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From the 7/23/2021 release of VAERS data:

Found 506,830 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 51 out of 5,069

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VAERS ID: 1463440 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-22
Onset:2021-07-06
   Days after vaccination:106
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Diarrhoea, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Despute getting both Pfizer vaccines, I am now Covid positive with mild symptoms.
Current Illness: Hashimotos HypoThyroidism Hypertension BOTH of these are controlled with RX for years
Preexisting Conditions: Hashimotos HypoThyroidism Hypertension BOTH of these are controlled with RX for years
Allergies: Sulfa, Peniccilin
Diagnostic Lab Data: 7/7/21 COVID19 +
CDC Split Type:

Write-up: mild symptoms: fever, no smell or taste, congestion and diarrhea


VAERS ID: 1463495 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

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

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1463499 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

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

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1463502 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

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

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1463519 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

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

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1463557 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-05
Onset:2021-07-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Myocarditis, Palpitations, Troponin increased, Vaccination complication
SMQs:, Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), 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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: guanfacine
Current Illness: none
Preexisting Conditions: tic disorder
Allergies: none
Diagnostic Lab Data: Troponin levels of 47 (7/8/21 19:00) then 77 (7/8/21 20:00) then 69 (7/9/21 02:00) then 36 (7/8/21 08:00)
CDC Split Type:

Write-up: Palpitations and chest pain Seen in ER on 7/8/21 and admitted overnight with rising troponin levels, improved by next day. Diagnosis of myocarditis related to COVID19 vaccine


VAERS ID: 1463627 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-19
Onset:2021-07-06
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injected limb mobility decreased, Injection site pain, Injection site swelling, Joint swelling, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Patient received vaccine on 6/19/21. She came into the pharmacy on 7/10/21 to ask about side effects she had been experiencing from the vaccine. She stated having severe pain in her arm at the injection site. I asked questions to determine the type of pain and when it occurred. She stated it started a week or two after the injection, there was localized swelling, tenderness, and difficulty with mobility. As I asked more questions she also mentioned swelling in her knee and leg and that she had gone to her orthopedic doctor to be checked out and they couldnt determine the cause. They asked if she wanted a scan done because she was concerned about a clot she declined. I asked if she told the provider she had recently recieved the J&J COVID-19 vaccine she said no. I suggested she return to the doctors office and let them know that as they may be more apt to do more thorough testing and examination to rule out possible clots.


VAERS ID: 1463673 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-02-27
Onset:2021-07-06
   Days after vaccination:129
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 & EN8732 / 2 RA / SYR

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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: This may not be the correct form, but I am writing to let you know that I received two Pfizer vaccinations one in February 2021 and one in March 2021, I was visiting family and have contracted COVID-19. It is clear, that the CDC needs to wa
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Positive Covid test on July 8th, 2021.
CDC Split Type:

Write-up: I have contracted Covid 19 while visiting family. Arrived on June 30th and became symptomatic on July 7, 2021.


VAERS ID: 1463718 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

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

Write-up: Small singular red bumps appear all over body.


VAERS ID: 1463722 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: 2nd dose pfizer vaccine was given to patient on 07/06/202. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window. We reached out to pt on 07/10/21 and left detailed message.


VAERS ID: 1463736 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: 1st dose pfizer vaccine was given to patient on 07/0762021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window. We reached out to pt on 07/15/21 and spoke to patient mother. Mother doesn''t think she wants her child to get another dose.


VAERS ID: 1463737 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: 2nd dose pfizer vaccine was given to patient on 07/06/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window. We reached out to pt on 07/10/21 but unable to talk to pt.


VAERS ID: 1463757 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: 2nd dose pfizer vaccine was given to patient on 07/06/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window. We reached out to pt on 07/10/21 to get the 1st dose again. Patient will return to the pharmacy to repeat dose on 07/14/21.


VAERS ID: 1463886 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-06
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Body temperature increased, Burning sensation, Dizziness, Feeling hot, Headache, Muscle spasms
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202107; Test Name: Body temperature; Result Unstructured Data: High
CDC Split Type: USJNJFOC20210718775

Write-up: BURNING SENSATION AT THE BACKSIDE OF HEAD AND FOOT; CRAMPS IN RIGHT LEG; FOOT GETTING HOT; FEELING DIZZY; HIGH BODY TEMPERATURES; HEADACHES; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 06-JUL-2021 for prophylactic vaccination. Batch number was not reported. per procedure, no follow up will be requested for this case. No concomitant medications were reported. On JUL-2021, Laboratory data included Body temperature (NR: not provided) High. On 06-JUL-2021, the subject experienced burning sensation at the backside of head and foot. On 06-JUL-2021, the subject experienced cramps in right leg. On 06-JUL-2021, the subject experienced foot getting hot. On 06-JUL-2021, the subject experienced feeling dizzy. On 06-JUL-2021, the subject experienced high body temperatures. On 06-JUL-2021, the subject experienced headaches. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the headaches, high body temperatures, burning sensation at the backside of head and foot, cramps in right leg, foot getting hot and feeling dizzy was not reported. This report was non-serious.


VAERS ID: 1464009 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-08
Onset:2021-07-06
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Joint swelling
SMQs:, Peripheral neuropathy (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Suddent large swelling in ankle joints, pain in joints. Now knees are get swelled up too. Sensation of burning in the site of swelling.


VAERS ID: 1464012 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-22
Onset:2021-07-06
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ? / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac function test, Pericardial effusion
SMQs:, Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: APAP, allopurinol 100mg PO daily, atenolol 25mg PO daily, Eliquis 5mg PO Q12H, furosemide 40mg PO daily, Lisinopril 2.5mg PO daily
Current Illness: unknown
Preexisting Conditions: AF, Systolic CHF, CKD stage 3, Heart failure with reduced ejection fraction, HTN, morbid obesity, PAH, Pericardial effusion, tricuspid regurgitation.
Allergies: NKDA
Diagnostic Lab Data: Cardiac workup performed.
CDC Split Type:

Write-up: Unknown which vaccine was given. Only selected Pfizer because VAERs wouldn''t let me proceed. Was not given at hospital. Given somewhere else. Cardiologist believes that that pericardial effusion (admitted here for that) may have been due to COVID vaccine given 2 weeks prior to admission, even though patient has advanced age and significant cardiac history


VAERS ID: 1464085 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Pt reports fainted in chair while waiting the 15 minutes after receiving the JJ vaccine and states hurt his right shoulder when he fell.


VAERS ID: 1464181 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-01
Onset:2021-07-06
   Days after vaccination:96
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 2 - / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall 10 Mg Atenolol 25 Mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Urgent care I have a nasal swab rapid test
CDC Split Type:

Write-up: Vaccine breakthrough. I tested positive for covid on July 9


VAERS ID: 1464205 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Rash
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? No
Hospitalized? No
Previous Vaccinations: Flu shot. Hives and rash all over body
Other Medications: Buspirone 7.5mg BID Epipen Famotidine 20mg Zaditor Levalbuterol 45mcg Xyzal Loratadine Singular Triamcinolone 0.1% Allegra
Current Illness: None
Preexisting Conditions: Seasonal allergies
Allergies: Flu shot Penicillin Prednisone Albuterol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash covering torso, chest, back and neck. Started 7-6-2021, stilling have 7-12-2021


VAERS ID: 1464233 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-28
Onset:2021-07-06
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: at home test positive
CDC Split Type:

Write-up: became symptomatic 07/06 at home test positive. Pt states he doesn''t feel and cannot be tested at MD office.


VAERS ID: 1464241 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Hypoaesthesia, Immediate post-injection reaction
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (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: Multi-vitamin daily
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Medical database and callout to the doctor twice on 07/07/2021 she did a question and answer observation over the phone and advised no medicine advised. Gave the directive to wait 10 days to see if it resolve on it own and to come in to be seen if it does not resolve with the timeframe.
CDC Split Type: vsafe

Write-up: Go the shot immediately burning down my arm waited :15 minutes to wrist and hand, hand went numb. Was told by pharmacy that it was normal later that evening the leg to feet went numb then into the night the entire left side from neck to face to cheek went numb. Face numbness went away after a day in a half. On day six: still having this numbness in arm and leg from the elbow to the hand numbness and the front the knee to the foot numbness on left side. Seems to be resolving with the face numbness resolving.


VAERS ID: 1464332 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 AR / IM

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

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

Write-up: Pt described bumps under buttocks, starting around 7:00pm the evening of the vaccine. These spread into hives and welts on the backs of the thighs, from under the buttocks to the top of the backs of the knees. Pt reports the hives as itching and stinging, and not improving with steroid cream and antihistamine prescribed by her teledoc.


VAERS ID: 1464391 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Missouri  
Vaccinated:2020-12-31
Onset:2021-07-06
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chest X-ray abnormal, Chest pain, Chills, Communication disorder, Computerised tomogram thorax abnormal, Diarrhoea, Dyspnoea, Fatigue, Headache, Hypoxia, Lung opacity, Malaise, Nausea, Pain, Pyrexia, Vaccine breakthrough infection, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: PMHx significant for DM2, HTN, Obesity.
Allergies: NKA
Diagnostic Lab Data: Diagnostic Results (07/10/2021 07:01 CDT CT Chest PE Protocol) IMPRESSION: VASCULAR: 1. No acute pulmonary embolus are visualized to level the segmental pulmonary arteries. CHEST: 1. Bilateral peripheral right greater than left nodular and groundglass airspace opacities which can be seen with Covid-19 pneumonia although other processes including multifocal pneumonia and septic emboli can have this appearance. [1] (07/10/2021 05:34 CDT XR Chest) FINDINGS: Normal cardiomediastinal silhouette. Right basilar airspace opacity seen better on the same day chest CT. A few other subtle peripheral airspace opacities seen on chest CT are less well seen on chest x-ray. No pleural effusions. No pneumothorax. No acute osseous abnormalities. IMPRESSION: Right basilar airspace opacity which may represent a developing pneumonia including Covid pneumonia. [2]
CDC Split Type:

Write-up: History of Present Illness Patient is a 38y/o F who presented to the ED with SOB and general malaise. PMHx significant for DM2, HTN, Obesity. Diagnosed with COVID on 7/6/21. Symptom onset 7/5. Pt with difficulty communicating 2/2 current condition. Endorses fevers/chills, SOB, CP, body aches, malaise, fatigue, HA, N/V. States she has also had chronic diarrhea. Unable to keep any PO down. Denies any bloody emesis/stools. States this AM she called EMS as she was so weak, she did not think she could make another day. Hypoxemic on arrival requiring 2L. Titrated down to RA in ED. Was fully vaccinated in December/January.


VAERS ID: 1464413 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-07-05
Onset:2021-07-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dyspnoea, Fatigue, Hyperhidrosis, Palpitations, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (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: Probiotics, multivitamin
Current Illness: None
Preexisting Conditions: Heart murmur, acne
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue 6 days Fever about 12 hours after 2nd dose, then again 6 days later (chills, sweating, shaking) Racing heart, 6 days after 2nd dose. Shortness of breath, 6 days after 2nd dose. Acetaminophen and ibuprofen.


VAERS ID: 1464471 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-01
Onset:2021-07-06
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: CSF protein increased, CSF red blood cell count, Guillain-Barre syndrome, Lumbar puncture, Magnetic resonance imaging spinal abnormal, Magnetic resonance imaging thoracic abnormal
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Cardiomyopathy (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lexapro, Yaz
Current Illness: no acute illness
Preexisting Conditions: depression on treatment
Allergies: NKDA
Diagnostic Lab Data: cervical spine MRI with symmetric enhancement of ventral and cervical nerve roots -Thoracic MRI w enhancement is seen on the surface of the lower thoracic cord/conus extending into the cauda equina nerve roots -lumbar MRI w prominent enhancement on the surface of the conus both ventrally and dorsally. Enhancement of the cauda equina nerve roots. No nodularity or thickening of nerve roots is suspected -all above MRI finding consistent with GBS -LP (CSF with 0 RBC 9 nucleated cells and 199 protein)
CDC Split Type:

Write-up: Patient currently hospitalized at hospital with high suspicion of Guillain Barre Syndrome


VAERS ID: 1464525 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-01-10
Onset:2021-07-06
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Back pain, Blood lactic acid, Blood urine present, COVID-19, Chest X-ray normal, Cough, Diarrhoea, Dysuria, Haemoglobin decreased, Laboratory test, Nausea, Neuropathy peripheral, Pain, Productive cough, Pyrexia, Red blood cells urine, SARS-CoV-2 test positive, Tachycardia, Thrombocytopenia, Transaminases increased, Troponin normal, Urine analysis, Urine leukocyte esterase positive, Vomiting, White blood cells urine positive
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Patient is a 70 year old male with RCC s/p left nephrectomy (2018), marginal zone lymphoma (2018) s/p 6 cycles chemotherapy, diabetes, HTN, CAD, esophageal strictures with multiple dilations, esophageal perforation causing constrictive carditis necessitating a cardiac window, and recurrent RCC from lymph node biopsy now on Cabozantinib
Allergies: codeine, nickel, cardizem LA, penicillin, rituxan
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 70 year old male with RCC s/p left nephrectomy (2018), marginal zone lymphoma (2018) s/p 6 cycles chemotherapy, diabetes, HTN, CAD, esophageal strictures with multiple dilations, esophageal perforation causing constrictive carditis necessitating a cardiac window, and recurrent RCC from lymph node biopsy now on Cabozantinib who presents to the ED after one day nausea and vomiting. Patient reports he is doing well until yesterday when he begins to have some abdominal pain on his left side radiating into his back. He has chronic back pain but feels like this pain is different. He did tolerate diet yesterday. This morning, he had 3 vomiting episode and watery bowel movement. He also endorses burning pain when urinating today. He states that he had several UTIs previously. Patient has chronic productive cough from COPD history but denies increase or worsening of cough. In the ED, he was found to be tachycardic HR 106 and febrile T 38.4. Labs notable for Hgb 11.1, lactic acid 1.8, and mild transaminitis (chronic). UA showed WCC, blood, leukocyte, and RBC. Patient was given 1L IVF and started on vanc and meropenem. CXR was unremarkable. Troponin negative. Covid from RPP came back positive. Patient stated that he had Covid previously in Jan 2021 and had both Covid vaccines on January. Of note, patient was diagnosed with marginal zone lymphoma on Jan 2019 and was on 6 cycles of bendamustine and rituximab previously in 2019, with current plan of observation. He was also diagnosed with left cell renal carcinoma on Sept 2018 s/p L nephrectomy 2018, SBRT. Metastatic disease was confirmed on Jan 2020 and patient is currently on cabozantinib. He has notable side effects while on treatment including neuropathy and thrombocytopenia.


VAERS ID: 1464527 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-02-01
Onset:2021-07-06
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Public       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: Multivitamin and vitamin d
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa, cephalosporins
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shingles


VAERS ID: 1464557 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-01
Onset:2021-07-06
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Disorientation, Drug screen negative, Patient elopement
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Standard drug tests returned negative results.
CDC Split Type:

Write-up: Daughter in hospital. Not on any medications. received second vaccination on June 26th. No history of mental illness. On July 10th, they found her disoriented, barefoot, wandering the neighborhood in middle of the night near my parent''s home. She was staying with them this weekend. I was worried she took ''shrooms based on behavior, but they don''t test for psylocybin in standard ER drug panels. She came up negative for drugs like THC, meth, and cocaine.


VAERS ID: 1464670 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Amnesia, Asthenia, Blood test, Computerised tomogram, Disorientation, Dizziness, Dysstasia, Electrocardiogram, Electroencephalogram, Headache, Magnetic resonance imaging, Movement disorder, Pain, X-ray
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Claritin Tylenol Wellbutrin lamotrigine denztropine
Current Illness: no
Preexisting Conditions: no
Allergies: amoxicillin
Diagnostic Lab Data: cat scan, eeg , ekg, x rays, blood test mri
CDC Split Type:

Write-up: dizziness, disoriented , could not stand, headache, could not stand, does not remember any of time after shot. , loss function of extremities., responded to pain , does not remember anything in ER was kept in hospital 4 days , began to move extremeties after 3 days. Extreme weakness in body , did not have awareness and body movements for several days.


VAERS ID: 1464713 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-06
Onset:2021-07-06
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042L20A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anosmia, COVID-19, Cough, Fatigue, Headache, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccinated with Moderna on 2/6/21 and 3/6/21. Symptom onset 7/6/21 with cough, loss of smell, headache and fatigue. Tested positive for Covid-19 on 7/10 2021.


VAERS ID: 1464723 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-06
Onset:2021-07-06
   Days after vaccination:122
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043L20A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anosmia, COVID-19, Cough, Fatigue, Headache, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccinated with Moderna on 2/6/21 and 3/6/21. Symptom onset 7/6 with cough, loss of smell, headache and fatigue. Tested positive for Covid-19 on 7/10/21.


VAERS ID: 1464755 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-05
Onset:2021-07-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra Vitamin D - 2000 IUD daily Complex Vitamin B Melatonin
Current Illness: Stomach bug 2 weeks prior
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, dizzy, fever, body aches


VAERS ID: 1464762 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Herpes simplex, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin Probiotic vitamin Birth control
Current Illness: None
Preexisting Conditions:
Allergies: Not applicable
Diagnostic Lab Data:
CDC Split Type:

Write-up: Herpes simplex flare up. Skin peeling on hands


VAERS ID: 1464780 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-26
Onset:2021-07-06
   Days after vaccination:102
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016B21A / 2 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: SARS-CoV+SARS-CoV-2 (COVID-19) Ag [Presence] in Respiratory specimen by Rapid immunoassay~SARS-CoV+SARS-CoV-2 (COVID-19) Ag [Presence] in Respiratory specimen by Rapid immunoassay test on 7/6/21 and was positive. Case investigation interview with patient has not been performed at the time of this note.


VAERS ID: 1464785 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 1 LA / IM

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

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

Write-up: The patient received their first Moderna vaccine while he was under the approved age of 18. The patient did not have any adverse events after the shot. I notified the guardian after the shot was administered that the shot was not approved for patients under the age of 18. The guardian understood and signed the consent form along with the patient''s signature. Let the guardian know if they have any questions or concerns to please call the pharmacy at any time


VAERS ID: 1464854 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-05
Onset:2021-07-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041CZ1A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial enlargement, Electrocardiogram, Fatigue, Full blood count, Hypertension, Myalgia, Pyrexia, Vomiting, White blood cell count decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Not known
Allergies: Penicillin, azithromycin, pistachio
Diagnostic Lab Data: CBC - Low WBC, high blood pressure, ECG
CDC Split Type:

Write-up: Fever, muscle aches, fatigue, vomiting, diarrhea, biatrial enlargement, high blood pressure


VAERS ID: 1465125 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-06-25
Onset:2021-07-06
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bradycardia, Chest X-ray normal, Computerised tomogram head, Dizziness, Fibrin D dimer normal, Hypoaesthesia, Paraesthesia, Presyncope, Ultrasound scan normal
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril Gabapentin Trazodone Atorvastatin
Current Illness: No other illnesses
Preexisting Conditions: HTN, Hyperlipidemia
Allergies: NKDA
Diagnostic Lab Data: CT Head was negative Chest X-ray negative D-Dimer negative US lower extremities negative
CDC Split Type:

Write-up: On 7/6/2021 while on vacation, I started developing sharp tingling feeling in my left leg. I then nearly had a syncopal episode, had trouble speaking and was leaning to the right. My wife had to hold me up. My brother in law had to carry me to the car as my left leg was not working at all. I was taken by ambulance to the nearest hospital and was worked up for possible CVA (which was ruled out). I was also checked for DVT of lower extremities which was negative. I am still having residual numbness and tingling to my left leg. I am still having symptomatic bradycardia with near syncope.


VAERS ID: 1465354 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-05
Onset:2021-07-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 575HC / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Pain in extremity
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan 50 mg tablet
Current Illness: None reported
Preexisting Conditions: Hypertension
Allergies: No Known Drug Allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Right arm pain, increasing pain in right arm and wrist for 6 days after vaccination, has been wearing a wrist brace because of the pain


VAERS ID: 1465770 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-03
Onset:2021-07-06
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 80777-0273-10 / 7+ LA / IM

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

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

Write-up: Dizziness and weakness, injection site pain, tenderness, swelling, redness, fatigue, headache, muscle pain, joint pain, severe chills started on Thursday, July 8 early evening and ended on Friday evening around 11:30 p.m. , had a fever that lasted the same amount of time. Side effects started on Tuesday, July 6, 2021. Injection on July 3, 2021 later in the afternoon pain from shot in the left arm, joint pain and redness occurred that night. On Wednesday, July 7, I started taking Ibuprofen 200 mg every 4 hours until Saturday, July 10, 2021. Symptoms seemed to be gone late Saturday night, July 10, 2021.


VAERS ID: 1465975 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-03-17
Onset:2021-07-06
   Days after vaccination:111
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (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: Methylphenidate
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bells Palsy symptoms


VAERS ID: 1465979 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Headache, Rhinorrhoea
SMQs:

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

Write-up: Headache 4 hrs after the shot & runny nose a day after the shot . Symptoms are less now


VAERS ID: 1466000 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-01
Onset:2021-07-06
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN EASLEY / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscle spasms
SMQs:, Dystonia (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: Truelicuty. Losartan. Htcz. Metformin
Current Illness: None
Preexisting Conditions: Diabetes. Hbp
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Cramping in.legs 5 fays


VAERS ID: 1466262 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-11
Onset:2021-07-06
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JOHNSON & JOHNS / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: 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: Multivitamin , normal dosage ibuprofen
Current Illness: None
Preexisting Conditions: None
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Muscle Weakness


VAERS ID: 1466455 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-01
Onset:2021-07-06
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 2 LA / SYR

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

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

Write-up: Moderna COVID-19 Vaccine EUA/ hives over body. primarily back of neck, back, stomach & legs. quantity total: ~40


VAERS ID: 1466462 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-01-23
Onset:2021-07-06
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Choking, Diplopia, Gait inability, Pain, Pain in extremity, Paralysis, Sleep disorder, Speech disorder, Visual impairment
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Ocular motility disorders (broad), Hypersensitivity (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multi Vitamin Amlodipine Hydralazine Hydrochlorothiazide Montelukast Omeprazole Ondansetron Potassium Vitamin D
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Shellfish
Diagnostic Lab Data: Various tests
CDC Split Type:

Write-up: Paralyzed head to feet, speech affected, prickly feelings in body like needled, double vision, extreme pain in feet and leg, unable to walk, affected vision, unable to sleep at night due to the pains, choking and symptoms are getting worse


VAERS ID: 1466470 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-01
Onset:2021-07-06
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deafness bilateral, Ear discomfort, Feeling abnormal, Muscular weakness, Myalgia, Oropharyngeal pain, Productive cough, SARS-CoV-2 test negative, Secretion discharge
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse
Current Illness: none
Preexisting Conditions: Endometriosis
Allergies: Amoxicillin, flagella
Diagnostic Lab Data: Negative cover test. 7/7/21
CDC Split Type:

Write-up: Four days after shot developed horrific cough with green mucous, sore throat, muscle pain, brain fog, intense arm weakness, and hearing loss. It is 7/13/21 and the symptoms of muscle pain have warn off, but still have hearing loss in both ears as if they were plugged (like being on an airplane) but do not pop. Still have some minor brain fog, as well as coughing up mucous, but the cough is getting better. When the symptoms started, I went to urgent care as I read that these were not symptoms of the vaccine. A rapid COVID test was performed and was negative, and was prescribed an inhaler.


VAERS ID: 1466537 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-06-01
Onset:2021-07-06
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH E0191 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Ear infection, Electrocardiogram
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin, sesame, mold
Diagnostic Lab Data: Blood test July 8 2021
CDC Split Type:

Write-up: Ear infection requiring cefdenir antibiotic Also concerns about heart ekg. Being referred to cardiologist


VAERS ID: 1466635 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039C21A / 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: Moderna 2nd dose given too early. First dose was on 6/21/21 and second dose was given 7/6/21.


VAERS ID: 1466672 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

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

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

Write-up: (The vaccine was administered greater than 6 hours after the vial was diluted, mix, and drawn up for injection


VAERS ID: 1466674 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-22
Onset:2021-07-06
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Herpes zoster, Injection site reaction
SMQs:, Opportunistic infections (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt. states received Phizer vaccine 2nd 04/22/2021 Physician visit 07/06/2021 and was recently diagnosed with Shingles 07/06/2021. Location on the right arm near and around injection site, around wrists. Treating with herbal remedies at home. No prior symptoms


VAERS ID: 1466816 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-07-03
Onset:2021-07-06
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Back pain, Chest pain, Musculoskeletal disorder, Painful respiration, Rash, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Exercise induced asthma
Allergies: Sensitivities to tree nuts specifically pistachios
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: He woke up with chest pain in the upper right quadrant at midnight and then it intensified when he was breathing deep breaths. They woke him up when he was sleeping and did not go away. Then, it continued through the next day and we asked our doctor if we needed to keep an eye on him because of all the reporting and stuff about the heart problems. They did a triage consult visit to see if it could be an adverse event from the vaccine. The course of action was to take 2 ibuprofen every 4 hours and use ice and heat to see if the pain improved to rule out musculoskeletal situations because that was what they thought it was. We did that for 2 days and then the pain moved to his back upper right quadrant and we noticed a rash all over his abdomen and we were not sure where he got that. Based on the fact that the pain moved the doctor was more confident that it was not an adverse event.


VAERS ID: 1466885 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

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

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

Write-up: pt is was given a injection on 07/06/2021 that was un-refrigerated at drawn up since 07/02/2021. pt did not report any symptoms.


VAERS ID: 1467310 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-01
Onset:2021-07-06
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: A patient''s parent thought she was over 12 years old and filled out the form with a wrong DOB saying over 12years old. She was given one dose Pfizer Covid -19 vaccine but no side effect was reported.


VAERS ID: 1467526 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-01-16
Onset:2021-07-06
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin, bupropion
Current Illness: none
Preexisting Conditions: HTN, GERD
Allergies: NKDA
Diagnostic Lab Data: +COVID PCR
CDC Split Type:

Write-up: +COVID presenting with cough, shortness of breath, fatigue after returning from travel


VAERS ID: 1467761 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

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

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

Write-up: 1st dose pfizer vaccine was given to patient on 07/06/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window. We reached out to pt on 07/10/21 and 7/12/2021 but unable to talk to pt.


VAERS ID: 1467768 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: 1st dose pfizer vaccine was given to patient on 07/06/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window. We reached out to pt on 07/10/21 and 7/12/2021 but unable to talk to pt.


VAERS ID: 1467769 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-29
Onset:2021-07-06
   Days after vaccination:68
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK UN / UN

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

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

Write-up: Got 1st shot of Pfizer at unknown location on 4/29/2021. Received a Jansen shot on 7/06/2021


VAERS ID: 1467780 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, Product storage error
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: 2nd dose pfizer vaccine was given to patient on 07/06/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window. We reached out to pt on 07/10/21 and 7/12/2021 but unable to talk to pt.


VAERS ID: 1467965 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Product storage error
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: 2nd dose pfizer vaccine was given to patient on 07/06/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2nd dose pfizer vaccine was given to patient on 07/06/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window.


VAERS ID: 1467971 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, Product storage error
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: 2nd dose pfizer vaccine was given to patient on 07/06/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window.


VAERS ID: 1467977 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

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

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

Write-up: 2nd dose pfizer vaccine was given to patient on 07/06/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window.


VAERS ID: 1468209 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: 1st dose pfizer vaccine was given to patient on 07/06/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window.


VAERS ID: 1468212 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

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

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

Write-up: 2nd dose pfizer vaccine was given to patient on 07/06/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window.


VAERS ID: 1469636 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-06
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Injection site pain, Lethargy, Myalgia, Nausea, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (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? 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
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210723315

Write-up: LETHARGY; COLD CHILLS; SORE ARM; NAUSEA; MUSCLE ACHE; HEADACHE; INJECTION SITE SORENESS; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. The patient''s past medical history included covid-19. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose was not reported, administered on 06-JUL-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 06-JUL-2021, the subject experienced lethargy. On 06-JUL-2021, the subject experienced cold chills. On 06-JUL-2021, the subject experienced sore arm. On 06-JUL-2021, the subject experienced nausea. On 06-JUL-2021, the subject experienced muscle ache. On 06-JUL-2021, the subject experienced headache. On 06-JUL-2021, the subject experienced injection site soreness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from sore arm, and the outcome of nausea, cold chills, muscle ache, headache, lethargy and injection site soreness was not reported. This report was non-serious.


VAERS ID: 1470205 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 2 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, 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: Unknown
Current Illness: Unknown
Preexisting Conditions: N/A
Allergies: NKDA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Recipient arrived to vaccine site with his mother. Recipient was given Moderna Vaccine Dose #1 on 6/22/2021. He is under 18 years old. His mother presented CDC card showing Dose #2 due on 7/6/2021. Recipient received dose 14 days early.


VAERS ID: 1470310 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-20
Onset:2021-07-06
   Days after vaccination:136
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 - / -

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

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

Write-up: Patient hospitalized after testing positive for COVID-19. Patient is fully vaccinated.


VAERS ID: 1470549 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: South Dakota  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness transient
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Glaucoma (broad), Optic nerve disorders (broad), Retinal 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: unknown
Current Illness: none reported
Preexisting Conditions: unknown
Allergies: no known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately 5 minutes after dose was administered reported loss of vision for 3 minutes and then vision returned. He denied feeling light headed or dizzy. Blood pressure was 119/62 from left arm. No report of double vision.


VAERS ID: 1470598 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (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: Levothyroxine 100mcg and levothyroxine 88mcg . lisinopril/hctz 20/12.5mg
Current Illness: No known health conditions
Preexisting Conditions: No known health conditions
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient developed tinnitus the evening after receiving her COVID shot on 7/6/21. The ringing has not improved since her vaccine


VAERS ID: 1470635 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Chills, Dizziness, Feeling hot, Influenza like illness, Injection site pain, Muscle spasms, Pain, Pyrexia, Thrombosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Per patient, she is on a birth control (Estarylla 0.25-0.035mg Tablets). But stopped on the day visit to the ER on 07/12/2021 after finding out that she has a blood clot.
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Tree nuts, Citrus seeds
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient received first Moderna dose on June 8, 2021 and second dose on July 6, 2021. Patient started having flu-like symptoms such as, Fever (but doesn''t know what temperature as she did not measure but she felt hot) and chills. After 1-2 days of flu-like symptoms she began to have painfulness around the left arm where she received both of her Moderna vaccines. This painfulness started 3-4 days after receiving the 2nd dose of Moderna vaccine. Patient was also having symptoms of pinching, aches, cramps on left arm along with light-headedness and dizziness. Patient visited the Emergency Department on July 12, 202 and confirmed by the Doctor that there is a blood clot on the left arm. The doctor at the Emergency Department wanted patient to reach out to the pharmacy and report the incident. Patient is currently prescribed for a blood thinner and will follow up with doctors tomorrow 07/15/2021 and another doctor in a week. Patient has allergies to Tree nuts and citrus seeds and was on a birth control Estarylla 0.25-0.035mg tablets until the day she found out that she has a blood clot (07/12/2021).


VAERS ID: 1470672 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure decreased, Dizziness, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Dehydration (broad)

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

Write-up: PT COMPLAINED OF DIZZINES,S, NAUSEA, AND DECREASED BP.. EMS called and pt taken to ER


VAERS ID: 1470788 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: The patient received the Covid vaccination at 10:30 am on 7/6/21. At around 2 or 3 pm he said his arm was really painful and it lasted through Thursday. On Friday his arm was just tender and over the weekend his arm was fine. When he woke up today (Wednesday) his arm was painful again and swollen. It has a bump on it about the size of a 4x4 post it. He doesn''t think it is necessary to contact his doctor at this time. He will try Ibuprofen and an ice pack and monitor and let us know how he is doing in the next 2-3 days.


VAERS ID: 1471059 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Dysstasia, Euphoric mood, Gait inability, Jaundice, Muscle spasms, Pain, Pyrexia, Yellow skin
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: - Extreme body aches on lower back and thighs/glutes. Could not walk and legs started to cramp for 2 days. - Face and skin began to turn yellowish in hue (Jaundice) -Extreme dizziness and feeling of euphoria where I could not stand -High Fever over 102.5 degrees.


VAERS ID: 1471309 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-15
Onset:2021-07-06
   Days after vaccination:113
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (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: High Cholesterol medicine blood pressure medicine
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bells Palsey


VAERS ID: 1471490 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-06-01
Onset:2021-07-06
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022821 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure decreased, Vertigo positional
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Vestibular disorders (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none at all
Current Illness: none for years
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: at home we saw that my blood pressure would suddenly drop during these movements
CDC Split Type:

Write-up: Vertigo would happen when I moved my head, for example if I lifted my head to look up at a shelf, or if lying down it would happen if I picked up my head off the pillow. Even moving my eyes up to look at someone would cause a feeling of vertigo. But, it did not happen after repeatedly lifting heavy objects (I work as a stock person). And did not occur when standing up, only when I would move my eyes or lifted my head.


VAERS ID: 1471658 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183-H / UNK LA / IM

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

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

Write-up: Client came to our site received 1st dose of Pfizer. Later found out that client had received Janssen Vaccine on April 7, 2021


VAERS ID: 1471661 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183-H / UNK 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: Client received 1st dose Pfizer vaccine on July 6,2021. Later found out client had received Janssen vaccine on April 7, 2021


VAERS ID: 1474027 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

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

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1474032 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Skin haemorrhage, Skin lesion
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Itching at Injection Site-Severe, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe. Additional Details: Patient came in with sore on her arm that looked like an oval area where her arm had been scraped. She said she was given the shot there, and it has been bothering her ever since (but it looked too low and immunizer said that is not where shot was given). She said it keeps bleeding every time she tries to clean it. I recommended some OTC products to help heal the area. She said she wanted to go to the doctor. I told her if she wanted to go to a doctor that would be fine.


VAERS ID: 1474035 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Systemic: Fever-Medium, Systemic: Fever lasting 8 days-Medium


VAERS ID: 1474037 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 021A21A / 1 RA / IM

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

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

Write-up: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1474634 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-03
Onset:2021-07-06
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, COVID-19, Chills, Cough, Diarrhoea, Dyspnoea, Headache, Immunodeficiency, Myalgia, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Vaccinated with Pfizer on 3/3/21 and 3/24/21. Symptom onset 7/6/21 with cough, chills, diarrhea, headache, weakness, shortness of breath, muscle aches, sore throat and abdominal pain. Tested positive for Covid-19 on 7/14/21. Client was given a 20 day isolation from her physician due to her being immunocompromised. At time of interview 7/15/21, client still had cough, chills, diarrhea, headache, shortness or breath and muscle aches. 7/15/21 is day 9 of her isolation.


VAERS ID: 1474638 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-24
Onset:2021-07-06
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, COVID-19, Chills, Cough, Diarrhoea, Dyspnoea, Headache, Immunodeficiency, Myalgia, Oropharyngeal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Kidney transplant 2006 - Immunocompromised
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccinated with Pfizer on 3/3/21 and 3/24/21. Symptom onset 7/6/21 with cough, chills, diarrhea, headache, weakness, shortness of breath, muscle aches, sore throat and abdominal pain. Tested positive for Covid-19 on 7/14/21. Client was given a 20 day isolation from her physician due to her being immunocompromised. At time of interview 7/15/21, client still had cough, chills, diarrhea, headache, shortness or breath and muscle aches. 7/15/21 is day 9 of her isolation.


VAERS ID: 1474687 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast pain, Decreased activity, Dyspnoea, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Lipodystrophy (broad)

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

Write-up: Severe heart palpitations between 55 up to 195 Bpm while sitting still and cannot do activities as a result. Shortness of breath and pain in the left side breast. Never had any of the symptoms before taking the 2nd dose of Pfizer vaccine.


VAERS ID: 1474779 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-25
Onset:2021-07-06
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Bradycardia, Chest discomfort, Dyspnoea, Echocardiogram, Electrocardiogram, Headache, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: B12 and vitamin d
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ekg Bloodwork Echocardiogram
CDC Split Type:

Write-up: Chest discomfort Windedness Pain in arms Braydicardia Headaches


VAERS ID: 1474976 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-03
Onset:2021-07-06
   Days after vaccination:64
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac failure congestive, Cerebellar haemorrhage, Craniotomy, Ventricular drainage
SMQs:, Cardiac failure (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: hypertension, DM
Preexisting Conditions: none
Allergies: aspirin
Diagnostic Lab Data:
CDC Split Type:

Write-up: dx:large cerebellar hemorrhage treatment: craniotomy, EVD outcome: poor, withdrawls from pain, CHF with EF 25-30%, Hospice consulted


VAERS ID: 1477747 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-07-02
Onset:2021-07-06
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Mouth swelling, Swelling face, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Medium


VAERS ID: 1478411 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-01
Onset:2021-07-06
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Cardiac monitoring, Cardiac stress test normal, Chest discomfort, Echocardiogram normal, Feeling abnormal, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvastatin 10mg every other day Tamsulosin .04 mg 2 X daily Zinc 100 mg Glucosomine 3000 mg Chrondroitin 2400 mg Vitamin d3 100 mg Vitamin C 2000 mg Centrum Silver multi
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: Hospital conducted echo cardiogram, stress test and blood work and found no abnormalities. I have been placed on a heart monitor for 2 weeks beginning July 15.
CDC Split Type:

Write-up: I was doing light yard work and felt discomfort in my chest. Went in the house to get hydrated and test my blood pressure and pulse. Rapid heart rate of 143. Monitored for 3 hours and was consistently 140-142. Called cardiologist who referred me to the Emergency Room at the hospital ER Administered Cardizen IV and returned to normal heart rate within 45 minutes. I have been experiencing foggy brain since the incident. I consider myself to be in perfect health and am very active.


VAERS ID: 1478419 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Feeling cold, Injected limb mobility decreased, Injection site pain, Limb discomfort, Musculoskeletal pain, Musculoskeletal stiffness, Neck pain, Neuralgia, Pain, Pain in extremity, Restlessness, Sinus pain, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Arthritis (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: Alendronate 70mg once weekly
Current Illness: none
Preexisting Conditions: diverticular disease which is currently under control with diet
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 6th July: injection in the morning by the afternoon arm is sore. Took 600mg Advil afternoon and 800mg at bedtime. Restless night waking frequently with arm neck and sinus pain. 7th July morning took 800mg Advil by afternoon arm is heavy like I can hardly lift it and pain now radiating to finger tips and down my legs from buttock like severe sciatic nerve pain. Manage to sleep for 3 hrs in the afternoon by evening pain worsening. 6.30pm felt cold even though 29C outside pain still severe and feels heavy to breath. 7.30 pm hot shower and to bed cramping in arm to finger tips, under breast, severe pain down from buttock to the soles of my feet and scalp tingling. 8.00pm my legs arm and head feel on fire. 8th July morning less cramping and arm still heavy but feel slightly improved from yesterday, sinus pain, neck stiff and breathing still heavy but not as bad. 9th July symptoms improving slowly.


VAERS ID: 1478441 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-24
Onset:2021-07-06
   Days after vaccination:132
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9624 / 2 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: SARS-CoV-2 test, Vaccine breakthrough infection
SMQs:, COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not documented in .
Current Illness: Not documented in .
Preexisting Conditions: Diabetes, hypertension.
Allergies: Not documented in
Diagnostic Lab Data: COVID-19 PCR test - 7/14/21
CDC Split Type: WEDSS DI#21074116

Write-up: Breakthrough Case


VAERS ID: 1478514 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-05-03
Onset:2021-07-06
   Days after vaccination:64
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blister, Herpes zoster, Scab
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad), Opportunistic infections (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: Vitamins C and D3, Garlic, Men''s multivitamin
Current Illness: None
Preexisting Conditions: Hemochromatosis
Allergies: None
Diagnostic Lab Data: None. Email visual visit only on July 12, 21
CDC Split Type:

Write-up: Shingles on right bicep , shoulder area and neck. Lasted about a week before blisters scabbed over


VAERS ID: 1478584 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-31
Onset:2021-07-06
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 1 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Cold sweat, Computerised tomogram, Condition aggravated, Cough, Electrocardiogram, Fatigue, Haemoptysis, Headache, Hypoaesthesia, Lymphadenopathy, Pain in extremity, Pulmonary thrombosis, Tinnitus, Ultrasound Doppler, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, venous (narrow), Guillain-Barre syndrome (broad), Hearing impairment (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (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? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: (7/7/21-7/12/21) EKGs, chest x-rays, ultrasounds (legs, arms, liver), blood tests, Catscan. Blood clots in right lung, slightly enlarged lymph nodes, possible pnuemonia
CDC Split Type:

Write-up: 1st Shot(5/3/21): Soreness in arm, Fatique 2nd shot(5/31/21): Soreness in arm, Fatique, headaches, developed a cough a week later which lasted about a week. Adverse event (7/6/21): Started coughing and spitting blood around 5:00pm. Coughing persisted throughout the evening. At 6:00am I told my mom I was having a problem. around 6:30am my body went numb, loud ringing in my ears, and broke out into a cold sweat, so we called 911. The paramedics arrived and checked me out, and they believed I was okay. When they left we decided to go to the ER. Admitted on 7/7/21-7/12/21


VAERS ID: 1478671 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-03
Onset:2021-07-06
   Days after vaccination:64
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Antiphospholipid antibodies negative, Blood culture negative, Cardiolipin antibody negative, Chest pain, Dizziness, Dyspnoea, Electrocardiogram abnormal, Fibrin D dimer increased, Gene mutation identification test negative, Haemoptysis, Protein S normal, Prothrombin level, Pulmonary embolism, Sinus tachycardia, Tinnitus, Ultrasound Doppler
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hearing impairment (narrow), Vestibular disorders (broad), Infective pneumonia (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: NKMA
Diagnostic Lab Data: D-Dimer day iof admission : 547ng/ml [0---230] Cardiolipin Antibodies -- Negative. Lupus Anticoagulant: Not Detected. Prothrombin 20210A Mutation Negative Factor V Leiden Mutation : Negative. Protein s Activity : Normal
CDC Split Type:

Write-up: 7/6/2021: Hemoptysis, ringing in ears, felt like fainting, shortness of breath -- Right Lower Chest Pain -- EMS called 7/7/2021: ER evaluation showed Acute Pulmonary Embolism --- $g Admitted to hospital--- $g IV Heparin --- $g Xarelto. Also IV Rocephin + Azithromycin. Blood Cultures Negative x 2. EKG Sinus tach 103. Light Hemoptysis continued x 3 days. Venous Duplex Bilateral Lower Extremities Negative for DVT. 7/10/2021: Bilateral Upper Extremity Venous Duplex Negative. 7/12/2021: Discharged Home


VAERS ID: 1478861 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New York  
Vaccinated:1921-07-06
Onset:2021-07-06
   Days after vaccination:36525
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Chills, Lymphadenopathy, Mononucleosis heterophile test negative, Pain, Pain in extremity, Pyrexia, SARS-CoV-2 test negative, Streptococcus test negative, Tonsillar erythema, Tonsillar hypertrophy
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none known
Diagnostic Lab Data: At clinic, on 7/14/21, they did a covid test, mono test and strept test, all of which were negative. But Dr. recommended a retake
CDC Split Type:

Write-up: Bodyaches , painfull joints ( more the knees), Fever(102 farenh) and chills the first day followed by swollen lymph nodes on both sides of my neck, super swollen tonsils , which were red with white patches. Then there was a sharp pain on my chest that ran down my left arm but lasted less then a minute.


VAERS ID: 1481090 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-07-06
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Therapeutic response unexpected
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Laryngitis; Pneumonia
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210717242

Write-up: EXPERIENCING MORE ENERGY POST VACCINATION; This spontaneous report received from a patient concerned an adult female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included pneumonia, and laryngitis. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1816022 expiry: 15-AUG-2021) dose was not reported, administered on 05-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 06-JUL-2021, the subject experienced experiencing more energy post vaccination. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of experiencing more energy post vaccination was not reported. This report was non-serious.


VAERS ID: 1481122 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-07-06
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 test, Suspected COVID-19, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210706; Test Name: COVID-19 virus test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210723506

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient concerned a female of unspecified age. Initial information was processed with the additional information received on 12-JUL-2021. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808980, expiry: not reported) dose was not reported,1 total, administered on 31-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 06-JUL-2021, the patient was tested positive for COVID-19 (suspected COVID-19 infection and suspected clinical vaccination failure). Laboratory data included: COVID-19 virus test (NR: not provided) Positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the suspected COVID-19 infection and suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000185610.; Sender''s Comments: V0:20210723506-COVID-19 VACCINE AD26.COV2.S-SUSPECTED CLINICAL VACCINATION FAILURE. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS.


VAERS ID: 1481205 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-07-06
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, Product storage error
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: Comments: The patient had no known allergies
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210727968

Write-up: VACCINE ADMINISTERED OUTSIDE OF RECOMMENDED STORAGE AREA; INCORRECT PRODUCT STORAGE; This spontaneous report received from a pharmacist concerned a 60 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808986, expiry: 18-AUG-2021) dose was not reported, administered on 06-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 06-JUL-2021, the subject experienced vaccine administered outside of recommended storage area. On 06-JUL-2021, the subject experienced incorrect product storage. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vaccine administered outside of recommended storage area and incorrect product storage was not reported. This report was non-serious.


VAERS ID: 1481347 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-03
Onset:2021-07-06
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Magnetic resonance imaging abnormal, 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chest pain, received motrin, MRI with myocarditis, elevated troponin le els


VAERS ID: 1481361 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-03
Onset:2021-07-06
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram normal, Fatigue, Feeling abnormal, Full blood count normal, Headache, Heart rate increased, Metabolic function test normal, Pain, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Hearing impairment (narrow), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Protonix,Qsymia,multivitamin, vitaminD, miralax, probiotics
Current Illness: None
Preexisting Conditions: GERD, obesity, dysfunctional gallbladder, Constipation
Allergies: Gabapentin, keflex
Diagnostic Lab Data: EKG 7/11/2021, I did not see results. I believe it was normal sinus rhythm. CBC normal, Complete Met panel normal both 7/12/2021
CDC Split Type:

Write-up: Dizziness, headache, body aches, increased heart rate with activity , fatigue, brain fog. Ordered meclizine and propanolol and rest and to follow up with primary care. Completed follow up with primary care next day due to symptoms worsening. To follow up with primary care if symptoms not resolved by 4 days. Blood work completed and normal. Medications help manage symptoms. Symptoms not worsened today, but have not resolved. Have also had ringing in ears. Will follow up with primary care on Monday for further instructions.


VAERS ID: 1481403 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-05
Onset:2021-07-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dehydration, Headache, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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: Lamictal generic brand - lamotrigene
Current Illness: None
Preexisting Conditions: Diagnosed with focal seizures in 2020 but they are rare. Been on medication consistently in early 2021
Allergies: None known
Diagnostic Lab Data: None - physician office called in a prescription for her
CDC Split Type:

Write-up: At first had symptoms that are common including mild fever, chills, headache , etc.. then experienced extreme vomiting which required a prescription from her pediatrician to control so she could keep liquids down. Vomited about 10 times in a few hours then managed to stop after the medication was administered. She is a petite person and it took a long time after the vomiting stopped to get her fully hydrated and able to urinate properly


VAERS ID: 1481759 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-06
Onset:2021-07-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008B21A / UNK LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Anaphylactic reaction, Heart rate increased, Swollen tongue, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVOTHYROXINE
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by the reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Anaphylactic Reaction; Rapid Heart rate; Narrowing of throat; swelling of tongue; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of ANAPHYLACTIC REACTION (Anaphylactic Reaction), HEART RATE INCREASED (Rapid Heart rate), THROAT TIGHTNESS (Narrowing of throat) and SWOLLEN TONGUE (swelling of tongue) in a 49-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008B21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included LEVOTHYROXINE for an unknown indication. On 06-Jul-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 06-Jul-2021, the patient experienced ANAPHYLACTIC REACTION (Anaphylactic Reaction) (seriousness criteria medically significant and life threatening). 06-Jul-2021, the patient experienced HEART RATE INCREASED (Rapid Heart rate) (seriousness criterion medically significant), THROAT TIGHTNESS (Narrowing of throat) (seriousness criterion medically significant) and SWOLLEN TONGUE (swelling of tongue) (seriousness criterion medically significant). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) (oral) for Adverse event, at a dose of 50 mg; EPINEPHRINE for Adverse event, at a dose of 0.3 mg; METHYLPREDNISOLONE SODIUM SUCCINATE (SOLUMEDROL) for Adverse event, at a dose of 125 mg; FAMOTIDINE (PEPCID [FAMOTIDINE]) for Adverse event, at an unspecified dose and frequency and PREDNISONE for Adverse event, at an unspecified dose and frequency. On 08-Jul-2021, ANAPHYLACTIC REACTION (Anaphylactic Reaction), HEART RATE INCREASED (Rapid Heart rate), THROAT TIGHTNESS (Narrowing of throat) and SWOLLEN TONGUE (swelling of tongue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Additional concomitant medication included "MP thyroid." Within 12 minutes of receiving the vaccine, the patient developed an anaphylactic reaction, with swelling of tongue, narrowing of the throat and a rapid heart rate. Oral diphenhydramine 50 mg and epinephrine injection 0.3mg was given to the patient by emergency medical technicians. The patient was taken in an ambulance where she received methylprednisolone sodium succinate 125 mg. She was taken to a local emergency room for treatment. In the emergency room, she was given famotidine and then discharged after observation. Approximately 12 hours later, the patient began to experience the same anaphylactic reaction again and was taken to another emergency room. The patient was treated with intravenous diphenhydramine and an epinephrine injection. She was observed in the emergency room then discharged with prescription medicine. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


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