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

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

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

This is page 576 out of 10,317

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VAERS ID: 1880347 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 320308D / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sprintec 28 day (OCT). All other medications stopped 5 days before vaccine per rheumatoid arthritis specialist doctors recommendation.
Current Illness: Sinus infection coupled with ear infection
Preexisting Conditions: Rheumatoid arthritis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Body aches and fever for 36+ hours. Onset of side effects took almost 11 hours post vaccine.


VAERS ID: 1880348 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-18
Onset:2021-11-16
   Days after vaccination:243
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / 2 - / -

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

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

Write-up: covid vaccine breakthrough event


VAERS ID: 1880397 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-11-10
Onset:2021-11-16
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -
TDAP: TDAP (ADACEL) / SANOFI PASTEUR - / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: have not had the rash tested yet, but planning too if it continues to spread and steroids don''t help
CDC Split Type:

Write-up: 11/16/21 6 days after receiving the J&J I woke up with an extremely itchy rash on my lower body. The itching is so unbearable that I went to a medical facility yesterday afternoon. I received 2 steroid shots there, and a steroid prescription that I was told to start the next morning which would be this morning. This morning I took 4 steroid pills. The rash is still completely unbearable and has now spread up my left side, and to both of my arms. I am still trying to decide if I need to go to the ER to be checked again, I am having Hot flashes but not a fever.


VAERS ID: 1880406 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-12
Onset:2021-11-16
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 11/17 SARS/COV-2, Positive
CDC Split Type:

Write-up: Breakthrough COVID


VAERS ID: 1880407 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330268D PFIZER / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acoustic stimulation tests, Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Covid#2
Other Medications: Wellbutrin, b vitamins, Maxzide, levothyroxine
Current Illness: None
Preexisting Conditions: CKD
Allergies: Ibuprofen
Diagnostic Lab Data: None. ENT hearing test in April after second dose? normal hearing no infection.
CDC Split Type:

Write-up: Tinnitus shortly after covid booster. Also experienced tinnitus after second vaccine on 4/2/21. Never resolved, worsened by booster.


VAERS ID: 1880422 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-17
Onset:2021-11-16
   Days after vaccination:244
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 11/17 SARS/COV-2, Positive
CDC Split Type:

Write-up: Breakthrough COVID


VAERS ID: 1880427 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fainted about 5 minutes after her vaccination. Mom called for help and nurses assisted and called 911 since child wasn''t responding. Upon the ambulance arriving patient was fully oriented, alert, and verbal. Mom and child went to the hospital for evaluation via ambulance. Patient''s HR and O2 were 48 and 88 @ 5:41 5:48 HR 79 O2 97 5:50 HR 97 O2 99 when patient left by ambulance(5:56) HR was 98 no O2 level obtained


VAERS ID: 1880432 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrodiuril- Lipitor- potassium- lisinopril- nexium- claritin
Current Illness: none
Preexisting Conditions:
Allergies: codeine- dental epinephrine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Red round large patch under vaccination- itchy. Stiffness in arm - though slight


VAERS ID: 1880443 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 4383666 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dyspnoea, Fatigue, Feeling hot, Pain, Pain in extremity, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: I felt very fatigue, sniffy nose, body felt warmer, very winded, body aches, chills, sore arm.


VAERS ID: 1880468 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-04
Onset:2021-11-16
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Appetite disorder, Back pain, COVID-19, Cough, Dyspnoea, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: arthritis, ascending aorta dilataion, atrial flutter, benign essential hypertension, chronic atrial fibrillation, malabsorption, osteoporosis, sleep apnea, stage 1 COPD, stroke acute -10/13/15
Allergies: Cats, Enalapril, trospium, Atenolol
Diagnostic Lab Data: COVID-19 PCR positive test
CDC Split Type:

Write-up: Change in appetite, congestion, cough, shortness of breath, back pain


VAERS ID: 1880470 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939909 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft, clonazepam, nortriptyline, singulair, clonodine, topamax, vyvanse, multivitamin, magnesium, turmeric, collagen protein, fiber supplements, B12, folic acid, nasicort nasal spray, fish oil, ibuprofen, Tylenol, Sudafed
Current Illness: Sinusitis
Preexisting Conditions: Depression Anxiety PTSD ADHD Hyperlipidemia Chronic sinusitis Hyperparathyroidism (corrected with recent surgery)
Allergies: Penicillin Neosporin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extremely sore arm, massive swelling of entire upper arm (not just at injection site), redness of skin around injection site, skin is hot to the touch of entire upper arm. I used telehealth treatment via Doctor?s on Demand. The doctor was able to see the redness and swelling over the video chat. The doctor stated that it was either a reaction from the vaccination or an infection, but that he did not want to wait and see which one it was. So I was prescribed antibiotics for a week plus diflucan for the yeast infection that antibiotics always cause. The doctor?s name was Aravindan Amuth. He is not my normal PCP. I did alert my PCP via portal. I have not yet picked up my prescriptions as they are not ready yet.


VAERS ID: 1880493 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-01
Onset:2021-11-16
   Days after vaccination:229
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Body temperature increased, COVID-19, Dyspnoea, Illness, Nausea, Productive cough, Pyrexia, SARS-CoV-2 test positive, Sputum discoloured
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: clopidogreL (PLAVIX) 75 mg tablet - 1 tablet (75mg) by mouth every evening for prevention of blood clot going to brain
Current Illness:
Preexisting Conditions: DVM Type 2, Anxiety, CVD, history of stroke,
Allergies: gabapentin
Diagnostic Lab Data: COVID-19 test.
CDC Split Type:

Write-up: Patient is currently hospitalized with COVID-19. Patient was diagnosed with COVID on 11/15/21 and subsequently was admitted to the hospital after an emergency room visit on 11/16/21. Admission note states: presents with complaint of cough, shortness of breath, weakness, fevers. Occasional nausea. Cough productive of yellowish sputum. She has been sick for 5 days. Reports that today is the 1st day that her temperature has been under 100. COVID-19 positive yesterday. She is vaccinated for COVID-19, but has not had booster. As of 11/18/21, patient is still hospitalized.


VAERS ID: 1880501 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chills, Consciousness fluctuating, Hyperhidrosis, Lethargy, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: The evening of my booster shot I began getting body aches and chills. That first night through the following night (a full 36 hours) I was feverish, in and out of consciousness, nauseated, in immense pain, had body aches and chills and sweat massive amounts, soaking out bed numerous times. As of around noon the 2nd day after (roughly 48hrs after injection) I feel mostly better, just lethargic and weak from such a horrible experience.


VAERS ID: 1880546 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034F21A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, fioricet, Flonase, norethindrone
Current Illness: No
Preexisting Conditions: Mixed migraines, endometriosis
Allergies: Penicillins
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe headache, swollen and painful lymph nodes in armpit.


VAERS ID: 1880571 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

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

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

Write-up: underneath arm pit its swollen.


VAERS ID: 1880582 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-10
Onset:2021-11-16
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Aphasia, COVID-19, Decreased appetite, Exposure to SARS-CoV-2, Fall, Gait disturbance, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (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:
Current Illness:
Preexisting Conditions: hypertension, HLD, BPH diet controlled DMT2, afib, goiter, thyroid nodules, diverticulosis, GERD, vitamin D3 deficienc, cardiomegaly, presbycusis, CKD, chronic anemia
Allergies: no known
Diagnostic Lab Data: COVID + 11/16/2021
CDC Split Type:

Write-up: Breakthrough COVID admitted 11/16/2021. First dose 4/19/2021. Patient fell down the night before the admission while trying to go to use the bathroom with the lights off. On the morning of admission, the sister noticed the patient was not speaking, had no appetite, and had a difficult time walking. Patient came to stay with his sister 2 days ago because son, who she (said) takes care of the patient, was recently admitted to the hospital for Covid PNA. Per sister, patient was vaccinated against COVID-19. Patient denies headache, dizziness, change in vision, numbness, fever, chills, chest pain, palpitations, SOB, nausea, vomiting, abdominal pain, dysuria, diarrhea, constipation.


VAERS ID: 1880592 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F21A / 3 LA / IM

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

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

Write-up: Patient got booster dose when immunocompromised and should have received additional full dose


VAERS ID: 1880594 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8027 / 3 RA / IM

Administered by: Public       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: Unknown
Current Illness: No
Preexisting Conditions: Takes a blood thinner
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received booster dose 13 days prior to 6 months. No adverse symptoms noted. Patient made aware of the situation via the phone after event was discovered.


VAERS ID: 1880609 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5618 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Paraesthesia, Throat irritation, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular 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:
Current Illness: none
Preexisting Conditions: none
Allergies: none known
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Vomited multiple times 5 minutes after receiving the vaccine. Also felt dizziness, tingling, and throat tickle.


VAERS ID: 1880622 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Underdose
SMQs:, 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:
Current Illness:
Preexisting Conditions: crohn''s
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received Moderna booster but has crohn''s and should have received full additional dose


VAERS ID: 1880645 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939909 / 3 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Dyspnoea, Seizure like phenomena, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Convulsions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (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: Keppra Tablet 500 MG twice per day Ferrous Sulfate Tablet 325 (65 Fe) MG daily Tamsulosin HCl Capsule 0.4 MG daily Furosemide Tablet 20 MG daily Mobic Tablet 7.5 MG (Meloxicam) every 24 hours PRN LORazepam Concentrate 2 MG/ML every 6 hou
Current Illness: currently on hospice services
Preexisting Conditions: CHF Chronic kidney disease A-Fib MI HYPERTENSION BENIGN PROSTATIC HYPERPLASIA MALIGNANT NEOPLASM OF BRONCHUS AND LUNG ANEMIA
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 11/16/21 Seizure-like activity reported by charge nurse approximately 20 minutes following Moderna booster vaccine. 11/17/21 Shortness of breath/wheezes noted by charge nurse. New orders obtained from LONG TERM CARE for Duoneb 0.5mg-3 ml every 6 hours PRN


VAERS ID: 1880717 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-11-06
Onset:2021-11-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8028 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ursodiol, Azathioprine, Alendronate, Fish Oil, Calcium, PreserVision (Areds2)
Current Illness: None
Preexisting Conditions: Autoimmune Hepatitis Type 1, Primary Biliary Cirrhosis
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I developed Bells Palsy 10 days after Pfizer booster on November 16. I received the booster on November 6th. Doctor has me on an anti-viral and steroids. I started the anti-viral on Nov. 17 and the steroids on Nov. 18, 2021


VAERS ID: 1880750 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033F21A / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Body temperature increased, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient c/o temperature of 101 the night after her vaccination. Patient also c/o of shortness of breath for 30 or 40 minutes the evening after vaccination. Patient stated symptoms resolved the following day.


VAERS ID: 1880766 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 066F21A / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Lymphadenopathy, Pain in extremity
SMQs:, 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: Lisinopril 10 MG-Hydrochlorothiazide 12.5mg
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling and soreness in armpit


VAERS ID: 1880785 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012F21A / 1 RA / IM

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

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

Write-up: Pt was inadvertently given a Moderna 0.5mL vaccine for her first dose. Pt is 16 years of age. As of 11/18/21 when this was brought to my attention, the patient had not experienced any adverse event.


VAERS ID: 1880788 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-13
Onset:2021-11-16
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: CHLAMYDIA INFECTION 5/11/21
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: COVID-19 ON 11/16/21
CDC Split Type:

Write-up: BREAKTHROUGH COVID INFECTION


VAERS ID: 1880815 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-11
Onset:2021-11-16
   Days after vaccination:250
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 01/14/2021 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: HYPERLIPIDEMIA, MIGRAINES, DEPRESSION, ANXIETY, ARTHRITIS
Allergies: CECLOR
Diagnostic Lab Data: COVID 19 NAAT ON 11/18/21
CDC Split Type:

Write-up: BREAKTHROUGH COVID INFECTION WITH MODERATE SYMPTOMS OF CONGESTION AND COUGH RECEIVED SECOND MODERNA ON 3/11/2021 LOT # 032M20A


VAERS ID: 1880845 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-24
Onset:2021-11-16
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Positive COVID19 test in ED visit 11/16/2021
CDC Split Type:

Write-up: Positive COVID19 test in ED visit 11/16/2021


VAERS ID: 1880867 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939906 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Feeding disorder, Headache, Lymphadenopathy, Muscular weakness, Pain, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Swollen glands from TDAP in 2005
Other Medications: Meloxicam about 4x per month for period pain, Vit D & Vit B12
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Brazil nut allergy
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Severe chills, fever & body pain first night, Vomiting, headache, unable to eat & severe fatigue the following day, Fatigue, muscle weakness and large swollen gland in neck on second day


VAERS ID: 1880870 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Extra dose administered, Feeling abnormal, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamictal, Isosorbide, Ezetimibe, Hydrazaline, Metoprolol, Vitamins B12, C, D, E, Zinc, Garlic, Tumeric, 81mg Aspirin
Current Illness: Diabetes type 2, hypertension, trigemenal neuralgia, sciatica, CAD, Bradycardia, sleep apnea
Preexisting Conditions: Diabetes type 2, hypertension, trigemenal neuralgia, sciatica, CAD, Bradycardia, sleep apnea
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I developed chills and fever the same night I took the Pfizer Booster. (11/16/2021). The next night, (11/17/2021), they got worse. I was shaking like a leaf on a tree. I did not take my temperature. I really felt too badly to get up and eat or drink or even find the thermometer. I took Aleve and Tylenol and Vitamin C. I felt better around 3 AM today (11/18/2021). I think I still have a bit of a chill. It''s not unbearable, like last night.


VAERS ID: 1880897 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Unknown  
Location: Tennessee  
Vaccinated:2021-11-06
Onset:2021-11-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Cardiac pacemaker insertion, Dyspnoea, Dyspnoea exertional, Electrocardiogram ambulatory abnormal, Fatigue, Presyncope
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: allopurinol, cinnamon, eliquis, ferrous fumarate, furosemide, gapapentin, Januvia, lipitor, losartan, metformin, montelukast, tamsulosin
Current Illness:
Preexisting Conditions: 1. Hypertension 2. Hyperlipidemia 3. Coronary artery disease s/p CABG 4. Type 2 diabetes mellitus with peripheral neuropathy 5. Permanent atrial fibrillation 6. CKD III 7. Ischemic cardiomyopathy 8. History of thyroid nodule 9. Chronic anemia
Allergies: codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: 84-year-old male with multiple comorbidities in ED after referral from cardiology office. on previous hospitalization, patient was noted to have an apparent 10-second pause during hospitalization and was discharged home with a Holter monitor. 11/16/2021 cardiology office and company monitoring machine called him and advised him of a 14-second pause overnight and advised him to come to the ED. He reports he felt near syncope and SOB with pause and has been significanlty more weak and fatigued 11/16/2021 with dyspnea that worsens with exertion. He denies any associated chest pain, orthopnea, PND, nausea, or diaphoresis. At present time he reports feeling fatigued but no other acute concerns. He received COVID Moderna vaccine x 3 with booster given last week. He denies any recent illness, exposure to illness, or travel. Pacemaker implanted 11/18/2021. Patient still hospitalized at home of this report. Event seems unrelated to COVID 19 vaccination. Patient has long standing history of cardiovascular disease. Report submitted as required per EUA.


VAERS ID: 1880904 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / SYR

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

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

Write-up: Itchy rash developed on chest and upper stomach soon after vaccinated. Mostly gone by morning


VAERS ID: 1880931 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

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

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

Write-up: Hive like rash.


VAERS ID: 1880932 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3302680 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Dysstasia, Fatigue, Pain, Pharyngeal swelling, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, One a Day Womens 50+, daily aspirin regimen, probiotics
Current Illness:
Preexisting Conditions: arhtritis
Allergies: allergy to sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tight/swollen throat within 15 minutes, Severe hip and lower back back within 18 hours lasting for two days, excessive fatigue within approximately 30 hours. Unable to stand completely upright for two days due to the pain even after taking 600 mg of Ibuprofen.


VAERS ID: 1880954 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Restasis eye drops, Estradiol tablets
Current Illness: none
Preexisting Conditions: Sjogren''s Syndrome, Eczema, Lichen Sclerosis
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, chills, nausea, fatigue, whole body pain.


VAERS ID: 1880967 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-11
Onset:2021-11-16
   Days after vaccination:250
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Aspartate aminotransferase increased, Blood albumin decreased, Blood bilirubin decreased, Blood calcium decreased, Blood creatinine increased, Blood urea increased, COVID-19, Chest X-ray abnormal, Cough, Dyspnoea, Haemoglobin decreased, Lung opacity, Malaise, N-terminal prohormone brain natriuretic peptide increased, Pleural effusion, Protein total decreased, Pulmonary congestion, Pyrexia, SARS-CoV-2 test positive, White blood cell count decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tumour lysis syndrome (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, aspirin, atorvastatin, bumetanide, cetirizine, clonidine, docusate, ferrous sulfate, hydralazine, Lantus, isosorbide mononitrate, levothyroxine, metoprolol tartrate, omeprazole, senna-s, sertraline, sodium bicarbonate
Current Illness:
Preexisting Conditions: OSA, CAD with stable angina pectoris, Type 2 diabetes, ESRD, anemia of chronic disease, heart failure, hyperlipidemia, hypertension, hypothyroidism, COPD
Allergies: Latex, cephalexin
Diagnostic Lab Data: 11/18/21 Pro-BNP: 45,210 BUN: 38; SCr: 4.19; Calcium: 7.8; AST: 58; total bilirubin: 0.23; total protein: 5.2; Albumin: 2.4 WBC: 2.4; HGB: 8.4 COVID-19 rapid: positive Chest X-ray: Small pleural effusions and associated lower lobe opacities. Mild vascular congestion without overt edema.
CDC Split Type:

Write-up: The patient became ill approximately 2 days prior to presentation to the ED. The patient has a new oxygen requirement of 6 L O2 by nasal cannula. The patient reports cough, shortness of breath, and fever. She is positive for COVID-19. The patient has received ceftriaxone, azithromycin, and dexamethasone. She is being admitted to the hospital.


VAERS ID: 1880999 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

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

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

Write-up: Patient started with a mild urticarial rash behind knees and back 24 hrs after covid vaccine. No respiratory symptoms described. Rx was started in Benadryl for symptoms.


VAERS ID: 1881008 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F214 / 1 RA / SYR

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

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

Write-up: I woke Tuesday morning and felt like I never went to bed the night before which I saw other people say this happened after the booster About 1 pm I decided to try to go fix something to eat I got the food ready and turned around and felt something funny next thing I knew I was waking up on the floor from passing out I knew not to get up right away so I laid there 30 min then finally got up and got my food ate. then I went back to bed and at about 4:30 I had some paperwork I need to scan and sent so this time luckily I was sitting at a desk. though I felt the same fainting coming so I laid my head down and just sat there and let it happen Wednesday I had an appointment I had to go to so I stopped by local store and grabbed a few things I got very hot in there and last I felt like I got just a little more sleep mind you I have been sleep 20hrs a day since tuesday


VAERS ID: 1881051 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Erythema, Injected limb mobility decreased, Musculoskeletal stiffness, Pain in extremity, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Arm soreness, redness, swelling, unable to raise arm above head, neck stiffness on injection site side, and anxiety. All symptoms started when she woke up 11/16/2021 @0530.


VAERS ID: 1881052 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-29
Onset:2021-11-16
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 LA / IM

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

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

Write-up: Tested positive for COVID 11/16/21 after being fully vaccinated.


VAERS ID: 1881086 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Condition aggravated, Dizziness, Dyspnoea, Fatigue, Muscle tightness, Musculoskeletal chest pain, Oropharyngeal pain, Orthostatic hypotension, Pain, Somnolence, Tension headache, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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: Hot and cold flashes, headache, mild achiness
Other Medications: Beconase, Symbicort, Telfast
Current Illness: Mild sore and dry throat suspected due to hay fever which began 3 weeks prior to vaccination (23/10).
Preexisting Conditions: Moderate-severe hayfever Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pulsating rib and chest pains, began at 10:00pm (16/11), ceased at 1:00am (17/11). Slight shortness of breath/wheezing, began at 10:00pm (16/11), ceased upon waking the next morning (17/11). Tightness in the auxillary region on L side (injection side), began at 10:00pm (16/11), ceased at 9:00pm (17/11). Lightheadedness and moderate tension headache, exacerbated by bending over, began at 9:00pm (16/11), dissipated 36 hours later (morning of 18/11) Postural hypotension, began at 9:00pm (16/11), dissipated 36 hours later (morning of 18/11) Moderate to severe fatigue began at 9:00pm (16/11), dissipated 36 hours later (morning of 18/11) Worsening of sore throat, has not resolved yet. Moderate to severe joint pain and whole body achiness began at 9:00pm (16/11), has not resolved yet. Most adverse events self-resolved. No medication was taken. Lengthy naps of 2-5 hours were taken throughout the first two days (16/11, 17/11) which I suspect made a tremendous impact on the recovery of adverse events.


VAERS ID: 1881129 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5618 / 1 RA / IM

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

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

Write-up: The child was 12 years old and Pediatric Pfizer was given


VAERS ID: 1881135 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-24
Onset:2021-11-16
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: BREAKTHROUGH INFECTION


VAERS ID: 1881163 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034F21A / 3 RA / IM

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

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

Write-up: Patient said she started itching from head to toe the evening after getting the vaccination. the itching comes and goes. There is no rash, swelling, or SOB.


VAERS ID: 1881217 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-04
Onset:2021-11-16
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 5548 / 2 RA / -

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

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

Write-up: Numbness/ pain by elbow


VAERS ID: 1881219 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-12
Onset:2021-11-16
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood culture, Blood lactic acid, C-reactive protein increased, COVID-19, Chest X-ray, Chills, Dizziness, Electrocardiogram, Fatigue, Full blood count, Headache, Hypoxia, Metabolic function test, Pain, Procalcitonin, Respiratory tract congestion, Troponin
SMQs:, Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ascorbic Acid 500mg daily Vitamin D3 1,000IU daily Vitamin B12 1,000IU daily ferrous sulfate 325mg Daily fluticasone gabapentin 300mg BID lactobacillus acidophilus daily pantoprazole 40mg daily prednisone 5mg BID Rituxan 1,000mg IV every 6
Current Illness: 3/19/2021 Possible pneumonia.
Preexisting Conditions: Obesity, hypertension, migraine, anemia, chronic low back pain, sleep-wake disorder, Interstitial lung disease, irritable bowel syndrome, dyspnea, vitamin d deficiency, Buffalo hum, polymyositis associated with autoimmune disease, thyroid colloid nodule, osteopenia.
Allergies: Augmentin - Rash Cephalexin - Hives Leflunomide - Nausea and Vomiting Levaquin - Leg pain and cramping
Diagnostic Lab Data: 11/18/2021: Lactic acid, troponin, blood cultures, procalcitonin, c-reactive protein inflammaion, cmp, CBC, Chest xray, EKG
CDC Split Type:

Write-up: Patient contracted COVID after being fully vaccinated, no booster Weakness, body aches, dizziness, chills, congestion, headache, hypoxic, fatigue.


VAERS ID: 1881263 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Keppra 1500mg/day
Current Illness: Basel cell carcinoma removed nov 3rd .
Preexisting Conditions: Brain cancer surgery 2010 and 2017 no seizures ever.
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: My left arm and leg suddenly felt like they were not there. I tried to move my leff arm but couldn?t. So i tried harder. At that time my entire body stArted pulsing like one jokt per second. ThE entire incident was about 20 or 30 seconds. When it stopped i took extra kepora and it has not recurred.


VAERS ID: 1881371 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-13
Onset:2021-11-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939903 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Back pain, Chills, Diarrhoea, Dizziness, Extra dose administered, Feeling abnormal, Headache, Interchange of vaccine products, Myalgia, Nausea, Neck pain, Oropharyngeal pain, Photophobia, Pyrexia, Respiratory tract congestion
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (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:
CDC Split Type:

Write-up: From the J&J vaccine, I never got any adverse reactions. When I got the Moderna booster shot, I developed a high fever (103-105) on said date in the form. Other symptoms that developed after were: muscle aches (particularly the hips, lower back, armpits, and the neck especially), extreme mental fog. A few hours later, with the previous symptoms persisting, I got a little sore throat (not the worst), chills, nausea, congestion, light sensitivity, light-headedness, and headaches on my forehead and behind my eyes. On 11/18/21, my fever and muscle aches have reduced and majority of my symptoms are gone. The only ones that have stayed were the sore throat, nausea, and headache. However, I developed diarrhea on this day as a new symptom. All I have done in terms of treatment was taking Tylenol and Motrin appropriately.


VAERS ID: 1882640 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051F21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: 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: None Known
Current Illness: none known
Preexisting Conditions: none known
Allergies: NKA
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: PT was given second shot to early


VAERS ID: 1882655 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051F21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: 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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2nd dose was too early


VAERS ID: 1882670 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-03-01
Onset:2021-11-16
   Days after vaccination:260
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: allopurinol, amlodipine, baby aspirin, vitamin d3, cq10, metformin, olmesartan
Current Illness:
Preexisting Conditions: HTN, NIDDM2, history of right pontine CVA 6/2020
Allergies: NKDA
Diagnostic Lab Data: COVID status positive 11/11/21 in outside facility and 11/17/21 in our facility.
CDC Split Type:

Write-up: Patient received Pfizer COVID vaccine on 2/8/21 and 3/1/21 out of state. On 11/16/21, patient admitted to our facility for acute respiratory failure with hypoxia due to COVID-19. As of today (11/18/21), patient is still admitted in our med/surg unit.


VAERS ID: 1882671 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: New York  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / UN

Administered by: School       Purchased by: ?
Symptoms: Abnormal behaviour, Fatigue, Posture abnormal, Seizure, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Dystonia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Abilify Tenex Clonidine
Current Illness: None
Preexisting Conditions: Autism
Allergies: None
Diagnostic Lab Data: Hospital exams didn''t show anything. He was referred to a neurologist and we''re still waiting to get an appointment.
CDC Split Type:

Write-up: A day after taking the vaccine, my son suddenly stopped reacting, after receiving good medication at the health room. The street described it as a seizure. He was unresponsive for 30 seconds, and his head tilted. They laid him down. After he came back he was very tired and was taken to the hospital for exams. I received this report from staff. It''s the first time we know that he had a seizure.


VAERS ID: 1882912 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-01
Onset:2021-11-16
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017F21A / 3 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Chills, Fatigue, Feeling abnormal, Feeling cold, Headache, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (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: Losartin, Cholestyramine, Amitriptyline, Qvar RediHaler , Claritin, Opcon-A , ? Culturelle Pro-well Probiotic
Current Illness:
Preexisting Conditions: high blood pressure, asthma, cancer survivor, obese
Allergies: 1. Vicodin 2. Pro-Air HFA 3. Topamax 4. Codine 5. All Penicillin 6. Lisinopril 7. Tussionex
Diagnostic Lab Data: none
CDC Split Type:

Write-up: At 10 am, felt slightly chilled, achy muscles, low grade headache. An hour later chills and aches increased and had brain fog. temp at 11 am was 98 with Tylenol. Around noon, chills, aches, headaches increased. By 6 pm symptons increased to extremely painful headache, chills, aches, tired. Around 7 pm shooting abodiminal pain for 5 hours. At 9 am my temp 99.3, then took Tylenol. By next morning symptoms subsided.


VAERS ID: 1882925 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-09
Onset:2021-11-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Chills, Extra dose administered, Fatigue, Pain, Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: high-dose influenza in 2013, age 69, difficulty breathing a few hours after receiving the vaccine.
Other Medications: Vitamin D3
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxocillin, fresh cherries, high-dose influenza vaccine
Diagnostic Lab Data:
CDC Split Type:

Write-up: 11/09/21 Received booster vaccine. By evening arm swelled slightly, was itchy, went away in about 5 days. 11/16/21 Felt fatigue, chills, achy body and abdominal cramps. Took two Naproxen that evening and the following day. Today fatigue, chills achy body are gone. However, abdominal pain still present. I have emailed my HCP today to inform her and seek advice. Side effects listed online indicate that these symptoms are normal, however, abdominal pain is rare, but listed.


VAERS ID: 1883124 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna, fever 103.9, intense localized reaction with doctors visit.
Other Medications: Prenatal vitamins
Current Illness: None
Preexisting Conditions: Endometriosis and migraines
Allergies: Nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever (100.5-101) sustained for 3 full days while on Tylenol q8. Redness and swelling at site. Nausea and vomiting. Malaise. Sneezing. Fatigue. Throbbing headache. Occasional shooting pains and soreness in joints. All symptoms sustained through today (over 72 hours post vaccine. This was Pfizer booster, had moderna for first and second dose?


VAERS ID: 1883991 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Utah  
Vaccinated:0000-00-00
Onset:2021-11-16
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, Product storage error, Product temperature excursion issue
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: USJNJFOC20211139494

Write-up: TEMPERATURE EXCURSION BETWEEN 49.82 TO 51.26 DEGREES FOR 48 HOURS; ADMINISTRATION OF VACCINE STORED OUTSIDE OF THE RECOMMENDED STORAGE CONDITION; INCORRECT PRODUCT STORAGE; This spontaneous report received from a health care professional concerned multiple patients. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 1822809 expiry: 07-MAR-2022) dose was not reported, administered on 16-NOV-2021 for prophylactic vaccination. No concomitant medications were reported. On 16-NOV-2021, the patient experienced temperature excursion between 49.82 to 51.26 degrees for 48 hours. On 16-NOV-2021, the patient experienced administration of vaccine stored outside of the recommended storage condition. On 16-NOV-2021, the patient experienced incorrect product storage. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the temperature excursion between 49.82 to 51.26 degrees for 48 hours, administration of vaccine stored outside of the recommended storage condition and incorrect product storage was not reported. This report was non-serious. This case, from the same reporter is linked to 20211139517.


VAERS ID: 1884649 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8028 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Dysphagia, Hypertension, Injection site swelling, Lymphadenopathy, Pruritus, Rash, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Swelling at Injection Site-Medium, Systemic: Allergic: Anaphylaxis-Severe, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Severe, Systemic: Allergic: Itch (specify: facial area, extremeties)-Severe, Systemic: Allergic: Itch Generalized-Severe, Systemic: Allergic: Rash (specify: facial area, extremeties)-Severe, Systemic: Hypertension-Severe, Systemic: Lymph Node Swelling-Severe


VAERS ID: 1884674 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 1 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

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


VAERS ID: 1884690 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Arthralgia, Chills, Condition aggravated, Confusional state, Coordination abnormal, Fatigue, Headache, Hyperhidrosis, Injection site pain, Lethargy, Myalgia, Nausea, Palpitations, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Ever since having been diagnosed with COVID19 twice in 2020, I have been having ongoing, relentless inflammation and joint pain, fatigue, exhaustion, headaches, confusion, depression, lack of motivation.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain at site, severe fatigue, chills, sweats, nausea, fever, headache, confusion, extreme lethargy, extreme lack of coordination, heart racing, joint pain, muscle pain full body.


VAERS ID: 1884703 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 3 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Headache, 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: ATORVASTATIN 20MG TABLET 1 PER DDAY ATENOLOL 25MG TABLET 1 PER DAY
Current Illness:
Preexisting Conditions:
Allergies: AMOXICILLIAN
Diagnostic Lab Data:
CDC Split Type:

Write-up: This was my booster and I developed a fever of 104 the evening of the day I had the booster. I took 1300 MG of Arthritis strength Tylenol but still had the fever after an hour so then I took 600 MG of Ibuprofen and the fever finally broke late evening. The next day 17Nov21 I had a massive headache and was achy but my fever was gone.


VAERS ID: 1884892 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-11-13
Onset:2021-11-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8028 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Globulin abnormal, Lymphocyte count increased, Platelet count increased, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: mild penicillin allergy (rash)
Diagnostic Lab Data: See above. The tests were performed on the evening of Tuesday, November 16th. I was seen at Hospital and Urgent Care
CDC Split Type:

Write-up: My doctor''s office told me to go to urgent care for chest tightening /pain. At urgent care my white blood cells, platelets and lympocytes all tested abnormally high. I am an extremely healthy person with no health conditions and my "numbers" from all my blood tests in the past are consistently stellar. I have the readings of several years on record. Most recent blood work (prior to incident) was done in Feb. 2021. I still have chest pain. Urgent care told me I had to go to the emergency room. They did additional tests. Those tests did look better except for my globulin which was out of the healhty range (very slightly). It has never been out of range. I was allowed to go home after 6 hours of hospital/urgent care testing. I still have chest pain.


VAERS ID: 1884901 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Chills, Lethargy, Musculoskeletal stiffness, Pain
SMQs:, Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (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: Overall body ache, chills, stiff neck, lower back pain, lethargic feeling for the entire day.


VAERS ID: 1885008 (history)  
Form: Version 2.0  
Age: 8.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-12
Onset:2021-11-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Oropharyngeal pain, Otitis media acute
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: - Sore throat - Non-recurrent acute suppurative otitis media of right ear without spontaneous rupture of tympanic membrane


VAERS ID: 1885022 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-14
Onset:2021-11-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Pain in extremity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra D, estrace
Current Illness: none
Preexisting Conditions: allergies, arthritis
Allergies: sulfa, codeine, aspirin, ceftin, torodol
Diagnostic Lab Data:
CDC Split Type:

Write-up: sore arm onset 12 hrs lasting about 12 hours headache onset 12 hours lasting about 36 hours 12 cm x 8 cm red itchy dermatitis onset 48 hours still lasting 4 days later slight improvement


VAERS ID: 1885026 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211D21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear infection, Erythema, Tinnitus
SMQs:, Anaphylactic reaction (broad), Hearing impairment (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: Penicillin
Diagnostic Lab Data: Doctor examined both ears, looked in right ear and noticed that it was very red almost infected.
CDC Split Type:

Write-up: Major Tinnitus in right ear. Minor Tinnitus in left ear Doctor prescribed antibiotic and gave a asteroid shot. 24 hours later the symptoms still exist.


VAERS ID: 1885028 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Headache, Muscular weakness, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme muscle pain; fatigue; headaches; loss of appetite; muscle weakness; body aches.


VAERS ID: 1885030 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-28
Onset:2021-11-16
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cerebellar stroke, Magnetic resonance imaging head
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow)

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

Write-up: MRI Brain done on 11/16/21 that showed subacute cerebellar stroke. Patient asymptomatic. Done for hx of migraine with aura, incidental finding.


VAERS ID: 1885031 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-15
Onset:2021-11-16
   Days after vaccination:246
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Diarrhoea, Dyspnoea, Pyrexia, Respiratory symptom, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: unknown
Preexisting Conditions: CHF, Tobacco use, anxiety, COPD, CKD, PVD, Diabetes, HTN
Allergies: NKA
Diagnostic Lab Data: COVID+
CDC Split Type:

Write-up: CHIEF COMPLAINT: SOB prior dx of covid with treatment, loose stools HISTORY OF PRESENT ILLNESS: PT is a 69 Years old Male with PMH of HTN, HLD, DM II, CAD s/p AICD, AFib on Eliquis s/p PPM, CHF, CKD, COPD not on home oxygen, nicotine dependence, and obesity who presents to the ED with progressive dyspnea and continued diarrhea in the setting of known COVID-19. Patient tested positive for COVID-19 on 11/12/2021. Patient is approximately on day 9 of symptoms. Initially, he had upper respiratory symptoms with rhinorrhea, cough, congestion, and fevers, but these have resolved. He states that he had has continued dyspnea. No chest pain. He has profuse diarrhea. No abdominal pain, nausea, or vomiting. Patient is vaccinated for COVID-19. He received monoclonal antibodies 2 days ago. He is not on oxygen at baseline. He has a pulse oximetry device at home.


VAERS ID: 1885117 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 32030BD / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D 5,000 iu Levothyroxine 75mcg
Current Illness:
Preexisting Conditions:
Allergies: dust
Diagnostic Lab Data:
CDC Split Type:

Write-up: Large, painful swollen lymph nodes on the side of my body that got the injection beginning the evening of the vaccine and continuing. Noticeably large in the area of my collar bone and armpit.


VAERS ID: 1885142 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-19
Onset:2021-11-16
   Days after vaccination:242
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Hypoxia, Mental disorder, Pyrexia, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Type 2 diabetes, hypertension
Allergies:
Diagnostic Lab Data: COVID PCR Positive on 11/18/21
CDC Split Type:

Write-up: COVID Breakthrough. Patient had some altered mental status and fever starting on 11/16/21. He presented to the ED on 11/18/21 with hypoxia and tested positive on 11/18/21.


VAERS ID: 1885151 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-07
Onset:2021-11-16
   Days after vaccination:193
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 11/18 SARS/COV-2, NAAT, Positive
CDC Split Type:

Write-up: Breakthrough COVID


VAERS ID: 1885167 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032F21N / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Decreased appetite, Facial discomfort, Fatigue, Headache, Hyperhidrosis, Nausea, Neck pain, Pain, Pain in jaw, Photophobia, Pyrexia, Rash pruritic, Sinus disorder
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Osteonecrosis (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Folic acid and methotrexate once per week with 5 tabs taken orally
Current Illness: None
Preexisting Conditions: Diagnosed with Scleroderma
Allergies: Sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Awoke the day after receiving the shot with chattering teeth chills, feverish 101.5 temp, aching all over, extreme headache, light sensitivity, my face felt like it would explode, sinuses were full and jaw ached and was nauseous. The next day I was better but still had light sensitivity and neck and head pain, no appetite and a bit nauseous. Went to bed that night and woke up drenched in sweat. The next morning my lower back was cover in an itchy rash but otherwise felt alot better. Tired easily that day.


VAERS ID: 1885173 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Headache, Hypersensitivity, Pain, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline, kelnor, multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Examined by pcp-allergic reaction
CDC Split Type:

Write-up: Fevers, body aches, severe joint pain, headaches, full body burning hives.


VAERS ID: 1885207 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Neck pain, Pain
SMQs:, Retroperitoneal fibrosis (broad), Arthritis (broad)

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

Write-up: Body Aches, Pain, Pain In Neck and Back lasting 3 days.


VAERS ID: 1885230 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-10
Onset:2021-11-16
   Days after vaccination:251
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Respiratory distress, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bumex, Zyloprim, Lipitor, Cardizem, Apresoline, Synthroid, Magnesium
Current Illness:
Preexisting Conditions: Type 2 DM, HTN, HLD, AKI, GERD
Allergies: None
Diagnostic Lab Data: SARS-CoV-2 by NAA; micro positive for SARs on 11/16/2021.
CDC Split Type:

Write-up: Patient received Moderna vaccines on 03/10/2021 and 04/07/2021. Patient presented to the ED on 11/02/2021 with complaints of respiratory distress. Patient found to be COVID-19 positive.


VAERS ID: 1885246 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-07
Onset:2021-11-16
   Days after vaccination:254
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Hypoxia, 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), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zyloprim, eliquis, lipitor, triphrocaps, tums, lantus, humalog, synthroid, mag-oxide, lopressor, ergocalciferol
Current Illness:
Preexisting Conditions: CKD, DM, HTN, CHF, morbid obesity
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received Moderna Vaccines on 03/07/21 and 04/03/21. While hospitalized, pt began experiencing fever, SOB, and hypoxia. Pt was tested for COVID, which came back positive.


VAERS ID: 1885261 (history)  
Form: Version 2.0  
Age: 6.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), 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:
Other Medications: No information given
Current Illness: No information given
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient passed-out and fell on the floor right after receiving the vaccine in the pharmacy. He regained consciousness shortly after without any intervention. We contacted 911 but refused further medication intervention. Patient monitored for 30 minutes and was able to walk out of the pharmacy.


VAERS ID: 1885268 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 069F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Limb injury, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Arthritis (broad)

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

Write-up: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-


VAERS ID: 1885397 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish oil, Flonase, vit-D, magonate
Current Illness: none
Preexisting Conditions: none
Allergies: Epinephrine, racemic amphetamine, fish derived products
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash on hands and neck area. Pt complained of itching/burning sensation


VAERS ID: 1885404 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-15
Onset:2021-11-16
   Days after vaccination:62
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Dyspnoea, Electrocardiogram, Electrocardiogram ambulatory, Extrasystoles, Fatigue, Palpitations
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Insect venom
Diagnostic Lab Data: EKG 10/08/2021. EKG 10/22/2021. Wearing of heart monitor 10/29/2021 to 11/12/2021. Heart rate varied from 46 bpm to 176 bpm. Average heart rate was 78 bpm. Event monitor mostly normal except for rare ectopic beats. Echocardiogram ordered for 11/30/2021. Follow-up visit with cardiologist 12/07/2021.
CDC Split Type:

Write-up: Adverse reaction: Heart palpitations; tightness in chest; difficulty breathing; lightheadedness from "attacks" with heavy breathing; shortness of breath when doing simple tasks and exhaustion. Treatment: No formal treatment prescribed other than rest. Outcome: Awaiting further testing for a formal diagnosis.


VAERS ID: 1885469 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-18
Onset:2021-11-16
   Days after vaccination:243
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: norvasc, lipitor, plavix, apreesoline, synthroid, cozaar, effexor, advair
Current Illness:
Preexisting Conditions: COPD, CAD, GERD, HLD, HTN, CVA, obstructive sleep apnea
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received pfizer vaccine on 03/18/21 and 04/08/21. While inpatient, pt tested positive for COVID. CXR showed developing COVID pneumonia.


VAERS ID: 1885499 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Oral mucosal blistering, Pain in extremity
SMQs:, Severe cutaneous adverse reactions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: 70, pounding heart, hard to breathe, chest pain
Other Medications: 0
Current Illness: 0
Preexisting Conditions: Heart disease Coratid Artery disease
Allergies: 0
Diagnostic Lab Data:
CDC Split Type:

Write-up: Very sore underarm and in mouth blisters


VAERS ID: 1885521 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-05
Onset:2021-11-16
   Days after vaccination:256
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dyspnoea, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol Succinate 25 MG Tablet Extended Release 24 Hour 1/2 tablet Orally Once a day Isosorbide Mononitrate ER 30 MG Tablet Extended Release 24 Hour 0.5 tablet Orally Once a day Clopidogrel Bisulfate 75 MG Tablet 1 tablet Orally On
Current Illness:
Preexisting Conditions: ASCVD, a) CABG times 5/19/96, b) PCI/stent to SVG-PDA 2012. CVA 2019 (right basal ganglia), residual cognitive impairment. Carotid stenosis, left CEA. Hypertension. Hyperlipidemia. Impaired fasting glucose. Anxiety. History of adenomatous colonic polyps. Glaucoma. Lumbar degenerative disc disease. Benign prostatic hyperplasia.
Allergies: Amoxicillin: upset stomach - Side Effects Cipro: skipped heartbeat; - Allergy Niacin: felt flushed; - Side Effects PENICILLIN DRUGS: unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: cough, congestion, family has noticed some shortness of breath but patient reports he doesnt notice being short of breath. starting 11/16/21


VAERS ID: 1885571 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-07
Onset:2021-11-16
   Days after vaccination:193
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Headache, Nasal congestion, Sinus congestion, Upper-airway cough syndrome
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ?GABA ?Naproxen 500 MG Tablet Delayed Release 1 tablet as needed Orally every 12 hrs ?Omeprazole 40 MG Capsule Delayed Release 2 tablets Orally Once a day ?Tylenol 325 MG Tablet 1 tablet as needed Orally every 4 hrs ?Vitamin D
Current Illness: none
Preexisting Conditions: Hypertension. Endometriosis. History of HSV (buttocks). History of adenomatous colon polyps. Obesity. Sleep apnea-mild (pt stopped CPAP). Major depression-in remission. Generalized anxiety disorder since menopause. Chronic cough- full work up done. Gabapentin seems to help. Gastric ulcer 7/2016. Recheck endoscopy showed it was healed. Mild/mod mitral valve regurg 12/16. Irregularity along anterior surface of tracheal rings on laryngoscopy 1/17. Will be having voice therapy and possible recheck. bilateral knee/hip DJD (had it replacements). Microscopic hematuria 11/17, one time only. repeat normal. Hx of myocarditis and paroxysmal Afib (hosp 12/2019). Followed by cardiology. On losartan low dose and metoprolol for rate control. Cardiologist gave her the option of novel anticoagulant, which she declined and prefers to take only Aspirin 81mg.
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, nasal congestion, sinus congestion, post nasal drainage. Patient denies sore throat, worsening cough, fever, chills, body aches, loss of taste, loss of smell, ear pain, nausea, vomiting, diarrhea, shortness of breath, chest pain. starting 11/17/21


VAERS ID: 1885623 (history)  
Form: Version 2.0  
Age: 8.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-11-12
Onset:2021-11-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blister, Erythema, Hypotonia, Tenderness
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 4 days later noticed an area of small blisters that are now flaccid, linear redness, no crusting that you would see in herpes and no dermatomal appearance like in shingles, tender but not itchy


VAERS ID: 1885693 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Diarrhoea, Headache, Hypersensitivity, Nausea, Pain, Physical examination, Pyrexia, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fevers, body aches, severe joint pain, headaches, nausea, vomiting, diarrhea, head to toe burning hives. Prior report incomplete. See Report


VAERS ID: 1885802 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-11-03
Onset:2021-11-16
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939904 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Albumin globulin ratio, Anion gap decreased, Anticoagulant therapy, Aspartate aminotransferase normal, Basophil count normal, Basophil percentage increased, Blood albumin decreased, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium decreased, Blood chloride increased, Blood creatinine increased, Blood glucose normal, Blood potassium normal, Blood sodium normal, Blood urea normal, Carbon dioxide decreased, Deep vein thrombosis, Differential white blood cell count normal, Eosinophil count normal, Eosinophil percentage, Full blood count, Globulin, Glomerular filtration rate decreased, Haematocrit normal, Haemoglobin decreased, Immature granulocyte count, Lymphocyte count, Lymphocyte percentage, Mean cell haemoglobin concentration decreased, Mean cell haemoglobin increased, Mean cell volume increased, Metabolic function test, Monocyte count, Monocyte percentage increased, Neutrophil count, Neutrophil percentage, Platelet count normal, Protein total normal, Red blood cell count decreased, Red blood cell nucleated morphology, Red cell distribution width normal, Ultrasound Doppler abnormal, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Haematopoietic erythropenia (narrow), Haemorrhage laboratory terms (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Tumour lysis syndrome (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: oxybutynin 5 MG Tb24 Xylitol 550 MG Disk folic acid 1 MG Tab trazodone 150 MG Tabs citalopram 20 MG Tabs omeprazole 20 MG Cpdr Glucos-Chond-Hyal Ac-Ca Fructo (MOVE FREE JOINT HEALTH ADVANCE OR) Free Text Medication Entry (OTHER) vitamin d3
Current Illness: None
Preexisting Conditions: Anemia
Allergies: None
Diagnostic Lab Data: Labs: O CBC WITH DIFF Collection Time: 11/16/21 3:20 PM Result Value Ref Range WBC 5.65 4.00 - 12.00 K/uL RBC 4.21 (L) 4.50 - 6.00 mil/uL Hgb 13.5 (L) 14.0 - 18.0 g/dL Hct 44.6 40 - 54 % MCV 105.9 (H) 80 - 98 fL MCH 32.1 27 - 33 pg MCHC 30.3 (L) 32 - 37 g/dL RDW 12.1 11.5 - 15.0 % Plt 163 150 - 450 K/uL Differential type Automated Abs neuts 3.40 1.80 - 7.80 K/uL Abs immature grans 0.01 0.00 - 0.07 K/uL Abs lymphs 1.51 0.80 - 3.30 K/uL Abs monos 0.51 0.10 - 1.00 K/uL Abs eos 0.15 0.00 - 0.40 K/uL Abs basos 0.07 0.00 - 0.20 K/uL Abs NRBCs 0.00 0.00 K/uL Neuts 60.2 % Immature grans 0.2 0.0 - 0.9 % Lymphs 26.7 % Monos 9.0 % Eos 2.7 % Basos 1.2 % NRBC 0.0 0.0 % Plt estimate Adequate RBC morphology Reviewed O COMPREHENSIVE METABOLIC PANEL Collection Time: 11/16/21 3:20 PM Result Value Ref Range Na 136 135 - 145 mmol/L K 4.7 3.6 - 5.3 mmol/L Cl 107 98 - 109 mmol/L CO2 22 21 - 32 mmol/L Anion gap w/o K 7 7 - 15 BUN 20 8 - 24 mg/dL Creatinine 1.57 (H) 0.7 - 1.5 mg/dL GFR non African Amer 44 (L) $g59 mL/min GFR African American 53 (L) $g59 mL/min Glucose 97 65 - 120 mg/dL SGOT/AST 26 5 - 40 IU/L Alk Phos 77 38 - 126 IU/L SGPT/ALT 31 6 - 60 IU/L Bilirubin total 0.3 0.2 - 1.4 mg/dL Protein 6.6 6.1 - 7.8 g/dL Albumin 3.2 3.2 - 5.0 g/dL Globulin (calc) 3.4 2.0 - 4.5 g/dL A:G Ratio 0.9 (L) $g1.0 Calcium 8.7 8.5 - 10.5 mg/dL
CDC Split Type:

Write-up: O VAS DUPLEX VENOUS LWR EXT RIGHT. Acute deep venous thrombosis right gastrocnemius and peroneal veins. Current treatment is Rivaroxaban 15 & 20 MG Tablet Therapy Pack.


VAERS ID: 1885861 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-05
Onset:2021-11-16
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039F21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Erythema, Loss of consciousness, Peripheral swelling, Rash, Rash macular, Rash pruritic, Rhinorrhoea, Scratch, Swelling, Swelling face, Urticaria
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro, zyrtec
Current Illness:
Preexisting Conditions: General Anxiety Disorder
Allergies: Latex, oxycodone
Diagnostic Lab Data: None so far
CDC Split Type:

Write-up: On Tuesday 11/16, in the evening, face swelling, nose running, itchy red spots appeared on arms and legs. Wednesday 11/17, woke up approx 4:30 AM with swollen/reddish hands and upper arms, hives on upper legs/hips, waist, below and above armpits. Went to dr in mid morning. Got rx for prednisone and was told to keep taking Zyrtec and Benadryl and bought calamine spray and cortisone cream and ice gel packs. Hives continued to fade and reappear and spread up sides. Hives became more prominent after scratching and could see scratch ?lines?. Thursday 11/18, no change in hives/swelling. I got dizzy and light headed and passed out in the afternoon. EMTs came and said it was prob a combination of prednisone, too much Benadryl, too many clothes, nor enough water. Hives in my side continued to be really bad and covered most of my torso. Friday 11/19, hives moving up to upper body and back. Dermatologist and pcp say wait it out. Friday PM hand swelling starting to go down. **side note, another working theory is this may be an allergic reaction to fabric softener. We''ve rehashed everything that was possibly washed with it and so far no acute reaction to any clothes/sheets/towels.


VAERS ID: 1885871 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018F21A / 3 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023M20 / 2 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan 12.5mg
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: Codeine, sulpha drugs, morphine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Dose 3/Booster?..side effects were severe chills, aches, nausea, headaches?.much like a severe, common flu.


VAERS ID: 1885941 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 087C21A / 3 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Chills, Cough, Fatigue, Headache, Pain
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Tachyarrhythmia terms, nonspecific (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: Zoloff
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: fatigue, headache, cough, sore, tired, chills, heart fluttering strong heartbeat


VAERS ID: 1885974 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032F21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia, Headache, Injection site rash, Injection site swelling, Lymphadenopathy, Mobility decreased, Pain in extremity, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: Undifferentiated Autoimmune Disease; Hashimotos Thyroiditis; Hyperparathyroidism; High Cholesterol; Osteoporosis; Vulvadynia; Polycythemia
Allergies: Reglan
Diagnostic Lab Data:
CDC Split Type:

Write-up: Two episodes of fainting night of 11/16/21; Fever with chills, began 11/15 and lasted 3 days; headache began 11/15, lasted 3 days; swollen lymph nodes throughout body, began 11/15; Rash and swelling around injection site extending entire outside of upper arm with arm pain to the point of being unable to use arm, which began night of 11/15; metallic taste in mouth, began 11/15


VAERS ID: 1886183 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Magnetic resonance imaging heart, Myocarditis
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None but patient had positive covid infection on 8/16/2021
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data: Cardiac MRI shows myocarditis
CDC Split Type:

Write-up: chest pain and shortness of breath for 2 days after 1st dose of Moderna Vaccine


VAERS ID: 1886452 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-11-12
Onset:2021-11-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Abdominal pain upper, Headache
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Kids'' probiotics & gummy vitamins
Current Illness: Congestion from seasonal allergies
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Stomach ache and headache on 11/16/2021 and 11/17/2021


VAERS ID: 1886756 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 077C21B / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Injection site pruritus, Rash, Somnolence
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan; Chlorthalidon; Metoprolol ER; Prolia; Xiidra; Vit. D3; Biotin; Turmeric/Curumin
Current Illness: Pre-hypertension; Sjorgrens
Preexisting Conditions: SAA
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day 1 - Pain in joints, Drowsy; Day 2 - Pain in joints, rash on forearms, Day 3 - Pain dissipated, rash continued, Day 4 - Rash on forearms and injection site began to itch.


VAERS ID: 1886881 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Hypoaesthesia, Hypoaesthesia oral, Oropharyngeal pain, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (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: Januvia, Setlakin, Fish Oil, Vitamin D3
Current Illness: None
Preexisting Conditions: Prediabetes
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain and tightness in chest and throat starting about 7-8 minutes after infection. Facial and lip numbness starting about 25 minutes after injection. Pain in chest and throat lasted hours into the night until I fell asleep. Woke up the next day with zero symptoms.


VAERS ID: 1887450 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Chills, Headache, Hyperhidrosis, Injection site pain, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy, Myalgia, Nausea, Palpitations
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: COVID-19 Vaccine dose 1 (10/26/2021), Meningitis Shot about 15 years ago
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: UNKNOWN
Diagnostic Lab Data:
CDC Split Type:

Write-up: Joint/Muscle pain, fever (48 hours), chills (started within an hour of receiving the vaccine, ongoing), nausea (comes and goes), swelling at injection site (immediate onset, ongoing), itching at injection site (immediate onset, ongoing), burning sensation at the injection site (immediate onset, stopped within 24 hours of receiving second dose), swollen painful lymph nodes (right armpit and base of neck on the right side, ongoing), palpitations (started at about 9:00PM 11/18/2021 and lasted about 12 hours), sweating (onset and length of duration same as palpitations), severe sudden headaches that come and go in waves (started at about 9-10PM 11/16/2021, ongoing), feeling of pressure on chest (onset and length of duration same as palpitations and sweating)


VAERS ID: 1887454 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-11-16
Onset:2021-11-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Fatigue, Headache, Muscular weakness, Myalgia, Nausea, Pyrexia, Rhinorrhoea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Multivitamin, Pepcid, Vitamin C and D
Current Illness: None
Preexisting Conditions: GERD
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Fatigue; headache; muscle aches; weakness; fever, chills; nausea; vomiting; cough/runny nose.


VAERS ID: 1887657 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Utah  
Vaccinated:0000-00-00
Onset:2021-11-16
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855191 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, Product temperature excursion issue
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211143086

Write-up: 45 TOTAL VIALS INVOLVED IN TEMPERATURE EXCURSION; ADMINISTRATION OF EXPIRED VACCINE; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1855191 and expiry: 11/APR/2022) dose was not reported, administered on 16-NOV-2021 for prophylactic vaccination. No concomitant medications were reported. On 16-NOV-2021, the patient experienced administration of expired vaccine. On an unspecified date, the patient experienced 45 total vials involved in temperature excursion. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the administration of expired vaccine and 45 total vials involved in temperature excursion was not reported. This report was non-serious. This case, from the same reporter is linked to 20211143090 and 20211139494.


VAERS ID: 1887658 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Utah  
Vaccinated:0000-00-00
Onset:2021-11-16
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855194 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, Product temperature excursion issue
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211143090

Write-up: 45 TOTAL VIALS INVOLVED IN TEMPERATURE EXCURSION; ADMINISTRATION OF EXPIRED VACCINE; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1855194 expiry: 09-APR-2021) dose was not reported, administered on 16-NOV-2021 for prophylactic vaccination. No concomitant medications were reported. On 16-NOV-2021, the patient experienced administration of expired vaccine. On an unspecified date, the patient experienced 45 total vials involved in temperature excursion. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the administration of expired vaccine and 45 total vials involved in temperature excursion was not reported. This report was non-serious. This case, from the same reporter is linked to 20211143086 and 20211139494.


VAERS ID: 1887880 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-15
Onset:2021-11-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site bruising, Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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: Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: Patient stated her arm was warm and had a bump at the injection site.her arm was then numb for monday and tuesday and was feeling better on wednesday.She said today it felt better but it was not 100%


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