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

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



Case Details (Reverse Sorted by Onset Date)

This is page 59 out of 5,069

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VAERS ID: 1457620 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-01
Onset:2021-07-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Extraocular muscle paresis, Facial paralysis, Facial paresis, Hypoaesthesia, Ophthalmoplegia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Ocular motility disorders (narrow), Immune-mediated/autoimmune 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: nonr
Current Illness: none
Preexisting Conditions: none
Allergies: Fluconazole
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient states reporting numbness, weakness, with paralysis to the left side of the face and left eye. He states he first noticed his left eye not closing and drooping of the mouth when brushing his teeth on 07/03/2021. Patient was seen by a provider and was palced on medication and diagnosed with Bells Palsy.


VAERS ID: 1457885 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-06-01
Onset:2021-07-03
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstrual disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Ibuprofen
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Change in menstrual cycles (extremely heavy periods for extended amount of time)


VAERS ID: 1458114 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-02
Onset:2021-07-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

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

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

Write-up: Tinnitus began spontaneously in the left ear 18 hours post-vaccination, followed by tinnitus in the right ear 12 hours later. Tinnitus is high pitched and constant. Symptoms have persisted without change. No associated ear pain, dizziness, headache or systemic symptoms. No prior history of tinnitus, no environmental risk (eg, loud noises) and no predisposing medical conditions.


VAERS ID: 1458122 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-30
Onset:2021-07-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B218 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Patient said swelling is still there like bee sting, feeling warm. no pain no fever


VAERS ID: 1458375 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-06-30
Onset:2021-07-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PAA165969 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Cardiac flutter, Dizziness, Fatigue, Head injury, Headache, Nausea, Syncope, Vertigo
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Day 1 fatigue and dizzy Day 2 nauseous and dizzy. Extremely tired heart fluttering. Day 3 headache. Dizzy. Vertigo. Nausea. Got up from a chair and fainted. Boyfriend shaking me woke me up. I got off the ground and immediately fainted again. Smacked my head on the garage floor both times. Day 4 So tired I can?t keep my eyes open. Heart is fluttering and punchy. Fatigue is unreal. Vertigo is debilitating. Day 5 same as above. Almost passed out in shower. Day 6 same as above Day 7 severe stomach ache after eating dinner. Had to lay down to avoid vomiting. Dizzy and vertigo so bad I?m holding on to walls to walk. Day 8 (Today) I?m so fatI


VAERS ID: 1458609 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-02
Onset:2021-07-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Hypoaesthesia, Mobility decreased, Nodule, Pain in extremity, Skin warm, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, montelask, prenatal vitamin
Current Illness: N/a
Preexisting Conditions: Asthma
Allergies: Augmentin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm is sore, cannot lift above head, golf ball sized knot, red welt the size of a softball, warm to the touch, numbness, has lasted now almost a week


VAERS ID: 1459454 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-07-03
Onset:2021-07-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Dizziness, Injection site pain, Nausea, Syncope, Tremor, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (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), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Site: Pain at Injection Site-Mild, Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Nausea-Medium, Systemic: Shakiness-Mild


VAERS ID: 1459724 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-30
Onset:2021-07-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 RA / IM

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

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

Write-up: Soars that looks like big mosquito bites located on the upper part of hands, elbows, knees and legs


VAERS ID: 1460011 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-31
Onset:2021-07-03
   Days after vaccination:94
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Fatigue, Influenza A virus test, Influenza B virus test, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Sensipar, Pepcid, Cellcept, Deltason, Demadex
Current Illness:
Preexisting Conditions: major depression, stage 3a kidney disease, status post kidney transplant, hyperlipidemia, chronic back pain
Allergies: codeine, hydrocodone-acetaminophen, sevelamer, tomato
Diagnostic Lab Data: SARS-CoV-2 and influenza AB antigens, POC positive for SARS on 7/3/21
CDC Split Type:

Write-up: Pt received Moderna vaccines on 3/31/21 and 4/28/21. Pt presented to the ED with complaints of diffused fatigue and fever. On 7/3/21 pt was found to be COVID-19 positive.


VAERS ID: 1460143 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-17
Onset:2021-07-03
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Fatigue, Nasal congestion, Nucleic acid test, 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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: SARS-CoV-2 RdRp Resp Ql NAA+probe~COVID-19 rapid diagnostic test (nucleic acid amplification test NAAT); positive
CDC Split Type:

Write-up: Started symptoms on 7/3, nasal congestion and fatigue


VAERS ID: 1460158 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-06-30
Onset:2021-07-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Adenovirus test, Blood thyroid stimulating hormone normal, Blood triglycerides normal, Cardiac imaging procedure abnormal, Chest discomfort, Chest pain, Coxsackie virus test negative, Cytomegalovirus test negative, Echocardiogram, Ejection fraction, Electrocardiogram ST segment elevation, Epstein-Barr virus test negative, Herpes simplex test negative, Magnetic resonance imaging heart, Myocarditis, Prohormone brain natriuretic peptide increased, Thyroxine free normal, Troponin increased
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Troponins peaked at 14 . Negative HSV, EBV, Coxsackie, CMV, adenovirus. TSH, free T4, triglycerides wnl. Pro-BNP elevated to 224. Cardiac MRI: IMPRESSION: 1. Subepicardial delayed gadolinium enhancement of the left ventricular inferolateral wall which is characteristic of myocarditis. 2. Normal size and function of the left ventricle. LVEF = 56%.
CDC Split Type:

Write-up: COVID vaccine-associated myocarditis. 3 days after his second Pfizer COVID vaccine, pt presented for chest pain and pressure. Troponin was initially elevated to 4.2, EKG showed ST elevations in lateral leads. Over the course of his stay, troponin dropped, then rose to peak of 14, then dropped again. He was treated with Naproxen 500 mg BID and Pepcid 20 mg BID for gastroprotection. As chest pain resolved, troponins improved, and EKGs improved. Echo and Cardiac MRI were done.


VAERS ID: 1460229 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-22
Onset:2021-07-03
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Hydrosalpinx, Laboratory test normal, Nausea, Ovarian cyst, Ovarian mass, Ultrasound pelvis abnormal, Urine analysis, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ferrous Gluconate; probiotic
Current Illness: No
Preexisting Conditions: No
Allergies: Aspirin; ibuprofen; Ceptra; Macrodantin
Diagnostic Lab Data: ER - Ultrasound; Urinalyses - negative ; bloodwork - everything was normal in bloodwork and I had no fever. Just pelvic exam at OB/GYN exam - there is a mass on ovaries - was able to feel it on the exam. Will repeat the Ultrasound in six to 8 weeks.
CDC Split Type: vsafe

Write-up: I had pretty extreme abdominal pain with vomiting. They did a pelvic ultrasound at ER - complex ovarian cyst and fluid in Fallopian tube. Zofran for nausea and two weeks of Doxycycline. And they had me follow up with OB/GYN which I did yesterday. The vomiting has resolved. I still have abdominal pain - but it''s not as severe as it was on the 3rd of July.


VAERS ID: 1460331 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-02
Onset:2021-07-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chills, Discomfort, Fatigue, Feeding disorder, Lymphadenopathy, Musculoskeletal stiffness, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Burning with fever, shivering, 101 degree fever, lyphnodes in arm, size of small mushroom, very uncomfortable , stiff arm, lypnodes in neck swollen, stiff neck, extremely pain, painful back (feels like sunburn), couldn''t eat or drink for 3 days, threw up water. Symptoms lasted for 3 days. Back pain, swollen lympnodes, stiff arm and neck still ongoing. Doctor made a house call, prescribed tylonol and ibopropin. Ongoing fatique.


VAERS ID: 1460338 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-02
Onset:2021-07-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / UN

Administered by: Private       Purchased by: ?
Symptoms: Injection site swelling, Injection site vesicles, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none known at the moment
Diagnostic Lab Data: none. We just visited a doctor
CDC Split Type:

Write-up: Rash that covers her whole body, more prominent in hands and feet. Swollen shot area that looks blistery, about 3 inches big..


VAERS ID: 1460388 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-02
Onset:2021-07-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Condition aggravated, Sleep disorder
SMQs:, 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: Metformin, tramadol, levoxothyrine
Current Illness: none, however since the vaccine was given I have not been able to sleep more than 45 minutes during the night. My hip pain has only since the vaccine.
Preexisting Conditions: hip pain from bursitis in both hips, cyatica on right side, cronic lower back pain
Allergies: flu vaccine, pollen, grass
Diagnostic Lab Data: I tried to get in to see my doctor but was unable to see get an appointment. So no tests have been done.
CDC Split Type:

Write-up: Since my injection my hip pain at night us such that I cannot sleep more than 45 minutes at a time. Since I got the vaccine I have not slept more than 3 hours a night or in a 24 hour period. Yesterday July 8, 2021 was the first time I have slept for six hours during the night.


VAERS ID: 1461685 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-03
Onset:2021-07-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Altered state of consciousness, Cold sweat, Dizziness, Hyperhidrosis, Laboratory test normal, Syncope
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), Cardiomyopathy (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: No illnesses at time of vaccination
Preexisting Conditions: No long-standing health conditions
Allergies: No Allergies
Diagnostic Lab Data: Lab tests normal.
CDC Split Type:

Write-up: Patient had syncope. Became dizzy and fell in and out of consciousness. Began perspiring and became clammy. Breathing was normal. Patient fully recovered after emergency room visit.


VAERS ID: 1461719 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-03
Onset:2021-07-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose normal, Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: Losartan, hydrochloride , metformin
Current Illness: None, my sugar is well controlled as well as blood pressure , I?m a very active person . I do have non alcoholic fatty liver . No meds to take diet and exercise are working .
Preexisting Conditions: Type 2 diabetic well controlled .
Allergies: Tylenol
Diagnostic Lab Data:
CDC Split Type:

Write-up: After receiving my first shot , within 5 minutes my feet was numb and tingling . This lasted for 5 hours I kept checking my sugar and blood pressure every hour . They were fine . I?m waiting to hear back from my doctor as this is not a listed side affect but I have read about many others having these issues .


VAERS ID: 1461890 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-02
Onset:2021-07-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 - / IM

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

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

Write-up: Rash on legs


VAERS ID: 1461967 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-01
Onset:2021-07-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / SYR

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

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

Write-up: Rash on tops of hands that hurts. Dr thinks contact dermatitis so she prescribed topical steroid cream.


VAERS ID: 1462040 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-03
Onset:2021-07-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / 1 LA / IM

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

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

Write-up: Redness, swelling, itching lasting 7 days


VAERS ID: 1462046 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-03
Onset:2021-07-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction, Cardiac arrest, Cardiogenic shock, Coronary artery occlusion
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (narrow), Anaphylactic reaction (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: carvedilol lisinopril atenolol gabapentin buspirone ferrous sulfate pantoprazole rivaraoxaban penteramine alprazolam cetirizine
Current Illness: - PE - CAD - GERD - Anxiety - Hypertension - Chronic hepatitis C - Factor V Leiden carrier - Substance use disorder
Preexisting Conditions: - PE - CAD - GERD - Anxiety - Hypertension - Chronic hepatitis C - Factor V Leiden carrier - Substance use disorder
Allergies: ibuprofen imitrex maxalt
Diagnostic Lab Data: the usual for STEMI and shock
CDC Split Type:

Write-up: Driving home (passenger) she suffered a cardiac arrest. Was found to have a total occlusion of her right coronary artery and an inferior ST elevation myocardial infarction and cardiogenic shock


VAERS ID: 1462148 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-30
Onset:2021-07-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Contusion
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (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: Irregular bruising


VAERS ID: 1462169 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-06-05
Onset:2021-07-03
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0187 / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Herpes zoster, Ophthalmic herpes zoster
SMQs:, Ocular infections (narrow), Opportunistic infections (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: Enalapril Rosuvastatin
Current Illness: None
Preexisting Conditions: High blood pressure Chlorestrol
Allergies: None
Diagnostic Lab Data: 07/08/2021. Office visit to Dr.
CDC Split Type:

Write-up: Herpes Zoster ophthalmicus


VAERS ID: 1462174 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-19
Onset:2021-07-03
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Migraine, Musculoskeletal discomfort, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sumatriptan on occasion, armour thyroid 90mg, multivitamin
Current Illness:
Preexisting Conditions: Multiple chemical sensitivity
Allergies: methylergonovine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Exactly two weeks after my first dose I got really dizzy and started spinning. It?s been one week and I?m still really dizzy. I also had a migraine for 5 days. I?m still having issues withy neck.


VAERS ID: 1462185 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-02
Onset:2021-07-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Activated partial thromboplastin time normal, Angiogram, Antineutrophil cytoplasmic antibody negative, Beta-2 glycoprotein antibody, Blood immunoglobulin G normal, Computerised tomogram head normal, Electrocardiogram normal, Full blood count normal, Gait disturbance, Headache, Hypoaesthesia, Impaired work ability, Injection site pain, International normalised ratio normal, Metabolic function test normal, Oedema, Pain in extremity, Paraesthesia, Prothrombin time normal, Thrombin-antithrombin III complex normal, Ultrasound Doppler, Urine analysis normal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: On July 6th I went to Emergency Room. Lab tests Completed: 1. Activated partial thromboplastin time 2. Complete Blood Count 3. Comprehensive metabolic panel 4. HcG qualitive, urine 5. Prothrombin time with INR 6. Urinalysis with microscopic reflex culture Lab Tests in Progress: 1. Anti-neutrophillic cytoplasm antibody 2. Antithrombin III activity 3. Beta 2 glycoprotien 1 antibodies, IGG,IGM,IGA 4. Complement, total 5. DNA antibody, double-stranded 6. Prothrombin 20210A mutation analysis Imaging Tests: 1. CT angio Head wo and/or w Contrast 2. CT Angio Neck wo and or w contrast 3. CT head wo contrast 4. ECG 12 lead 5. Vascular US duplex lower extremity venous righ ER Doctor said all test came back normal and that he didn''t have an answer as to what''s causing the sudden numbness. My discharge papers say Diagnoses: 1. Edema, unspecified type 2. Paresthesia of right lower extremity
CDC Split Type:

Write-up: I received my first vaccine dose on Friday July 2nd. I had a sore arm where it was injection and headache like they told me I would. Saturday July 3rd when I was on my way to work, my lower legs both felt very sore, very similar to how my arm felt. Sunday July 4th, I took my 2 year old twins for a walk at the lake. On our way back to the car, I suddenly started walking funny and it felt like I was dragging my right foot. When I got to the car, I went to rub my foot and noticed my entire right foot was numb along with half of my lower right leg. The feeling was similar to what happens when your foot or leg falls asleep. Come Tueaday July 6th my foot and leg were still numb. I work full time and I''m constantly on my feet and it was getting hard and uncomfortable to walk. After work I called my doctors office and they told me to call emergency services since the numbness came on suddenly. I didn''t call emergency services but did go to the ER where they ran a bunch of tests.


VAERS ID: 1463022 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-03
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VASCEPA; FENOFIBRATE
Current Illness: LDL (take Vascepa and Fenofibrate to help try to control LDL); Triglycerides (Take Vascepa and Fenofibrate to help try to control Triglycerides.)
Preexisting Conditions: Comments: Normally in good health
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210713929

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION /ANOTHER VARIANT; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. The patient''s concurrent conditions included ldl (low density lipoprotein), and triglycerides, and other pre-existing medical conditions included normally in good health. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported)at a frequency of 1 total, dose was not reported, administered on 21-MAY-2021 for prophylactic vaccination. Concomitant medications included eicosapentaenoic acid ethyl ester for ldl, and triglycerides, and fenofibrate for ldl, and triglycerides. On 03-JUL-2021, the subject experienced suspected clinical vaccination failure and suspected covid-19 infection / another variant. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from suspected covid-19 infection / other variant, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: 20210713929-covid-19 vaccine ad26.cov2.s-Suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1463060 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-03
Onset:2021-07-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA B04021A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure measurement, Dyspnoea, Feeling abnormal, Hypersensitivity, Pharyngeal swelling, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: VITAMIN B1 [THIAMINE]
Current Illness:
Preexisting Conditions: Comments: NO medical history was reported by reporter.
Allergies:
Diagnostic Lab Data: Test Date: 20210703; Test Name: Blood pressure; Result Unstructured Data: Blood pressure 147 high
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Allergic Reaction; Tongue and throat swelled; Tongue and throat swelled; Feeling odd; Shortness of breath/not breathing as normal; This spontaneous case was reported by a patient and describes the occurrence of HYPERSENSITIVITY (Allergic Reaction), SWOLLEN TONGUE (Tongue and throat swelled) and PHARYNGEAL SWELLING (Tongue and throat swelled) in a 52-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. B04021A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. NO medical history was reported by reporter. Concomitant products included THIAMINE (VITAMIN B1 [THIAMINE]) for an unknown indication. On 03-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Jul-2021, the patient experienced HYPERSENSITIVITY (Allergic Reaction) (seriousness criterion hospitalization), SWOLLEN TONGUE (Tongue and throat swelled) (seriousness criterion hospitalization) and PHARYNGEAL SWELLING (Tongue and throat swelled) (seriousness criterion hospitalization). On an unknown date, the patient experienced FEELING ABNORMAL (Feeling odd) and DYSPNOEA (Shortness of breath/not breathing as normal). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at an unspecified dose and frequency. At the time of the report, HYPERSENSITIVITY (Allergic Reaction), SWOLLEN TONGUE (Tongue and throat swelled), PHARYNGEAL SWELLING (Tongue and throat swelled) and FEELING ABNORMAL (Feeling odd) outcome was unknown and DYSPNOEA (Shortness of breath/not breathing as normal) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 03-Jul-2021, Blood pressure measurement: 147 (High) Blood pressure 147 high. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Patient was suffered with Shortness of breath , feeling better. patient doesn''t have a main doctor but provides information of the hospital and Doctor that treat his allergic reaction after taking the vaccine, gives consent to safety follow up. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1463076 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-01
Onset:2021-07-03
   Days after vaccination:63
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Artery dissection, Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Couple of medications
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Had a heart attack due to a tear in artery.


VAERS ID: 1463529 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-26
Onset:2021-07-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Full blood count, Lymphadenopathy, Metabolic function test
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: Face to face visit with primary care on 7/8/21. Chest X-ray, CBC and CMP on 7/10/21
CDC Split Type:

Write-up: Right axillary lymphadenopathy


VAERS ID: 1463763 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-02
Onset:2021-07-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dehydration, Diarrhoea, Electrolyte imbalance, Malaise, White blood cell count normal
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Dehydration (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: none
Current Illness: none
Preexisting Conditions: old age
Allergies: unknown, allergy to cats and dogs
Diagnostic Lab Data: about 14 test were done, we do not have the results other than the verbal info from the doctor that electrolytes were on the low side as result of 7 days of Diarrhea and white blood cell count was normal, indicating no other infections beside the vaccine reaction.
CDC Split Type:

Write-up: around 24 hours after receiving the second dose my wife became ill with Diarrhea which progressed to severe Diarrhea ever few minutes for hours at a time. This became progressively worse and since we are uninsured we trusted it would go away after a few days. After 7 days ( the maximum duration we saw on the internet for this side effect) things were not better and we visited the ER Doctor noted my wife was dehydrated and he ran blood tests Plus gave her 1 liter of Sodium Chloride, Ibuprofen and Simethicone and Aceminphen. He noted there was not much else he could do and we needed to be patient for things to get better plus gave advice on food ( which we already tried) AS of right now Sunday night 7/11/2021 my wife still has severe Diarrhea , no real improvement over the last 5 days.


VAERS ID: 1463916 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-06-02
Onset:2021-07-03
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anti-thyroid antibody, Anti-thyroid antibody negative, Blood thyroid stimulating hormone, Hypothyroidism, Thyroxine decreased, Thyroxine free decreased, Tri-iodothyronine normal
SMQs:, Hypothyroidism (narrow), Hyperthyroidism (broad), Immune-mediated/autoimmune 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: dextro-amphetamine ER fluoxetine
Current Illness:
Preexisting Conditions: ADHD, autism
Allergies:
Diagnostic Lab Data: TSH 415, T4 <0.3, free T4 <0.1, T3 41, free T3 134, anti thyroglobulin Ab (-), anti thyroidperoxidase Ab (-)
CDC Split Type:

Write-up: patient presented with profound hypothyroidism within weeks of second COVID vaccine


VAERS ID: 1463993 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-01
Onset:2021-07-03
   Days after vaccination:63
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Skin discolouration
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (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: Birth control: Drosperinone 3mg
Current Illness: High-grade squamous lesions in cervix - LEEP/cone biopsy on 4/29/21
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Symptoms: Significant bruising on bilateral legs and Left arm, dark red/purple spots on Left knee present 2 months after receiving vaccine. No physical activity, unexplainable bruising


VAERS ID: 1464045 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-02
Onset:2021-07-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Bedridden, Fatigue, Headache, Loss of personal independence in daily activities, Mobility decreased, Nausea
SMQs:, Acute pancreatitis (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: flu vaccine makes me sick age 72, 73 , 74
Other Medications: Atenolol 25mg
Current Illness: none
Preexisting Conditions: none
Allergies: statins, antivert, meloxicam, aspercreme anesthesia
Diagnostic Lab Data: none
CDC Split Type:

Write-up: July 3 -I was completely bedridden , weak, and nauseous, -I had a piercing headache --I took migraine medication which did not help and ibuprophen for pain- July 4, I was better and able to function, headache went away in the morning-- , July 5th I was so tired I could not get up or do anything and had piercing headache took ibuprophen- -July 6th I was too tired to do anything and had piercing headache took ibuprofen-- July 6 - 11 I was better but very tired and still had headache took ibuprofen every day-- Today I am better and the headache is much less but I am very tired all the time.


VAERS ID: 1464088 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-02
Onset:2021-07-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Body temperature increased, Illness, Impaired work ability, Oropharyngeal pain, SARS-CoV-2 test negative, Upper respiratory tract infection
SMQs:, Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3; Aller-Tec; Rosuvastatin; Calcium; Pantoprazole; Levothyroxine.
Current Illness: None.
Preexisting Conditions: Thyroid issues; Intradural cystic neoplasm on my pancreas.
Allergies: Indomethacin; Darvon.
Diagnostic Lab Data: I was tested for COVID and the test results came back negative and I was later diagnosed with an upper respiratory infection. I was not prescribed any meds but he did tell me to take ibuprofen and drinks lots of fluids and get lots of rest.
CDC Split Type: vsafe

Write-up: July 3, 2021 I woke with 102 degree temperature and then I was sick throughout the week and on Tuesday, July 6, 2021, I called sick for work and on Wednesday, July 7th, 2021 I went into work and got sent home and sent to the doctors. I was tested for COVID and the test results came back negative and I was later diagnosed with an upper respiratory infection. I was not prescribed any meds but he did tell me to take ibuprofen and drinks lots of fluids and get lots of rest. I started to feel better July 8, 2021 but I still had a slight sour throat on Friday July 9, 2021, and was able to return to work. I finally feel normal.


VAERS ID: 1464132 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-03
Onset:2021-07-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

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

Write-up: headache for 9 days


VAERS ID: 1464203 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-01
Onset:2021-07-03
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test negative, 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: Ibuprofen
Current Illness: NO
Preexisting Conditions: NO
Allergies: UK
Diagnostic Lab Data: At home test positive rapid antigen invalid PCR positive
CDC Split Type:

Write-up: became symptomatic, home test positive, rapid antigen invalid, PCR positive.


VAERS ID: 1464215 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-07
Onset:2021-07-03
   Days after vaccination:87
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 LA / IM

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

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

Write-up: became symptomatic 07/03, at home test positive, rapid antigen invalid, PCR inconclusive


VAERS ID: 1464225 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-29
Onset:2021-07-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dry skin, Pruritus, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Dry skin reaction all over the body. Itching and peeling of the skin. This symptom lasted for a week.


VAERS ID: 1464482 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-05-28
Onset:2021-07-03
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Chills, Cough, Dyspnoea, Electrocardiogram normal, Hypoaesthesia, Influenza like illness, Influenza virus test negative, Myalgia, Nasal congestion, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Neosporin
Diagnostic Lab Data: Flu test negative Covid test negative Chest X-ray clear EKG normal
CDC Split Type:

Write-up: Flu like symptoms. Stuffy nose, cough, shortness of breath, muscle aches, chills. Numbness in the whole right arm from shoulder to fingertips.


VAERS ID: 1464489 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-31
Onset:2021-07-03
   Days after vaccination:94
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Blood culture, Blood lactic acid, COVID-19, Chest X-ray, Cough, Differential white blood cell count, Dyspnoea, Electrocardiogram, Fatigue, Full blood count, International normalised ratio, Metabolic function test, Prothrombin time, Pyrexia, SARS-CoV-2 test positive, Urine analysis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: citalopram (CeleXA) 10 mg tablet doxycycline (VIBRAMYCIN) 100 mg capsule hydroCHLOROthiazide (HYDRODIURIL) 25 mg tablet lovastatin (MEVACOR) 10 mg tablet nystatin-triamcinolone (MYCOLOG II) cream predniSONE (DELTASONE) 5 mg tablet promethaz
Current Illness:
Preexisting Conditions:
Allergies: Aspirin
Diagnostic Lab Data: Updated Procedure 07/10/21 1713 POCT COVID-19 PCR Collected: 07/10/21 1713 | Final result | Specimen: Swab from Nares POC COVID-19 PCR DetectedAbnormal Lot # 1000266367 Point of Care COVID-19 PCR Testing Method Cepheid Lot Expiration Date 5.15.2022 Patient Care Timeline (7/11/2021 00:00 to 7/12/2021 16:48:05) 7/12/2021 Event Details User 15:12 Patient arrived in ED 15:12:23 Emergency encounter created 15:12:53 Patient (adult) arrived in ED 15:12:53 Arrival Complaint weakness 15:26:16 Patient roomed in ED To room AA334 , RN 15:31:22 Orders Placed Sepsis Communication: Patient undergoing SIRS/sepsis screening ; Vital signs Q30M - While in ED , DO 15:31:23 Lab Ordered URINALYSIS, CULTURE IF INDICATED, BLOOD CULTURE, PROTIME-INR, APTT, CBC AND DIFFERENTIAL, LACTIC ACID, PLASMA, COMPREHENSIVE METABOLIC PANEL , DO 15:31:23 XR Ordered XR CHEST 2 VW , DO 15:31:23 Imaging Exam Ordered , DO 15:31:23 ECG Ordered ECG 12-LEAD: HOSPITAL OR TEST FACILITY , DO 15:31:23 Orders Placed Vital signs Q2H x 2, then Q4H x 48H, then per unit policy - Perform additional vital signs PRN if concern for deterioration, For non-ICU admissions ; Notify provider: Specify: For further fluid orders after bolus fluids completed ; Notify provider: Temperature less than: 96; Systolic blood pressure less than: 90; MAP less than: 65; SpO2 less than: 90; Specify: Or lactate level greater than 4 mmol/L following fluid resuscitation - notify attending provider., Notify for temper... ; Strict intake and output ; Comprehensive metabolic panel - Repeat STAT ; Lactic acid - STAT ; CBC and differential - Repeat STAT ; APTT - Repeat STAT ; Protime-INR - Repeat STAT ; Blood culture ; Urinalysis, Culture if Indicated - Urine, Clean Catch ; Chest X-Ray, 2 Views, PA and Lateral ; ECG 12-lead: HOSPITAL or TEST FACILITY Once Chest pain , DO 15:31:28 Orders Completed Sepsis Communication: Patient undergoing SIRS/sepsis screening , DO 15:31:29 Lab Ordered URINALYSIS CULTURE IF INDICATED, CHEMICAL DIPSTICK , DO 15:31:29 Lab Ordered CBC WITH AUTO DIFFERENTIAL , DO 15:35:15 XR Ordered XR CHEST 1 VW 15:35:15 Imaging Exam Ordered 15:35:15 Orders Discontinued Chest X-Ray, 2 Views, PA and Lateral (07/12/21 1531) 15:35:15 Orders Modified Order Modified - X-ray chest 1 view, Portable (Comment: Modified from Chest X-Ray, 2 Views, PA and Lateral) , DO 15:36:53 Assign Resident DO assigned as Resident , MD 15:36:59 Assign Physician , MD 15:38 Vitals Assessment , RN 15:38 Vitals Assessment , RN 15:38 Vitals Reassessment Vitals Timer Restart Vitals Timer: Yes Restart Vitals Timer: Yes , RN 15:38 Other Flowsheet Documentation Vitals Resp: 20 Other flowsheet entries BP: 121/50Abnormal Temperature: 36.9 ?C (98.4 ?F) Temp Source: Oral Heart Rate: 68 SpO2: 84 %Abnormal Weight: 84.5 kg (186 lb 4.6 oz) Weight Method: Bed Scale Change in Weight (%): 0.00 S/F Ratio: 400 Oxygen Therapy: None (Room air) , RN 15:38:28 Assign Attending , DO assigned as Attending, DO 15:38:28 Assign Physician , DO 15:39:18 Height/Weight , RN 15:39:18 Temperature Reassessment Temperature Reassessed , RN 15:39:18 PMH NOT REVIEWED , RN 15:45 Collect APTT - Repeat STAT Completed APTT - Repeat STAT - Type: Blood ; Source: Blood, Venous , RN 15:45 Collect Blood culture Completed Type: Blood ; Source: Blood, Venous Blood culture ; Blood culture , RN 15:45 Collect CBC auto differential - Once Completed CBC auto differential - Once - Type: Blood ; Source: Blood, Venous , RN 15:45 Collect Comprehensive metabolic panel - Repeat STAT Completed Comprehensive metabolic panel - Repeat STAT - Type: Blood ; Source: Blood, Venous , RN 15:45 Collect Lactic acid - STAT Completed Lactic acid - STAT - Type: Blood ; Source: Blood, Venous , RN 15:45 Collect Protime-INR - Repeat STAT Completed Protime-INR - Repeat STAT - Type: Blood ; Source: Blood, Venous , RN 15:45:21 Print Label for APTT - Repeat STAT Completed APTT - Repeat STAT - Type: Blood ; Source: Blood, Venous , RN 15:45:21 Print Label for Blood culture Completed Blood culture - Type: Blood ; Source: Blood, Venous ,RN 15:45:21 Print Label for CBC auto differential - Once Completed CBC auto differential - Once - Type: Blood ; Source: Blood, Venous , RN 15:45:21 Print Label for Comprehensive metabolic panel - Repeat STAT Completed Comprehensive metabolic panel - Repeat STAT - Type: Blood ; Source: Blood, Venous , RN 15:45:21 Print Label for Lactic acid - STAT Completed Lactic acid - STAT - Type: Blood ; Source: Blood, Venous , RN 15:45:21 Print Label for Protime-INR - Repeat STAT Completed Protime-INR - Repeat STAT - Type: Blood ; Source: Blood, Venous , RN 15:45:29 Specimens Collected Comprehensive metabolic panel - Repeat STAT - ID: 21YH-193C3060 Type: Blood , RN 15:45:35 Specimens Collected Lactic acid - STAT - ID: 21YH-193C3059 Type: Blood , RN 15:45:36 Specimens Collected APTT - Repeat STAT - ID: 21YH-193G0483 Type: Blood Protime-INR - Repeat STAT - ID: 21YH-193G0483 Type: Blood CBC auto differential - Once - ID: 21YH-193H1164 Type: Blood , RN 15:45:37 Specimens Collected Blood culture - ID: 21YH-193M0431 Type: Blood , RN 15:45:44 Print Label for Blood culture Completed Blood culture - Type: Blood ; Source: Blood, Venous , RN 15:45:48 Specimens Collected Blood culture - ID: 21YH-193M0433 Type: Blood , RN 15:47 Peripheral IV 07/12/21 1547 20 G Right Antecubital Placed Placement Date/Time: 07/12/21 1547 Size (Gauge): 20 G Orientation: Right Location: Antecubital Site Prep: Chlorhexidine , RN 15:47:34 Orders Acknowledged New - Sepsis Communication: Patient undergoing SIRS/sepsis screening ; Vital signs Q30M - While in ED ; Vital signs Q2H x 2, then Q4H x 48H, then per unit policy - Perform additional vital signs PRN if concern for deterioration, For non-ICU admissions ; Notify provider: Specify: For further fluid orders after bolus fluids completed ; Notify provider: Temperature less than: 96; Systolic blood pressure less than: 90; MAP less than: 65; SpO2 less than: 90; Specify: Or lactate level greater than 4 mmol/L following fluid resuscitation - notify attending provider., Notify for temper... ; Strict intake and output ; Comprehensive metabolic panel - Repeat STAT ; Lactic acid - STAT ; CBC and differential - Repeat STAT ; APTT - Repeat STAT ; Protime-INR - Repeat STAT ; Blood culture ; Urinalysis, Culture if Indicated - Urine, Clean Catch ; Chest X-Ray, 2 Views, PA and Lateral ; ECG 12-lead: HOSPITAL or TEST FACILITY Once Chest pain ; Modified - X-ray chest 1 view, Portable (Comment: Modified from Chest X-Ray, 2 Views, PA and Lateral) , RN 15:47:45 Peripheral IV 07/12/21 1547 20 G Right Antecubital Assessment IV Assessment: Within Defined Limits Infiltration Score: 0 Phlebitis Score: 0 Site Assessment: Clean; Dry; Intact Dressing Status: Dry; Intact; Clean Line Status: Blood return noted; Flushed Dressing Type: Transparent , RN
CDC Split Type:

Write-up: COUGH, FEVER, FATIGUE, SHORTNESS OF BREATHE


VAERS ID: 1464563 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-07-03
Onset:2021-07-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

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

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

Write-up: Patient fainted and fell on the ground about 10 minutes after the vaccine was administered. We called the ambulance and they came 10 minutes later and checked his vitals. Patient did not leave on the ambulance.


VAERS ID: 1464764 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-02
Onset:2021-07-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Heart rate increased, Scalloped tongue
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypertension (narrow), Dehydration (broad)

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

Write-up: Elevated heart rate and blood pressure going on 10 days. Blood pressure is 136/85. Heart rate is 103 resting, 153 after exercise. Scalloped tongue starting on 7/12. Tounge has never appeared this way prior to vaccine.


VAERS ID: 1466243 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-07-03
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210703; Test Name: COVID-19; Result Unstructured Data: POSITIVE
CDC Split Type: USJNJFOC20210718648

Write-up: CONFIRMED CLINICAL VACCINATION FAILURE; CONFIRMED COVID-19 INFECTION; This spontaneous report received from a consumer via a company representative concerned a 42 year old male of unspecified race and ethnicity. 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, intramuscular, batch number: Unknown, expiry: Unknown) dose was not reported, 1 total, administered on 13-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. It was reported that the patient became aware of loss of smell and tested positive on 03-JUL-2021 (confirmed covid-19 infection and confirmed clinical vaccination failure). Laboratory data included: COVID-19 (NR: not provided) POSITIVE. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the confirmed covid-19 infection and confirmed clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This case, from the same reporter is linked to 20210720833.; Sender''s Comments: V0: 20210718648-COVID-19 VACCINE Ad26.COV2.S- confirmed clinical vaccination failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1466536 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-07
Onset:2021-07-03
   Days after vaccination:87
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Respiratory failure, 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), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen, Biotin, bupropion, calcium carb-cholecalciferol, capsaicin 0.025% cream, ferrous sulfate, fexofenadine, fluticasone, gabapentin, lactobacillus rhamnousus, levothyroxine, lidocaine foot cream, multivitamin, nicotine gum, olanz
Current Illness:
Preexisting Conditions: Heart failure with preserved ejection fraction, hx of adenocarcinoma of colon, anemia, B-12 deficiency, depression, hx of DVT, factor V deficiency, fibromyalgia, hyperlipidemia, hypothyroidism, neuropathy/peripheral neuropathy, hx of PE.
Allergies: Sulfa antibiotics
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received both doses of the Moderna COVID-19 vaccine (on 3/1/2021 and 4/7/2021). She subsequently developed COVID, testing positive via PCR on 7/3/2021 and was admitted to our hospital on 7/3/2021. She was never ill enough to be in the ICU, instead staying in the general med/surg COVID unit until she was discharged on 7/7/2021. Her primary discharge diagnosis was "COVID-19 pneumonia with mild hypoxemic respiratory failure".


VAERS ID: 1466617 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-02
Onset:2021-07-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diplopia, Loss of personal independence in daily activities, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Ocular motility disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 6/4/2021 5:00PM Pfizer EW0182 @ Tiffin Walmart Pharmacy
Other Medications: vitamin D, Vitamin C,
Current Illness:
Preexisting Conditions: diabetes
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 6/4/2021 5:00PM first dose Pfizer EW0182, the second day (6/5/2021) morning, eyes see objects were very blurry, and double images for a whole day, cannot do anything that day, then it seemed okay. (6/6/2021 morning is ok, recovered). The second dose at 7/2/2021 5:00PM Pfizer EW0181 , and the next day until now (already 10 days) , see things blurry and double images. but the blurry degree is less than the first time (6/5/2021)


VAERS ID: 1466759 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-04
Onset:2021-07-03
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram head normal, Dysarthria, Dysphagia, Facial pain, Facial paralysis, Ophthalmoplegia
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), Ocular motility disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 3 Blood Pressure Medications Humalog, Lantus, Metformin Statins Oxybutynin
Current Illness: None
Preexisting Conditions: COVID-19 disease dx 1-28-2021 passive antibodies on 1-30-2021 Hypertension Diabetes Mellitus
Allergies: Morphine
Diagnostic Lab Data: CT scan of head 7-3-2021
CDC Split Type:

Write-up: On 7-3-2021 the client was at a gathering. Friends noted that her left face was drooping and her words slurred. She has a history of stroke in the family. She went immediately to ER . Her CT of the head was normal. Consultation with OSU neurologist on 7-3-21 by teleconference dx Bell''s palsy. the client has had no improvement of sx. Today she is reporting continued pain in the left side of her face that feels like" a bad sinus infection and toothache at the same time". Her words remain slurred and left side of face paralyzed, Left eye unable to close on own, difficulty swallowing.


VAERS ID: 1466766 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-22
Onset:2021-07-03
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Burning sensation, Constipation, Headache, Hypoaesthesia, Lumbar puncture, Magnetic resonance imaging, Paraesthesia, Peripheral coldness, Pyrexia, Urinary retention, Vision blurred
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal 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:
Allergies:
Diagnostic Lab Data: Various tests including lumbar puncture and MRI?s
CDC Split Type:

Write-up: 14 days after the injection developed severe headache and fever. Went to ER. More symptoms developed: Severe Numbness from the waste down Severe pins and needles sensation from the waste down Severe Burning sensation from the waste down Severe coldness on feet that has moved up past ankles Unable to urinate Unable to have a bowel moment Blurry vision


VAERS ID: 1466919 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-02
Onset:2021-07-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

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

Write-up: Moderate diarrhea on and off beginning 2 days after 2nd dose of vaccination.


VAERS ID: 1466932 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-02
Onset:2021-07-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test normal, Computerised tomogram normal, Electrocardiogram normal, Fatigue, Gait disturbance, Hypoaesthesia, Pain in extremity, Paraesthesia, Pruritus, Rash, Rash pruritic, Sensory loss, Ultrasound Doppler normal
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet compounded medication hydrocortisone (HYTONE) 1 % cream hydrOXYzine (VISTARIL) 25 MG capsule ibuprofen (MOTRIN) 600 MG tablet naproxen (NAPROSYN) 500 MG tablet predniSONE (DELTASONE) 10 MG tablet predni
Current Illness: NA
Preexisting Conditions: tobacco use
Allergies: Norco
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Patient calling for Acute COVID-19 Vaccine and NUMBNESS. Vaccine given Friday - Symptoms started Sunday. Symptoms include: Patient received her Covid vaccine on Friday in her right arm. Saturday morning, her right leg also felt sore. Sunday morning, she says that her right foot and the right side of lower leg, from about halfway down from her leg to her foot she started to experiencing numbness. She says it came on suddenly. She is still experiencing the numb feeling and says that it makes it difficult to walk. Per Patient Report: On Friday I received my first vaccine dose. On Sunday, Less than 48 hours later, I suddenly lost sensation/feeling in my right foot and half of my lower right leg. I still haven''t gained feeling back so I called the nurse line yesterday. They recommended I call 911. I decided to drive myself to ER. They ran a bunch of blood work, did an EKG, an ultrasound of my leg and did CT scan. All findings were normal with no explanation of what could could''ve caused the sudden numbness. The ER doctor said I needed to follow up with primary. My discharge papers said unexplained paresthesia. Went to ED again on 7/12/21 for rash. History of Present Illness Patient is a 36-year-old female, who presents to the emergency department complaining of pruritus for the last few hours. Past medical history is significant for otherwise healthy female. Patient states that she thinks she is having an allergic reaction she has itching all over her body. Patient states she did try some Benadryl cream without any relief. She expresses that the primary itching area is her torso. She expresses that this began while she was at work earlier today. She denies any new detergents, soaps, lotions, or changes in oral intake. She denies any known exposures. She does express that she got her Covid vaccine over 5 days ago and she did have some described paresthesias of her right lower extremity. She expresses that she was evaluated for this and that it comes and goes. She denies any trauma or injuries. She denies any further systemic symptoms at this time including fevers, chills, cough, congestion, difficulty swallowing describing appropriate tolerance of her secretions, denies difficulty breathing, chest pain, abdominal pain, nausea, vomiting, change in bowel bladder habits, episodes of incontinence, or any other concerns. And Urgent Care visit 7.13.21 - HPI: This is a 36-year-old female who presents to urgent care for evaluation of itchy rash to her torso. Rash started yesterday. She believes this is an allergic reaction to the COVID-19 vaccine which she received on 07/02. She states that she has been having a myriad abnormal symptoms including right leg numbness, fatigue, and this itchy rash. This is the 3rd time she has been evaluated for this. She tells me she had a full work up on 7/6 and was told everything was normal and then was seen in ER yesterday when the rash started and started on benadryl, prednisone, and Pepcid. She has been taking the Benadryl without much relief, but hasn''t yet taken her other medications. She denies any new or worsening numbness/tingling to her foot. She states she does get some pain in the foot when working and standing for long periods of time. She has an appointment to establish with primary care on Thursday. She denies any new exposures, lotions, soaps, or detergents.


VAERS ID: 1467318 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-01
Onset:2021-07-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Hypoaesthesia, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: Intregra plus Garden of Life Woman Multivitamin Garden of Life Vitamin C Garden of Life Vitamin D Glucosamine Chondroitin MSM
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa Products Latex Cashews Pistachios
Diagnostic Lab Data: Awaiting blood results requested by Dr. to explore autoimmune diseases.
CDC Split Type:

Write-up: Left side of body (the side of the body of the injection site) numbness, pain, and tingling on my Face, Arm, Neck, back, foot and leg. These symptoms have been present every day since the injection 7-3-2021 to current (7-13-2021)


VAERS ID: 1467538 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-07-01
Onset:2021-07-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Fatigue, Hyperhidrosis, Musculoskeletal discomfort, Painful respiration, Renal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Hypoglycaemia (broad)

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

Write-up: discomfort in left shoulder blade area. pain in taking breath in back. tiredness, sweats, and discomfort in both kidney areas.


VAERS ID: 1467541 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-27
Onset:2021-07-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Back pain, Burning sensation, Crying, Decreased appetite, Gastrooesophageal reflux disease, Muscle spasms, Muscle twitching, Nausea, Pain, Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (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: Daily take Melatonin and Ellura.
Current Illness: None
Preexisting Conditions: None
Allergies: Lactose Intolerance
Diagnostic Lab Data: (Pending / Scheduling)
CDC Split Type:

Write-up: Burning pains everywhere that come and go at random, sometimes lasts days. Neurological. First day of "adverse event" was July 3rd, but the night before I had thrown up but felt fine. On July 3rd, had first time bad Acid Reflux, took OTC Prilosec which helped over the course of a few days. Someone suggested trying Claritin for the random burning, but it does not help. Strong back pain. Random bouts of nausea (trying not to throw up to avoid Acid Reflux again). Difficulty eating and drinking as a result of symptoms. Sleeping a lot more than usual. Weak in general. A few days ago started to feel better, still kept diet specific to avoiding Acid Reflux. Overnight, horrible burning in limbs and random parts of body came back. Slept and napped for about 18 hours yesterday as burning was ongoing. Can sleep through pain. Pain is instant upon waking up. Sometimes (like right now as I write this) burning is tolerable, sometimes it is unbearable and crying hurts too. Muscle spasms and twitching occasionally, sometimes in frequent in a session. Primary doctor agrees that all of these symptoms are from the vaccine.


VAERS ID: 1468189 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-07-02
Onset:2021-07-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin (300mg, everyday); Sertraline (25mg, every other day); Ajovy (225mg, 1 shot once a month)
Current Illness: None
Preexisting Conditions: ADHD, depression, anxiety
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness. I''m dizzy, when I am moving or using my computer or just doing nothing. Lips and hands go numb. It kind of just comes out of nowhere. The most recent was when I was eating (all things I know I am not allergic to) and my lips just went numb. Before that, my hands went numb, and I have not pin-pointed why.


VAERS ID: 1468206 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-03
Onset:2021-07-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

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

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

Write-up: 1st dose pfizer vaccine was given to patient on 07/03/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window.


VAERS ID: 1468207 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-03
Onset:2021-07-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 RA / IM

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

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

Write-up: 1st dose pfizer vaccine was given to patient on 07/03/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window.


VAERS ID: 1468363 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-07-03
Onset:2021-07-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Discomfort, Headache, Tinnitus
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Finasteride, 1mg daily
Current Illness:
Preexisting Conditions: Asthma GERD Removed Gallbladder in February 2021
Allergies: Penicillin, Ceclor, Suprax, Zithromax, Ceftin
Diagnostic Lab Data: Went to hospital -was basically ignored over the tinnitus Referred to cardiologist specialty for cheat pain
CDC Split Type:

Write-up: Constant, roaring, and very loud tinnitus-mostly in right ear, but definitely in both ears Headaches and facial pressure on right side, same side as loudest tinnitus Sparks of quickly arriving and quickly leaving severe chest pain slightly left of center


VAERS ID: 1469607 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-07-03
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821281 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Bronchitis, Chest pain, Chills, Dizziness, Hot flush, Neuralgia
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ATORVASTATIN; AMLODIPINE; METOPROLOL TARTRATE; CLONIDINE; NTG; ASA
Current Illness: Alcohol use (May be 2-3 drink at dinner, a couples of times per month.); Coronary artery disease; Marijuana abuse; Myocardial bridging; Smoker (About 1 pack per day. Trying to cut back.); Variant angina; Vasospasm
Preexisting Conditions: Medical History/Concurrent Conditions: Electrocardiogram (Blockage, but no infarction.); Hospitalisation; Comments: The patient had no known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210708459

Write-up: BRONCHITIS AND DIFFICULTY BREATHING; SHARP BURNING PAIN IN CHEST; DIZZINESS; HOT FLASHES; NERVE PAIN IN LEGS; CHILLS; This spontaneous report received from a patient concerned a 54 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included hospitalized, and electrocardiogram, and concurrent conditions included prinzmetal variant angina, myocardial bridge, non-obstructive coronary disease, vasospasm, alcohol user, smoker, and marijuana abuse, and other pre-existing medical conditions included the patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821281 and expiry: UNKNOWN) dose was not reported, administered on 02-JUL-2021 12:00 for prophylactic vaccination. Concomitant medications included acetylsalicylic acid, amlodipine, atorvastatin, clonidine, glyceryl trinitrate, and metoprolol tartrate. On 03-JUL-2021, the subject experienced bronchitis and difficulty breathing. On 03-JUL-2021, the subject experienced sharp burning pain in chest. On 03-JUL-2021, the subject experienced dizziness. On 03-JUL-2021, the subject experienced hot flashes. On 03-JUL-2021, the subject experienced nerve pain in legs. On 03-JUL-2021, the subject experienced chills. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from nerve pain in legs on 03-JUL-2021, was recovering from chills, and hot flashes, and had not recovered from bronchitis and difficulty breathing, sharp burning pain in chest, and dizziness. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure as case was assessed as non-serious.


VAERS ID: 1469608 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-07-03
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Back pain, Dizziness
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210709096

Write-up: DIZZINESS OR LIGHT HEADEDNESS; PAIN LOWER BACK; WEAKNESS; This spontaneous report received from a patient concerned a 45 year old female. 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: 204A21A, and expiry: UNKNOWN) dose was not reported, administered on 02-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-JUL-2021, the subject experienced dizziness or light headedness. On 03-JUL-2021, the subject experienced pain lower back. On 03-JUL-2021, the subject experienced weakness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from dizziness or light headedness, weakness, and pain lower back. This report was non-serious.


VAERS ID: 1469611 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Unknown  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-07-03
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210710769

Write-up: PRODUCT STORAGE ERROR; PUNCTURED VACCINE DOSE ADMINISTERED TO PATIENT AFTER 6 HOUR HOLD PERIOD IN REFRIGERATOR; This spontaneous report received from a pharmacist concerned a 34 year old of unspecified 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: 203A21A, and expiry: 07-AUG-2021) dose was not reported, administered on 03-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-JUL-2021, the subject experienced product storage error. On 03-JUL-2021, the subject experienced punctured vaccine dose administered to subject after 6 hour hold period in refrigerator. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the product storage error and punctured vaccine dose administered to patient after 6 hour hold period in refrigerator was not reported. This report was non-serious.


VAERS ID: 1469623 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Nevada  
Vaccinated:0000-00-00
Onset:2021-07-03
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210703; Test Name: COVID-19 virus test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210719118

Write-up: CONFIRMED CLINICAL VACCINATION FAILURE; CONFIRMED COVID 19 INFECTION; This spontaneous report received from a patient via a company representative concerned a 49 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 03-JUL-2021, the subject experienced confirmed covid 19 infection. Laboratory data included: COVID-19 virus test (NR: not provided) Positive. On an unspecified date, the subject experienced confirmed clinical vaccination failure. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from confirmed covid 19 infection, and the outcome of confirmed clinical vaccination failure was not reported. This report was non-serious. This report was associated with product quality complaint Sender''s Comments: V0: Medical Assessment comment not required as per standard procedure as the case is assessed as non-serious.


VAERS ID: 1469679 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Florida  
Vaccinated:2021-07-02
Onset:2021-07-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

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

Write-up: Heart Attack one day after vaccine; This spontaneous case was reported by a consumer and describes the occurrence of MYOCARDIAL INFARCTION (Heart Attack one day after vaccine) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 02-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Jul-2021, the patient experienced MYOCARDIAL INFARCTION (Heart Attack one day after vaccine) (seriousness criteria medically significant and life threatening). At the time of the report, MYOCARDIAL INFARCTION (Heart Attack one day after vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product was not reported. Treatment details was not reported. Patient had a bad experience with the vaccine as had a heart attack one day after vaccine. Company Comment Very limited information regarding this event has been provided at this time. Further information has been requested. Reporter did not allow further contact; Sender''s Comments: Very limited information regarding this event has been provided at this time. Further information has been requested.


VAERS ID: 1470129 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-06-03
Onset:2021-07-03
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Gingival bleeding, Immunoglobulin therapy, Petechiae, Platelet count decreased, Rash, Thrombocytopenia
SMQs:, Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Gingival disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Thrombocytopenia resulting in undetectable platelets that improved with 4 days of dexamethasone and IVIG with improvement in gum bleeding and petechial rash of bilateral lower extremities


VAERS ID: 1470449 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-26
Onset:2021-07-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood cholesterol increased, Chills, Cough, Dehydration, Dizziness, Dyspnoea, Fatigue, Glucose tolerance impaired, Hypertension, Muscle spasms, Oropharyngeal pain, Pain, Pollakiuria, Rhinorrhoea, Sneezing
SMQs:, Anaphylactic reaction (broad), Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Lipodystrophy (broad), Hypersensitivity (broad), Dehydration (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: Ibuprofen, B12, Magnesium, Potassium, Biotin.
Current Illness:
Preexisting Conditions: Chronic regional pain syndrome, anxiety.
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Runny nose, fatigue, muscle spasms, hypertension, pre-diabetes, high cholesterol, body aches, shortness of breath, dizziness, frequent urination, constant coughing, dehydration, sneezing, throat pain, and chills.


VAERS ID: 1470452 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-03
Onset:2021-07-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820096 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: Pt had 1st Pfizer dose 4/27/2021 then 2nd Pfizer dose 5/18/2021 at the Pharmacy , then presented to us on 7/3/2021 requesting the J & J immunization. Pt stated NO to receiving any previous Covid-19 vaccines. We were unable to access medical record at that moment so immunized customer believing they had honestly answered the questions pertaining to previous immunizations. Went to add this immunization into the medical record and found the previous immunizations.


VAERS ID: 1470519 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-03
Onset:2021-07-03
   Days after vaccination:91
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Discomfort, Erythema, Insomnia, Liver function test normal, Metabolic function test, Pruritus, Rash, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None at time of vaccination. Was taking terbinafine at time of adverse event (for 29 days).
Current Illness: None
Preexisting Conditions: None
Allergies: Due to adverse event, we have listed terbinafine as a possible allergy
Diagnostic Lab Data: A comprehensive metabolic panel was ordered at the ER, because terbinafine can case side effects to the liver. It was found that my liver function was completely normal. A blood cell count was also taken and everything was normal
CDC Split Type:

Write-up: It was a fully body rash the developed over the course of 24 hours. The night before I noticed a bit of itching an a bump that seemed like a bug bite. The following morning I had many such bumps in clusters on my neck and arm (and a few more bumps on my legs). At the time I thought I had bed bugs. By about 6 PM, I had more bumps and many of them had spread and turned into welts. There were bumps and rashes on all limbs, my neck and redness on my chest and back, The itchiness was severe. While not extremely painful, it was extremely uncomfortable and seemed like it would be hard to sleep or do anything. Around 9 PM I took Allegra to try and alleviate symptoms. I also used hydrocortison cream and calamine lotion all over my body to reduce symptoms of itching. By around 11 PM, I the rash was spreading into my face in the form of some bumps and redness. I visited the ER after consultation with a nurse over the phone, who said that anaphylactic shock could be a possibility and that it would be best to go in. At the ER, I was treated with 50 mg diphenhydrAMINE , 20 mg famotidine , 10 mg dexAMETHasone. I was given a prescription for dexAMETHasone and instructed to take a refill in 3 days if I still had symptoms. I was discharged a couple hours later. I did not need to refill the dexAMETHasone as the sympoms subsided and was almost unnoticeable by day 3 (and completely gone by day 4).


VAERS ID: 1470520 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-07
Onset:2021-07-03
   Days after vaccination:87
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Laboratory test abnormal
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: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: at home test positive rapid invalid PCR inconclusive
CDC Split Type:

Write-up: became symptomatic 07/03, at home test positive, rapid antigen invalid and PCR inconclusive.


VAERS ID: 1474228 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-15
Onset:2021-07-03
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN LOT # 202A21A / 1 AR / SC

Administered by: Public       Purchased by: ?
Symptoms: Balance disorder, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular 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: gabapentin, lotrel, lipitor, ambien
Current Illness: Was in recovery from GBS which had occurred in October 2020.
Preexisting Conditions: HTN, hyperlipidemia
Allergies: eggs (nausea), lactose intolerant, bisoprolol ( AV block), coreg, indocin,
Diagnostic Lab Data: No additional tests.
CDC Split Type:

Write-up: Pt noticed increased weakness in legs after receiving COVID vaccine. Had been walking steadily. Now unsteady with walking, feeling like legs will buckle. Pt referred for home PT.


VAERS ID: 1474387 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-07-03
Onset:2021-07-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Inappropriate schedule of product administration, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: PT PRESENTED TO PHARMACY FOR 2ND DOSE AT 2 WEEKS INSTEAD OF THE RECOMMENDED 4 TO 6 WEEKS. FIRST DOSE GIVEN 6/19/2021. SECOND 7/3/21. PT EXPERIENCED MILD SYMPTOMS AFTER SECOND DOSE (LOW GRADE TEMP, FATIGUE FOR APPROXIMATELY 24 HOURS). NO FOLLOW-UP CARE NECESSARY.


VAERS ID: 1474562 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-26
Onset:2021-07-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: trulicity, lisinopril, metoprolol, levothyroxine, rosuvastatin, and multivitamin
Current Illness: diabetes, high blood pressure, kidney disease, high cholesterol
Preexisting Conditions: diabetes, kidney failure,
Allergies: penicillian
Diagnostic Lab Data:
CDC Split Type:

Write-up: One week after injection, server pain on the whole left arm, arm pit, and back shoulder blade. The pain has not gone away.


VAERS ID: 1474702 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-07-03
Onset:2021-07-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mobility decreased, Pain in extremity
SMQs:, Parkinson-like events (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Patient has not been seen by a provider at this time.
CDC Split Type:

Write-up: Patient states that his arm has been and still is sore. He has lost mobility and it''s painful (7 on pain scale) when trying to raise his arm above his head. He can perform pull movements, but cannot perform any push movements.


VAERS ID: 1474807 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-10
Onset:2021-07-03
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Amnesia, Asthenia, Body temperature increased, Chills, Cough, Dizziness, Hypersomnia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Evening of June 10th, slept 4 hours (usual is 2 hour nap). 3 hr naps since then. Day of vaccine, slight cough. Some light-headedness since then. 3 July severe chills at about 3 AM. Severe weakness, lightheaded, 22 hours sleeping through to next day. 101? temp at 3 PM followed by 102.6? temp at 7:40 PM. On 14 July, he called to let his PCP know that he''d "lost short term memory."


VAERS ID: 1478115 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-18
Onset:2021-07-03
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye pain, Headache, Photopsia, Vision blurred, Vitreous detachment, Vitreous floaters
SMQs:, Anticholinergic syndrome (broad), Accidents and injuries (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Allergy medicine anaphylactic shock
Other Medications: Vit d,b,c,zinc,magnesium and calcium
Current Illness: No
Preexisting Conditions: Spine injury
Allergies:
Diagnostic Lab Data: Diagnosed with posterior vitreous detachment Blurred vision 7/8 ophthalmology appt diagnosed with above 7/12 trip to ER with more lights flashes and increased blurred vision and difficulty focusing
CDC Split Type:

Write-up: Acute and sudden blurred vision Posterior vitreous detachment diagnosed and the blurred vision a secondary thing Sore eyes and unable to focus flashes of light, floaters and headaches


VAERS ID: 1478243 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-01
Onset:2021-07-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Muscle twitching, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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: I was sick in bed for several days. I thought I had an ear infection and warned the doctor who told me to still get the flu vacc
Other Medications: none
Current Illness: headache from crown replacement
Preexisting Conditions: none
Allergies: wheat, soy, pine nuts, shellfish, mold
Diagnostic Lab Data: none
CDC Split Type:

Write-up: tremor or twitch of right thumb


VAERS ID: 1478249 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-03
Onset:2021-07-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 LA / IM

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

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

Write-up: Swollen, red, painful for 2weeks +


VAERS ID: 1478401 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-25
Onset:2021-07-03
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Fatigue
SMQs:

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

Write-up: Extreme fatigue. Starting around June 30th.


VAERS ID: 1479064 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-03
Onset:2021-07-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disorientation, Eye movement disorder, 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), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamotrigine 200mg, valcyclovir 500mg
Current Illness:
Preexisting Conditions:
Allergies: kna
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient''s eyes rolled back, head fell back and patient passed out. 911 was called. Patient came to approximately 1 min later and felt disoriented. Medics arrived and took her to hospital for evaluation.


VAERS ID: 1481061 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-07-03
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207821A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Body temperature decreased, Headache, Heart rate, Heart rate abnormal, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210703; Test Name: Body temperature; Result Unstructured Data: 101 F; Test Date: 20210703; Test Name: Pulse rate; Result Unstructured Data: not reported; Test Date: 20210703; Test Name: Body temperature decrease; Result Unstructured Data: 97.1 F
CDC Split Type: USJNJFOC20210708993

Write-up: PULSE RATE; HEADACHE(COMING AND GOING); NAUSEA; FEVER; This spontaneous report received from a patient concerned a 67 year old male. 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: 207821A, expiry: UNKNOWN) dose was not reported, administered on 03-JUL-2021 09:30 for prophylactic vaccination. No concomitant medications were reported. On 03-JUL-2021, the subject experienced pulse rate. On 03-JUL-2021, the subject experienced headache (coming and going). On 03-JUL-2021, the subject experienced nausea. On 03-JUL-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 101 F, Body temperature decrease (NR: not provided) 97.1 F, and Pulse rate (NR: not provided) not reported. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever on 03-JUL-2021, had not recovered from headache(coming and going), and the outcome of nausea and pulse rate was not reported. This report was non-serious.


VAERS ID: 1481082 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-07-03
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Culture, Streptococcal infection, Streptococcus test
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: Alcoholic (Beer twice a week.); Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies. The patient did not have had any drug abuse/illicit drug use.
Allergies:
Diagnostic Lab Data: Test Date: 20210703; Test Name: Streptococcus identification test; Result Unstructured Data: Positive; Test Date: 20210705; Test Name: Culture nose; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210713761

Write-up: CONFIRMED COVID-19 INFECTION; STREPTOCOCCUS BACTERIAL INFECTION; This spontaneous report received from a patient concerned a 47 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non-smoker, and alcoholic, and other pre-existing medical conditions included the patient had no known allergies. the patient did not have had any drug abuse/illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and expiry: 07-AUG-2021) dose was not reported, administered on 25-JUN-2021 13:00 for prophylactic vaccination. No concomitant medications were reported. On 03-JUL-2021, the subject experienced streptococcus bacterial infection. Laboratory data included: Streptococcus identification test (NR: not provided) Positive. On 05-JUL-2021, the subject experienced confirmed covid-19 infection. Laboratory data included: Culture nose (NR: not provided) Positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from confirmed covid-19 infection, and the outcome of streptococcus bacterial infection was not reported. This report was non-serious.; Sender''s Comments: V0 Medical assessment comment not required as per standard procedure as the case was assessed as non-serious.


VAERS ID: 1481240 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Arkansas  
Vaccinated:0000-00-00
Onset:2021-07-03
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Muscle disorder, Muscular weakness, Myalgia, Pain in extremity, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210728979

Write-up: CAN''T FOCUS; DECREASED MUSCLE MOVEMENT; ARM PAIN; CAN''T PICK UP A JUG OF MILK; HEADACHE; MUSCLE PAIN; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose was not reported, administered on 25-JUN-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 03-JUL-2021, the subject experienced can''t focus. On 03-JUL-2021, the subject experienced decreased muscle movement. On 03-JUL-2021, the subject experienced arm pain. On 03-JUL-2021, the subject experienced can''t pick up a jug of milk. On 03-JUL-2021, the subject experienced headache. On 03-JUL-2021, the subject experienced muscle pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache, can''t focus, muscle pain, arm pain, decreased muscle movement, and can''t pick up a jug of milk. This report was non-serious.


VAERS ID: 1481245 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-07-03
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Headache, Muscular weakness, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210703; Test Name: Body temperature; Result Unstructured Data: 101 F
CDC Split Type: USJNJFOC20210729174

Write-up: LEG GIVING OUT; HEADACHE; FEVER OF 101 F; This spontaneous report received from a patient concerned a 67 year old male. 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: 207A21a, expiry: 07-AUG-2021) dose was not reported, administered on 03-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-JUL-2021, the subject experienced headache. On 03-JUL-2021, the subject experienced fever of 101 f. Laboratory data included: Body temperature (NR: not provided) 101 F. On 12-JUL-2021, the subject experienced leg giving out. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from leg giving out, and the outcome of headache and fever of 101 f was not reported. This report was non-serious.


VAERS ID: 1481476 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-01
Onset:2021-07-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051CZ1A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Insomnia
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: Trazodone, zyrtec
Current Illness: None
Preexisting Conditions:
Allergies: Propofol, celexa,
Diagnostic Lab Data:
CDC Split Type:

Write-up: Insomnia. I take trazodone for sleep which has worked for years. Since getting the shot 2 weeks ago I havent slept more than 4-5 hours a night, waking in the early morning 2-4 am , unable to go back to sleep. This is ongoing.


VAERS ID: 1483433 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-30
Onset:2021-07-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Electrocardiogram, Electrocardiogram change, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Name: EKG; Result Unstructured Data: Test Result:Unknown; Test Name: troponin level; Result Unstructured Data: Test Result:elevated
CDC Split Type: USPFIZER INC2021830765

Write-up: Severe chest pain; difficulty in breathing; EKG changes; elevated troponin level; This is a spontaneous report from a contactable consumer or other non hcp. A 12-years-old male patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; formulation: Solution for injection, Lot Number was not reported), via an unspecified route of administration, administered in Arm Left at the age of 12-year-old on 30Jun2021 as single dose for covid-19 immunization. Medical history was reported as none. The patient''s concomitant medications were not reported. Patient had no relevant past drug history and known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient did not receive any other medications within 2 weeks of vaccination. On 03Jul2021 05:30 the patient experienced severe chest pain, difficulty in breathing, ekg changes, elevated troponin level. The patient was hospitalized for the events. The patient underwent lab tests and procedures which included electrocardiogram: unknown, troponin increased: elevated. The adverse event resulted in Emergency room/department or urgent care. The patient received treatment for the adverse event with Pain medication. The clinical outcome of events was recovering. Information about batch/Lot number has been requested.


VAERS ID: 1483438 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-06-18
Onset:2021-07-03
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea
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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZOLOFT; GABAPENTIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Drug allergy (Known allergies: Macro Bid antibiotic)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021830836

Write-up: Having a difficult time breathing; This is a spontaneous report received from a contactable consumer or other non hcp. A 47-years-old female patient received second dose of bnt162b2 (PFIZER BIONTECH-COVID19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration, administered in Arm Left on 18Jun2021 09:00 as single dose for COVID-19 immunization. Medical history included drug hypersensitivity from an unknown date and unknown if ongoing, known allergies: Macro Bid antibiotic. Concomitant medications included sertraline hydrochloride (ZOLOFT) and gabapentin taken for an unspecified indication, start and stop date were not reported. Prior and since the vaccination, patient was not tested and diagnosed with COVID19.The patient was not hospitalized after vaccination. The patient did not received any other vaccine within 4 weeks prior to COVID-19 Vaccine. The patient experienced having a difficult time breathing (dyspnoea) on 03Jul2021.The outcome of the event was not resolved. No follow-up attempts are possible, information about lot/batch number cannot be obtained.


VAERS ID: 1483466 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-20
Onset:2021-07-03
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Skin discolouration
SMQs:, Hypotonic-hyporesponsive episode (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: USPFIZER INC2021831758

Write-up: the bend same arm she got the injection, it is a little bit a colored that''s almost like a bruise but it''s not a bruise.; This is a spontaneous report from a contactable consumer (Patient''s parent). A 15-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot Number: EW0181), via an unspecified route of administration in deltoid left (left upper arm) on 20Jun2021 (at the age of 15 years old) as dose 1, single for covid-19 immunization. The patient medical history and concomitant medications were not reported. Reporter stated trying to figure out, her daughter got her first dose Pfizer vaccine on 20Jun2021 and she scheduled to get by next sunday to get her second dose but last night or now this morning on 03Jul2021 she has like a knot or spot on her arm right towards the bend same arm she got the injection, it is a little bit a colored that''s almost like a bruise but it''s not a bruise. Not at the injection site it''s further down and today marks the second week she got it on two weeks ago and again it just popped up this morning and again don''t know if we need to be concerned or not. Reporter was worried about that color on her arm. Reporter had no idea about treatment received for the problem. The outcome of event was not resolved.


VAERS ID: 1483578 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-07-01
Onset:2021-07-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH SA6780 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Decreased appetite, Diarrhoea, Fatigue, Headache, Illness, Nausea, Pyrexia, Vaccination site pain, Vomiting, Weight decreased
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021849676

Write-up: I have had diarrhea, have gone through the bathroom as of now 15 times, I have had vomiting, nausea, I cannot eat I have not eaten since I got the shot; I have now lost 5 pounds; I have had diarrhea, have gone through the bathroom as of now 15 times, I have had vomiting, nausea, I cannot eat I have not eaten since I got the shot; I have now lost 5 pounds; I have had diarrhea, have gone through the bathroom as of now 15 times, I have had vomiting, nausea, I cannot eat I have not eaten since I got the shot; I have now lost 5 pounds; I have had diarrhea, have gone through the bathroom as of now 15 times, I have had vomiting, nausea, I cannot eat I have not eaten since I got the shot; I have now lost 5 pounds; I have had diarrhea, have gone through the bathroom as of now 15 times, I have had vomiting, nausea, I cannot eat I have not eaten since I got the shot; I have now lost 5 pounds; Headache; Tiredness; I started getting very sick and it is now Tuesday and I am still very sick; I have chills, I have fever, I have an arm that hurts where I got the shot; I started getting very sick and it is now Tuesday and I am still very sick; I have chills, I have fever, I have an arm that hurts where I got the shot; I started getting very sick and it is now Tuesday and I am still very sick; I have chills, I have fever, I have an arm that hurts where I got the shot; I started getting very sick and it is now Tuesday and I am still very sick; I have chills, I have fever, I have an arm that hurts where I got the shot; This is a spontaneous report received from a contactable consumer (patient). A patient (age and gender not reported) received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: SA6780), dose 1 via an unspecified route of administration on 01Jul2021 as, single dose for covid-19 immunization. The patient medical history was not reported. The patient''s concomitant medications were not reported. On 03Jul2021, patient started getting very sick and it is now Tuesday and I am still very sick; I have chills, I have fever, I have an arm that hurts where I got the shot. On an unspecified date, patient have had diarrhea, have gone through the bathroom as of now 15 times, I have had vomiting, nausea, I cannot eat I have not eaten since I got the shot; I have now lost 5 pounds, headache, tiredness. The outcome of the events patient started getting very sick and it is now Tuesday and I am still very sick; I have chills, I have fever, I have an arm that hurts where I got the shot and patient have had diarrhea, have gone through the bathroom as of now 15 times, I had vomiting, nausea, I cannot eat I have not eaten since I got the shot; I have now lost 5 pounds (Appetite lost) was not recovered. Patient needed to go to the emergency room that not going to the emergency room because they guys pretend patient wasn''t there and did nothing. When paraphrased the above concern, Consumer stated, Right patient cannot eat at all, patient even tried to eat salty crackers and patient cannot eat them. And now patient have lost 5 pounds. Further Consumer stated this was very difficult. When somebody who was very sick this was difficult to try to get help. Shame on you all, shame on you. I wish you would, I wish you would because I was very sick. Consumer further stated, this happened to me once ago and all I did listen to music for 2 minutes nobody ever answered the phone, so I hung up the phone I called again. The outcome of the events patient has had diarrhea, have gone through the bathroom as of now 15 times, I have had vomiting, nausea, I cannot eat I have not eaten since I got the shot; I have now lost 5 pounds, headache, tiredness was unknown.


VAERS ID: 1483718 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-26
Onset:2021-07-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 RA / IM

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

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

Write-up: Systemic: Tinnitus-Severe


VAERS ID: 1483742 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-22
Onset:2021-07-03
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Lymph node pain, Lymphadenopathy, Skin warm
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injection was administered in my right arm- painful, swollen, and hot lymph nodes in my right armpit


VAERS ID: 1483844 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-07
Onset:2021-07-03
   Days after vaccination:57
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

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

Write-up: Rash appeared two months later. Appears to be shingles.


VAERS ID: 1483938 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-01
Onset:2021-07-03
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: pantoprazole, allopurinol, norethindrone
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Two ER visits 7/14 and 7/17 Saw primary 7/12 treated as allergic reaction. Rash will not go away. Will see more doctors next week.
CDC Split Type:

Write-up: Rash at site. Rash progressed all over body over the course of the next few weeks. Treated twice at the ER for allergic reaction. Nothing is helping.


VAERS ID: 1484121 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-25
Onset:2021-07-03
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphonia, Cough, Dizziness, Dysphonia, Pyrexia, Secretion discharge
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever 7/3/21 Cough and Mucous - green mucous 7/3/21 to 7/13/21 Sore Throat 7/3/21 - 7:00am Lost voice 7/3/21 - 8:00pm. 24 hours Hoarse voice - 7/5/21 to 7/13/21. 9 days Dizziness 7/5/21 to Present. Treatment over the counter dizziness medication.


VAERS ID: 1484467 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-03
Onset:2021-07-03
   Days after vaccination:61
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 2 - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Anaemia, Breech presentation, COVID-19, Caesarean section, Delivery, Haemoglobin decreased, Postpartum haemorrhage, Premature rupture of membranes, Procedural haemorrhage, SARS-CoV-2 test positive, Uterine leiomyoma
SMQs:, Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, Tums, ferrous sulfate, prenatal vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: SARS-COV-2 (COVID-19) by NAA, Micro: SARS-CoV-2 Detected (7/3/2021)
CDC Split Type:

Write-up: Patient was admitted on 7/3 for PLTCS 2/2 Prelabor rupture of membranes with baby in breech presentation. She was taken to the OR. One minute apgar of 3 and five minute apgar of 9. She was found to have uterine fibroids during the case. The procedure was complicated by postpartum hemorrhage with blood loss of 1334mL. Patient''s hgb nadir down to 7.2; she was asymptomatic. Patient as given IV Venofer x2 doses. She was discharged on post operative day #2 in stable condition. She was prescribed iron sulfate 325mg TID for her anemia.


VAERS ID: 1484582 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-07-03
   Days after vaccination:85
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Blood test
SMQs:, Liver related investigations, signs and symptoms (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: Multivitamins
Current Illness: None
Preexisting Conditions: None
Allergies: N/A
Diagnostic Lab Data: Blood Work- 7/03/2021 Schedule Liver Ultrasound 07/23/2021
CDC Split Type:

Write-up: High Levels of ALT (SGPT) at 65 on 7/03/2021, the Last result was on 06/29/2019 ALT (SGPT) at 20


VAERS ID: 1484668 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-01
Onset:2021-07-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 0178 / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Asthenia, Dizziness, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular 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: Levothyroxine
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizzy, very weak. Arms and shoulders felt like they weighed a ton. Sick to my stomach. Lasted about 2 weeks.


VAERS ID: 1484749 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-03
Onset:2021-07-03
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bone pain, Discomfort, Hypoaesthesia, Injected limb mobility decreased, Injection site muscle weakness, Injection site pain, Injection site reaction
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Osteonecrosis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atorvastatin 20mg, levothyroxine 75mcg, fluticasone nasal spray, furosemide 20mg, mupirocin ointment, metronidazole 0.75% gel, famotidine 20mg, nystatin cream
Current Illness:
Preexisting Conditions: hypertension, thyroid disease, rosacea, GERD
Allergies: aluminum hydroxide, aspirin, atenolol ,cephalexin, clindamycin, dust mite, erythromycin, pepper, ibuprofen, mercurochrome, triamterene/hydrochlorothiazide, zoledrnic acid
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient arrived at the pharmacy 7-19-21 reporting she began to experience left arm weakness between the shoulder and elbow on 7/3/21 .She was unable to move or use the arm for 3 days, at which time it resolved. She also reports a sharp, bone pain just above the injection site-she experiences the pain only when she touches the area, (began 7/3/21). She continues to experience this pain as of the time of this report. She also reports a feeling of compression/numbness on the on the outside of her lower left leg between the ankle and the knee, this started 7/3/21 it has improved but has not completely resolved. Patient states she has not reported this to her health care provider


VAERS ID: 1484823 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-03
Onset:2021-07-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Diarrhoea, Dysgeusia, Fatigue, Nausea, Parosmia, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Within (3) hrs of receiving vaccine I had an awful repellant like smell & taste, causing extreme nausea for about (5) hrs along with severe diarrhea with 99.9-101 fever for (3) days. The taste & smell of roach spray like was awful, scared my husband & I. To this date I have no sense of smell or taste & feel tired all the time. Haven''t gone to ER being afraid to be among others who may have Delta variant but am considering going if symptoms persist. My 2nd vaccine is on July 24.


VAERS ID: 1484835 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-07-01
Onset:2021-07-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Dizziness, Feeling abnormal, Hyperhidrosis, Injection site pain, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins B-Complex, C, D, and Moringa
Current Illness:
Preexisting Conditions: Diagnosed with Thalassemia, non-alcoholic fatty liver ? (not sure if this was already healed, did not go to the doctor for follow up check up)
Allergies: Shrimp, gluten and dairy sensitive, certain antibiotics (but do not remember what they are)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Got my first dose of Pfizer shot on July 1st at 4 p.m. Did not have any reaction on the first 15 minutes of the shot. The next day, July 2, I only had some pain on the area I was injected. However, on July 3, I woke up feeling dizzy, lightheaded, and weakness. At first I did not attribute it to the vaccine. I thought maybe I had low hemoglobin due to my thalassemia. However, my feeling dizzy and lightheaded persisted until July 5th. On July 6th and 7th, I felt the dizziness and lightheadedness subsided. However on the 8th, I felt dizzy and lightheaded again, but this time I experienced brain fog, tinnitus, and was sweating on and off. So, I have been experiencing these symptoms on and off since my first vaccination until now (July 19th). I have not experienced this before. Aside from the medical condition I have mentioned earlier, I do not know of any known underlying health conditions that might trigger these symptoms.


VAERS ID: 1484986 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-06-02
Onset:2021-07-03
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Full blood count, Testicular torsion, Ultrasound testes abnormal
SMQs:

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

Write-up: Testicular torsion


VAERS ID: 1486338 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-01-23
Onset:2021-07-03
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SYNTHROID; ASA; RIBOFLAVIN; VITAMIN A + D; ZINC; MAGNESIUM; TOPAMAX
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Foramen ovale patent (Verbatim: PFO); Hereditary coproporphyria (Verbatim: HCP); Hypothyroidism (Verbatim: Hypothyroid)
Allergies:
Diagnostic Lab Data: Test Date: 20210703; Test Name: PCR Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC2021870371

Write-up: On 03Jul2021, I contracted Covid, delta, variant; On 03Jul2021, I contracted Covid, delta, variant; This is a spontaneous report from a contactable nurse (Patient). A 53-year-old non-pregnant female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; formulation: Solution for injection, Lot Number: EL9262 and Expiry date was not reported) dose 2 via an unspecified route of administration in arm Left on 23Jan2021 09:00 (age at vaccination was 53-year-old) and dose 1 (Lot number: EL3246 and Expiry date was not reported) via an unspecified route of administration in right arm on31Dec2020 13:15 as single dose for covid-19 immunisation. The patient had no known allergies. Medical history included Hypothyroid, PFO, HCP from an unknown date and unknown if ongoing. Prior to the vaccination, the patient was not diagnosed with COVID-19. Post vaccination, the patient had tested for COVID-19. Concomitant medications in two weeks were included levothyroxine sodium (SYNTHROID), asa (ASA), riboflavin (RIBOFLAVIN), ergocalciferol, retinol (VITAMIN A + D), zinc (ZINC), magnesium (MAGNESIUM), topiramate (TOPAMAX) taken for an unspecified indication, start and stop date were not reported. The patient did not receive any other vaccines within four weeks. The patient was hospice that continues to take masking precautions, hand hygiene. On 03Jul2021 16:00 she contracted covid, variant. Due to events patient visited Emergency room/department or urgent care. Treatment received for the events was Promethazine, Albuterol inhaler, Tessalon pearls. The patient underwent lab tests and procedures which included PCR nasal Swab positive on 03Jul2021. The outcome of the event was recovering.; Sender''s Comments: Based on the information in the case report, a possible causal relationship between events Covid-19 and suspect drug BNT162B2 cannot be excluded


VAERS ID: 1486806 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-06-16
Onset:2021-07-03
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Tested positive for covid-19


VAERS ID: 1486906 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-07-02
Onset:2021-07-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Capillary fragility
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: Citalopram Sinvastin Temazepam aspirin Phenternin multi vitamin Iron pill Xyzal (Allergy pill) Nasal spray for Allergy
Current Illness: sinus infection (2 weeks before vaccine)
Preexisting Conditions:
Allergies: no
Diagnostic Lab Data: 07/07/2021 went to go see PCP and they stated that it should go away... Blood test was ran and it resulted normal
CDC Split Type:

Write-up: Patient report that she has burst blood vessels in her feet and ankle area...both feet are having issues.. goes away and comes back


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