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

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

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

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VAERS ID: 1885295 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-27
Onset:2021-11-18
   Days after vaccination:264
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 RA / IM

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

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

Write-up: Hospitalized for COVID infection with related sepsis.


VAERS ID: 1885301 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-11-15
Onset:2021-11-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 3 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Dyspnoea, Intensive care, Oxygen saturation decreased
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (broad), Infective pneumonia (broad)

Life Threatening? Yes
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: See Attached Medication List.
Current Illness: Flair up of Psoriatric arthritis
Preexisting Conditions: Chronic
Allergies: NKA
Diagnostic Lab Data: Notify the Medical Center for further information on testing. He was admitted on 11/18/2021.
CDC Split Type:

Write-up: Resident had shortness of breath and low O2 sat (55%). He was taken by his daughter to the Medical Center. He was admitted into the ICU due to COVID vaccine side effects.


VAERS ID: 1885308 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 RL / IM

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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: Unknown at this time. Urged to consult with PCP.
CDC Split Type:

Write-up: Received call to report patient developed hives and welts 24 hours after administration of Pfizer 5-11 Covid-19 vaccine. Stated this morning most of the welts and hives were gone.


VAERS ID: 1885312 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear discomfort, Head discomfort, 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: Norco
Current Illness: N/a
Preexisting Conditions: Spondylosis degenerative disc disease ovarian cysts hydrosalpinx
Allergies: Berries robinul
Diagnostic Lab Data: Na
CDC Split Type:

Write-up: Ears clogged slight head pressure. Ringing in ears. No other symptoms. No pain No nose running No fever.


VAERS ID: 1885314 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032F21A / UNK - / IM

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

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

Write-up: Patient received a full dose of Moderna for his booster.


VAERS ID: 1885336 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 3 RA / IM

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

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

Write-up: Received Pfizer in error when she wanted Moderna for her Booster. The two staff members before her got a dose of Pfizer and in error she was given the same instead of the Moderna which was available as well. The nurse administering repeated the question from registration- " are you feeling well today, and which arm but not which med".


VAERS ID: 1885348 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-30
Onset:2021-11-18
   Days after vaccination:233
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Covid + on 11/18/2021 Admitted into the hospital on 10/31/2021
CDC Split Type:

Write-up: Breakthrough Case


VAERS ID: 1885361 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye pain, Eye swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Glaucoma (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: severe headache, fatigue, body/muscle ache
Other Medications: pantoprazole, trazodone, zytec
Current Illness:
Preexisting Conditions: acid reflux
Allergies: latex, sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: swollen and painful right eye


VAERS ID: 1885362 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-31
Onset:2021-11-18
   Days after vaccination:232
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Extra dose administered, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Medication errors (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Covid + on 11/18/2021, Admitted to the hospital on 11/09/2021.
CDC Split Type:

Write-up: Breakthrough Case, Patient also received Booster, Moderna Lot #040B21A on 09/27/2021 at medical facility.


VAERS ID: 1885389 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Vaccination site reaction, Vaccination site warmth
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Localized redness and warmth adjacent to vaccine site. (vaccine given in L deltoid, reaction in L tricep)


VAERS ID: 1885395 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939909 / 3 LA / IM

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

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

Write-up: PATIENT GIVEN HALF DOSE OF MODERNA BOOSTER AND SHOULD HAVE BEEN GIVEN FULL DOSE DUE TO BEING IMMUNO COMPRIMISED


VAERS ID: 1885400 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: New York  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

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

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

Write-up: Patient is 12 years-old and was administered the 5-11 year-old 10 microgram dose rather than the 12+ 30 microgram dose. Family was informed and they will receive the correct 30 microgram dose in 3 weeks on schedule.


VAERS ID: 1885402 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-11-18
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Senior Living       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: legs numbness


VAERS ID: 1885406 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-11-16
Onset:2021-11-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Chest pain, Echocardiogram, Fibrin D dimer increased, Illness
SMQs:, Haemorrhage laboratory terms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: tramadol 50mg prn
Current Illness:
Preexisting Conditions: steatosis
Allergies: none
Diagnostic Lab Data: elevated crp and elevated ddimer. he had echo done and saw a cardiologist. that was stable. chest pain did resolve.
CDC Split Type:

Write-up: febrile illness and then chest pain for about 24 hours


VAERS ID: 1885415 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose administered, Headache, Pain
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: Moderna, January 2021. Headache, body aches, chills, nausea
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received my COVID booster vaccine. By the evening, not even 8 hours later, I presented with body aches and a headache. Into the next day, I still present with these symptoms


VAERS ID: 1885424 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA L032F21A / 3 LA / IM

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

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

Write-up: headache, body aches - neck and back, mild lymphadenopathy left axilla


VAERS ID: 1885453 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident, Speech disorder, Transient ischaemic attack
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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: NORCO 10-325MG
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT DAUGHTER STATED FATHER HAD REACTION. HE WAS NOT ABLE TO SPEAK, IT LOOK LIKE HE HAD A STROKE. WENT TO HOSPITAL BUT NO STROKE OR TIA WAS DETERMINED. HOSPITAL BELIEVES IT WAS REACTION TO VACCINE


VAERS ID: 1885494 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chills, Injection site erythema, Injection site swelling, Injection site warmth, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)

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

Write-up: Severe chills, bodyache,joints ache Quarter size red area injection site. Swelling warm to touch.


VAERS ID: 1885527 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-10
Onset:2021-11-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 077C21B / UNK - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: Patient came to a public vaccination clinic on 11/18/21 where he stated he had not yet received a covid-19 vaccine. He was then given the Pfizer vaccine as a "1st dose". When charting his vaccination, it was found out that patient received the Moderna Covid-19 vaccine on 11/10/21. Patient was too early for his second dose and received the wrong manufacturer. Unknown if patient experienced any side effects at the time of submitting this VAERS report.


VAERS ID: 1885529 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939909 / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin B12, doxycycline, advair, ventolin, cartia XT, valsartan-HCTZ, cetirizine, ferrous sulfate, spririva, fenofibrate, amlodipine, flonase, atorvastatin
Current Illness: none
Preexisting Conditions: hypertension, hyperlipidemia, osteoarthritis, mild asthma
Allergies: Penicillin
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: No adverse reaction; vial past viability was administered


VAERS ID: 1885538 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-19
Onset:2021-11-18
   Days after vaccination:272
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Covid + on 11/18/2021
CDC Split Type:

Write-up: Breakthrough Case Fully vaccinated Received Moderna Booster on 11/01/2021 at CVS Pharmacy Store #8039. Lot #033F


VAERS ID: 1885540 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu shot, unknown brand or date
Other Medications: unknown
Current Illness:
Preexisting Conditions: high blood pressure
Allergies: nicotine smoke, garlic, strawberries, sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 10 minutes after getting the vaccination the patient returned to the pharmacy counter to inform me she was breaking out in hives on her arms. I observed some redness on both her arms. I took her blood pressure which was 186/112 in the right arm and 185/111 in the left arm. Patient had no other symptoms. I gave patient 25mg of diphenhydramine. She took that and left the store shortly after. I called her later that evening and she said the hives had completely resolved and she had no other symptoms.


VAERS ID: 1885556 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330308D / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Cough, Dyspnoea, Eye swelling, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Swollen face (eyes), shortness of breath, tightness/pressure in chest area, cough. Took Cetirizine 10mg; reduced swelling in the face and eyes.


VAERS ID: 1885558 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-07
Onset:2021-11-18
   Days after vaccination:225
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 - / -

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

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

Write-up: Breakthrough Case


VAERS ID: 1885561 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939909 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, 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: Aldactone, ASA, Entresto, Coreg, Advair, Lasix, atorvastatin, lexapro, proair, esomeprazole, krill oil
Current Illness: none
Preexisting Conditions: smoking, obesity, hypertriglycerides, asthma, anxiety, CHF, OSA, COPD, depression
Allergies: Erythromycin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: No adverse reaction; vial past viability and administered to patient


VAERS ID: 1885582 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Influenza like illness, Pain, Sensitive skin
SMQs:

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

Write-up: Patient states flu like symptoms that started 24 hours after booster shot. States she had extreme body aches skin sensitivity all over her body and chills that resolved in 24 hours with tylenol use.


VAERS ID: 1885588 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8030 / 3 LA / IM

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

Write-up: Patient is reporting pain across the top of her left breast about 13 hours after the booster.


VAERS ID: 1885599 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939909 / UNK RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atorvastatin, plaquenil, pantoprazole, aspirin, docusate sodium, amlodipine, potassium chloride, vit D, chlorthalidone, doxazosin, losartan potassium, levothyroxine, carvedilol, trazodone
Current Illness: none
Preexisting Conditions: hypertension, vit d deficiency, hyperlipidemia, hypothyroid, GERD, COPD
Allergies: methotrexate
Diagnostic Lab Data: None
CDC Split Type:

Write-up: None; vial past viability


VAERS ID: 1885634 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 RA / IM

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

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

Write-up: The patient on 11/17/2021 received a 1st dose of the 10mcg/0.2ml vaccination (5-11 yr old). This patient based on the birthday should have received the Pfizer 12+ vaccination of 30mcg/0.3ml. The nurse thought the system had made a mistake and she proceeded to vaccinate with the inappropriate vaccine. The patients were notified and they returned on 11/18/2021 and the nurse administered an additional 20mcg/0.4ml to complete the total recommended dose of 30 mcg.


VAERS ID: 1885653 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-25
Onset:2021-11-18
   Days after vaccination:146
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Moderna Vaccine 6/25/2021, 5/21/2021. Hospitalized 11/18/21


VAERS ID: 1885673 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1611 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Headache, Mobility decreased, Pain, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
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: 2nd Covid, 2nd Shigrex -mild symptoms, headache, feeling generally unwell
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Uncontrolable shaking, couldn''t breathe. Severe body aches, difficult and painful to move. Severe headache. Fever of 102.5 degrees.


VAERS ID: 1885688 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Palpitations, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (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: gastritis medications
Current Illness: unknown
Preexisting Conditions: gastritis
Allergies: nka
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Client received Pfizer booster at approximately 1455 Client alerted nurse she was feeling palpitations while sitting in the observation area. She stated she wanted her vital signs to be taken. Client was AAOx3 and was breathing normally. Client denied shortness of breath or difficulty breathing. No hives or redness observed on client arms, neck or face. Client stated she had received Janssen as her first dose but had no reactions to the vaccine. Client vital signs were taken by EMT 1500 BP 140/80 HR 76 RR 14 PUPILS PERLA within normal limits. Client sat in gravity chair without assistance. Client stated she was feeling ?like a pounding feeling in her chest all the way to her ears?. At 1507 Auscultation of heart was done by EMT and confirmed palpitations every 3-5 secs. Client stated she had no medical conditions except for gastritis and takes some meds for it. She stated she had no allergies. She stated she only feels out breath when she?s in a hurry when busy. But no history of palpitations. Client stated she felt chest pressure and felt ?shaky?. 1510 BP 130/82 HR 78 with palpitations. At 1516 EMS was called for further assessment of client. Client?s Husband informed RN that two years ago an Arrythmia had been confirmed to patient, but no further follow-up was done. Client was very shaky due to being anxious about the situation and was being guided to have controlled breathing with Student nurse.. At Approximately 1525 EMS arrived at vaccination site and took over client?s care. AT 1539 Client walked with assistance by paramedics to the EMS truck. Client was taken to hospital.


VAERS ID: 1885705 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-10
Onset:2021-11-18
   Days after vaccination:281
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 2 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anion gap increased, Atelectasis, Blood bicarbonate normal, Blood calcium decreased, Blood creatinine increased, Blood glucose decreased, Blood potassium normal, Blood sodium normal, Blood urea increased, Chest X-ray abnormal, Coronavirus infection, Coronavirus test positive, Cough, Dyspnoea, Exposure to SARS-CoV-2, Haematocrit decreased, Haemoglobin decreased, Hypoglycaemia, Malaise, Oropharyngeal pain, Pleural effusion, Pyrexia, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Lactic acidosis (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Tumour lysis syndrome (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 11/18/21 Coronavirus 2 PCR Detect, V symptomatic POSITIVE
CDC Split Type:

Write-up: CHIEF COMPLAINT Fever and sore throat HISTORY OF PRESENT ILLNESS Patient is a 71 y.o. male who presents with past medical history (residing in adult foster care, wheelchair mobile) with medical conditions including HTN, diabetes type II, intellectual disability, schizophrenia, prior HIT (2012), prior stroke, bronchiectasis, anemia of chronic disease, CKD stage 5 (rising baseline creatinine most recently around 5.5, patient interested in peritoneal HD), renal mass (likely RCC, currently under surveillance, associated with pulmonary micronodules which may represent metastatic disease). Patient presented to Hospital with complaint of cough, dyspnea, sore throat and fever. He reports that there are many people in his group home that are COVID positive. He denies any vomiting or diarrhea. Plans in the emergency department were for him to undergo monoclonal antibodies and he had agreed, but lab results returned with a creatinine in noted at 6.14 and glucose of 49 (asymptomatic). He was found to be COVID positive. Hemoglobin 9.8, hematocrit 29.3, white blood cell count 7.8, glucose 48, sodium 138, potassium 4.2, bicarb 21, and gap of 19, creatinine of 6.14, BUN of 106, calcium 8.3, chest x-ray shows interval resolution of small bilateral pleural effusions and associated bibasilar atelectasis. Given the concern for increasing creatinine in level above his baseline and hypoglycemia he was admitted to the hospital for further evaluation and treatment. Patient was seen in room. He reports doing well and is eating dinner. He reports that his entire group home has come down with COVID and he started developing symptoms. He denies any dizziness, lightheadedness, shaking related to his hypoglycemia. He reports that he has not eaten anything since this morning, as he has been in the emergency department this entire time. He denies any chills. He reports his shortness of breath is only intermittent and denies any at this current time. He denies any chest pain, nausea, vomiting and diarrhea constipation or urinary complaints. He has remained on room air. He endorses that he has been followed with outpatient Nephrology with the consideration of peritoneal hemodialysis given his recent rising creatinine levels.


VAERS ID: 1885724 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034F21A / 3 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE QUADRIVALENT) / SANOFI PASTEUR UJ764AA / N/A RA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft, pantoprazole, oxybutynin, Januvia, atenolol, rosuvastatin, Pro-Air, mirtazapine, zinc, vitamin e, vitamin d3, vitamin c, vitamin b-12, probiotic, magnesium, docusate sodium, Centrum Silver Women, calcium-citrate, brimonidine, betimo
Current Illness: COVID 10/2021
Preexisting Conditions: hypertension, GERD, hyperlipidemia, Type 2 diabetes mellitus, skin lesion, anemia, BMI 25.0-25.9 adult
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient requested COVID booster during office visit. Patient had COVID in October. Per provider, patient was past their quarantine window & asymptomatic at visit. Provider asked what the patient was treated with, patient told provider that they were treated with antibiotics and steroids. Patient completed questionnaire for COVID vaccine & circled "No" on the question about receiving monoclonal antibodies. Patient received 0.25mL booster per protocol. Patient called later that day after leaving office, verified patient per name & DOB, patient stated that she forgot that she had received monoclonal antibodies and she was concerned since she received the COVID booster. Patient also received the flu shot on the same day. Patient has not developed any signs nor symptoms; spoke with patient today and patient states that she felt fine. CDC has been reached out to for guidance on the situation.


VAERS ID: 1885744 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D
Current Illness: COVID 19
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tachycardia persisting now for 18 hours. Pulse has been no lower than 110 and as high as 152 checked on auto blood pressure cuff and manually. Tachycardia has continued, even at rest.


VAERS ID: 1885751 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

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

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

Write-up: Circular rash size of half dollar and growing. Warm, tender and itchy.


VAERS ID: 1885814 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Underdose
SMQs:, Medication errors (broad)

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

Write-up: Client is age 17 and received Pfizer 5-11 formulation. Multiple safeguards to prevent this type of error were in place, including color-coded wristbands, staff education prior to the clinic and just-in-time training at clinic, only one vaccine type per vaccinator station, and at least 2 points in clinic flow where age and vaccine type are verified. Due to errors by multiple staff members, this error happened. The client and guardian (father) were immediately informed of the error. Per CDC guidance, the client may receive another age-appropriate dose of Pfizer vaccine in 21 days; the client/guardian were encouraged to discuss this with his pediatrician. At the time of this submission, no known adverse effects have occurred.


VAERS ID: 1885823 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Injection site pain, Lymph node pain, Pain, Pyrexia, Tenderness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: N/A
CDC Split Type:

Write-up: Fever, aches, started overnight after the shot. Soreness at injection site, localized soreness in armpit (lymph node). Fever (100.4) lasted one day. Arm and lymph node tenderness still present (two days).


VAERS ID: 1885852 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939909 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Feeling abnormal, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (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: Moderna 2nd dose
Other Medications: Patient stated that she felt "like a horse kicked her in the arm" a few hours after vaccination. She had chills and was shivering and had pain in her arm. She took some tylenol and went to sleep. The next day, she felt like she was going
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated that she felt "like a horse kicked her in the arm" a few hours after vaccination. She had chills and was shivering and had pain in her arm. She took some tylenol and went to sleep. The next day, she felt like she was going to vomit all day and felt "fuzzy" and "woozy". She drove to pick up her granddaughter from school and tried to park the car in the garage. She says she was so dizzy that she pulled the car in sideways and claims that she had "an out-of-body experience". She says that they did not react to the first dose, but was sick all day from the second dose.


VAERS ID: 1885869 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5618 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Rash, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concerta 27mg
Current Illness: Mild cold the week of vaccination.
Preexisting Conditions: None.
Allergies: No current allergies. History of food allergies (past) and currently sensitive to chemical/preservatives in food. + h/o food allergies and does not eat products with "chemicals" because they cause him to behave with funny or he is intolerant. Had multiple food allergies as infant which he outgrew per mom and has seen allergist for a long time for these food allergies. 7 year old sibling who had covid vaccine at the same time and does not have food allergies without any hives
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received the covid vaccine at 2:30 pm on Wednesday , Thursday evening began with hives, which were diffuse and covered 80% of his back (based on picture) parents showed. He was given Benadryl and had no shortness of breath/chest pain, and dad reports "bumps" were improved 1 hour later, dad then gave Benadryl at 2am and the hives remained improved and by morning they were gone. No respiratory distress, shortness of breath, or throat swelling. This morning at 11am had small start of hives and was immediately given Benadryl. No chest pain/short of breath, + tired and no fever/cough/ST No new foods/soap/lotion/detergent or items per parents. pmhx- mom reports that when he was very young- maybe 1 year or under he had multiple vaccines given and within 2 hours had severe rage/anger and then was ok 2 hours after the vaccine. Since then receives vaccines only one at a time. No /v/d/resp distress/abd pain/headache/st, appetite is ok, drinking well, urine output normal


VAERS ID: 1885881 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1620 / 1 LA / IM

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

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

Write-up: Patient presented with his father for COVID-19 vaccine. Father completed the admin/consent form and listed patient''s age in 2 locations as 12 years old. Our clinic administered the adult/adolescent dose of the Pfizer COVID-19 vaccine. Upon entering the patient''s shot into our system, we noted the child is actually 11 years old. The father put the wrong age on the form. Patient should have received the pediatric dose of the vaccine. Spoke to patient''s father to inform him of the error. He stated his son is doing fine, and not having any adverse symptoms or reactions.


VAERS ID: 1885906 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 067F21A / 1 LA / IM

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

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

Write-up: Patient received Moderna but not 18 years of age at time of vaccine


VAERS ID: 1885911 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Conjunctival haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Conjunctival disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: montelukast, tri-sprintec, levothyroxine, elderberry, multivitamin
Current Illness: none
Preexisting Conditions: Nicotine dependence, hypothyroidism, hyperglyceridemia
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: subconjunctival hemorrhage started later that day and worsened the next morning


VAERS ID: 1885918 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect dose administered, Product administration 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: Humira 40mg/0.8ml syringe
Current Illness: none
Preexisting Conditions: Psoriatic arthritis
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Lower than authorized dose volume (0.25 ml) administered, once identified patient notified and returned for additional 0.25 ml to equate to 0.5 ml (recommended third dose of Moderna COVID-19 vaccine for immunocompromised patients), per recommendation via CDC COVID-19 Vaccine Administration Errors and Deviations.


VAERS ID: 1885923 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855191 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Hypoaesthesia oral, Limb discomfort, Lip swelling, Paraesthesia, Pharyngeal paraesthesia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No information provided
Current Illness: No information provided
Preexisting Conditions: No information
Allergies: Yes , but she does not remember
Diagnostic Lab Data: No
CDC Split Type:

Write-up: While I was working, a lady came to the counseling window to ask a question. She told me she had gotten a Johnson and Johnson COVID shot ten minutes before and stated her arms felt numb, tingly, and heavy. She asked whether this normal. I told her it?s not a normal, common side effect. I asked her if she had a history of reactions to vaccinations. She told me she hadn?t. I asked her for her name and phone number so I can report it to VAERs. She then complained of sudden numbness in her upper lip. I realized it might be an allergic reaction. I grabbed a chair and had her sit down. I then got an epipen and went into the office to tell a manager to call 911. I went back to check on the customer and asked how she was doing. She stated her throat was starting to tingle. I noticed upper lip was starting to swell. I asked her if she could wait for the paramedics to arrive, but she asked me to give her the epipen shot. She mentioned she got an epipen shot when she young. She didn?t know what she?s allegoric to, but this wasn?t the first time she was given an epipen shot. I gave her the shot. She started feeling better, and I gave her some water and some candy because she appeared to be in a state of low-sugar. The paramedics arrived shortly after this. I explained the situation to the paramedics and what I had done for the customer. Leaving the customer in the care of the paramedics, I went back to the pharmacy. She left with the paramedics shortly after this.


VAERS ID: 1885924 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal, Muscle spasms, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: Hypertension, Diabetes
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lightheadedness - in a fog while walking around, muscle cramps throughout the body, and two rounds of having a fever. Temperature unknown


VAERS ID: 1885929 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-12
Onset:2021-11-18
   Days after vaccination:220
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Nasal congestion, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ascorbic acid (VITAMIN C) 1000 MG tablet Take 1,000 mg; 11/18/21 o aspirin 81 MG chewable tablet Chew 81 mg by mouth o azithromycin (ZITHROMAX) 250 MG tablet o fenofibrate micronized (LOFIBRA) 134 MG capsule o fluticasone (FLO
Current Illness:
Preexisting Conditions: Allergy history unknown o Hyperlipidemia o Shortness of breath o Sleep apnea
Allergies: no known allergies
Diagnostic Lab Data: 11/18/21 SARS-CoV-2 PCR - Detected
CDC Split Type:

Write-up: 11/18/21-56-year-old male is coming in with nasal congestion cough and chills that started yesterday. He reports he is vaccinated against COVID-19 since May. Review of Symptoms: Review of Systems Constitutional: Positive for chills. Negative for activity change, appetite change, fatigue and fever. HENT: Positive for congestion, rhinorrhea and sore throat. Respiratory: Positive for cough. Negative for shortness of breath, wheezing and stridor. Cardiovascular: Negative for chest pain, palpitations and leg swelling. Gastrointestinal: Negative for diarrhea, nausea and vomiting. Skin: Negative for rash. Neurological: Negative for dizziness and headaches. All other systems reviewed and are negative. 11/19/21 Received Regeneron infusion


VAERS ID: 1885930 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dry mouth, Feeling abnormal, Interchange of vaccine products, Throat irritation, Tongue pruritus
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Medication errors (broad), Dehydration (broad)

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

Write-up: Patient originally received Janssen vaccine and was here for Moderna booster. The vaccine was administered and she developed ?itchy tongue and throat.? She didn?t have trouble breathing just very dry mouth and ?weird? feeling. I gave her diphenhydramine 25mg and symptoms did not progress. She sat here for 45 minutes and she started feeling better. No other side effects were found.


VAERS ID: 1885959 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-27
Onset:2021-11-18
   Days after vaccination:295
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anosmia, COVID-19, Cough, Exposure to SARS-CoV-2, Rhinorrhoea, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not listed
Current Illness:
Preexisting Conditions: Not listed
Allergies: none listed
Diagnostic Lab Data: 11/18/21 COVID-19 RESULT Detected Abnormal
CDC Split Type:

Write-up: 11/18/21-In the last month, have you been in contact with someone who was confirmed or suspected to have Coronavirus / COVID-19? Yes Have you had a COVID-19 viral test in the last 14 days? Yes - Positive result Do you have any of the following new or worsening symptoms? Runny nose;Cough;Loss of smell Have you traveled internationally or domestically in the last month? No


VAERS ID: 1885961 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211D21A / N/A AR / IM

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

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

Write-up: Patient presented to the vaccination site on 11/18/2021. The client notified PHN that he received a both doses of Sinovac COVID vaccine in different country on 3/28/2021 and 5/6/2021. PHN submitted a medical consult via text message to Vaccine Operations Leads, requesting to proceed with the COVID vaccine Janssen. Per CDC guidance, approval to proceed with COVID vaccine Janssen was obtained from medical consult team via text message from PHN, Vaccine Operations Lead, per Dr. Client received COVID vaccine Janssen Lot#211D21A on 11/18/2021. The client did not report any symptoms during the 30 minute observation period. RN educated client on possible adverse reactions and when to seek medical care. The client left the vaccination site at 1530 walking with steady gai


VAERS ID: 1886107 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-05
Onset:2021-11-18
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033F22A / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: 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: Melatonin 5mg Lexapro 20mg Famotidine 10mg
Current Illness: Collagenous colitis
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itchy neck began on 11/17/2021. Broke out in hives on 11/18/2021. Hives on face, neck, back, stomach, and one on my knee. Began Xyzal medication that evening and following morning. Hives have continued to come and go.


VAERS ID: 1886114 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018F21A / UNK 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderna vial was punctured at 12pm 11/17/21 left out overnight in the refrigerator. Staff member drew and administered dose from punctured vial at around 10am on 11/18/21


VAERS ID: 1886126 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Booster doses of 0.5 ml administered instead of 0.25ml. 0.25ml was warranted dose for subject patient.


VAERS ID: 1886137 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211D21A / 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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Pt received dose one hour after the punctured vial should have been discarded. No ADRs so far


VAERS ID: 1886138 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018F21A / UNK 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderna vial was punctured at 12pm 11/17/21 left out overnight in the refrigerator. Staff member drew and administered dose from punctured vial at around 10am on 11/18/21


VAERS ID: 1886145 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Agitation, Anxiety, Autonomic nervous system imbalance, Blood culture negative, CSF culture, CSF test, Chills, Computerised tomogram abdomen normal, Condition aggravated, Confusional state, Dysarthria, Dyskinesia, Echolalia, Enterovirus test, Fatigue, Headache, Herpes simplex test, Hypotension, Laboratory test, Language disorder, Magnetic resonance imaging head, Neuropsychiatric symptoms, Paraneoplastic syndrome, Procalcitonin normal, Psychotic disorder, Pyrexia, Tachycardia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Malignancy related conditions (narrow), Dyskinesia (narrow), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: buspirone 10 mg bid levothyroxine 100 mcg daily lorazepam 1 mg daily sertraline 150 mg daily
Current Illness: none
Preexisting Conditions: history of ovarian teratoma anxiety hypothyroid
Allergies: hydrocodone oxycodone penicillin V
Diagnostic Lab Data: see item 18 answers still pending: CSF aseptic, cx pending Blood cx ngtd HSV, enterovirus naat pending CSF encephalitis panel pending Serum encephalitis panel pending MRI head pending to r/o space occupying lesion Obtain CT chest tomorrow to complete eval for occult tumor
CDC Split Type:

Write-up: Had covid booster and flu shot at work and 4 hours later began to have progressive fatigue, chills, confusion, dysarthria, echolalia, dyskinesia, emesis and was taken to the ER. In the ER she was found to be hypotensive and febrile to 39.2 with tachycardia. Her psychiatric symptoms resolved with lorazepam, toradol and acetaminophen. She was admitted for ongoing care as she remained hypotensive requiring norepinephrine. With remote teratoma 2015 s/p resection and no e/o recurrence I wonder if her COVID (and/or influenza) vaccinations reactivated a senescent paraneoplastic syndrome. Her prodromal headache, fever and dysautonomia have now been complicated by two prolonged episodes of anxiety, agitation, psychosis, dyskinesias, diminished language output and echolalia which are concerning for an encephalitis like picture. Her dramatic improvement after high dose lorazepam with complete normalization of neuropsychiatric symptoms but not all autonomic symptoms is puzzling. Her symptoms are not typical for anxiety attacks. She was responsive enough during the episodes to argue strongly against generalized seizures. CT abd/pelvis did not show recurrent mass. Procalcitonin negative, arguing against systemic bacterial infection/sepsis. Her symptoms are too delayed to attribute to anaphylaxis to vaccinations.


VAERS ID: 1886167 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Booster doses of 0.5 ml administered instead of 0.25ml. 0.25ml was warranted dose for subject patient


VAERS ID: 1886444 (history)  
Form: Version 2.0  
Age: 8.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Syringe issue
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: nil
Current Illness: nil
Preexisting Conditions: nil
Allergies: nil
Diagnostic Lab Data: Nil
CDC Split Type:

Write-up: When the student nurse injected the child the first time, there was significant spilling and less than half the dose was administered. The student withdrew the needle and attempted a 2nd time with another loaded syringe. However, she felt resistance and unable to inject the vaccine, so she withdrew the needle without giving any vaccine. Her partner saw that, and helped her administered a full dose (0.2 ml) with another loaded syringe. The child received 3 pokes at her left arm, and one full dose was delivered.


VAERS ID: 1886454 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site induration, Injection site mass, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth, Pain in extremity
SMQs:, 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: vitamin c, vitamin d, zinc, calcium
Current Illness: none
Preexisting Conditions: none
Allergies: sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: day of injection - sore arm day after injection - arm more sore (took advil) pain at injection site, very itchy, red, swollen lump 2nd day after injection - hard lump at injection site, red, skin warm to touch


VAERS ID: 1886479 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache
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: Pfizer after first 2 dozes
Other Medications: Hydrocodone-Acetaminophen, Potassium, Premarin
Current Illness: None
Preexisting Conditions: Arthritis
Allergies: Neomycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Horrible, throbbing head-ache (felt like my head was going to explode) I had the same head-ache issues after the first 2 injections, but did not realize that they were caused by the Covid shots until I experienced the same symptoms after this booster shot


VAERS ID: 1886514 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939905 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FINASTERIDE 5MG,Amlodipine 10mg,Atorvastatin 20mg, and regular vitms.
Current Illness: nO
Preexisting Conditions: nONE
Allergies: NO
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Sore with some redness and little swollen.


VAERS ID: 1886718 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / SYR

Administered by: Senior Living       Purchased by: ?
Symptoms: Computerised tomogram head normal, Haemoglobin normal, Haemorrhage, Lethargy, Lip swelling, Petechiae, Platelet count decreased, Swelling, Swollen tongue, Thrombocytopenia, Urinary tract infection
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
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: Home Medications (11) Active aspirin 81 mg oral delayed release tablet 81 mg = 1 tab, Oral, Daily Bactrim DS 800 mg-160 mg oral tablet 1 tab, Oral, BID bisacodyl 10 mg rectal suppository 10 mg = 1 supp, PRN, PR, Daily citalopram 10 mg oral
Current Illness: Maderna booster given 2 days prior. CT negative for acute changes. Patient history paroxysmal A. fib on aspirin therapy with advanced dementia and ongoing decline very mild venous bleeding of her tongue with petechiae. Started November 18 with swelling. Labs revealed platelet count decreased from 813,000 in October down to 44,000 which could be related to Covid vaccine platelet induced thrombocytopenia. At baseline, patient chews tongue and nonverbal based on records. Hgb stable 13.1. Obese, nonambulatory
Preexisting Conditions: Hospice/DNR Dementia-pureed diet, nonambulatory with lift to transfer-Chews tongue Atrial fibrillation-paroxysmal Essential hypertension Facial skin lesion Generalized osteoarthritis Hyperlipidemia Hypothyroidism Intellectual disability Major depressive disorder
Allergies: NKA
Diagnostic Lab Data: see 18
CDC Split Type:

Write-up: presented to ED one day after bleeding with petechiae and swollen tongue/lip. Ongoing lethargy to -family elected short term care versus further workup/repeat labs. platelet count 44,000 from prior 113,000 in oct. Hgb without changes-13.1 CT of head revealed no acute changes. Hx of afib and was also treated for a UTI. Called nursing at the facilty 11/19 for follow up and she remains comfortable with no other changes to mouth. She is on short term care.


VAERS ID: 1886720 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dizziness, Musculoskeletal chest pain, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Cancer in remission
Allergies:
Diagnostic Lab Data: could not obtain medical care at the time (on job site)
CDC Split Type:

Write-up: dizziness (would have passed out if I hadn''t laid down), extreme pain on left side under ribs, chills, nausea, diarrhea


VAERS ID: 1886751 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Incorrect route of product administration
SMQs:, Anticholinergic syndrome (broad), Drug abuse and dependence (broad), Vestibular disorders (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily multi vitamins, supplemental vitamins C
Current Illness: None
Preexisting Conditions: Overweight, irregular heart beat since birth
Allergies: Sulfur based medicine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Lightheaded afterward / dizzy. Nurse jammed the needle into muscle improperly causing me to bleed like I''ve never done before. She immediately put pressure on it and it stopped, but feel this was done inaccurately. Not sure if it was the shot injection or the actual contents that caused the light headedness.


VAERS ID: 1887455 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 3 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Hypoaesthesia, Joint range of motion decreased, Mobility decreased, Pain, Skin discolouration, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Seasonal allergies
Preexisting Conditions:
Allergies: Penicillin, bananas, avocado, pineapple, raspberries, blackberries, kiwi.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Swelling, extreme tenderness to tendons/ligaments (shoulder Joint ), significant decrease in ROM of the right shoulder (unable to abduct arm, move arm behind body, limited and painful to move are Forward and/or straighten arm at the elbow) , right pinky and ring finger numbness, visible change in color (purple/blue) to both fingers and decrease in temperature to right hand overall especially pinky and ring finger (significantly cooler than the left hand).


VAERS ID: 1887458 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain lower, Cold sweat, Headache, Myalgia, Nausea, Pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (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: MMR. Anaphylactic
Other Medications:
Current Illness:
Preexisting Conditions: Lyme disease
Allergies: MMR vaccine, egg, juniper
Diagnostic Lab Data:
CDC Split Type:

Write-up: Throbbing Headache: 3rd dose, started on day 2 muscle aches 2nd dose: started 4 hours later lasted 5 days Muscle aches 3rd dose/booster: started 12 hours later cold sweats 2nd dose: started 4 hours later lasted 4 days Cold sweats 3rd dose/booster: started 24 hours later sharp lower abdominal pain: 3rd dose started 10 hours later nausea, sore arm: 2nd and 3rd dose lasted 20 hours


VAERS ID: 1887652 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: New Mexico  
Vaccinated:0000-00-00
Onset:2021-11-18
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18228811 / 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: USJNJFOC20211142072

Write-up: INJECTION GIVEN AFTER 6 HOUR PUNCTURE EXPIRY TIME BY 15 MINUTES; INCORRECT PRODUCT STORAGE; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. 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: 18228811, and expiry: 20-MAR-2022) dose was not reported, administered on 18-NOV-2021 for prophylactic vaccination. No concomitant medications were reported. On 18-NOV-2021, the patient experienced injection given after 6 hour puncture expiry time by 15 minutes. On 18-NOV-2021, the patient experienced incorrect product storage. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the injection given after 6 hour puncture expiry time by 15 minutes and incorrect product storage was not reported. This report was non-serious.


VAERS ID: 1887655 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Utah  
Vaccinated:0000-00-00
Onset:2021-11-18
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211D21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered
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: USJNJFOC20211142459

Write-up: VACCINE GIVEN 15 MINUTES AFTER EXPIRED BASED ON THE 6 HOUR WINDOW AFTER PUNCTURE; This spontaneous report received from a health care professional 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: 211D21A, and expiry: UNKNOWN) dose was not reported, administered on 18-NOV-2021 for prophylactic vaccination. No concomitant medications were reported. On 18-NOV-2021, the patient experienced vaccine given 15 minutes after expired based on the 6 hour window after puncture. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of vaccine given 15 minutes after expired based on the 6 hour window after puncture was not reported. This report was non-serious.


VAERS ID: 1887656 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:2021-11-18
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211D21A / 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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211142831

Write-up: INCORRECT PRODUCT STORAGE; VACCINE ADMINISTERED 1 HOUR AFTER THE ALLOWED 6 HOUR WINDOW AFTER INITIAL PUNCTURE (WITHOUT ANY ASSOCIATED ADVERSE EVENT); This spontaneous report received from a pharmacist 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: 211D21A, expiry: UNKNOWN) dose was not reported, administered on 18-NOV-2021 for prophylactic vaccination. No concomitant medications were reported. On 18-NOV-2021, the patient experienced vaccine administered 1 hour after the allowed 6 hour window after initial puncture (without any associated adverse event). On an unspecified date, the patient experienced incorrect product storage. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vaccine administered 1 hour after the allowed 6 hour window after initial puncture (without any associated adverse event) and incorrect product storage was not reported. This report was non-serious.


VAERS ID: 1887876 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011F21 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Hives, weakness or fatigue


VAERS ID: 1887882 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8030 / 6 RA / IM

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

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

Write-up: Error: Wrong Dose of Vaccine - Too High-


VAERS ID: 1887886 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5618 / 1 LA / IM

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

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

Write-up: Error: Wrong Dose of Vaccine - Too Low-


VAERS ID: 1887891 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Dizziness, Dysphagia, Dyspnoea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Mild


VAERS ID: 1887892 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076C21A / 3 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 LA / SYR

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

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

Write-up: Fever began around 9pm the same day as getting a Moderna booster. Was not able to sleep because of fever, extreme headache, and all over body soreness. The next day, my head was throbbing, fever was persistent, and had trouble eating. Would experience nausea with every bite. Symptoms continued through the morning of 11/20 (currently still having symptoms).


VAERS ID: 1887898 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027H21B / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect route of product administration, Injection site erythema, Injection site pruritus, Injection site swelling
SMQs:, Drug abuse and dependence (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (narrow)

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

Write-up: Site: Itching at Injection Site-Mild, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: injection may have been given too low


VAERS ID: 1887902 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8030 / 6 LA / IM

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

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

Write-up: Error: Wrong Dose of Vaccine - Too High-


VAERS ID: 1887950 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 3 - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chills, Dizziness, Fatigue, Pain
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Enbrel, methotrexate, carvidolil, multi vitamin, K2, d3, folic acid, calcium+D, biotin
Current Illness: None
Preexisting Conditions: High blood pressure, rheumatoid arthritis
Allergies: Penicillin
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Light headed, chills, body and joint aches, fatigue. Lasted over 24 hours - fatigue lasted the longest. All over symptoms by 11/20 6am.


VAERS ID: 1887982 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-11-16
Onset:2021-11-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

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

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

Write-up: Chills Fever Exhaustion Weakness Malaise


VAERS ID: 1887990 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin Estradiol Progesterone Testosterone Components thyroid Vitamin d Vitamin b Biotin Calcium
Current Illness: None
Preexisting Conditions: Hypothyroid
Allergies: Morphine Bees
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash, swelling, pain at site injection


VAERS ID: 1887991 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027H21B / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Burning sensation, Chills, Fatigue
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: liquid benedryl repatha lovenox
Current Illness: none
Preexisting Conditions: bowel cancer surgery patient.total collectomy ileostomy reversal jpouch
Allergies: demerol ketamine iron dextran penicillin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: burning in heart burning in kidney fatigue chills weakness


VAERS ID: 1887999 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: South Dakota  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032F21A / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Headache, Injection site pain, Injection site swelling, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atenolol 100mg, aspirin 81mg, multivitamin, glucosamine 1500mg chondroitin 1200mg, fish oil 1000mg
Current Illness: none
Preexisting Conditions: hypertension
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Injection site pain and swelling, also fatigue, headache, joint pain ,chills, nausea, and fever.


VAERS ID: 1888004 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039F21A / 1 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Headaches and nausea, 42yrs, 6Apr21, COVID19, Janssen,
Other Medications: None
Current Illness: Ear infection
Preexisting Conditions: Ear Infections, sinus infections
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: -Right arm is sore and unable to move comfortably during daily routine and work. -Full body fatigue for 48 hours.


VAERS ID: 1888017 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / IM

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

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

Write-up: I had normal side effects at first and then my right arm started on the tricep area and now is hurting underneath on the sides of the armpit and down the right side. So painful it feels like something is ripping when I lift my arm. I cannot fully extend it without pain. The pain is not getting better and now it is 4 days after the shot. It feels like it is swollen. Really painful and cannot lift or move my arm like normal.


VAERS ID: 1888025 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939905 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: as described before
Other Medications: Chronic medications: bupropion 300mg, amitriptyline 25mg, dicyclomine 10mg, pantoprazole 40mg, levothyroxine 125mg, citalopram 40mg,
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient had a her primary series of covid vaccination completed with the pfizer vaccine. She reported no issues with the first dose but experienced tingling in the left arm and face immediately after the second injection in the Spring. She chose to get the moderna booster just in case the adverse event was due to the pfizer vaccine. After receiving the moderna booster she started experiencing the same tingling in the entire left arm, neck, and left side of the face just like before. The tingling was unilateral in presentation. Patient described the sensation to being similar to the sensation of a novocaine injection. The event started within 5 minutes of the injection and lasted a few hours before resolving.


VAERS ID: 1888034 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Lymphadenopathy, Malaise, Neck pain
SMQs:, Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvance, Klonopin, Synthroid, seroquel, Robaxin
Current Illness: None
Preexisting Conditions: Hypothyroidism, ADHD, anxiety, insomnia
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, fatigue, swollen lymph nodes, generally feeling sick, neck and shoulder pain


VAERS ID: 1888071 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Influenza like illness, Injection site erythema, Injection site swelling, Lymph node pain, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, metformin, valsartan/HCTZ
Current Illness:
Preexisting Conditions: hypertension, type 2 diabetes, hypothyroidism
Allergies: NO
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received the Pfizer booster on left deltoid 3 days ago. Had flu-like symptoms for 24-48 hrs. Now complaining of left swollen and tender axillary nodes. Also with tender left supraclavicular lymphadenopathy. Mild erythema and swelling of injection site. Pt initially received the Jansen vaccine $g 6 months ago.


VAERS ID: 1888078 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076C21A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 2nd shot of Moderna Covid vaccine
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma, arthritis
Allergies: Penicillin, sulfa, demerol Garlic, soy, egg, chicken, black pepper, green pepper, tomato, oats, corn, wheat, citrus, celery, chocolate, coffee, pekoe tea, cane sugar Latex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme joint pain all over body, headache, fever (100.7), fatigue


VAERS ID: 1888160 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-11-16
Onset:2021-11-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Electric shock sensation, Tinnitus
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hearing impairment (narrow)

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

Write-up: Feeling of waves in ears and back of head. Started last night and has been constant


VAERS ID: 1888223 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-30
Onset:2021-11-18
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / N/A LA / SYR
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR - / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin E 400IU, Carvedilol 12mg, Amlodipine Besylate 10mg, Dexilant DR 60mg, CoQ10 100mg
Current Illness:
Preexisting Conditions: High blood pressure.
Allergies: Gastropods, IV with Contrast
Diagnostic Lab Data:
CDC Split Type:

Write-up: None at time/date of injection


VAERS ID: 1888227 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Fibrin D dimer normal, Troponin normal
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: D-Dimer - Negative / Troponin- Negative (11/20/2021)
CDC Split Type:

Write-up: Patient present with left sided chest pain starting several hours after the COVID 19 vaccine. States it continued over several days without improvement


VAERS ID: 1888241 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034F21A / 3 RA / 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: Error: Booster Given Too Early-


VAERS ID: 1888255 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Injection site bruising, Injection site erythema, Injection site pain, Injection site swelling, Pain, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Body Aches Generalized-Medium, Systemic: Chills-Medium, Systemic: Fever-Mild


VAERS ID: 1888305 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Fall, Feeling abnormal, Headache, Hypertension, Pain, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Accidents and injuries (narrow), Hypertension (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: norvasc, lipitor, losartan
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: pain all over body, chills, head ache, head swimming, falling, high blood pressure, cough, congestion


VAERS ID: 1888306 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211D2A / 1 LA / IM

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

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

Write-up: PT DESCRIBED PRURITIC RASH OVER CHEST, LEGS ~1.5 TO 2 HOURS FOLLOWING VACCINATION


VAERS ID: 1888335 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: 17 YEAR OLD RECEIVED MODERNA


VAERS ID: 1888380 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-11-16
Onset:2021-11-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vaccination site pruritus
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: Many for pain, depression, lupus, Hashimoto''s
Current Illness: Flu vaccine
Preexisting Conditions: Hashimoto''s, mental illness, depression, degenerative disc disease, lupus, pain
Allergies: Many allergies and skin sensitivity
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itchy at vaccination site.


VAERS ID: 1888392 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-02
Onset:2021-11-18
   Days after vaccination:230
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: Unknown
Preexisting Conditions: COPD, GERD, AAA, HTN, Prediabetes
Allergies: Albuterol sulfate, Percocet
Diagnostic Lab Data: COVID+ Breakthrough
CDC Split Type:

Write-up: CHIEF COMPLAINT: pt''s 29 year old boyfirend sent pt. in for eval due him testing positive for covid. pt. has hx. of COPD and wears 4 L''s oxygen chroniclly. pt. denies any symptoms.


VAERS ID: 1888406 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Headache, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Arm pain for 2 days Inability to move arm for 2 days Chest pain for 1 hour Fever for 2 days Headache for 3 days


VAERS ID: 1888428 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NCD: 59267-1000 / 3 LA / IM
FLUA4: INFLUENZA (SEASONAL) (FLUAD QUADRIVALENT) / SEQIRUS, INC. PF 2021-22 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: after 2nd Pfizer vaccine - injection site soreness and extreme fatique for 1 day
Other Medications: levothyroxin simvastin
Current Illness: none
Preexisting Conditions: hypothyroidism high cholesterol
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: injection sites soreness for 2 days fatique for 1 day swollen lymph node in left underarm (Pfizer booster site)


VAERS ID: 1888439 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F21A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cyclobenzaprine, sprionolactone, ozempic, isosorbide dinitrate, furosemide, omeprazole, Novolin 70/30, atorvastatin, Hydroxyzine pamoate, possibly lisinopril, carvedilol
Current Illness: none known
Preexisting Conditions: Diabetes
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: After receiving her booster dose of moderna covid 19 vaccine, (0.25ml) pt reported a very swollen arm to the pharmacy on 11/20. She stated that it was red, itchy and very swollen. This started the day after vaccination- ice packs and her prescription antihistamine have helped but it has remained inflamed. I counseled her that this was not unheardof, to continue what she has been doing and contact her dr if it remains bothersome on monday or worsens in the meantime.


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