National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

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)

This is page 548 out of 10,317

Result pages: prev   449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 534 535 536 537 538 539 540 541 542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560 561 562 563 564 565 566 567 568 569 570 571 572 573 574 575 576 577 578 579 580 581 582 583 584 585 586 587 588 589 590 591 592 593 594 595 596 597 598 599 600 601 602 603 604 605 606 607 608 609 610 611 612 613 614 615 616 617 618 619 620 621 622 623 624 625 626 627 628 629 630 631 632 633 634 635 636 637 638 639 640 641 642 643 644 645 646 647   next


VAERS ID: 1904528 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F21A / 3 LA / IM

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

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

Write-up: Moderna dose was drawn up and administered after recommended 12-hour punctured Beyond Use Date but before recommended 24-hour room temperature unpunctured Beyond Use Date.


VAERS ID: 1904529 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F21A / 3 LA / IM

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

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

Write-up: Moderna dose was drawn up and administered after recommended 12-hour punctured Beyond Use Date (BUD) but before recommended 24-hour room temperature unpunctured BUD.


VAERS ID: 1904534 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F21A / 3 LA / IM

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

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

Write-up: Moderna dose was drawn up and administered after recommended 12-hour punctured Beyond Use Date (BUD) but before recommended 24-hour room temperature unpunctured BUD.


VAERS ID: 1904536 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Delaware  
Vaccinated:2021-11-08
Onset:2021-11-18
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 320308D / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Drainage, Headache, Oropharyngeal pain, Pain, Productive cough, SARS-CoV-2 test negative, Secretion discharge
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Olmesartan Medoxomil 20mg; Rosvastatin Calciu 10mg; Flovent H
Current Illness: none
Preexisting Conditions: Asthma (controlled)
Allergies: none
Diagnostic Lab Data: 11/20/2021 Baseline Covid-19 test at pharmacy (Reference ID 2324445504). Negative result received 11/23/2021
CDC Split Type:

Write-up: 11/18/2021: Severe chills to the core, causing shivering for about 20 minutes in afternoon; 11/19-21: Dull headache, and body aches (muscular) for next few days; 11/19-24: Upper respiratory drainage with slight sore throat and cough; 11/20: Received Covid-19 test at pharmacy; 11/23: Test results received: NEGATIVE; 11/22 - present (11/28/2021): Very thick, sticky clear mucus in lungs with productive coughs with frequency of coughing and mucus improving. Recovery anticipated. Treatment was taking 2 aspirins per day for 2-days on 11/19-20.


VAERS ID: 1904537 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F21A / 3 LA / IM

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

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

Write-up: Moderna dose was drawn up and administered after recommended 12-hour punctured Beyond Use Date (BUD) but before recommended 24-hour room temperature unpunctured BUD.


VAERS ID: 1904539 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F21A / 3 LA / IM

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

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

Write-up: Moderna dose was drawn up and administered after recommended 12-hour punctured Beyond Use Date (BUD) but before recommended 24-hour room temperature unpunctured BUD.


VAERS ID: 1904541 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F21A / 3 LA / IM

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

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

Write-up: Moderna dose was drawn up and administered after recommended 12-hour punctured Beyond Use Date (BUD) but before recommended 24-hour room temperature unpunctured BUD.


VAERS ID: 1904545 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Cough, Ear pain, Headache, Influenza virus test negative, Lacrimation increased, Oropharyngeal pain, Pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test negative, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Lacrimal disorders (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Methotrexate, aimovig, plaquenil, lyrica, folic acid, inflectra,
Current Illness:
Preexisting Conditions: Fibromyalgia , rheumatoid arthritis, chronic migraines
Allergies: Penicillin, fresh tomatoes
Diagnostic Lab Data: Negative Covid test, negative flu test 11/26/2021
CDC Split Type:

Write-up: Fever, sore throat, ear ache, cough, runny nose, sneezing, no energy, body Aches, headache, watery eyes


VAERS ID: 1904557 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-11-11
Onset:2021-11-18
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA WAG 3586 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest pain, Computerised tomogram, Electrocardiogram, Injection site erythema, Injection site swelling, Pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Junel oral contraceptive
Current Illness: None
Preexisting Conditions: Asthma
Allergies: allergic to neomycin and curare (anesthesia)
Diagnostic Lab Data: EKG, blood work, chest x-ray, and CT scan all in emergency room on 11/19/21
CDC Split Type:

Write-up: Redness and swelling (about 4 inches in diameter) at injection site on 11/12/21-11/14/21 Sharp chest pain and shooting pain down left arm beginning on 11/19/21


VAERS ID: 1904563 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / -

Administered by: Private       Purchased by: ?
Symptoms: Cerebellar infarction, Interchange of vaccine products, Magnetic resonance imaging head abnormal, Tinnitus, Vertigo, White matter lesion
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Hearing impairment (narrow), Vestibular disorders (narrow), Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: pt denied
Preexisting Conditions: pt denied
Allergies: nkda
Diagnostic Lab Data: MRI brain: large acute/subacute infarct involving medial inferior right cerebellum. Minimal nonspecific periventricular white matter changes adjacent posterior horn lateral ventricles MRA Brain:
CDC Split Type:

Write-up: it is documented that pt received 2 Pfizer vaccines and then had a Moderna booster on 11/17/21. on 11/17/21 or 11/18/21 it is documented that pt had a bit of ringing in her ears. on 11/22/21 while on vacation at lunch, she developed sudden vertigo and called emergency number. Her MRI showed "large acute/subacute infarct involving medial inferior right cerebellum. Minimal nonspecific periventricular white matter changes adjacent posterior horn lateral ventricles."


VAERS ID: 1904668 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Feeding disorder, Illness, Pyrexia, Retching
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: This spontaneous case was reported by a consumer and describes the occurrence of FEEDING DISORDER (Not been able to eat), RETCHING (Dry heaving), ILLNESS (Sickness) and PYREXIA (Running a fever) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013F21A) for COVID-19 vaccination. Previously administered products included for Product used for unknown indication: Pfizer COVID19 Vaccine (first dose; lot EJ1685) on 04-Jan-2021 and Pfizer COVID19 Vaccine (second dose;lot EL3302) on 25-Jan-2021.Past adverse reactions to the above products included No adverse event with Pfizer COVID19 Vaccine and Pfizer COVID19 Vaccine.On 18-Nov-2021 at 11:30 AM, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Nov-2021, the patient experienced FEEDING DISORDER (Not been able to eat), RETCHING (Dry heaving) and PYREXIA (Running a fever). 18-Nov-2021, the patient experienced ILLNESS (Sickness). At the time of the report, FEEDING DISORDER (Not been able to eat), RETCHING (Dry heaving), ILLNESS (Sickness) and PYREXIA (Running a fever) outcome was unknown. Concomitant product use was not provided by the reporter.Treatment information was not provided.Around 6 o''clock in the evening, the patient had been sick. The patient was not been able to eat, running a fever and had dry heaving.


VAERS ID: 1904864 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, Product temperature excursion issue
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: USMODERNATX, INC.MOD20213

Write-up: This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (1 expired booster dose was administered) and PRODUCT TEMPERATURE EXCURSION ISSUE (temperature excursion) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 005C21A) for COVID-19 vaccination. No Medical History information was reported.On 18-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (1 expired booster dose was administered) and PRODUCT TEMPERATURE EXCURSION ISSUE (temperature excursion). On 18-Nov-2021, EXPIRED PRODUCT ADMINISTERED (1 expired booster dose was administered) and PRODUCT TEMPERATURE EXCURSION ISSUE (temperature excursion) had resolved.For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.No concomitant medication information was provided.No treatment medication were provided.The vial was exposed to room temperature range from 9:30AM 17Nov2021 to administration 18Nov2021.The expired booster dose was administered to a female patient 18Nov2021.


VAERS ID: 1905355 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

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

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

Write-up: Client fainted at 4:08 pm (vaccine given at 4:07 pm). No injuries occurred from the fainting. Client felt dizzy and nauseous. He drank some water and felt better at 4:11 pm. It is believed that he held his breath while the vaccine was given. The client left at 4:40.


VAERS ID: 1905372 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Feeling hot, Incoherent, Lethargy, Mobility decreased, Pain, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin 40 mg, magnesium, zinc, krill oil, D3 MG
Current Illness: None
Preexisting Conditions: None - minor cholesterol control
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient awoke at 11:30 PM after going to sleep at around 9:30. She was gravely chilled, shaking uncontrollably and nearly unintelligible. She was achy but no serious fever to the touch of my cheek. She wanted ibuprofen which I got for her and she took two pills. She went back to sleep after covering completely with a heavy comforter for warmth. The following day she was lethargic and physically unable to perform anything other than basic non-physical actions. She took a long, hot bath for an hour. She slept normally that night and the following day was feeling mostly normal.


VAERS ID: 1905405 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F21A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna Dose 1
Other Medications: Antihistamine; Vitamin D; Vitamin C; Vitamin B 12; Biotin; Metoprolol,
Current Illness: No
Preexisting Conditions: Asthma
Allergies: Latex; Lipitor
Diagnostic Lab Data: No.
CDC Split Type: vsafe

Write-up: A couple hours after the vaccine my body got achy all over again resulting in me taking Tylenol for about 2 days or so but finally went away. The injections site got a little sore and puffy for a few days also, but went away on its own as well.


VAERS ID: 1905462 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

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

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

Write-up: Child is $g11 years old and received 5-11 Pfizer dose


VAERS ID: 1905551 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse reaction, Arrhythmia, Blood creatine phosphokinase, Blood creatine phosphokinase MB, Blood magnesium, Chest X-ray, Chest pain, Dyspnoea, Dyspnoea exertional, Electrocardiogram, Feeling cold, Fibrin D dimer, Full blood count, Heart rate increased, Hypertension, Hypoaesthesia, Impaired work ability, International normalised ratio, Metabolic function test, Palpitations, Paraesthesia, Pregnancy test, Tachycardia, Tremor, Troponin I
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nasacort Allerfy, Culturelle Probiotics
Current Illness: Cold 1 month prior to vaccination (Tested negative for COVID at time of cold symptoms)
Preexisting Conditions: None
Allergies: Sudafed
Diagnostic Lab Data: Chest X-Ray 12 Lead EKG x 2 CBC with differential, CK Total and CKMB, Comprehensive Metabolic Panel, D-Dimer Quantitative, Magnesium, Protime-INR, Troponin I, hCG Serum Qualitative Emergency Room visit and PCP visit
CDC Split Type:

Write-up: 10 minutes after my Pfizer injection, my left arm (which was injected with the vaccine) became numb. I actually began to pinch it because it felt so weird. Next my legs both became numb, followed by my right arm and face. At this point my heart started to beat extremely fast. I do wear an apple watch and checked my heart rate. It was at 184. I checked my pulse myself and it did match up to the tachycardia. At this time, I started to shake. I am assuming because I was scared and flagged down the pharmacist stating I think I am having a reaction. They immediately had me sit back down, got me water, and I removed my mask to start taking deep breaths to calm my heart rate. The pharmacist got me 50 MG of Benadryl. After I took this, my heart rate ranged from 140-180 for the next 30 minutes. At this time, the numbness and shaking would come and go. I also got extremally cold once my heartrate started to slow down. I left pharmacy after 45 minutes of monitoring with a heart rate of 120. I went home and took a nap to rest. I continued to take 50 MG of Benadryl every 4 hours at this time.. Near the end of the 4 hours, my extremities and face started to tingle. My heart rate remained between 120-130 when walking around my house. At rest it would sit at 100. 12+ hours after my vaccination, I was extremely cold, had palpitations, chest pain, my resting heart rate was tachycardic, my extremities were tingling while taking the Benadryl. My brother in law who is a paramedic came to check on me during the evening. My heart rate was jumping from 140 to 80 to 120 to 140. He noticed an arrythmia. I am 29 with no cardiac history. At this time he recommended I go to the emergency room. At the emergency room the ER physician performed a cardiac workup with lab work, chest x-ray, and 12 lead EKG. He gave me ativan to see if my tachycardia was stress related and 1 bag of fluids. At the end of my visit, he did discharge me home stating that I fall into the 1-2% of patients who experience this type of reaction. It is benign and should resolve withing 24-36 hours. I went home and relaxed for the next 2 days. During these 2 days I continued to experience chest pain, tachycardia, palpitations, and SOB with any exertion or movement. 6 days post vaccination, I followed up with my PCP. At this time I had high blood pressure, tachycardic at 140 BPM, SOB, and severe chest pain. My PCP prescribed me Beta Blockers at this time hoping that in 14 days we could take me off the blockers and my adverse reaction would resolve. Currently, I am taking the Beta Blockers at home while out on medical leave from work.


VAERS ID: 1905581 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH BOOSTER / 3 LA / -

Administered by: Work       Purchased by: ?
Symptoms: Chills, Headache, Pain, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

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

Write-up: Chill, headache,bodyache and sore on left arm


VAERS ID: 1905595 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939909 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Lymphadenopathy, Pain in extremity, Peripheral swelling, Skin discolouration
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (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: Takes Allergy Medicine for Seasonal Allergies
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received 1st Moderna covid vaccine on 11/17/21. Woke up the next morning with swelling and pain in arm, and swollen lymph node. The next day, bruising was noted extending to the end of the right breast nipple, color was a dark purple. When reported today, the bruising is becoming lighter in color, with a yellowish tent. Is concerned regarding getting a second vaccine. Instructed to see PCP.


VAERS ID: 1905735 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Insomnia, Lymphadenopathy, Musculoskeletal stiffness, Neck pain, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan, Hydrochlorothiazide, one cholesterol medication
Current Illness: None
Preexisting Conditions: Hypertension and obesity
Allergies: Pollen
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: I got the shot the Thursday on my right arm and the flu shot on my left arm. By that evening the back of my neck was stiff and sore. The stiffness and soreness has really not gone away on my left side where I got the flu shot. It feels like a bruise if you touch the skin. I kept thinking it was swollen lymph nodes and it would probably go away. On Friday I went to the doctor and they said it was probably a reaction to the flu shot, which I have never had before and I get that shot every year. They gave me some Tylenol because I was not able to sleep at night. The week before I got the shot I was working and I strained a muscle but it was feeling better by Tuesday. I had a physical on Tuesday and everything was fine. They said it could also be just the strain in my muscle.


VAERS ID: 1905750 (history)  
Form: Version 2.0  
Age: 8.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dehydration, Malaise, Nausea, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad), Dehydration (narrow)

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

Write-up: Child began having mild body tremors and nausea about 30 hours after the vaccine, then vomited repeatedly over the next ~20 hours. Experienced malaise and dehydration for about 24 hours after vomiting stopped. No fever at any time.


VAERS ID: 1905761 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 1 LA / IM

Administered by: Unknown       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: pediatric patient received adult dose


VAERS ID: 1905863 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 071F21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Feeling abnormal, Lip swelling, Paraesthesia oral
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately 5 minutes after vaccine patient stated she was "feeling weird". She then began to say her lips were "tingling". At this time 50 of diphenhydramine was given to the patient. Minor swelling was noted to her upper lip. Patient was taken to the ED for monitoring.


VAERS ID: 1905914 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-12
Onset:2021-11-18
   Days after vaccination:220
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 1 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Condition aggravated, Dyspnoea, Dyspnoea exertional, Hyponatraemia, Hypoxia, Oxygen saturation decreased, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin 81 MG tablet atorvastatin (LIPITOR) 80 MG tablet benzonatate (TESSALON) 100 MG capsule buPROPion (WELLBUTRIN XL) 150 MG 24 hr tablet lisinopril (ZESTRIL) 2.5 MG tablet metoprolol-XL (TOPROL-XL) 25 MG tablet Multiple Vitamins-M
Current Illness:
Preexisting Conditions: OSA (obstructive sleep apnea) Pneumonia due to COVID-19 virus Coronary artery disease Hypertension Left-sided carotid artery disease Anemia due to recent lower GI bleed Hyperlipidemia Hyponatremia
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized 11/18/2021; COVID-19 positive 11/18/2021; fully vaccinated BRIEF OVERVIEW: Discharge Provider: MD, MPH Primary Care Provider at Discharge: MD Admission Date: 11/18/2021 Discharge Date: 11/20/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hyponatremia [E87.1] Pneumonia due to COVID-19 virus [U07.1, J12.82] HOSPITAL COURSE: Patient admitted with SOB, fevers and hypoxia down to 88%. On admission patient was started on dexamethasone. He required up to 2L of nasal cannula but weaned to room air at rest in the am of 11/20/21. Patient was still desatting to 87% with activity and so was discharged with home O2. CONSULTS / RECOMMENDATION: Further wean O2 at home. Patient was given a pulse ox to assist with weaning at home. Goal oxygen concentration of 92%.


VAERS ID: 1905950 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-15
Onset:2021-11-18
   Days after vaccination:248
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Ageusia, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Condition aggravated, Cough, Decreased appetite, Dyspnoea exertional, Headache, Laboratory test normal, Respiratory tract congestion, SARS-CoV-2 test positive, Transaminases increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Taste and smell disorders (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin 81 MG tablet atorvastatin (LIPITOR) 10 MG tablet B Complex-C (SUPER B COMPLEX) TABS benzonatate (TESSALON) 100 MG capsule Cholecalciferol (VITAMIN D3) 1000 UNITS TABS dexamethasone (DECADRON) 6 MG tablet famotidine (PEPCID) 20 MG ta
Current Illness:
Preexisting Conditions: OSA (obstructive sleep apnea) Pneumonia due to COVID-19 virus Acute respiratory failure with hypoxia (HCC) Essential hypertension PAD (peripheral artery disease) (HCC) Duodenitis Colon polyps Class 1 obesity with serious comorbidity and body mass index (BMI) of 33.0 to 33.9 in adult, unspecified obesity type Unspecified severe protein-calorie malnutrition (HCC) Senile nuclear cataract, bilateral Lattice degeneration of both retinas Posterior vitreous detachment, bilateral Dyslipidemia
Allergies: Codeine PCN
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized 11/21/2021; COVID-19 positive 11/18/2021; fully vaccinated BRIEF OVERVIEW: Discharge Provider: DO Primary Care Provider: MD Admission Date: 11/21/2021 Discharge Date: Nov 23, 2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure with hypoxia (HCC) [J96.01] Pneumonia due to COVID-19 virus [U07.1, J12.82] HOSPITAL COURSE: Patient is a 72-year-old female with a past medical history of dyslipidemia, depression, obesity, OSA who presented secondary to a chief complaint of headache, loss of taste, decreased appetite, coughing congestion. She also started noting shortness of breath with exertion. She received both doses of Pfizer vaccine in March 2021. When EMS arrived she was 80% on room air. She was placed on 4 L nasal cannula. In the emergency department she was otherwise hemodynamically stable. Her labs were unremarkable. Her chest x-ray showed findings consistent with COVID-19 infection. She was known to be COVID positive on 11/18/2021. She was admitted for COVID-19 pneumonia. She was started on Decadron and was out of the window for remdesivir and monoclonal antibodies. She weaned to 3 L nasal cannula with activity per Pulmonary rehab evaluation. She was noted to have mildly elevated transaminases secondary to COVID-19. She had improvement of her symptoms and was discharged home on 11/23/2021 with home oxygen.


VAERS ID: 1905960 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-11-15
Onset:2021-11-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 3 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal distension, Abdominal pain, Diarrhoea, Dizziness, Flatulence, Haematochezia, Hyperhidrosis, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Influenza Vaccine, ages unknown, hives
Other Medications: Zyrtec
Current Illness: None
Preexisting Conditions: Back Pain, Pelvic Floor Dysfunction, Irritable Bowl Syndrome, Allergies, Gastroparesis
Allergies: Cephalosporins, Doxycycline, Seasonal, Influenza Vaccine, IV Contrast, Certain Dyes, Pets
Diagnostic Lab Data:
CDC Split Type:

Write-up: I experienced terrible abdominal pain, sweats, light headedness, nausea, bloating, gas, and diarrhea for 5 hours consistently. There was also blood in my stool at one point. The pain I experienced was not reduced by over the counter medications. Since that time I have suffered with gas, bloating, abdominal pain daily. I have also intermittently experienced diarrhea. I have an appointment with a Gastroenterologist on December 6th


VAERS ID: 1906098 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: NO ADVERSE REACTION NOTED. PATIENT SHOULD HAVE RECEIVED PFIZER VACCINE DUE TO AGE


VAERS ID: 1906105 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: NO ADVERSE REACTION. DUE TO AGE PATIENT SHOULD HAVE RECEIVED PFIZER INSTEAD OF MODERNA


VAERS ID: 1906177 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Erythema, Fatigue, Malaise, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amitriptyline, Ibuprofen, Tizanidine, and topical diclofenac,
Current Illness: no acute illness within 30 days
Preexisting Conditions: MS, Migraine HA, IBS, anemia
Allergies: Sumatriptan
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Localized redness and swelling, fever to 101 x 2D, fatigue, malaise and left axillary pain


VAERS ID: 1906202 (history)  
Form: Version 2.0  
Age: 4.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 RA / IM

Administered by: School       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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Four year old was given a pediatric dose of Pfizer vaccine (0.2ml). Pt did not have any reaction and reported was completely healthy and fine on a follow-up call several days later.


VAERS ID: 1906207 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-08-16
Onset:2021-11-18
   Days after vaccination:94
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Atrial flutter, Blood test, Cardiac ablation, Cardioversion, Electrocardiogram abnormal, Palpitations, Post procedural haemorrhage, Tachycardia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations: Atrial flutter, 67, 8/16/21, MrNa, Pfizer
Other Medications: Metoprolol Succinate, Methimazole, Triumeq, Lumbrokinase, D3, & K2, Vit C, Multi-vitamin, Krill oil, Astaxanthin, B12
Current Illness: none
Preexisting Conditions: Hyperthyroidism/Graves, HIV
Allergies: Prednisone, Gabapentin, diesel fumes, cigarette smoke, perfumes
Diagnostic Lab Data: EKG and numerous blood tests, 11/18/21 thru 11/24/21
CDC Split Type:

Write-up: A racing heart rate of approx. 135 bpm was noticed early on 11/18/21, this persisted and my portable ECG showed tachycardia and I was advised to go to the ER. At the ER I was diagnosed with Atrial Flutter and was later admitted. As this is the 3rd time I have had an incident like this (9/14/21, 9/16/21, 11/18/21) and had already been through 2 Electro conversions, this time we would wait to stabilize and then proceed to ablation surgery, scheduled for 11/23/21. I was transferred from first Hospital ER to another Hospital where the ablation procedure was done by Dr. Some bleeding occurred post surgery and I was released on 11/24/21


VAERS ID: 1906210 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 RA / IM

Administered by: Unknown       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: 12 y/o M was given a pediatric dose of Pfizer (0.2 ML)


VAERS ID: 1906442 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 4 LA / IM

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

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

Write-up: patient called on 11/29/2021 and said she got additional booster dose instead of flu vaccine . checked consent form and she marked flu vaccine but on the form technitian marked moderna 3rd dose. (she got 3rd dose at pharmacy and 4th dose(0.25ml) here). patient is ok. she recieved flu shot on 11/29/2021


VAERS ID: 1906745 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-28
Onset:2021-11-18
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051F21A / 3 LA / IM

Administered by: Unknown       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: Progesterone, probiotic, vitamin B and folic acid, biotin,
Current Illness: NA
Preexisting Conditions: NA
Allergies: Keflex and crustacean.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives starting on 11/18/21. They come and go and occur on all parts of my body other than my face. Doctor prescribed prednisone and zyrtec, which help, but as of 11/29, I still have ongoing hives.


VAERS ID: 1906932 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-07
Onset:2021-11-18
   Days after vaccination:225
Submitted: 0000-00-00
Entered: 2021-11-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Diarrhoea, Fatigue, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estradiol 2mg daily Provera 5mg daily Zolpidem 5mg HS
Current Illness: None documented
Preexisting Conditions: Benign lipomatous neoplasm of the skin Uterine fibroid
Allergies: Penicillin - Throat swelling
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient contracted COVID after being fully vaccinated. No booster runny nose, cough, sore throat, congestion, chills, fatigue, vomiting, diarrhea


VAERS ID: 1908336 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-06
Onset:2021-11-18
   Days after vaccination:285
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030M20A / 1 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Blood pressure
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211118; Test Name: COVID-19 test; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (went to see her daughter, and she and her husband tested positive to covid19) and DRUG INEFFECTIVE (LACK OF DRUG EFFECT) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 037c21a, 013a21a and 030m20a) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure. On 06-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 05-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Nov-2021, the patient experienced COVID-19 (went to see her daughter, and she and her husband tested positive to covid19) and DRUG INEFFECTIVE (LACK OF DRUG EFFECT). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) for Chills, at an unspecified dose and frequency and PARACETAMOL (TYLENOL [PARACETAMOL]) for Chills, at an unspecified dose and frequency. At the time of the report, COVID-19 (went to see her daughter, and she and her husband tested positive to covid19) and DRUG INEFFECTIVE (LACK OF DRUG EFFECT) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 18-Nov-2021, SARS-CoV-2 test: positive (Positive) Positive. Patient is on concomitant medications of blood pressure medicine. chills is a symptom of COVID-19 hence not captured. Company Comment- This case concerns a 79 year-old, female patient with no relevant medical history, who experienced the non serious unexpected AESI of COVID-19. The event occurred approximately 8 days after the booster dose of mRNA-1273 vaccine and 8 months after the second dose of the vaccine. Vaccination schedule was administered correctly (first and second doses administered 27 days apart). Drug ineffective was considered as an additional event. The rechallenge was not applicable. The benefit-risk relationship of mRNA-1273 vaccine is not affected by this report. This case was linked to MOD-2021-392008 (Patient Link).; Sender''s Comments: This case concerns a 79 year-old, female patient with no relevant medical history, who experienced the non serious unexpected AESI of COVID-19. The event occurred approximately 8 days after the booster dose of mRNA-1273 vaccine and 8 months after the second dose of the vaccine. Vaccination schedule was administered correctly (first and second doses administered 27 days apart). Drug ineffective was considered as an additional event. The rechallenge was not applicable. The benefit-risk relationship of mRNA-1273 vaccine is not affected by this report.


VAERS ID: 1908426 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034F21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, Inappropriate schedule of product administration
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: USMODERNATX, INC.MOD20213

Write-up: Potentially got the dose from a vial punctured longer than 12 hours ago; More than 36 days after the first dose receiving the second dose; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Potentially got the dose from a vial punctured longer than 12 hours ago) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 36 days after the first dose receiving the second dose) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 034F21A) for COVID-19 vaccination. No Medical History information was reported. On 18-Nov-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Potentially got the dose from a vial punctured longer than 12 hours ago) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 36 days after the first dose receiving the second dose). On 18-Nov-2021, EXPIRED PRODUCT ADMINISTERED (Potentially got the dose from a vial punctured longer than 12 hours ago) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 36 days after the first dose receiving the second dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant product use was provided by the reporter. No treatment medication was provided.


VAERS ID: 1908601 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Work       Purchased by: ?
Symptoms: Chills, Fatigue, Immunisation, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy (Known allergies: Yes)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101646049

Write-up: Aches; fatigue; Chills; fever; dose received: 3/dose number = 3; This is a spontaneous report from a contactable consumer, the patient. A 26-year-old non-pregnant female patient received third (booster) dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on 18Nov2021 (at the age of 26-years-old) as a single dose for COVID-19 immunisation. Medical history included unspecified allergy. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medication was not reported. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on 13Jan2021 (at the age of 25-years-old) and second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on 03Feb2021 (at the age of 25-years-old) as a single dose for COVID-19 immunisation. On 18Nov2021 at 17:00, the patient experienced aches, fatigue, chills and fever. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were taken as a result of the events which included treatment with diphenhydramine citrate, ibuprofen (IBUPROFEN PM). Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events aches, fatigue, chills and fever were resolved on an unknown date in Nov2021. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1908673 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-10-07
Onset:2021-11-18
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / UNK - / OT
FLU4: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE QUADRIVALENT) / SANOFI PASTEUR - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Decreased appetite, Extra dose administered, Fatigue, Pyrexia, Wrong product administered
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211119; Test Name: body temperature; Test Result: 100.3 {DF}; Result Unstructured Data: 100.3
CDC Split Type: USSA2021SA392822

Write-up: The patient was vaccinated with FLUZONE HIGH DOSE QUADRIVALENT instead of COVID-19 VACCINE; The patient was vaccinated with FLUZONE HIGH DOSE QUADRIVALENT twice instead of COVID-19 VACCINE; Initial information regarding an unsolicited valid non-serious case was received from a other health care professional via Regulatory Authority (RA) (Reference number- 00868442) and transmitted on 22-Nov-2021. This case involves a 66-year-old female patient who had no appetite (decreased appetite), fever of 100.3 (pyrexia) and fatigue after receiving INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE [FLUZONE HIGH-DOSE QUADRIVALENT] instead of Coronavirus disease (COVID-19) VACCINE (wrong product administered and extra dose administered) The patient''s medical history, medical treatment(s), vaccination(s) and family history were not provided. On 07-Oct-2021, the patient received a dose of suspect INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE lot number not reported via unknown route in unknown administration site for prophylactic vaccination. On 18-Nov-2021, the patient received 0.7 ml dose of suspect INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE (lot UJ7760C, expiry date: 30-Jun-2022) via intramuscular route in the right deltoid for prophylactic vaccination instead of booster dose of COVID-19 VACCINE. It was a case of an actual medication error due to extra dose administered and Wrong vaccine administered (latency same day) On 19-Nov-2021 the patient developed a non-serious no appetite (decreased appetite), fever of 100.3 (pyrexia) and fatigue 1 month 12 days following first dose of INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE and 1 day following last dose of INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE. It was reported "The caller stated that a patient came into the office to receive a COVID Booster vaccine on 18 NOV 2021, however the patient was given the FLUZONE HIGH DOSE QUADRIVALENT injection in error. The caller stated that the patient has now received 2 doses of the flu shot, as she received a prior flu shot on 07 OCT 2021. The patient reported fatigue, fever of 100.3 and no appetite on 19 NOV 2021. The caller wants to know how to care for the patient. consumer who received two Fluzone HD. She asks for appropriate follow-up" No other relevant test was provided. It was not reported if the patient received a corrective treatment for the events. At time of reporting, the outcome of clinical events was unknown This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder''s compliance with the requirements set out in the Directive 2001/83/EC and Module. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.


VAERS ID: 1908780 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Oklahoma  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939909 / UNK - / OT

Administered by: Unknown       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: 4 patients received dose past viability time; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (4 patients received dose past viability time) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939909) for an unknown indication. No Medical History information was reported. On 18-Nov-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (4 patients received dose past viability time). On 18-Nov-2021, EXPIRED PRODUCT ADMINISTERED (4 patients received dose past viability time) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was provided by reporter. No treatment information was provided by reporter.


VAERS ID: 1908810 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 3 RA / OT

Administered by: Unknown       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: SERTRALINE; FAMOTIDINE; CLARITIN ALLERGIC; MELATONIN
Current Illness: Depression; GERD; Seasonal allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: administered one dose to a patient that was expired on 29Oct2021; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (administered one dose to a patient that was expired on 29Oct2021) in a 37-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 034C21A) for COVID-19 vaccination. Previously administered products included for Product used for unknown indication: Fluzone (Lot number- UT356JA, Route of administration- Intramuscular, Body site - Left deltoid) on 17-Nov-2021 and pfizer (The patient had Pfizer as a primary series). Past adverse reactions to the above products included No adverse event with Fluzone and pfizer. Concurrent medical conditions included Depression, GERD and Seasonal allergy. Concomitant products included OXYMETAZOLINE HYDROCHLORIDE (CLARITIN ALLERGIC) from 2017 to an unknown date for Allergic reaction NOS, SERTRALINE from 2019 to an unknown date for Depression, FAMOTIDINE from 2021 to an unknown date for GERD, MELATONIN from 2020 to an unknown date for Sleep disorder NOS. On 18-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (administered one dose to a patient that was expired on 29Oct2021). On 18-Nov-2021, EXPIRED PRODUCT ADMINISTERED (administered one dose to a patient that was expired on 29Oct2021) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No treatment information was provided. After administration of vaccine patient was closely monitored for 30 minutes, no adverse events occurred. Most recent FOLLOW-UP information incorporated above includes: On 22-Nov-2021: Follow up received On 22-Nov-2021 contains Significant information. Patient demographics, medical history and Concomitant medications were added. Route of administration and anatomical location of Suspect product added.


VAERS ID: 1908840 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:2021-01-30
Onset:2021-11-18
   Days after vaccination:292
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: AZORAN [OMEPRAZOLE.]
Current Illness: Blood pressure high (Blood Pressure is under control by taking Medication.)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: SARS-CoV-2 test; Test Result: Negative ; Result Unstructured Data: Negative.
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (Shortness Of Breath (SOB) after booster) and FATIGUE (Tired after booster) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 034F21A, 014M20A and 012M20A) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure high (Blood Pressure is under control by taking Medication).Concomitant products included OMEPRAZOLE (AZORAN [OMEPRAZOLE]) for an unknown indication.On 30-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form.On 27-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form.On 18-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Nov-2021, the patient experienced DYSPNOEA (Shortness Of Breath (SOB) after booster) and FATIGUE (Tired after booster). At the time of the report, DYSPNOEA (Shortness Of Breath (SOB) after booster) and FATIGUE (Tired after booster) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: negative (Negative) Negative. Lab test included Cardiac Lab values ECG, cardiac test, cardiac enzymes. No treatment information was provided.


VAERS ID: 1908981 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-04-19
Onset:2021-11-18
   Days after vaccination:213
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019D21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Inflammation, Lymphadenopathy, Myalgia, Tenderness, Vaccination site erythema
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: This spontaneous case was reported by a consumer and describes the occurrence of INFLAMMATION (Inflamed), TENDERNESS (Tender/soft to the touch), VACCINATION SITE ERYTHEMA (injection site has turned red), LYMPHADENOPATHY (swollen/about the size of a baseball/Underneath my armpit where it meets my chest) and MYALGIA (sore) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 034F21A, 491B21A and 019D21A) for COVID-19 vaccination. No Medical History information was reported. On 19-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form.On 18-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form.On 18-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Nov-2021, the patient experienced INFLAMMATION (Inflamed), VACCINATION SITE ERYTHEMA (injection site has turned red), LYMPHADENOPATHY (swollen/about the size of a baseball/Underneath my armpit where it meets my chest) and MYALGIA (sore). On an unknown date, the patient experienced TENDERNESS (Tender/soft to the touch). The patient was treated with PREDNISONE for Adverse event, at a dose of 1 dosage form. At the time of the report, INFLAMMATION (Inflamed), TENDERNESS (Tender/soft to the touch), VACCINATION SITE ERYTHEMA (injection site has turned red), LYMPHADENOPATHY (swollen/about the size of a baseball/Underneath my armpit where it meets my chest) and MYALGIA (sore) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.No Concomitant medication was reported.This case was linked to MOD-2021-396142, MOD-2021-396037 (Patient Link).


VAERS ID: 1909203 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER / UNK LA / SYR
FLU4: INFLUENZA (SEASONAL) (AFLURIA QUADRIVALENT) / SEQIRUS, INC. - / UNK RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Influenza like illness, Temperature intolerance
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Flu like symptoms for 36 hours and heat sensitivity on extremities for 5 days


VAERS ID: 1909268 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-11-01
Onset:2021-11-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939904 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Dyspnoea, Exposure during pregnancy, Fatigue, Night sweats, Rash, Respiratory tract congestion, SARS-CoV-2 test positive, Tachycardia
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamin qD
Current Illness:
Preexisting Conditions: Inappropriate sinus tachycardia
Allergies:
Diagnostic Lab Data: 11/18/21 positive covid 19 PCR test
CDC Split Type:

Write-up: I received my first dose of Moderna 12/31/20 (registered nurse) and my second dose around 1/28/21. I received my Moderna booster on 11/1/21. On 11/10/21 I became symptomatic but thought it was due to pregnancy complications (severe shortness of breath and tachycardia with minimal exertion and night sweats without a fever). I?m currently 36wks pregnant (due 12/23/21). On 11/18/21 Myself, my husband, and my 2.5yr old tested positive via PCR for covid-19. My husband has received his Pfizer series and booster (10/4/21). Our contact and exposure risk is low. I have been out on medical leave due to a high risk pregnancy, my husband has been teleworking, and my daughter stays at home with with us. My husband stayed asymptomatic other than maybe fatigue. I developed severe congestion on the 19th that last 3 days straight. I have also had a covid rash on my left foot, shortness of breath, tachycardia, fatigue, and loss of taste and smell. It?s now nov 30 and I only have a rash and intermittent congestion left. We just had a high risk ultrasound yesterday 11/29 and baby appears fine at this time.


VAERS ID: 1909367 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-16
Onset:2021-11-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 320308D / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Back pain, Chlamydia test, Dizziness, Fatigue, Full blood count, Gram stain, Impaired work ability, International normalised ratio, Metabolic function test, Neisseria test, Pelvic pain, Perineal pain, Prothrombin time, Smear vagina, Ultrasound abdomen, Ultrasound scan vagina, Urine analysis, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Vestibular 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nexium, vitamin D, vitamin C, Loestrin Fe birth control, Wellbutrin XL, Zyrtec
Current Illness: none at time of vaccination
Preexisting Conditions: endometriosis, GERD
Allergies: Cashews, penicillin
Diagnostic Lab Data: 11/27/21 at the emergency room i was ordered a urinalysis, CBC w/ diff, CMP, transvaginal and abdominal ultrasound, aPTT, PT/INR, gonorrhea/chlamydia screen, and gram stain/wet mount of vagina.
CDC Split Type:

Write-up: 2 days after receiving the vaccine on 11/18/21 I began to have heavy vaginal bleeding and pelvic pain. today is day 13 of pelvic pain, vaginal bleeding and clots. I was seen in the Emergency Room on saturday 11/27/21 because the pain had become worse, i was feeling lightheaded and fatigued. i was unable to report to work that day and on sunday 11/28/21 due to the pain. the pain is mostly located on my left lower pelvic region but at times refers to my left lower back and throughout my pelvic and perineal region.


VAERS ID: 1909396 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-11-05
Onset:2021-11-18
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 3 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, Diverticulitis
SMQs:, Gastrointestinal nonspecific inflammation (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: Estrogen, Welchol, vitamin D, biotin, Fexofenadine, Omeprazole, Buspirone, Montelukast, Sudogest, allergy shots weekly
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: It started probably that Thursday but I am not a 100% sure I was not having any early symptoms before getting the vaccine. But I noticed on 11/18/2021 since it was worse. I went to urgent care and they put me in Augmentin for 7 days. I saw my doctor and she increased it to 14 days. I was diagnosed with diverticulitis and it is actually my second time with it. She said it was not necessary to do any medical tests but if it continued then she would do some. Also, I had the flu shot on 10/02/2021.


VAERS ID: 1909401 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: PH3080060

Write-up: Student is only 16yrs old and received Moderna instead of Pfizer. No symptoms to report.


VAERS ID: 1909623 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-16
Onset:2021-11-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 067F21A / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Gait disturbance, Pain in extremity, Peripheral swelling, X-ray limb normal
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pramepexole, 2 x 0.125 / day each evening Tafluprost ophthalmic solution, 0.0015% one drop each eye at bedtime Vitamin C, 1000 mg Vitamin B12, 5000 mcg Vitamin D3, 25 mcg Myomin, 500 mg L-Methylfolate, 1000 mcg
Current Illness: None
Preexisting Conditions: Sleep Apnea Restless Leg Syndrome/Periodic Leg Movement Disorder Glaucoma suspect
Allergies: none
Diagnostic Lab Data: Bilateral foot X-Rays performed 11/29/2021 findings: "Mineralization alignment appears normal. No fractures or periosteal reaction appreciated. Soft tissues normal". Radiologist impression: "No acute abnormality".
CDC Split Type:

Write-up: Symptoms started as very painful second toe of left foot with the ball of the left foot also very sensitive. After a day or two the pain changed and spread to the balls of both feet. After a week the balls of the feet are not so sensitive, but the tops of the forefoot were painful with some swelling, especially in the left foot. At this time (two weeks after receiving the Moderna booster shot) the tops of the feet are very tender making it painful to walk.


VAERS ID: 1909740 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-21
Onset:2021-11-18
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Cough, Dyspnoea, Myalgia, Oropharyngeal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: evaluation of generalized weakness, myalgias, cough, shortness of breath, sore throat


VAERS ID: 1909751 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 4 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered, Hallucination, Headache, Magnetic resonance imaging, Migraine
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, Sodium Chloride 1gm, Vitamin D3; Citracal D3; Biotin
Current Illness: fell at 0615 the morning of the vaccine, lost balance while carrying cupcakes
Preexisting Conditions: pseudotumor cerebri, Thyroid, anxiety, depression
Allergies: Tetracycline
Diagnostic Lab Data: awaiting MRI
CDC Split Type:

Write-up: patient forgot she had received her booster already and came in for her another one. It was not caught until after the patient had went home. migraine headache, hallucinations


VAERS ID: 1909764 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-11
Onset:2021-11-18
   Days after vaccination:252
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / 2 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, COVID-19, COVID-19 pneumonia, Chronic kidney disease, Condition aggravated, Cough, Diarrhoea, Hypoxia, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine (NORVASC) 5 MG tablet aspirin 81 MG tablet atorvastatin (LIPITOR) 20 MG tablet Bevacizumab (AVASTIN IV) Calcium Polycarbophil (FIBERCON PO) carvedilol (COREG) 6.25 MG tablet cetirizine (ZYRTEC) 10 MG tablet Cholecalciferol
Current Illness:
Preexisting Conditions: Pneumonia due to COVID-19 virus HTN (hypertension) ASHD (arteriosclerotic heart disease) GERD (gastroesophageal reflux disease) GI bleed COVID-19 AMD (age-related macular degeneration), bilateral Diabetes mellitus Hyperlipidemia
Allergies: Metformin Tape Zocor
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized 11/18/2021; COVID-10 positive 11/18/2021; fully vaccinated BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: MD Admission Date: 11/18/2021 Discharge Date: Nov 23, 2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1] Pneumonia due to COVID-19 virus [U07.1, J12.82] COVID-19 [U07.1] AKI on CKD 3a HOSPITAL COURSE: Patient is a 90-year-old woman with history of hypertension, hyperlipidemia and type 2 diabetes with vaccinated with Moderna in February/March this year but has not received a booster shot who present with a 2-3 days of severe body aches, fevers, cough and diarrhea. She was found to be COVID-19 positive. Patient was hypoxemic at 86% on room air and was placed on 2 L of oxygen. Patient was admitted for COVID-19 pneumonia was placed on IV Decadron and remdesivir. She improved with a supportive treatment. Patient was also found to have mild Aki likely prerenal in setting of GI lost and use of losartan and MAaxzide. This medications were held and she was status post gentle IV fluid resuscitation which resulted the improving renal function but never back to her previous baseline of last year. I suspect this is likely her current baseline. She will need a follow up BMP in 3 days. Patient was discharged in stable condition.


VAERS ID: 1909818 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: New York  
Vaccinated:2021-10-28
Onset:2021-11-18
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032F21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Body temperature increased, Feeling hot, Functional gastrointestinal disorder, Retching, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: metoprolol ER 100 mg od/ morning nifedipine 3 mg bd sertraline 50 mg pm trazodone 25 mg pm atorvastatin 20 mg in the evening low dose aspirin 81 mg in the morning famotidine 20 mg 1 morning /1 in the evening iron sulfate 325 mg in the m
Current Illness: no
Preexisting Conditions: blood pressure controlled by medication chronic kidney damage aorta dissection pace maker
Allergies: crab
Diagnostic Lab Data: fast Covid-19 test- negative PCR Covid-19 test- negative
CDC Split Type: vsafe

Write-up: On 11/18/2021 in the evening around 09:00 PM- warm and muscle joint aches, dry heaves and intestinal problems. I did not vomit but I came close a couple of times. At that point it did not seem bad. At 01:00 AM I took my temperature and it was 102. I took some Tylenol. In the morning my temperature was 101, I called my PCP and he suggested I take a COVID-19 test. I went to the Emergent Care. The doctor evaluated me and then administered a fast COVID-19 test and it was negative they took a PCR COVID-19 test. A couple of days later I received the results and they were also negative. All my symptoms resolved in 2 days


VAERS ID: 1909989 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F21A / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Ear pain, Headache, Injection site pain, Injection site warmth, Neck pain, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, hctz, omeprazole, metoprolol, budesonide, ezetimibe, buspirone, bupropion
Current Illness: no
Preexisting Conditions: HTN
Allergies: sulfa and pcn
Diagnostic Lab Data: Client spoke with PCP today. PCP was not concerned with puffiness and told her would evaluate if still there with appt in several weeks. Reports PCP was aware of similar side effects post COVID vaccination.
CDC Split Type:

Write-up: Day after vaccination developed hot spot at site if injection and extreme soreness. Several days after vaccination noticed an earache on side of vaccination with pain running below ear to shoulder. Had a spot on head that had pain shooting through it. Not a full blown headache. On same side. Puffiness noted above your left collar bone by neck. Puffy area soft. Today 11/30/21 all symptoms resolved except puffy area above left collar bone. Area size of silver dollar.


VAERS ID: 1910027 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-16
Onset:2021-11-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Lymphadenopathy, 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec od Singulair od
Current Illness: Early October I had an allergy flare that gave me a sinus infection. Treated with amoxicillin and Prednisone.
Preexisting Conditions: allergies and asthma
Allergies: erythromycin betadine
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: 2 days post vaccine, 11/18/2021- in the morning I woke up with pain in my left arm pit and the left side of my neck and I could feel I had swollen lymph nodes. The same side as I received my vaccine. I contacted my doctor because it did not happen with the other 2 doses. The doctor said it was probably an immune response from the vaccine. It resolved on it''s own in 2 days.


VAERS ID: 1910233 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-11-15
Onset:2021-11-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F21A / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Vaccination complication
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: Flonase 50mcg twice a day Progesterone 90mg once a day Bi-Eft trochef Vitamin D Digestion GB Curcumin Fish Oil CBD Oil
Current Illness: None.
Preexisting Conditions: Low Functioning Thyroid
Allergies: April 2021 Sulfa Eggs September 20221 Sulfa gluten Egg All dairy Almonds Cat Fish Goats Milk Romain lettuce Sesame Broccoli Hops Parsley Scallops Shrimp Barley Buck Wheats Honeydew melon Leaks Mackerel Mandarin Oranges Papaya Pistachio Nuts Sheep''s Milk Tempeh Black Pepper Buffalo Milk Dill Fig Keifer Malt Mango Molasses Pear Plumb Spelt Vegan Cheese Yogurt
Diagnostic Lab Data: None.
CDC Split Type: vsafe

Write-up: I had covid arm after the boost shot. All of my previous symptoms from the first shot worsened. I did not seek any care.


VAERS ID: 1911777 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Illinois  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Influenza like illness, Myalgia, Oropharyngeal pain, Pyrexia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: she noticed a rash in both arms, legs and the back/ Rash (inflammation and redness)/ eliminated the rash but not the redness generated by it; Fever; Flue like symptoms; Sore throat; Body aches; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (Flue like symptoms), OROPHARYNGEAL PAIN (Sore throat), MYALGIA (Body aches), RASH (she noticed a rash in both arms, legs and the back/ Rash (inflammation and redness)/ eliminated the rash but not the redness generated by it) and PYREXIA (Fever) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 18-Nov-2021 at 8:00 AM, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Nov-2021, the patient experienced INFLUENZA LIKE ILLNESS (Flue like symptoms), OROPHARYNGEAL PAIN (Sore throat), MYALGIA (Body aches) and PYREXIA (Fever). On 20-Nov-2021, the patient experienced RASH (she noticed a rash in both arms, legs and the back/ Rash (inflammation and redness)/ eliminated the rash but not the redness generated by it). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Rash, at an unspecified dose and frequency. At the time of the report, INFLUENZA LIKE ILLNESS (Flue like symptoms), OROPHARYNGEAL PAIN (Sore throat), MYALGIA (Body aches) and PYREXIA (Fever) outcome was unknown and RASH (she noticed a rash in both arms, legs and the back/ Rash (inflammation and redness)/ eliminated the rash but not the redness generated by it) had resolved with sequelae. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. She took some Benadryl worked and eliminated the rash but not the redness generated by it.


VAERS ID: 1912151 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-11-16
Onset:2021-11-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3725 / 3 LA / IM
UNK: VACCINE NOT SPECIFIED (OTHER) / UNKNOWN MANUFACTURER - / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin xl 300mg
Current Illness:
Preexisting Conditions: Prolapsed discs in lumbar spine
Allergies: Seaweed, tropical fruits
Diagnostic Lab Data:
CDC Split Type:

Write-up: Cheat pain. Started quickly and got moderate within an hour. Lasted for over 7 days. Right in center of chest under sternum. Felt like a tightness in my heart area.


VAERS ID: 1912206 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New Mexico  
Vaccinated:0000-00-00
Onset:2021-11-18
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / OT
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 031542202 / UNK - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ADCIRCA
Current Illness: Primary pulmonary hypertension
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211161711

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient concerned a 36 year old female of unknown race and ethnicity. The patient''s weight was 75.9 kilograms, and height was not reported. The patient''s concurrent conditions included: primary pulmonary hypertension. The patient received selexipag (tablet, oral, batch number: 031542202 expiry: 31-AUG-2022) 1600 mcg orally 2 times daily, therapy dates were not reported for primary pulmonary hypertension. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration not reported , batch number: Unknown and expiry: Unknown) 1 total, dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. Concomitant medications included tadalafil. On 18-NOV-2021, the patient diagnosed with covid-19 infection and suspected clinical vaccination failure. Patient stated that she was fully vaccinated and symptoms have been fairly mild. The action taken with covid-19 vaccine ad26.cov2.s was not applicable; and dose of selexipag was not changed. The outcome of the suspected covid-19 infection and suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint.; Sender''s Comments: V0: 20211161711-COVID-19 VACCINE AD26.COV2.S-Suspected clinical vaccination failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS 20211161711-UPTRAVI- Suspected clinical vaccination failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1912311 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Unknown  
Location: Wyoming  
Vaccinated:0000-00-00
Onset:2021-11-18
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211D21A / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Vertigo
SMQs:, Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient or the patient''s immediate family had no history of Vertigo.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211164679

Write-up: This spontaneous report received from a patient concerned a 37 year old of unspecified sex. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: The patient or the patient''s immediate family had no history of Vertigo.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 211D21A expiry: 04-NOV-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 severe vertigo (felt very dizzy and light headed also felt like the room was spinning around). On 23-NOV-2021, treatment medications included: meloxicam.The action taken with covid-19 vaccine ad26.cov2.s was not applicable.The patient was recovering from vertigo (felt very dizzy and light headed also felt like the room was spinning around).This report was non-serious.


VAERS ID: 1912681 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-01
Onset:2021-11-18
   Days after vaccination:262
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Decreased appetite, Influenza virus test, Mental status changes, Respiratory syncytial virus test, SARS-CoV-2 test positive
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: glucophage, aricept, humalog, lantus, mevacor, namenda
Current Illness:
Preexisting Conditions: alzheimers, hypotension,
Allergies: Codeine
Diagnostic Lab Data: COVID-19, Flu, RSV by NAA positive for SARS on 11/18/2021
CDC Split Type:

Write-up: Pt received Pfizer vaccines on 03/01/2021 and 03/22/2021. Pt was brought to the ED by her husband with complaints of AMS on 11/18/21. Pt was noted to not be eating or drinking as usual. Pt was found to be COVID positive. Pt was not hypoxic and was not a candidate for Remdesivir. Pt discharged on 11/26 with home care.


VAERS ID: 1912682 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-01
Onset:2021-11-18
   Days after vaccination:262
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Decreased appetite, Influenza virus test, Mental status changes, SARS-CoV-2 test positive
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: glucophage, aricept, humalog, lantus, mevacor, namenda
Current Illness:
Preexisting Conditions: alzheimers, hypotension,
Allergies: Codeine
Diagnostic Lab Data: COVID-19, Flu, RSV positive for SARS on 11/18/2021
CDC Split Type:

Write-up: Pt received Pfizer vaccines on 03/01/2021 and 03/22/2021. Pt was brought to the ED by her husband with complaints of AMS on 11/18/21. Pt was noted to not be eating or drinking as usual. Pt was found to be COVID positive. Pt was not hypoxic and was not a candidate for Remdesivir. Pt discharged on 11/26 with home care.


VAERS ID: 1912683 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-01
Onset:2021-11-18
   Days after vaccination:262
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Hypophagia, Influenza virus test, Mental status changes, Respiratory syncytial virus test, SARS-CoV-2 test positive
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: glucophage, aricept, humalog, lantus, mevacor, namenda
Current Illness:
Preexisting Conditions: alzheimers, hypotension,
Allergies: Codeine
Diagnostic Lab Data: COVID-19, Flu, RSV by NAA positive for SARS on 11/18/2021
CDC Split Type:

Write-up: Pt received Pfizer vaccines on 03/01/2021 and 03/22/2021. Pt was brought to the ED by her husband with complaints of AMS on 11/18/21. Pt was noted to not be eating or drinking as usual. Pt was found to be COVID positive. Pt was not hypoxic and was not a candidate for Remdesivir. Pt discharged on 11/26 with home care.


VAERS ID: 1912865 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, No adverse event
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not applicable. Dose administered too soon and medications at time of vaccination not necessary.
Current Illness: Not applicable. Dose administered too soon.
Preexisting Conditions: Not applicable. Dose administered too soon and chronic health conditions are not relevant.
Allergies: Not applicable. Dose administered too soon and previous ADRs do not add to assessment.
Diagnostic Lab Data: not applicable ? dose given too soon therefore no medical tests/lab results indicated
CDC Split Type:

Write-up: For unknown reason (not documented in chart) patient received the first Moderna COVID-19 Vaccine dose on10/28/21 and the second dose of Moderna COVID-19 Vaccine on 11/18/21 which is earlier than 28 days and outside of the 4-day grace period. There were no adverse events associated with administration of the vaccine. Per CDC guidance, doses inadvertently administered earlier than the grace period should not be repeated.


VAERS ID: 1912881 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939909 / 1 LA / IM

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

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

Write-up: Wrong vaccine given, should have been Pfizer due to age.


VAERS ID: 1912936 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

Administered by: Other       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:
CDC Split Type:

Write-up: Administration of improperly stored vaccine.


VAERS ID: 1912940 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Headache, Hypoaesthesia, Immediate post-injection reaction, Pain in extremity, Paraesthesia, Paraesthesia oral, Somnolence, Trigger finger, Vaccination site pruritus
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (narrow), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: Immediately at time of vaccine, left hand starting tingling and I experienced tingling on both sides of my mouth. My arm itched at vax site. I sat for a few moments, as instructed and experienced slight dizziness. Felt tired after returning to work that day. The day after, Friday 11/19/21, I experienced chills, numbness & tingling on left side (which is where I received the shot). I was unable to close or bend my fingers. My arm hurt and continues to itch at the vax site. I felt sleepy and slight headache.


VAERS ID: 1913018 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not available
Current Illness: No
Preexisting Conditions: None
Allergies: No allergy to previous vaccines
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pfizer vaccine was given as a second dose of COVID-19 to a patient who had received the Moderna vaccine as her first dose.


VAERS ID: 1913079 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 213D21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Fall, Pain, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Accidents and injuries (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: PATIENT CALLED ON 12/1/21 STATING SHE STARTED HURTING ALL OVER. THIS BEGAN ONE DAY AFTER HER SHOT. STARTED IN HER SHOULDER AND WENT DOWN HER BACK, AND THEN HER LEGS BEGAN TO HURT (THROBBING). SHE IS STILL HURTING TODAY. SHE ALSO MENTIONED SHE DID FALL SUNDAY 11/28/21.


VAERS ID: 1913164 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-11-15
Onset:2021-11-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Acute kidney injury, Ascites, Colitis, Diarrhoea, Gastroenteritis Escherichia coli, Gastrointestinal pathogen panel, Hepatic cirrhosis
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atovaquone, diphenhydramine, vitamin D, flonase, furosemide, loperamide, loratidine, oxycodone, pantoprazole, posaconazole, tacrolimus, ursodiol, valacyclovir
Current Illness:
Preexisting Conditions: Acute myeloblastic leukemia, underwent a stem cell transplant 6/2/2021, anxiety, hypertension
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received the second dose of his Moderna vaccine following his allogeneic stem cell transplant on 11/15/21 (prior doses were 2/2/21, 10/8/21, and 11/15/21 with the initial being prior to her transplant). He then presented to the emergency department on 11/18/21 with abdominal pain and diarrhea and was admitted to the hospital. At admission he was found to have a Enteropathogenic E.coli colitis (positive on GI multiplex panel) which was likely a cause of the diarrhea. He was also found to have a new onset cirrhosis of unknown etiology. He is still admitted for management of her ascites and newly developed AKI.


VAERS ID: 1913385 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-15
Onset:2021-11-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angiogram normal, Angiogram pulmonary normal, Fatigue, Fibrin D dimer increased, Headache, Impaired work ability, Neck pain, Petechiae, Rash erythematous, Venogram normal
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hypersensitivity (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: None
Diagnostic Lab Data: D-dimer results - all elevated (normal range is: < 0.59): 0.83 (11/18), 4.05 ( 11/22), 7.64 (11/22), $g35.0 (11/30). ED visit on 11/22: normal results for CTPE and CTA of head/neck and CTV of head. Other workup still in progress.
CDC Split Type:

Write-up: She reported severe headache and right neck pain for 2 days after vaccine - beginning the night of the day she got the vaccine with, severe fatigue, was unable to work. On 11/17, she noted red spots, which were diagnosed as petechiae at routine clinic appointment on 11/18. Labs performed included CBCPD and d-dimer. Platelets were lower than her baseline but still in normal range. D-dimer mildly positive at 0.83, repeat showed rapid rise to 4.05 and had normal results for CTPE, CTA of head/neck and CTV of head/neck with d-dimer even higher at 7.64 that same day, but symptoms had all resolved except mild neck pain. Symptoms seemed resolved but follow-up d-dimer very elevated at $g 35. Additional studies are pending and Hematology consult, and patient remains off work until further workup, and ideally normalization of labs.


VAERS ID: 1913412 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA FK5127 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), 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: Patient develops red and swollen arm after injection
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: SWOLLEN AND RED ARM


VAERS ID: 1913421 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-11-16
Onset:2021-11-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8028 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blister, Erythema, Oral herpes, Oral pain
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: AZELASTINE HCL NA carboxymethylcellulose 0.5 % ophthalmic solution cycloSPORINE 0.05 % ophthalmic emulsion fluticasone propionate 50 MCG/ACT nasal spray ketoconazole 2 % shampoo levothyroxine 137 MCG tablet Take 137
Current Illness: None
Preexisting Conditions: PAST MEDICAL HISTORY 1. Multiple myeloma. (A) Diagnosed in 03/2016 with M spike of 3.8. Kappa free light chain was 63.6, kappa lambda ratio of 87, beta2 microglobulin at 2849. UPEP positive for Bence Jones protein. Bone marrow aspirate biopsy showed 75% plasma cells. FISH panel showed amplification of 1q, monosomy 7, monosomy 13, +17, deletion 17p. Skeletal survey was negative. He went on to receive therapy with VRD for a total of 6 cycles from May through September 2016 with mild neuropathy, and he went on to autologous peripheral blood stem cell transplant 10/2016, followed by an allo in 12/2016. (B) Following the allogeneic transplant, day 84 bone marrow evaluation from 03/20/2017 were positive with abnormal positive cells 0.02%, peripheral blood chimerisms were 100% donor by CD3, CD33, and CD56. Whole bone marrow chimerisms also at 100%. SPEP showed monoclonal spike at 0.1g/dL IgG kappa. Cytogenics were normal male karyotype myeloma FISH panel enriched CD138 cells showed abnormal for +1q and deletion 13, normal for 6q, 11q, and 17p. No evidence of translocation 4;14 or 4;16, consistent with presence of minimal residual disease. (C) He was in complete remission at his 1-year posttransplant evaluation in 12/2017. 2. Dyslipidemia, continues pravastatin. 3. Left inguinal hernia repair 2007. 4. Arthroscopy of the right knee in 1987. 5. History of degenerative lumbar spine disk disease. 6. Parainfluenza 03/23/2017. 7. Osteonecrosis of his jaw (medication related), noted prior to transplant, with prior history of Zometa 8. Skin cancers. Invasive squamous cell from left lower lip, basal cell carcinoma x 2 on right malar/infraorbital area in 03/01/2018 . Underwent Mohs of the lip in 6/2018 and then of the eye lesion in 7/2018. 9. Catheter associated thrombus. Apixiban discontinued once port removed in Jan 2018. 10. Acute Skin GVHD treated with prednisone 1 mg/kg on 01/24/2017 with improvement. PUVA added 2/6/2017 and PDN taper started. PUVA stopped 3/3/2017 due to skin sensitivity. 11. Nephrotic syndrome related to GVHD per renal biopsy 7/2020. See GVHD above. 12. Possible CKD. 13. Neuropathy since treatment for MM, but worsened in 2020. Gapapentin trialed 4/2020 without noticeable benefit. 14. Late acute skin GVHD, diagnosed 06/27/2017, after completing cyclosporine, treated by resuming cyclosporine and prednisone 1 mg/kg per day. 15. Pulmonary nodules, multiple from 10/2020, likely consistent with acute pulmonary histoplasmosis. Had weeks of fevers that were unresponsive to multiple antibiotic regimens. Bronchoscopy negative from 10/2020. Treated with voriconazole. Chest CT 12/31/20 stable from 10/2020. Chest CT 3/5/21 with increased size of nodules. LLL VATS wedge resection 3/22/21 with necrotizing granulomatous nodule involving lung parenchyma. No malignancy/neoplasm. Infectious studies negative upon outside review, but SCCA review on 5/11/21 revealed necrotizing granulomatous nodule invovling lung parenchyma with silver stain positive for organism morphologically suggestive of histoplasmosis. Voriconazole stopped by end of 4/2021 and stable to improved CT chest since then, most recent 11/2021. 16. Scoliosis 17. Bilateral carpal tunnel, s/p release on right side 3/15/21 and left release on 4/15/21. 18. Rectal prolapse, confirmed per defecography 2/2021. Physical therapy started 4/2021. 19. Seasonal allergies 20. Arthritis in wrists.
Allergies: Tylenol-rash, clindamycin-rah, penicillin-rash
Diagnostic Lab Data: Swab was not completed to verify dx.
CDC Split Type:

Write-up: HSV stomatitis symptoms started 2 days after patient received COVID vaccine-erythema, pain in mouth and blisters. On 4th day after onset of symptoms, was started on Valtrex. Started to improved 2 days after starting treatment. Resolved by day 7 after treatment.


VAERS ID: 1913449 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-05
Onset:2021-11-18
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939903 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthma, Chest X-ray, Condition aggravated, Gastrooesophageal reflux disease, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific dysfunction (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Loratidine, Amlodipine, Lisinopril, Raloxifene, Famotidine $g$g$g
Current Illness: Asthma, Reflux Flares
Preexisting Conditions: High Blood Pressure, Allergies, Asthma, GERD, Stage 3 Chronic Kidney Disease
Allergies: Penicillin, Keflex, Sulfa, Prilosec, Colchicine; Strawberries,
Diagnostic Lab Data: Chest x-rays, two views.
CDC Split Type:

Write-up: Medium-sized lump on arm for 5+/- days. Asthma, present for several days before, became a bit worse, due to concurrent reflux from my GERD of long standing. Don''t believe the Booster had to do with reason I was recommended to report, which was concerned I may have inspirated stomach acid to cause possible pneumonia. x-rays were negative for any impacts or congestion.


VAERS ID: 1913479 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Virginia  
Vaccinated:2008-11-18
Onset:2021-11-18
   Days after vaccination:4748
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Product administration error, 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: No adverse event-- administration error- the patient should have received Pfizer (first dose of COVID vaccine unknown), at our clinic for 2nd dose


VAERS ID: 1913500 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-05
Onset:2021-11-18
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939903 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthma, Chest X-ray normal, Condition aggravated, Gastrooesophageal reflux disease, Limb mass
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Gastrointestinal nonspecific dysfunction (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Loratidine, Amlodipine, Lisinopril, Raloxifene, Famotidine $g$g$g
Current Illness: Asthma, Reflux Flares
Preexisting Conditions: High Blood Pressure, Allergies, Asthma, GERD, Stage 3 Chronic Kidney Disease
Allergies: Penicillin, Keflex, Sulfa, Prilosec, Colchicine; Strawberries,
Diagnostic Lab Data: Chest x-rays, two views.
CDC Split Type:

Write-up: Medium-sized lump on arm for 5+/- days. Asthma, present for several days before, became a bit worse, due to concurrent reflux from my GERD of long standing. Don''t believe the Booster had to do with reason I was recommended to report to Urgent Care by my U.C. Nurse Help Line, which was concerned I may have inspirated stomach acid to cause possible pneumonia. Urgent Care x-rays were negative for any impacts or congestion.


VAERS ID: 1913502 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 2 LA / 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: None--- submitting form because patient should have received Pfizer (age) instead of Moderna. Patient is doing well


VAERS ID: 1913571 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Incorrect dose administered, 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: N/A
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Seasonal allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: 9 year old patient was given .025 Moderna booster dose (meant for his father) in error. Patient should have received 0.2 of pediatric Pfizer 5-<12.


VAERS ID: 1913640 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 1 RA / IM

Administered by: Other       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? 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 received dose of Moderna on 11/10/21 at off-site vaccine clinic. Patient received Pfizer vaccine on 11/18/21 at off-site vaccine clinic. Incentives were given at each vaccine clinic.


VAERS ID: 1913773 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Unknown  
Location: New Jersey  
Vaccinated:2021-01-20
Onset:2021-11-18
   Days after vaccination:302
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Headache, Inappropriate schedule of product administration, Malaise, Nasal congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Medication errors (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: not known
Current Illness: not known
Preexisting Conditions: not known
Allergies: not known
Diagnostic Lab Data: PCR + for Covid 11/22/2021
CDC Split Type:

Write-up: Client had Moderna vaccines for Covid on Jan 20 and Feb 20 2021. Developed symptoms of Covid 11/18 - nasal congestion, cough, headache. PCR + for Covid 11/22.


VAERS ID: 1914233 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Goitre, Lymphadenopathy
SMQs:, Hypothyroidism (broad), Hyperthyroidism (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: Moderna covid
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Glandular swelling including thyroid. Reported on first dose, occured after all 3 doses.


VAERS ID: 1914256 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-11-12
Onset:2021-11-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032F21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Chills, Culture positive, Fatigue, Herpes zoster, Pain
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin D3, vitamin B12
Current Illness: none.
Preexisting Conditions: RA with chronic joint pain. Also, Graves disease in remission, not taking any medications for it for several years now.
Allergies: none
Diagnostic Lab Data: 11/23: culture of blister fluid confirmed Shingles diagnosis. No additional tests.
CDC Split Type:

Write-up: On 11/17 or 18 developed significant pain, chills, fatigue and then developed blisters on 11/21. Made MD appointment & diagnosed with Shingles on 11/23 and began 7 day treatment with Valtrex. Still having pain in shingles area, slowly seems to be improving.


VAERS ID: 1914553 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8030 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Gait disturbance, Headache, Injected limb mobility decreased, Neck pain, Pain in extremity, Tinnitus
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: TDAP-01/02/2015; age 66. First dose of Pfizer Covid vaccine-04/04/2021; age 71.
Other Medications: Multivitamin Calcium Actonel 35 1x week allegra
Current Illness: none
Preexisting Conditions: scoliosis-repaired
Allergies: Sulfa, penicillin, codeine, propofol, tramadol, relafen, morphine
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Severe pain in side, back and front of neck, head-back of head, side of head, side of face, jaw, ears....I felt like I had been beaten up about my head and neck. Ringing in the ears (which still persists), dizziness, unsteady on feet. Severe pain in left arm, not able to lift arm. All symptoms lasted for over a week, with tinnitus still present.


VAERS ID: 1915426 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Interchange of vaccine products, Vaccination complication
SMQs:, Arthritis (broad), Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: adverse reaction after his Moderna booster; fri-sat - aching in every joint, sun until today- he is fine; 1st and 2nd dose Pfizer and Moderna booster dose; This spontaneous case was reported by a consumer and describes the occurrence of INTERCHANGE OF VACCINE PRODUCTS (1st and 2nd dose Pfizer and Moderna booster dose), VACCINATION COMPLICATION (adverse reaction after his Moderna booster) and ARTHRALGIA (fri-sat - aching in every joint, sun until today- he is fine) in a 57-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Previously administered products included for Product used for unknown indication: PFIZER BIONTECH COVID-19 VACCINE (Dose 2) and PFIZER BIONTECH COVID-19 VACCINE (Dose 1). Past adverse reactions to the above products included No adverse event with PFIZER BIONTECH COVID-19 VACCINE and PFIZER BIONTECH COVID-19 VACCINE. On 18-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Nov-2021, the patient experienced INTERCHANGE OF VACCINE PRODUCTS (1st and 2nd dose Pfizer and Moderna booster dose). On 19-Nov-2021, the patient experienced ARTHRALGIA (fri-sat - aching in every joint, sun until today- he is fine). On an unknown date, the patient experienced VACCINATION COMPLICATION (adverse reaction after his Moderna booster). On 18-Nov-2021, INTERCHANGE OF VACCINE PRODUCTS (1st and 2nd dose Pfizer and Moderna booster dose) had resolved. On 20-Nov-2021, ARTHRALGIA (fri-sat - aching in every joint, sun until today- he is fine) had resolved. At the time of the report, VACCINATION COMPLICATION (adverse reaction after his Moderna booster) outcome was unknown. Concomitant medications and treatment medications were not provided by reporter. Patient had aching in every joint from Fridayto Saturday and Sunday to 23-Nov-2021, patient was fine.


VAERS ID: 1915445 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Alabama  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / UNK - / OT

Administered by: Unknown       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Received expired dose of the Moderna vaccine; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Received expired dose of the Moderna vaccine) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 046C21A) for COVID-19 vaccination. No Medical History information was reported. On 18-Nov-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Nov-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Received expired dose of the Moderna vaccine). On 18-Nov-2021, EXPIRED PRODUCT ADMINISTERED (Received expired dose of the Moderna vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were mentioned. No treatment details were reported.


VAERS ID: 1915729 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 3 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Chromatopsia, Eye movement disorder, Eye pain, Fatigue, Photophobia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Ocular motility disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OMEPRAZOLE; MAGNESIUM; FISH OIL; AZELASTINE; MULTIVITAMIN [VITAMINS NOS]
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: body temperature; Result Unstructured Data: Experiencing a mild fever
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: eye pain from movement,eye pain from light and light changes, eye ball pain; when he moved his eyes side to side and up and down he had eye pain; seeing red/black in the dark; eye pain from light and light changes; mild fever between 101.5 -102; very tired, fatigue; This spontaneous case was reported by a consumer and describes the occurrence of EYE PAIN (eye pain from movement,eye pain from light and light changes, eye ball pain), EYE MOVEMENT DISORDER (when he moved his eyes side to side and up and down he had eye pain), CHROMATOPSIA (seeing red/black in the dark), PHOTOPHOBIA (eye pain from light and light changes) and PYREXIA (mild fever between 101.5 -102) in a 56-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004F21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Previously administered products included for Product used for unknown indication: Pfizer vaccine (Patient had the first two doses of the Pfizer where he experienced fever, swollen lymph nodes, mild symptoms), Pfizer vaccine (Patient had the first two doses of the Pfizer where he experienced fever, swollen lymph nodes, mild symptoms), PFIZER BIONTECH COVID-19 VACCINE (Patient had the first two doses of the Pfizer where he experienced fever, swollen lymph nodes and mild symptoms). Past adverse reactions to the above products included Fever with Pfizer vaccine; Swollen lymph nodes with PFIZER BIONTECH COVID-19 VACCINE; and Vaccination adverse reaction with Pfizer vaccine. Concomitant products included OMEPRAZOLE, MAGNESIUM, FISH OIL, AZELASTINE and MULTIVITAMIN [VITAMINS NOS] for an unknown indication. On 17-Nov-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Nov-2021, the patient experienced PYREXIA (mild fever between 101.5 -102) and FATIGUE (very tired, fatigue). On 19-Nov-2021, the patient experienced EYE PAIN (eye pain from movement,eye pain from light and light changes, eye ball pain), EYE MOVEMENT DISORDER (when he moved his eyes side to side and up and down he had eye pain), CHROMATOPSIA (seeing red/black in the dark) and PHOTOPHOBIA (eye pain from light and light changes). The patient was treated with NAPROXEN SODIUM (ALEVE) for Adverse event, at an unspecified dose and frequency. At the time of the report, EYE PAIN (eye pain from movement,eye pain from light and light changes, eye ball pain) had resolved and EYE MOVEMENT DISORDER (when he moved his eyes side to side and up and down he had eye pain), CHROMATOPSIA (seeing red/black in the dark), PHOTOPHOBIA (eye pain from light and light changes), PYREXIA (mild fever between 101.5 -102) and FATIGUE (very tired, fatigue) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 101.5-102 (High) Experiencing a mild fever. Patient received Aleve for eye pain and treatment information for other reported events was not provided. Reporter did not allow further contact


VAERS ID: 1915778 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-06
Onset:2021-11-18
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure measurement, Blood test, Carbon dioxide, Cardiac stress test, Echocardiogram, Ejection fraction, Electrocardiogram, Left ventricular failure
SMQs:, Cardiac failure (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Blood Pressure; Result Unstructured Data: top number was high, monitored BP for 2 weeks and was found to be consistently high; Test Date: 20211027; Test Name: Blood work; Result Unstructured Data: everything was normal; Test Date: 20211027; Test Name: Carbon dioxide; Result Unstructured Data: Carbon dioxide was 34mm OL/L; Test Date: 20211112; Test Name: Stress test; Test Result: Positive ; Result Unstructured Data: Positive; Test Date: 20211118; Test Name: Stress test; Test Result: Positive ; Result Unstructured Data: Positive; Test Date: 20211118; Test Name: Echocardiogram; Result Unstructured Data: echo was fine; Test Name: Left Ventricular Ejection Fraction; Result Unstructured Data: supposed to be ejecting 60% was only ejecting 40% which was pretty bad.; Test Name: EKG; Result Unstructured Data: Abnormal; Test Date: 20211118; Test Name: EKG; Result Unstructured Data: The imaging revealed left ventricular systolic failure which they believed came from cardiomyopathy. Left ventricle which was supposed to be ejecting 60% was only ejecting 40%
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: imaging revealed left ventricular systolic failure/left ventricle which is supposed to be ejecting 60% is only ejecting 40%; This spontaneous case was reported by a consumer and describes the occurrence of LEFT VENTRICULAR FAILURE (imaging revealed left ventricular systolic failure/left ventricle which is supposed to be ejecting 60% is only ejecting 40%) in a 44-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 005C21A and 005C21A) for COVID-19 vaccination. No Medical History information was reported. On 06-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Nov-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced LEFT VENTRICULAR FAILURE (imaging revealed left ventricular systolic failure/left ventricle which is supposed to be ejecting 60% is only ejecting 40%) (seriousness criterion medically significant). The patient was treated with CHLORTHALIDONE for Blood pressure high, at an unspecified dose and frequency and ALBUTEROL [SALBUTAMOL] for Breathing difficult, at an unspecified dose and frequency. At the time of the report, LEFT VENTRICULAR FAILURE (imaging revealed left ventricular systolic failure/left ventricle which is supposed to be ejecting 60% is only ejecting 40%) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 27-Oct-2021, Blood test: normal (normal) everything was normal. On 27-Oct-2021, Carbon dioxide: abnormal (abnormal) Carbon dioxide was 34mm OL/L. On 12-Nov-2021, Cardiac stress test: positive (Positive) Positive. On 18-Nov-2021, Cardiac stress test: positive (Positive) Positive. On 18-Nov-2021, Echocardiogram: normal (normal) echo was fine. On 18-Nov-2021, Electrocardiogram: abnormal (abnormal) The imaging revealed left ventricular systolic failure which they believed came from cardiomyopathy. Left ventricle which was supposed to be ejecting 60% was only ejecting 40%. On an unknown date, Blood pressure measurement: high (High) top number was high, monitored BP for 2 weeks and was found to be consistently high. On an unknown date, Ejection fraction: abnormal (abnormal) supposed to be ejecting 60% was only ejecting 40% which was pretty bad.. On an unknown date, Electrocardiogram: abnormal (abnormal) Abnormal. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. About a month after the patient got the 2nd dose (beginning of Jul2021) had a hard time breathing so consulted the healthcare provider (HCP). They took blood pressure (BP) and the "top number" was high. They monitored BP for 2 weeks and this was found to be consistently high. Patient was started on a medication but this did not give any relief so was shifted to another medication. Again, this did not give the relief of the condition. Patient was eventually given Chlorthalidone. The imaging revealed left ventricular systolic failure which was believed to be came from cardiomyopathy. The left ventricle which was supposed to be ejecting 60% was only ejecting 40% and her doctor mentioned that this could be due to the vaccine. Patient had not experienced symptoms like this before receiving the Moderna COVID-19 and patient was extremely physically active. The patient received 2 unspecified medications. Company comment- This case concerns a 44-year-old, female patient with no relevant medical history reported, who experienced the unexpected event of left ventricular failure. The event occurred 5 months and 14 days after the second dose of mRNA-1273. The rechallenge was not applicable since the event happened after the second dose. The benefit-risk relationship of mRNA-1273 is not affected by this report. information was requested.; Sender''s Comments: This case concerns a 44-year-old, female patient with no relevant medical history reported, who experienced the unexpected event of left ventricular failure. The event occurred 5 months and 14 days after the second dose of mRNA-1273. The rechallenge was not applicable since the event happened after the second dose. The benefit-risk relationship of mRNA-1273 is not affected by this report. information was requested.


VAERS ID: 1915792 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Loss of consciousness, Swelling, Vaccination site pain
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: USMODERNATX, INC.MOD20213

Write-up: swelling in armpit; Passed out; fatigue; arm has been sore all time; This spontaneous case was reported by a consumer and describes the occurrence of SWELLING (swelling in armpit), LOSS OF CONSCIOUSNESS (Passed out), VACCINATION SITE PAIN (arm has been sore all time) and FATIGUE (fatigue) in a 23-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013F21A) for COVID-19 vaccination. No Medical History information was reported. On 18-Nov-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Nov-2021, the patient experienced VACCINATION SITE PAIN (arm has been sore all time). On 19-Nov-2021, the patient experienced SWELLING (swelling in armpit), LOSS OF CONSCIOUSNESS (Passed out) and FATIGUE (fatigue). On 19-Nov-2021, LOSS OF CONSCIOUSNESS (Passed out) had resolved. At the time of the report, SWELLING (swelling in armpit) and VACCINATION SITE PAIN (arm has been sore all time) had not resolved and FATIGUE (fatigue) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication was reported. No treatment medication use was reported. Company comment: This is a Spontaneous case concerning a 23-year-old, male patient with unknown medical history, who experienced the unexpected non serious event of loss of consciousness. The event occurred approximately one day after the first dose of mRNA 1273 vaccine. The benefit-risk relationship of mRNA 1273 vaccine is not affected by this report.; Sender''s Comments: This is a Spontaneous case concerning a 23-year-old, male patient with unknown medical history, who experienced the unexpected non serious event of loss of consciousness. The event occurred approximately one day after the first dose of mRNA 1273 vaccine. The benefit-risk relationship of mRNA 1273 vaccine is not affected by this report.


VAERS ID: 1915938 (history)  
Form: Version 2.0  
Age: 8.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Eye irritation, Eye swelling, Product administered to patient of inappropriate age
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Corneal disorders (broad), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy to nuts (tree nuts); Egg allergy (Egg); Peanut allergy (peanuts)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101630015

Write-up: patient age 8 years old; The shot was given at 2:30pm. By 4pm we noticed significant eye swelling and irritation. Gave him a full adult dose of Benadryl (25mil) and contacted our pediatrician. By 5 eyes were nearly swelled; The shot was given at 2:30pm. By 4pm we noticed significant eye swelling and irritation. Gave him a full adult dose of Benadryl (25mil) and contacted our pediatrician. By 5 eyes were nearly swelled; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP). The reporter is the parent. A 8 year-old male patient received bnt162b2 (BNT162B2), administered in arm left, administration date 18Nov2021 14:30 (Lot number: FK5127) at the age of 8 years as dose 1, single for covid-19 immunisation. Relevant medical history included: "Known allergies: Egg" (unspecified if ongoing), notes: Egg; "Known allergies: peanuts" (unspecified if ongoing), notes: peanuts; "Known allergies: tree nuts" (unspecified if ongoing), notes: tree nuts. There were no concomitant medications. The following information was reported: EYE SWELLING (medically significant), EYE IRRITATION (medically significant) all with onset 18Nov2021 16:00, outcome "recovered" (Nov2021) and all described as "The shot was given at 2:30pm. By 4pm we noticed significant eye swelling and irritation. Gave him a full adult dose of Benadryl (25mil) and contacted our pediatrician. By 5 eyes were nearly swelled". The event "the shot was given at 2:30pm. by 4pm we noticed significant eye swelling and irritation. gave him a full adult dose of benadryl (25mil) and contacted our pediatrician. by 5 eyes were nearly swelled" and "the shot was given at 2:30pm. by 4pm we noticed significant eye swelling and irritation. gave him a full adult dose of benadryl (25mil) and contacted our pediatrician. by 5 eyes were nearly swelled" was evaluated at the physician office visit. Therapeutic measures were taken as a result of eye swelling, eye irritation. Additional information: After first dose of Benadryl it took approximately 18 hours (and a second and third dose of Benadryl) for his eye swelling to completely go away. The patient did not have any other vaccine in 4 weeks. The patient did not have any other medication in two weeks. The patient did not have covid-19 prior vaccination and the patient did not tested for covid-19 post vaccination.


VAERS ID: 1915942 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8P41 / 3 LA / -

Administered by: Work       Purchased by: ?
Symptoms: Chills, Immunisation, Pain, Pyrexia, Vaccination site pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101635018

Write-up: This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP). The reporter is the patient. A 24 year-old male patient received bnt162b2 (BNT162B2), administered in arm left, administration date 18Nov2021 (Lot number: FF8P41) at the age of 24 years as dose 3 (booster), single for covid-19 immunisation. The patient had no relevant medical history. There were no concomitant medications. Vaccination history included: Bnt162b2 (Dose 2, single, lot number:EL3247, expiry date was not reported, at left arm), administration date: 19Feb2021, when the patient was 23 years old, for COVID-19 immunization; Bnt162b2 (Dose 1, single, lot number:EL3247, expiry date not reported, at left arm), administration date: 29Jan2021, when the patient was 23 years old, for COVID-19 immunization.The following information was reported: IMMUNISATION (non-serious) with onset 18Nov2021, outcome "unknown", described as "Third injection/booster"; PYREXIA (non-serious) with onset 19Nov2021, outcome "recovering", described as "feverish"; PAIN (non-serious) with onset 19Nov2021, outcome "recovering", described as "body aches"; CHILLS (non-serious) with onset 19Nov2021, outcome "recovering", described as "chills"; VACCINATION SITE PAIN (non-serious) with onset 19Nov2021, outcome "recovering", described as "sore injection site". Therapeutic measures were not taken as a result of pyrexia, pain, chills, vaccination site pain. Additional information: Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19.


VAERS ID: 1916090 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / UNK LA / SYR
FLU4: INFLUENZA (SEASONAL) (AFLURIA QUADRIVALENT) / SEQIRUS, INC. - / UNK RA / SYR
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 0. / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: booster shot - had flu like symptons for 2 days, skin/heat rash for 5 days


VAERS ID: 1916459 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-11-12
Onset:2021-11-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH BM8841 / 1 RA / -

Administered by: Work       Purchased by: ?
Symptoms: Asthenia, Chest pain, Dizziness, Dyspnoea, Fatigue, Feeling abnormal, Headache, Nausea, Pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

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

Write-up: after a week of receiving vaccine, I no longer feel the same as before. The lack of energy, feeling fatigue, nauseous, dizzy, weak, short of breath, body ache and constant chest pain and headache.


VAERS ID: 1916938 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain lower, Abdominal pain upper, Chills, Headache, Migraine, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: After second Moderna Covid vaccine, same reactions on March 25, 2021.
Other Medications: Prescription medications: Plaquenil 200 mg every day and twice a day on Monday, Wednesday and Friday Estradiol cream 2x week Prolia injections for osteoporsis - twice yearly - started 8/2013 PRN Prescription medications: Imitrex - 25 mg for
Current Illness: Systemic poison ivy rash requiring medrol pack and then steroid injection (I had checked before I got the booster and it had been long enough afterwards to get the booster)
Preexisting Conditions: lupus ? SLE fibromyalgia osteoporosis - advanced chronic migraines TMJ syndrome Fibrocystic breast disease osteoarthritis arterial bridge in heart chronic gastritis diverticulosis lactose intolerance actinic keratosis on my face; atypical cells on biopsy of a mole chronic ear infections w/eardrum perforated several times Raynaud''s Syndrome Hemochromatosis carrier Vertigo, BPPV, cervicocranial syndrome, imbalance, neck pain
Allergies: ALLERGIES: MACROBID, Levoquin - rash, achromycin, Darvocet, cats, lactose intolerant Erythromycin - stomach pain/nausea, Augmentin - vomiting Poison Ivy causes a systemic rash that requires a doctor?s visit
Diagnostic Lab Data: No medical tests done but my primary care doctor wanted to see me in the office when I called asking if it was normal to have a headache every day after the booster shot for two weeks. So I did go in to see her.
CDC Split Type:

Write-up: I got the vaccine booster about 12:30 in the afternoon on 11/17/21. Around 1:00 or so in the morning I woke up with chills and a migraine. The migraine continued into the next two days accompanied by nausea and vomiting. I also had stomach pains in my lower abdomen about the time the chills started, sharp stabbing pains. The severe migraine finally let up about the second day but then for the next two weeks I had a headache that would not go away, no matter what I took to relieve the pain. The headaches finally stopped on Tuesday, November 30, 2021. Also for about a week after the vaccine I was nauseated off and on.


VAERS ID: 1916951 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-11-10
Onset:2021-11-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 3 - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Blood test normal, Chest pain, Computerised tomogram head, Extra dose administered, Headache, Hypertensive crisis, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Hypertension (narrow), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Medication errors (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Glycopperolate, Citrucel, Protonix, Vit D.
Current Illness: None
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: Bloodwork and CT of the head normal.
CDC Split Type:

Write-up: After third dose of Vaccine I started having Chest Pains. Pains are minimal now but my blood pressure has increased and I am having blurred vision and headaches. Nov 26 I went to the Emergency Room for a Hypertensive Crisis with BP of 209/117.


VAERS ID: 1917044 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-11-12
Onset:2021-11-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Pain in extremity, Skin discolouration
SMQs:, Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: healthy
Allergies: pcn
Diagnostic Lab Data: prednisone started and improved quickly within 24 hours much better and almost gone per mother.
CDC Split Type:

Write-up: blue/purple discoloration to the plantar distal surface of his feet, causing pain


VAERS ID: 1917118 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Impaired work ability, Loss of personal independence in daily activities, Lymph node pain, Lymphadenopathy, Muscle spasms, Myalgia, Pruritus, Pyrexia, Urticaria, Weight bearing difficulty
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: MULTIVITAMIN, MAGNESIUM EVERY OTHER DAY
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 12-36 hours after: mild fever, chills, severe fatigue unable to work or perform normal activities 36h-3 days after: mild-moderate fatigue, able to work but not at full capacity 3-6 days after: lymph node (axillary and in the neck) swelling and moderate to severe pain, unable to lift objects more than 10 lbs or perform normal weight bearing exercise. Working but with modifications. 7th day after: odd cramping and myalgias lasting 1-10 minutes in quadriceps, triceps, pectoralis muscles, flank, and upper back areas. 8-9 days: no symptoms 10 days to current time, day 13: systemic hives (scalp, face, neck, axillary, anterior forearms and antecubital spaces, palms, trunk circumferentially, groin and buttocks, posterior knees. Unable to perform daily functions, relying heavily on diphenhydramine, unable to work, visit to MD on 3rd day of hives and steroidal treatment (prednisone 60mg X2 days, 40mg X4 days, and 20mg X4 days) initiated with hydroxazine 10-50mg q8h prn for itching. Some moderate improvement in symptoms noticed 12 hours post steroidal treatment. Notable on day 10, heavy workout with sweating, use of a new brand of coconut oil soap (with no hx of soap sensitivities), but hives began prior workout and use of soap.


VAERS ID: 1917159 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-10-31
Onset:2021-11-18
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017F21A / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Feeling hot, Hyperhidrosis, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: the second shingrix injections gave me extreme chills for 12 hours a few years ago.. After dose 1 my arm swell and hot and a ras
Other Medications: Ranolazine 500mgs 2 a day every 12 hours, Metoprolol 25mgs I cut it in half and take it twice a day 12 hours apart. Atorvastatin 20mgs once a day Low dose aspirin 80mgs coated once a day. I take time released calcium 600mgs once a day
Current Illness: None
Preexisting Conditions: I have heart medication, I don''t have any heart issues, but due to the genetics we have a high chance of getting a heart attack.
Allergies: Adhesive.
Diagnostic Lab Data: None due to it being a virtual visit. I just took my blood pressure, at 132 over 78. this was later during the day after the incident.
CDC Split Type: vsafe

Write-up: I collapse, I didn''t lose consciousness I don''t know how I ended up on the floor. after 45 minutes I was very nauseous, i was sweating profusely and I was so weak that I couldn''t take off my clothes. I didn''t throw up i was so hot and I''ve never felt this way. It went through my mind that I could be going thru a heart attack. I didn''t have shortness of breath or chest tightness, no pressure and nothing of the sort. I didn''t experience any sickness after the 2 hours of sleep. I did a virtual visit on Monday on the 22 of November and I will be seeing Cardiologist and a Neurologist.


VAERS ID: 1917164 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-18
Onset:2021-11-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 1 UN / IM

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

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

Write-up: None Administration Error- dose administered 12 days after QR code expiry date


VAERS ID: 1917195 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-28
Onset:2021-11-18
   Days after vaccination:204
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036A21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: COPD on 3 L nasal cannula at baseline, chronic pain, rheumatoid arthritis, hypertension, tobacco use
Allergies:
Diagnostic Lab Data: COVID rapid antigen +11/18/21
CDC Split Type:

Write-up: Date of Admission 11/18/2021 Date of Discharge 11/23/2021 Reason for Hospitalization pt states she can''t catch her breath. Hx of COPD, on baseline 3L Hospital Course a 70yo woman with PMHx of COPD on 3L baseline, chronic pain, rheumatoid arthritis, tobacco use, who was admitted for further management of COVID-19 pneumonia. CT PE was negative for PE. Pt was treated with dexamethasone, remdesivir, baricitinib. She showed improvement and was able to ambulate with her baseline 3-4L NC without desaturating or becoming too short of breath. She was discharged home with family on 11/23 with 5 more days of dexamethasone to complete a 10d course.


VAERS ID: 1917264 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Virgin Islands  
Vaccinated:2021-11-17
Onset:2021-11-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 3 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Arthralgia, Injection site pain, Mobility decreased, Myalgia, Pain, Tendon pain
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament 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: Moderna 2nd dose vaccine, had COVID arm, I started with pain but very mild. Received it in my right arm and had a small TIA.
Other Medications: None reported.
Current Illness: None reported.
Preexisting Conditions: None reported.
Allergies: None reported.
Diagnostic Lab Data: No X-rays were taken.
CDC Split Type: vsafe

Write-up: After my third vaccine, I experience left shoulder pain, muscular and tendon pain. I went to the doctor because I already had a regular check-up appointment. My pain is one inch below and on the sides where the vaccine was injected. I think it was in the muscular and tendon area where my pain is. I can also say after my second vaccine, I got COVID arm and also had a small TIA but I did not go to the emergency room. To this day, I still have pain to my left shoulder, muscular and tendon. When I over exert myself or lift anything my pain gets worse. The pain increments and I cannot move my left shoulder and arm at all. My doctor told me to wait it out for a few days to see if the pain goes away.


Result pages: prev   449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 534 535 536 537 538 539 540 541 542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560 561 562 563 564 565 566 567 568 569 570 571 572 573 574 575 576 577 578 579 580 581 582 583 584 585 586 587 588 589 590 591 592 593 594 595 596 597 598 599 600 601 602 603 604 605 606 607 608 609 610 611 612 613 614 615 616 617 618 619 620 621 622 623 624 625 626 627 628 629 630 631 632 633 634 635 636 637 638 639 640 641 642 643 644 645 646 647   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=548&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166