (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: Novolog Tresiba Simvastatin Metoprolol
Current Illness:
Preexisting Conditions: Type 1 diabetic Tachycardia Hyperlipidemia
Allergies: Cortisone
Diagnostic Lab Data: Home glucose levels running in excess of 300
CDC Split Type:

Write-up: Elevated blood Glucose levels for approximately 4 days with no change in activity levels or caloric intake. Resulted in double to triple the insulin intake.


VAERS ID: 1715566 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Abdominal pain upper, Body temperature increased, Illness, Lethargy, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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:
Other Medications: Vit. D, C, mood, gerd, iron, colesterol, gabapentin
Current Illness:
Preexisting Conditions:
Allergies: Celiac disease
Diagnostic Lab Data:
CDC Split Type:

Write-up: My stomach started hurting I got nauseous next day I was lethargic sick and elevated temperature


VAERS ID: 1715627 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031C21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: rcvd 2 separate vaccines


VAERS ID: 1715645 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-14
Onset:2021-09-15
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 2 - / 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: Tested positive for COVID 19 on 09/17/2021


VAERS ID: 1715663 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-05
Onset:2021-09-15
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Diarrhoea, Oropharyngeal pain, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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; fLUTICASONE;ATORVASTATIN, FISH OIL; VITAMIN C
Current Illness: none
Preexisting Conditions: hyperlipidemia; allergic rhinitis; lumbosacral radiculopathy; cardiomegaly; hypertension; history of adenomatous polyp of colon
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: sore throat; nonproductive cough; fever; chills; body aches, diarreha starting on 9/15/21


VAERS ID: 1715685 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-13
Onset:2021-09-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Neuralgia, Pyrexia, Sinus congestion, Sinus pain
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: gapaentin, apap, Kurvelo
Current Illness: old traumatic injury to LUE from trauma occasional pain flares uses 7 tramdol at the most in one month
Preexisting Conditions: no other
Allergies: lactose
Diagnostic Lab Data: none
CDC Split Type:

Write-up: within 48 hours developed sinus congestion and pain, fever 100.5 and severe flare on neuralgia in her LUE


VAERS ID: 1715691 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-14
Onset:2021-09-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 LA / SYR

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

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

Write-up: I have muscle aches, headaches, it felt like i had the flu


VAERS ID: 1715695 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Pallor
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), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: UNKNOWN
Allergies: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: After giving Covid-19 vaccine, patient lost consciousness shortly later and lasted less than 1 minute, then patient gained his consciousness quickly. His face looked pale. He wanted to lie down and went with his mother to their car to rest while waiting ambulance to come.


VAERS ID: 1715764 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-10
Onset:2021-09-15
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Epididymal enlargement, Protein urine present, Red blood cell count, Scrotal swelling, Urobilinogen urine, White blood cell count
SMQs:, Acute renal failure (broad), Angioedema (broad), Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Proteinuria (narrow), Tubulointerstitial diseases (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: omeprazole, ritalin, buspirone, dicyclomine, tretinoin cream, benzoyle peroxide wash, clindamycin topical gel, multivitamin, vitamin B12, vitamin D3, cetirizine 10mg daily
Current Illness: None
Preexisting Conditions: Anxiety, depression, short gut syndrome, scoliosis
Allergies: NKDA
Diagnostic Lab Data: UA with 100 protein and 2.0 urobiligen, no significant WBC or RBC
CDC Split Type:

Write-up: Patient with left scrotal enlargement with evidence of right sided epidydimal enlargement


VAERS ID: 1715781 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-14
Onset:2021-09-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Asthenia, Diarrhoea, Fatigue, Headache, Nausea
SMQs:, Acute pancreatitis (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: Triamcinolone 1% Cream, Furosemide 20mg Tablet, Microgestin 1/20 1-20mg-mcg Tablet
Current Illness: none
Preexisting Conditions: current ovarian cysts
Allergies: Latex, Most fresh fruits and vegetables
Diagnostic Lab Data:
CDC Split Type:

Write-up: headache, stomach pain, fatigue, weak, tired, diarrhea, nausea. all started day after (9/15/21), still having headache and stomach pains (9/20/21).


VAERS ID: 1715841 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-13
Onset:2021-09-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / UNK LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / UNK RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 27
Other Medications: Adderall 15mg, Unisom
Current Illness: Multiple Sclerosis, Pseudo-tumor Cerebri, ADHD,
Preexisting Conditions: Multiple Sclerosis, Pseudo-tumor Cerebri, ADHD
Allergies: Flagyl, compazine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash on right upper arm. size of a paper bill. The rash occured five days after the initial shot. It is raised, has heat to it and does not blanche. It is sore and itches. I am also having nerve pain in arms and legs. The nerve pain is extreme and hurts.


VAERS ID: 1716088 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-14
Onset:2021-09-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Hypoaesthesia, Neuropathy peripheral, Pain in extremity, Sensitive skin, Urine analysis
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (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: pain in lower body mucle groups
Other Medications: 900 mg lithium extended release 112 mcg levothyroxine
Current Illness: none known
Preexisting Conditions: bipolar 1 sleep apnea poor diet lack of regular exercise poor sleep habits
Allergies: pollen, dander, dust mites, strawberries, penecillin
Diagnostic Lab Data: I visited two separate emergency departments, had blood tests and a urine analysis. Gabapentin and Tylenol was recommended along with a healthy diet, more exercise and less stress. No measures have been taken medically to alleviate the numb quality or its sensitivity to touch when it is painful.
CDC Split Type:

Write-up: numb upper right leg as if in neuropathy numb lower left leg as if in neuropathy


VAERS ID: 1716093 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-28
Onset:2021-09-15
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Ultrasound scan
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prenatal vitamin and iron supplement
Current Illness:
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Sonogram
CDC Split Type:

Write-up: 6 weeks 5 days pregnant. Due date: April 18, 2022. Miscarriage diagnosed: Sept. 15, 2021


VAERS ID: 1716336 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-09-14
Onset:2021-09-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site pruritus, Injection site swelling, Muscular weakness, Pain, Pyrexia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: Lexapro; Topamax; Seriquil.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever of 101 and higher for over 24 hours. Swelling and itching of injection sight. Sever shaking and body aches. Low grade fever lasting a week. Fatigue lasting for a week. Arm weakness lasting a week.


VAERS ID: 1716344 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 (THIS WA / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blepharospasm, Heart rate increased, Neck pain, Pain, Skin discolouration
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Took normal RX''s that A.M. around 6:30 a.m. - Lisinopril 20-12.5 mg, Bystolic 5 mg, Rosurvastin Calcium 20 mg, Fenofibtrate 134 mg, Librax clindinium 5-2.5 mg, Cymbalta 60 mg, Tramadol HCL 50 mg, Bayer Asprin 81 mg
Current Illness: None
Preexisting Conditions: high blood pressure, high cholesterol, Celiac Disease, Sleep Apnea (on a C-Pap), chronic pain (3 prior back surgeries and degenerative disc disease)
Allergies: Celiac Disease (Gluten, wheat, rye, etc.) / allergic reactions to morphine drips
Diagnostic Lab Data: Saw NP that Friday, Sept 17th for Back Therapy - She looked at my eyes and evaluated me. No further test were performed since Sharp Neck Pains had stopped
CDC Split Type:

Write-up: - Twitching of eyes for 24 hrs. (had Cataract surgery on both eyes with enhanced vision implants April & May 2021) - Sharp shooting throbbing pain on right neck artery (lasted for 2 days) / Could feel a strong pulse / heart beat - Dark Lines appeared from corner of both eyes up to eye brows


VAERS ID: 1716379 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-14
Onset:2021-09-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: School       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Dizziness, Fall, Hyperhidrosis, Loss of consciousness, Near death experience, Pyrexia
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: I woke up with a fever the morning after receiving my second dose at around 0400. I went and got a drink of water and then went back to sleep. About an hour later I woke up with extreme epigastric pain. I rolled around in pain for probably about 45 minutes, trying to find a way to lay comfortably. I decided to get up and seeing if I could defecate and maybe that would relieve my pain. I was in so much pain and sweating profusely that I was forgetting to breath. I kept telling myself, remember to breath because if not, I am going to die. when I stood up from the toilet I took a few steps over to the sink where I got light headed. I tried splashing some water on my face to cool off but I got too dizzy and fell to the ground. I think I passed out because I remember laying on the ground for a few minutes and the sink water was still running. Then I got up and walked over to the kitchen and got another sip of water. Still, drenched in sweat, I got dizzy again, knowing I may pass out I found the wall and then a desk, and got as low as possible. I think I hit the ground pretty hard again but did not pass out. I was still in extreme pain at this time. I layed on the living room hardwood floor like a starfish for about 20 minutes because it felt cool. After about 5-10 minutes of that time, my epigastric pain subsided. As I layed in a puddle of sweat I decided I needed to ice my forehead so I grabbed an ice pack from the freezer and layed on the couch. My fever quickly went to chills and after about 10 minutes on the couch I went back to bed to warm up. I never experienced so much pain in my life. I thought I was dying/going to die.


VAERS ID: 1717850 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:2021-09-15
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816027 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Off label use, 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:
Current Illness: Allergic to cats; Allergic to dogs; Asthma; Dust allergy; Eczema; Egg allergy; Pollen allergy
Preexisting Conditions: Comments: The patient had an unspecified pulmonary artery issue.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210934927

Write-up: OFF LABEL USE - VACCINE ADMINISTERED TO A MINOR; DRUG ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE; This spontaneous report received from a parent concerned a 16 year old male. The patient''s weight was 165 pounds, and height was 71 inches. The patient''s concurrent conditions included: asthma, eczema, allergy to cats, allergy to dogs, allergy to eggs, allergy to pollen, and dust allergy, and other pre-existing medical conditions included: The patient had an unspecified pulmonary artery issue. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1816027, expiry: UNKNOWN) dose was not reported, administered on 15-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 15-SEP-2021, the patient experienced off label use - vaccine administered to a minor. On 15-SEP-2021, the patient experienced drug administered to patient of inappropriate age. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the off label use - vaccine administered to a minor and drug administered to patient of inappropriate age was not reported. This report was non-serious.


VAERS ID: 1717870 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Alabama  
Vaccinated:0000-00-00
Onset:2021-09-15
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (In the week of 07-06-12-2020 (as reported)); Comments: Patient was a 63 years old male, very good health.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210936134

Write-up: INAPPROPRIATE SCHEDULE OF VACCINE; This spontaneous report received from a patient concerned a 63 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included: covid, and other pre-existing medical conditions included: Patient was a 63 years old male, very good health. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 09-APR-2021, and dose was not reported, administered on 15-SEP-2021 for prophylactic vaccination. The batch numbers were not reported and has been requested. No concomitant medications were reported. On 15-SEP-2021, the patient experienced inappropriate schedule of vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of inappropriate schedule of vaccine was not reported. This report was non-serious. This report was associated with product quality complaint: 90000193904.


VAERS ID: 1717879 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Maryland  
Vaccinated:0000-00-00
Onset:2021-09-15
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal distension, Anxiety, Dyspnoea, Eructation, Fatigue, Feeling hot, Headache, Injection site pain, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Drug allergy; Non-smoker; Penicillin allergy
Preexisting Conditions: Medical History/Concurrent Conditions: Antiviral prophylaxis; Hepatitis B immunization; Hepatitis prophylaxis; Immunization; Pertussis immunisation; Poliomyelitis vaccine; Smallpox immunisation; Vaccination; Comments: The patient had tons of allergies and she did not had any chronic conditions nor did she take any medications. The patient was taking an allergy pill, a probiotic, and vitamins regularly.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210936570

Write-up: FELT HOT; ANXIOUS; SHORTWINDED; BLOATED; MORE BELCHING; TENDERNESS AND PAIN AT INJECTION SITE; FELT TIRED AND FATIGUED; HEADACHE; SORE ARM/ ARM PAIN; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. The patient''s past medical history included: smallpox vaccination, polio vaccination, hepatitis a vaccination, hepatitis b vaccination, measles, mumps and rubella vaccination, pertussis vaccination, typhoid vaccination, and shingles vaccination, and concurrent conditions included: drug allergy, penicillin allergy, non alcohol user, and non smoker, and other pre-existing medical conditions included: The patient had tons of allergies and she did not had any chronic conditions nor did she take any medications. The patient was taking an allergy pill, a probiotic, and vitamins regularly. The patient was previously treated with oseltamivir phosphate for drug allergy; and experienced drug allergy when treated with prednisone non-company for drug used for unknown indication, and drug allergy when treated with morphine non-company. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808986, and expiry: UNKNOWN) dose was not reported, administered on 15-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 15-SEP-2021, the patient experienced sore arm/ arm pain. On 18-SEP-2021, the patient experienced felt hot. On 18-SEP-2021, the patient experienced anxious. On 18-SEP-2021, the patient experienced shortwinded. On 18-SEP-2021, the patient experienced bloated. On 18-SEP-2021, the patient experienced more belching. On 18-SEP-2021, the patient experienced tenderness and pain at injection site. On 18-SEP-2021, the patient experienced felt tired and fatigued. On 18-SEP-2021, the patient experienced headache. Treatment medications (dates unspecified) included: diethylamine salicylate/methyl nicotinate. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from felt hot, anxious, shortwinded, bloated, more belching, felt tired and fatigued, and headache on 19-SEP-2021, and had not recovered from sore arm/ arm pain, and tenderness and pain at injection site. This report was non-serious.


VAERS ID: 1718355 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-14
Onset:2021-09-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PAA165969 / 1 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Electric shock sensation, Headache, Migraine, Musculoskeletal stiffness, Vaccination site pain
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Adhesive tape allergy (Known allergies: Paper tape); High cholesterol; Palpitations (Heart palpitations); Thrombophilia
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101211914

Write-up: Migraine; Stiff neck; Brain zaps on the back right side of head; Pain in injection arm; Headache; This is a spontaneous report from a contactable consumer, the patient. A 31-year-old male patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: PAA165969) via an unspecified route of administration in the right arm on 14Sep2021 at 14:30 (at the age of 31-years-old) as a single dose for COVID-19 immunisation. Medical history included heart palpitations, high cholesterol, thrombophilia, and allergy to paper tape. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient did not receive any concomitant medications. On 15Sep2021 at 01:00, the patient experienced migraine, stiff neck, pain in injection arm, and the patient had been experiencing brain zaps on the back right side of the head, especially when the patient started to drift off to sleep, it jolted the patient back awake. It felt like an electrical zap inside the patient''s brain shocking him every about 5 to 10 minutes. It had subsided but still had it once or twice every hour. The patient''s headache also did not go away with medicine (unspecified). The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department, or urgent care. Therapeutic measures were not taken as a result of the events migraine, stiff neck, pain in injection arm, and brain zaps on the back right side of head. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events migraine, stiff neck, pain in injection arm, headache, and brain zaps on the back right side of head was not recovered at the time of this report.


VAERS ID: 1718361 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101212245

Write-up: nausea; vomiting; This is a spontaneous report from a contactable consumer or other non hcp. A 17-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection), dose 2 via an unspecified route of administration on 15Sep2021 (Batch/Lot number was not reported) as DOSE 2, SINGLE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. Caller states her daughter received the second dose of the Comirnaty Vaccine today and is vomiting. Caller asking if there are any contraindications to administering any particular medications to treat her nausea and vomiting after receiving the Comirnaty Vaccine. Outcome of the event was not recovered. The Lot number for BNT162b2 was not provided and will be requested during follow up. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1718382 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-13
Onset:2021-09-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling, Vaccination site warmth
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: FARXIGA; SIROLIMUS; MEDROXIPROGESTERONE; SYNTHROID; MONTELUCAST; RYBELSUS; ALLEGRA; EZETIMIBE; IRBESARTAN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Contrast media allergy (CT Contrast); Lymphangioleiomyomatosis (LAM); Thyroid cancer; Type 2 diabetes mellitus (Diabetes Type 2)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101219445

Write-up: Site injection - redness, mild swelling,hot, itchy; Site injection - redness, mild swelling,hot, itchy; Site injection - redness, mild swelling,hot, itchy; Site injection - redness, mild swelling,hot, itchy; This is a spontaneous report from a contactable consumer. A 57-year-old non-pregnant female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3183) via an unspecified route of administration on 13Sep2021 at 16:30 (at the age of 57-years-old) as a single dose for COVID-19 immunisation. Medical history included lymphangioleiomyomatosis (LAM), diabetes type 2 and thyroid cancer. The patient had known allergy to computerized tomography (CT) contrast. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient received other vaccines within four weeks prior to the vaccination. Concomitant medications included, varicella zoster vaccine recombinant glycoprotein E (rge) (cho) (SHINGRIX) and pertussis vaccine/ tetanus vaccine toxoid/diphtheria vaccine toxoid (DPT); both taken on 24Aug2021 for immunisation, dapagliflozin propanediol monohydrate (FARXIGA), sirolimus (MANUFACTURER UNKNOWN), medroxyprogesterone acetate (MEDROXIPROGESTERONE), levothyroxine sodium (SYNTHROID), montelukast sodium (MONTELUCAST), semaglutide (RYBELSUS), fexofenadine hydrochloride (ALLEGRA), ezetimibe (MANUFACTURER UNKNOWN), irbesartan (MANUFACTURER UNKNOWN); all from unknown dates for unknown indications and unknown if ongoing. The patient previously received codeine (MANUFACTURER UNKNOWN), ibuprofen (MANUFACTURER UNKNOWN) and paracetamol/ oxycodone hydrochloride/oxycodone terephthalate (PERCOCET); all for unknown indications from unknown dates and experienced drug allergy. On 15Sep2021, the patient experienced site injection - redness, mild swelling, hot, itchy. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events site injection - redness, mild swelling, hot, itchy was resolving at the time of this report.


VAERS ID: 1718716 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-13
Onset:2021-09-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Work       Purchased by: ?
Symptoms: Fatigue, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: escitalpram
Current Illness:
Preexisting Conditions:
Allergies: na
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient experienced weakness in legs 2 days after vaccine with fatique


VAERS ID: 1718737 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-29
Onset:2021-09-15
   Days after vaccination:229
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Biopsy, Cough, Dyspnoea, Intensive care, Mouth ulceration, Positive airway pressure therapy
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 68 years old female who has past medical history significant for history of breast cancer. She also has history of hypertension. She also has past medical history significant for no other medical problems. She does have history of a recurring breast cancer which is triple negative has been started on a recent new chemotherapeutic regimen. She also has a mouth ulcer which according to her has been recently biopsied. Patient comes into the hospital for the reason of shortness of breath. She was in usual state of health and became significantly short of breath over the last 48 hours. He ultimately decided to come to the hospital and required BiPAP initially and was initially admitted to hospital intensive care unit but then transferred to progressive care unit. She has been weaned off of the BiPAP and is currently on nasal cannula FiO2 but was evaluated twice. She was also complaining cough. She denies any hemoptysis. She does have some shortness of breath at the time of my evaluation. She was denying any fevers or chills and has been fully vaccinated against COVID-19.


VAERS ID: 1718813 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-18
Onset:2021-09-15
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142, EL3247 / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Nasal congestion, Paraesthesia, Productive cough, Rhinorrhoea, Upper-airway cough syndrome
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: History of PEs on coumadin and COPD on oxygen.
Allergies: No known allergies
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: SOB, nasal congestion and rhinorrhea with postnasal drip, productive cough with copious clear sputum, pins and needle feeling in his chest bilaterally with inspiration.


VAERS ID: 1718881 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-09-12
Onset:2021-09-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Injection site pain, Neuralgia, Pain, Pain in extremity
SMQs:, Peripheral neuropathy (narrow), Extravasation events (injections, infusions and implants) (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: n/a
CDC Split Type:

Write-up: Arm pain, radiating from injection site down to fingers. Constant pain, burning, type. Associated as nerve pain.


VAERS ID: 1718883 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-03-20
Onset:2021-09-15
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Malaise, Pertussis, SARS-CoV-2 test positive, Upper respiratory tract infection
SMQs:, Anaphylactic reaction (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril; Venlafaxine; Metformin; Lipitor; Omeprazole; Nuvigil; Ropinirole; Aspirin everyday
Current Illness: None
Preexisting Conditions: UC; type 2 diabetic; Ventricular Hypertrophy; Arthritis; Bipolar.
Allergies: None
Diagnostic Lab Data: August 12, 2021, tested for Covid, test came back negative. Dr. gave me a shot of Depo-Medrol and Z-pak. The next day Saturday, July 30, 2021, I coughed all day, just dry hacking. First of August my symptoms where so bad I went to a Urgent care on a Sunday afternoon around 4:15pm. They tested me for Covid and the test came back negative. On September 7th, I spoke with a family doctor, Dr. and I explained my symptoms, and he concluded that I have whooping cough and he wrote me a prescription for another Z-pak.
CDC Split Type: vsafe

Write-up: On July 29, 2021, a Friday, I started coughing a lot and I ignored it. The next day Saturday, July 30, 2021, I coughed all day, just dry hacking. First of August my symptoms where so bad I went to an Urgent care on a Sunday afternoon around 4:15pm. They tested me for Covid and the test came back negative however, the doctor said I had a really bad upper respiratory infection. He prescribes Chlo hist cough syrup and an antibiotic, I don''t recall the name. About ten days later I still had the bad cough. On or about August 12, 2021, I went to my PCP doctor, Dr. and him I still wasn''t feeling well. Every time I went to the doctors, I would get tested for Covid, test came back negative. Dr. gave me a shot of Depo-Medrol and Z pack. September 7th, I spoke with a family friend who is a doctor, Dr. and I explained my symptoms, and he concluded that I have whooping cough and he wrote me a prescription for another Z-pak. On September 15, 2021, I tested positive for Covid. That same day I went to the hospital and they gave me 4 infections Monoclonal Antibodies.


VAERS ID: 1718891 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-14
Onset:2021-09-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 LA / SYR
FLU4: INFLUENZA (SEASONAL) (AFLURIA QUADRIVALENT) / SEQIRUS, INC. - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Illness, Pyrexia, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Paxil 10 mg, Rexulti .5 MG, testosterone 3 mg
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: None: pharmacist stated on Saturday 9/18 he doesn''t advise getting both at once so I am not sure why the tech there advised it.
CDC Split Type:

Write-up: I became sick the next afternoon with a low grade fever and cough. I have had body aches, a cough, congestion for a week. I have had no throat pain.


VAERS ID: 1718917 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-07
Onset:2021-09-15
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       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: Albuterol 90mcg PRN cough and congestion sucralfate QID 1 gram
Current Illness: None documented
Preexisting Conditions: Congestive heart failure
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient contracted COVID after being fully vaccinated


VAERS ID: 1718938 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-25
Onset:2021-09-15
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

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

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

Write-up: PATIENT HAD COVID-19 PFIZER VACCINE Dose 1 date: 03/25/2021, Dose 2 date: 04 /15/2021, AND TESTED POSITIVE TO COVID.


VAERS ID: 1718972 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 LA / IM

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

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

Write-up: Patient was given 2nd dose of Pfizer COVID-19 vaccine series on Day 14 which was earlier than the recommended minimum interval between the two dose series. Patient reports no major adverse effects


VAERS ID: 1718979 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-13
Onset:2021-09-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Gait disturbance, Hip arthroplasty, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Osteoporosis/osteopenia (broad), Osteonecrosis (broad), Arthritis (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient c/o low back pain and hip pain and hard to walk and weak in that leg joint post COVID vaccination x1.


VAERS ID: 1718989 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-09-14
Onset:2021-09-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Injection site pain, Musculoskeletal stiffness, Neck pain, Pyrexia, Sneezing, Spinal pain
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Neck/spine stiffness and soreness lasting in excess of 1 week Pain at injection site lasting ~3 days Fever lasting through following day Sneezing lasting approximately 1 hr, occurring ~6 hours after vaccination


VAERS ID: 1719003 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-22
Onset:2021-09-15
   Days after vaccination:146
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / UNK - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Diarrhoea, Dysphagia, Oropharyngeal pain, Productive cough, SARS-CoV-2 test positive, Sputum discoloured
SMQs:, Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ARANELLE 0.5/1/0.5-35 MG-MCG TABS cetirizine (ZYRTEC) 10 MG tablet Multiple Vitamins-Minerals (MULTIVITAMIN PO)
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data: COVID 19+ Antigen
CDC Split Type:

Write-up: Sore Throat This is a new problem. The current episode started yesterday. The problem has not changed since onset.There has been no fever. Associated symptoms include diarrhea (x3 over 24 hours, watery), trouble swallowing and cough (yellow production). Pertinent negatives include no congestion and no shortness of breath. She has tried nothing for the symptoms. No loss of taste or smell. COVID vaccinated x2


VAERS ID: 1719040 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-13
Onset:2021-09-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dysmenorrhoea, Fatigue, Heavy menstrual bleeding, Intermenstrual bleeding, Menstrual disorder, Pelvic pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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: Propanolol 80mg daily Levothyroxine 88mcg daily
Current Illness: none
Preexisting Conditions: Thyroid disease Asthma (mild)
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: On 9/15/21 my menstrual cycle started around its scheduled time, but I had a heavier menstrual flow, along with painful cramps, pelvic pain, and extreme fatigue. The best way I can compare my cramps and pelvic pain are close to pregnancy contractions. I haven''t had this sort of menstrual pain before and my usual dose of Tylenol 1,000mg that I take for my normal menstrual cramps did not alleviate the pain. It is now day 7 and I still have spotting and pelvic pain on and off (which are both abnormal for me). My usual cycle ends around the 5th day and cramping usually stops after day 2.


VAERS ID: 1719065 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-13
Onset:2021-09-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Condition aggravated, Diarrhoea, Gout, Rash
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Arthritis (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Gout
Other Medications: Amplodipine Brsylate 10mg. Hydrochlorothiazide 25 mg. Tamsulosin HCL 0.4 mg Folic Acid 1000 mg.
Current Illness: Gout
Preexisting Conditions: High blood pressure High A1C
Allergies: None
Diagnostic Lab Data: Doctor treated me for gout
CDC Split Type:

Write-up: Gout Mild Diarrhea Skin rash Chills but no fever


VAERS ID: 1719069 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-07-06
Onset:2021-09-15
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol fluticasone metformin multivitamin propranolol xarelto simvastatin
Current Illness: None documented
Preexisting Conditions: panic disorder, generalized anxiety disorder, gout, reactive airway disease, hypercapnia, steatosis of liver, calcification of coronary artery, pulmonary embolus, obesity, type II diabetes
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient contracted COVID after being fully vaccinated


VAERS ID: 1719078 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-11
Onset:2021-09-15
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, Body temperature increased, COVID-19, Cough, Nasal congestion, SARS-CoV-2 test positive, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none known
Current Illness: none known
Preexisting Conditions: none known
Allergies: none known
Diagnostic Lab Data: rapid + test for Covid on 9/19/2021
CDC Split Type:

Write-up: Client was vaccinated for Covid with Pfizer vaccines on 3/11 and 4/3/2021. On 9/15 developed Covid symptoms: nasal congestion, sneezing, cough, temp 102 x 1 day, loss of taste and smell. Tested + with rapid test on 9/19/2021. Reported as a case of breakthrough Covid in a fully vaccinated person.


VAERS ID: 1719082 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-09-10
Onset:2021-09-15
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 206AZIA / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood folate, Blood thyroid stimulating hormone, C-reactive protein, Dizziness, Full blood count, Gingival pain, Joint instability, Limb discomfort, Metabolic function test, Sensory disturbance, Serum ferritin, Stomatitis, Thyroid function test
SMQs:, Severe cutaneous adverse reactions (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Gingival disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin D3; Folic Acid - the day prior to the vaccination
Current Illness: none
Preexisting Conditions: none
Allergies: Ampicillan; Aspartame
Diagnostic Lab Data: Blood tests; CBC, Folate, Ferritin, C Reactive Protein, Thyroid, Comprehensive Metabolic Panel, TSH
CDC Split Type:

Write-up: Sudden heaviness and instability in arms and legs, weird sensation in gums and roof of mouth, then sensation in head and starting to black out


VAERS ID: 1719111 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-26
Onset:2021-09-15
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aderall atorvastatin epinephrine
Current Illness: None Documented
Preexisting Conditions: Cervical neuritis ADD History of thoracic outlet syndrome Hearing loss
Allergies: None documented
Diagnostic Lab Data:
CDC Split Type:

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


VAERS ID: 1719127 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-14
Onset:2021-09-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Headache, Pain, Pain in extremity, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Sore arm, 38, 8/9/2021, Moderna #1
Other Medications:
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: - Body aches: started around 24 hours after injection and ended around 48 hours after injection - Fever: started around 28 hours after injectin and ended around 40 hours after injection - sore arm: started 24 hours after shot and ended around 4 days - armpit soreness and slight swelling: started around 30 hours after injection and lasted 5 days - Headache: started around 24 hours after injection and lasted about 1 day **no treatment for adverse events **adverse events eventually cleared


VAERS ID: 1719158 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-29
Onset:2021-09-15
   Days after vaccination:229
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / SYR

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

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

Write-up: +COVID test following completed Pfizer COVID19 vaccine series


VAERS ID: 1719164 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-09-15
Onset:2021-09-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821281 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Decreased appetite, Headache, Injection site pain, Lethargy, Muscle twitching, Tinnitus
SMQs:, Dyskinesia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hearing impairment (narrow), Hypoglycaemia (broad)

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

Write-up: Severe headache (9/15-today), pain in injection site(9/15-today), chills (24 hrs post injection), loss of appetite (72 hrs post injection), eyes twitching (9/15-today), very lethargic (9/15-today), ringing in ears (9/15-today).


VAERS ID: 1719203 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-07
Onset:2021-09-15
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8757 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, glimepiride, asprin, jardiance, clopidogrel bisulafate, Olmesartan, Metoprolol tartrate, simvastatin
Current Illness: high blood pressure, diabetes
Preexisting Conditions: high blood pressure, diabetes
Allergies: None
Diagnostic Lab Data: 9/17/2021 visual
CDC Split Type:

Write-up: Shingles


VAERS ID: 1719221 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-08
Onset:2021-09-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Bell's palsy, Eyelid function disorder
SMQs:, Taste and smell disorders (narrow), Hearing impairment (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)

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

Write-up: Bell''s Palsy on RIGHT side of face. Half her face can''t smile, can hardly close eye, lost sense of taste on 1/2 her face.


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