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From the 7/16/2021 release of VAERS data:

Found 479,813 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 62 out of 4,799

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VAERS ID: 1440986 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / UNK - / 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: VACCINE WAS IN THE FREEZER FOR $g 14 DAYS. IT SHOULD BE MOVED OUT TO THE REFRIGERATOR AFTER 14 DAYS.


VAERS ID: 1440997 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / UNK - / 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: VACCINE WAS IN THE FREEZER FOR $g 14 DAYS. IT SHOULD BE MOVED OUT TO THE REFRIGERATOR AFTER 14 DAYS.


VAERS ID: 1441004 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / UNK - / 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: VACCINE WAS IN THE FREEZER FOR $g 14 DAYS. IT SHOULD BE MOVED OUT TO THE REFRIGERATOR AFTER 14 DAYS.


VAERS ID: 1441026 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-06-22
Onset:2021-06-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, 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: Herbal stress relief tea
Current Illness: None
Preexisting Conditions: Kerataconus
Allergies: Some fragrances, and yeast in cosmetic products.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Chest tightness and difficulty breathing.


VAERS ID: 1441076 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cromolyn Sodium 100mg x2; valtrex 500mg; vitamin d 5,000mg
Current Illness: none
Preexisting Conditions: diagnosed with systemic mastocytosis
Allergies: sulfa and penicillin; diagnosed with systemic mastocytosis and couldn''t list my allergies due to the volume
Diagnostic Lab Data: allergic to injectable steroids and was given prescription for oral medication.
CDC Split Type:

Write-up: broke out in hives all over body


VAERS ID: 1441128 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-12
Onset:2021-06-25
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Electrocardiogram, Hypoxia, Tachycardia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC birth control
Current Illness: None
Preexisting Conditions: Endometriosis; allergic rhinits
Allergies: Sulfa; Latex; adhesive
Diagnostic Lab Data: ECG.
CDC Split Type:

Write-up: Tachycardia (up to 155); hypoxia; chest tightness.


VAERS ID: 1441305 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-06-24
Onset:2021-06-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site swelling, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pravachol, acyclovir, pantoprazole, bupropion, hydrochlorothiazide, clonazepam, lisinopril
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient called 7 day post Moderna Covid vaccination #1 saying that she had been experiencing some muscle soreness on both sides of her neck as well as some redness/swelling around the injection site. Told her the injection site reaction was quite common and should subside over time and is ok to use with OTC pain relievers (ibuprofen, naproxen, acetminophen). The muscle soreness was a noted adverse event in trials and told her if it did not appear to get better or progressed, she should notify her physician. She did not seem real concerned, just thought we should know and she still planned on getting her second shot in approximately 3 weeks.


VAERS ID: 1442297 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-06-25
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Adnexa uteri pain, Back pain, Nausea
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? 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: USJNJFOC20210660739

Write-up: ABDOMINAL PAIN, CRAMPS LIKE KIDNEY PAIN OR LIKE CRAMPING THAT COMES PREMENSTRUAL; PAIN OVER THE OVARY; BACK PAIN THAT IT IS ON THE RIGHT SIDE IS THE MOST; NAUSEA; This spontaneous report received from a patient concerned a 52 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: 201A21A, and batch number: 201A21A expiry: UNKNOWN) dose was not reported, administered on 25-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 25-JUN-2021, the subject experienced abdominal pain, cramps like kidney pain or like cramping that comes premenstrual. On 25-JUN-2021, the subject experienced pain over the ovary. On 25-JUN-2021, the subject experienced back pain that it is on the right side is the most. On 25-JUN-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from back pain that it is on the right side is the most, and the outcome of abdominal pain, cramps like kidney pain or like cramping that comes premenstrual, nausea and pain over the ovary was not reported. This report was non-serious.


VAERS ID: 1442301 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-06-25
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Headache, Nasopharyngitis, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic reaction to antibiotics (Some antibiotics cause sensitivity but patient did not list which ones.); Food allergy (patient stated some antibiotics causes sensitivity but did not list which ones); Head cold; Migraine headache (patient sometimes gets migraines after eating certain foods, and had a little bit of a headache after eating one of those foods last week.)
Preexisting Conditions: Medical History/Concurrent Conditions: Hyperthyroidism
Allergies:
Diagnostic Lab Data: Test Date: 20210625; Test Name: Body temperature; Result Unstructured Data: 99 F; Comments: fever was 99 degrees Farenheit
CDC Split Type: USJNJFOC20210660901

Write-up: BODY ACHES; DULL HEADACHE; FEVER; HEAD CONGESTION WORSENED; This spontaneous report received from a patient concerned a 55 year old female. The patient''s weight was 147 pounds, and height was 67 inches. The patient''s past medical history included hyperthyroidism, and concurrent conditions included allergic to chocolate and caffeine, head congestion, migraines, and allergic to some antibiotics. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and expiry: UNKNOWN) dose was not reported, administered on 25-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 25-JUN-2021, the subject experienced body aches. On 25-JUN-2021, the subject experienced dull headache. On 25-JUN-2021, the subject experienced fever. On 25-JUN-2021, the subject experienced head congestion worsened. Laboratory data included: Body temperature (NR: not provided) 99 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from body aches, dull headache, fever, and head congestion worsened. This report was non-serious.


VAERS ID: 1442303 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-06-25
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Contusion, Muscle spasms, Nodule, Pain in extremity
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BENAZEPRIL; AMLODIPINE; METFORMIN
Current Illness: Blood pressure; Diabetes
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210660975

Write-up: EXTREMELY LARGE BRUISE 5 INCH LONG ON FOREARM; BUMP NODULE PEA SIZE; CRAMPING IN LEGS; SORE ARM; This spontaneous report received from a patient concerned a 59 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included blood pressure, and diabetes.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029, expiry: 09-JUL-2021) dose was not reported, administered on 24-JUN-2021 for prophylactic vaccination. Concomitant medications included amlodipine for blood pressure, benazepril for blood pressure, and metformin for diabetes. On 25-JUN-2021, the subject experienced extremely large bruise 5 inch long on forearm. On 25-JUN-2021, the subject experienced bump nodule pea size. On 25-JUN-2021, the subject experienced cramping in legs. On 25-JUN-2021, the subject experienced sore arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from extremely large bruise 5 inch long on forearm, bump nodule pea size, sore arm, and cramping in legs. This report was non-serious.


VAERS ID: 1442309 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-25
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Diarrhoea, Pain in extremity
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcoholic (1-2 beer at evening); Cigarette smoker
Preexisting Conditions: Comments: No known allergies and patient does not abuse drug or have illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210661488

Write-up: DIARRHEA; SORE ARM; This spontaneous report received from a patient concerned a 61 year old male. The patient''s weight was 170 pounds, and height was 68 inches. The patient''s concurrent conditions included alcohol user, and cigarette smoker, and other pre-existing medical conditions included no known allergies and patient does not abuse drug or have illicit drug usage. 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. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 25-JUN-2021, the subject experienced sore arm. On 26-JUN-2021, the subject experienced diarrhea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from diarrhea, and sore arm. This report was non-serious.


VAERS ID: 1442768 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-06-25
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Incorrect dose administered, Off label use
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: USJNJFOC20210661376

Write-up: REVACCINATED/PATIENT RECEIVED 2 DOSES OF THE JANSSEN COVID19 VACCINE; OFF LABEL USE; This spontaneous report received from a health care professional concerned a 50 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: 202A21A, expiry: UNKNOWN) dose was not reported, administered on APR-2021, and dose was not reported, administered on 25-JUN-2021 13:15 for prophylactic vaccination. No concomitant medications were reported. On 25-JUN-2021, the subject experienced revaccinated/subject received 2 doses of the janssen covid19 vaccine. On 25-JUN-2021, the subject experienced off label use. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the revaccinated/patient received 2 doses of the janssen covid19 vaccine and off label use was not reported. This report was non-serious.


VAERS ID: 1442774 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:2021-06-25
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210664597

Write-up: OUT OF SPECIFICATION PRODUCT USED; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A expiry: 07-AUG-2021) dose was not reported, administered on 25-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 25-JUN-2021, the subject experienced out of specification product used. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of out of specification product used was not reported. This report was non-serious.


VAERS ID: 1442780 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-25
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chest pain, Dizziness, Pain, Taste disorder
SMQs:, Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Guillain-Barre 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:
Current Illness: Blood pressure high (The patient takes a water pill and two other medication.); Gout (The patient takes medication for gout).
Preexisting Conditions: Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210666592

Write-up: FELT TASTE OF BLOOD IN MOUTH; FELT SORENESS; FEELING OF PAIN IN CHEST; NO ENERGY; DIZZINESS; This spontaneous report received from a consumer concerned a 37 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included high blood pressure, and gout, and other pre-existing medical conditions included the patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, expiry: UNKNOWN) dose was not reported, administered on 23-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 25-JUN-2021, the subject experienced dizziness. On 25-JUN-2021, the subject experienced no energy. On 26-JUN-2021, treatment medications included: paracetamol. On 27-JUN-2021, the subject experienced felt soreness. On 27-JUN-2021, the subject experienced feeling of pain in chest. On 29-JUN-2021, the subject experienced felt taste of blood in mouth. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from dizziness, and no energy, and the outcome of felt soreness, feeling of pain in chest and felt taste of blood in mouth was not reported. This report was non-serious.


VAERS ID: 1442787 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:2021-06-25
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / UNK - / -

Administered by: Other       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:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: Rash; Comments: The patient had no history of drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210667956

Write-up: A RASH OVER LEFT CHEST, TOP BOTTOM LIP, AND RIGHT SIDE; This spontaneous report received from a patient concerned a 60 year old female. The patient''s weight was 325 pounds, and height was 67 inches. The patient''s past medical history included a rash of the same type, and concurrent conditions included non-alcohol user, and non-smoker, and other pre-existing medical conditions included the patient had no history of drug abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1816022, expiry: UNKNOWN) dose was not reported, administered on 22-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 25-JUN-2021, the subject experienced a rash over left chest, top bottom lip, and right side. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from a rash over left chest, top bottom lip, and right side. This report was non-serious.


VAERS ID: 1442810 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Nebraska  
Vaccinated:0000-00-00
Onset:2021-06-25
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Lethargy, Malaise, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Comments: No known drug allergies
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210700531

Write-up: NAUSEA; VOMITING; FELT SICK; FELT TIRED; LETHARGIC; This spontaneous report received from a patient concerned a 57 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and expiry: UNKNOWN) dose was not reported, administered on 25-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 25-JUN-2021, the subject experienced lethargic. On 25-JUN-2021, the subject experienced felt tired. On 26-JUN-2021, the subject experienced vomiting. On 26-JUN-2021, the subject experienced felt sick. On 29-JUN-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from felt sick on 28-JUN-2021, was recovering from vomiting, had not recovered from lethargic, and felt tired, and the outcome of nausea was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment is not required as per standard procedure as case assessed as non-serious.


VAERS ID: 1442847 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 RA / IM

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

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

Write-up: Systemic: Fever-Medium


VAERS ID: 1443060 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 2 LA / IM

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

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

Write-up: Patient received second dose 1 day earlier than 4 day grace period. No adverse effects noted.


VAERS ID: 1443079 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-23
Onset:2021-06-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiomegaly, Influenza like illness, Palpitations, Ventricular extrasystoles
SMQs:, Cardiac failure (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Hypokalaemia (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: nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient stated had mild flu-like symptoms after vaccine then developed heart palpitations about 48-72 hours after vaccination. Went to ER about 4 days after vaccine; Diagnosed her with heart inflammation and pvcs; has f/u with cardiologist on 7/9


VAERS ID: 1443089 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH RW0196 / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Hot flush, Pain, Pyrexia
SMQs:, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Heart failure
Allergies: Deltoid; latex; paper take; spicy stuff
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: Within 30 minutes I experienced the worst hot flash ever, I had to go to the pharmacy to just make sure everything is okay. The same day I had diarrhea, fever, pain all over body.


VAERS ID: 1443111 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-06-22
Onset:2021-06-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood bilirubin increased, Blood fibrinogen increased, C-reactive protein increased, Hepatitis, Hyperbilirubinaemia, Immunoglobulin therapy, Pharyngitis streptococcal, Pyrexia, Rash, Red blood cell sedimentation rate increased, SARS-CoV-2 antibody test negative, SARS-CoV-2 test negative, Streptococcus test positive, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Hepatitis, non-infectious (narrow), Anaphylactic reaction (broad), Acute pancreatitis (narrow), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Oropharyngeal infections (narrow), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CRP 221.7, Fibrinogen 575, sed rate 29, AST 65, ALT 77, bilirubin 3.2, Strep throat screen POSITIVE, SARS COVID PCR and AB screen negative.
CDC Split Type:

Write-up: Fever, vomiting, rash, hepatitis with direct hyperbilirubinemia, acute kidney injury (resolving) Amoxicillin for strep throat, IVIG for possible Kawasaki disease,


VAERS ID: 1443157 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Pt had a syncopal event 2mins after vaccination. BP 104/70, HR 99, RR 17 -- $g 98/55, 73, 18. Pt recovered. Pt stable and released from the vaccination site.


VAERS ID: 1443167 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-24
Onset:2021-06-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / UN
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pruritus, Rash macular, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levo thyroxine 75mcg
Current Illness:
Preexisting Conditions: arthritus
Allergies: penicillin, aspirin,
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: On the second day after my second vaccine shot, I developed 4 or 5 large red blotches on my upper arm. They were itchy and slightly swollen. It has been 8 days since the vaccine shot and I think the area may be slightly faded. The itchiness is not as bad as it was initially.


VAERS ID: 1443208 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Nausea, Pruritus, Throat irritation, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Hives, itchy throat, itchy all over body. Nausea and vomiting. Headache


VAERS ID: 1443236 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-24
Onset:2021-06-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Computerised tomogram, Electrocardiogram, Laboratory test, Pain, Pyrexia, Retching, SARS-CoV-2 test negative, Tachycardia, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), COVID-19 (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: Two EKG''s CT scan of the abdomen covid test
CDC Split Type: vsafe

Write-up: Took to ER at 5am because he was dry heaving, and vomiting. They did an EKG and a CT scan of the abdomen and lab work. He was placed on hydratation, 6 bags of fluids as well as Zofran for the vomiting also he also had tachycardia. He also experienced chills to the point he was shakiness when he go the tachycardia. He also has fever of 108.F and he was given Tylenol for relief of pain. He was then transferred to Hospital at 4pm and stayed there till 11pm. He also received an EKG exam at the Hospital. They also did a Covid test which was negative. As far os today my son has recovered.


VAERS ID: 1443264 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-20
Onset:2021-06-25
   Days after vaccination:66
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: COVID-19, Cough, Oropharyngeal pain, Pulmonary pain, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I take a multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I had a Covid-19 test and it was positive. 06/28/2021
CDC Split Type: vsafe

Write-up: I test positive for COVID on 06/28/2021. I have had a slight fever, congestion, sore throat, coughing, pain in the lungs.


VAERS ID: 1443290 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bone pain, Chills, Fatigue, Headache, Pain, Pain of skin, Streptococcus test negative, Tonsillar hypertrophy
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Osteonecrosis (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: Citalopram; metformin; amlodipine; levothyroxine; prenatal vitamins; VD3; gabapentin.
Current Illness: No
Preexisting Conditions: Hypothyroidism Hashimoto''s; PCOS; running asthma.
Allergies: Penicillin; sulfa drugs; Bentel
Diagnostic Lab Data: I had a strep test.
CDC Split Type: vsafe

Write-up: Began 06/25/2021 that night of my vaccine, I began getting very tired, had a bad headache, chills, and pain all over, bones and skin. The next day my tonsils swollen. I went to my dr. 06/29/2021 and tested for strep, and it was negative. It was treated like a bacteria infection and prescribed a Z-Pac.


VAERS ID: 1443424 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 2 LA / IM

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

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

Write-up: Patient received first dose of Moderna at age 15. Per guidance from CDC, patient received 2nd dose off label.


VAERS ID: 1443540 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-12
Onset:2021-06-25
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Computerised tomogram, Echocardiogram, Myocarditis
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT scan, Chest Xray, blood tests, ECHO test
CDC Split Type:

Write-up: Severe Myocarditis


VAERS ID: 1443608 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-01
Onset:2021-06-25
   Days after vaccination:85
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / 2 - / SC

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: pericarditis


VAERS ID: 1443609 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain lower, Diarrhoea, Headache, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinapril Setaline Glucose Senior Vitamin Omega 3 Vitamin C extended Release 65 Micrograms of iron 2x daily 2x Vitsaimin D capuls 2000 unit 2x daily Atorvastain
Current Illness:
Preexisting Conditions:
Allergies: Lisinapril Setaline Glucose Senior Vitamin Omega 3 Vitamin C extended Release 65 Micrograms of iron 2x daily 2x Vitsaimin D capuls 2000 unit 2x daily Atorvastain
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated that she received a pain in her lower abdomen. She woke up in the middle of the night with a fever and loose bowel movement. When she made it back to her bed she started vomiting. Patient also states that she had a serve headache. Patient stated that she had loose stool for five days. She could only keep down water and sports drink.


VAERS ID: 1443698 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 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: One of our stores got confused with the storage parameters around the Pfizer vaccine and exceeded the 14 day freezer window. The Vaccine was placed inside the freezer on 6/5/21 and taken out on 6/25/21 and placed into the refrigerator. The store has vaccinated 50 people from 6/25/21 ? 6/29/21. The temperature range for the days the vaccine was in the freezer was -0.9 (warmest) to -5.9 (coldest) with an avg temp of -4.9


VAERS ID: 1443703 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-26
Onset:2021-06-25
   Days after vaccination:91
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039A21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Burning sensation, Chills, Erythema, Fatigue, Pain, Pyrexia, Rash, Rash pruritic, Sleep disorder, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (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: COVID Moderna Vaccine - Dose 1 - felt very weak and had chills; felt cold at times; headache and very tired. Started in the afte
Other Medications: Mesalamine - 3 pills a day
Current Illness: no - ulcerative colitis flare up in February before the first vaccine
Preexisting Conditions: ulcerative colitis -had a flare up in February 2020 but it''s been pretty well managed
Allergies: no
Diagnostic Lab Data: ER on June 25 and June 26 - ER - two visits - no labs or medical tests besides visual exam and vitals My primary care doctor ordered lab work which I got done today - July 2, 2021 - at my doctor''s clinic My GI doctor communicated with my primary care doctor through email - referred me to a dermatologist who I saw today, too. They were going to give me Allegra and prescribe me some better/different ointment cream (Triamcinolone - .1%) to put on the rash in case I get more rashes. If it comes back - they will put me on Benadryl. If I end up having to take the Benadryl too often they will get me back on Steroids.
CDC Split Type: vsafe

Write-up: The day of the vaccine, in the afternoon, and intense body aches and had chills and back pain. Felt tired, had fever (at around 5 pm and lasted 24 hours) and didn''t sleep much - I was trying to massage my body( the aches started at around 5 pm and lasted 24 hours) at 04:00 in morning because of the aches - even in bottom of feet. By next day, fever wasn''t coming back and I was very tired. By Sunday, no body aches, just tired. June 25th, I noticed a rash - itching on my hand on and of through the night. I started feeling my neck itching but no signs of anything until past 5 in the afternoon. My daughter noticed how red it was and it started spreading to my back, too and parts of my leg and my belly. I took Benadryl and applied Hydrocortisone cream. That didn''t help. It night, past 9:00 pm, it was still spreading and I could feel like the top of my hands and between my fingers were burning. And rash had spread on my arms and towards my hands. My upper lip was full of the rash and my chin. I went to 25th of June, ER - they gave me some medication - Prednisone Steroids and more Benadryl and Pepcid. I was able to sleep through the night without itchiness but it woke me up in the morning with the itching. I was going to take the Benadryl and the Pepcid (twice a day) - and I was still applying the Cortisone. By 06:00, it started to get pretty bad again - everywhere was very itchy and I took more Benadryl and used the cream and 98% of my face of was covered by rashes- even eyelids and they felt hot. From my chest up and on top of head was red. My arms didn''t'' have anything at that point but by almost midnight - on the 26 I went to ER again and they gave me an EpiPen - and Steroids. They waited and when they saw the medication was taking affect they released me home. My temperature was 99 degrees - slightly higher than my usual. By three o''clock in morning, the 27th, the itching woke me up again - two more Benadryl and applied more Cortisone cream and waited for it to kick in and in the morning, I picked up for the pharmacy a prescription for Steroids for three more days - I took some Sunday, Monday and Tuesday. The hives - I sometimes had to take the cream every four hours instead of 6 - they all over my body. Yesterday, very early morning, I woke up with hives throughout the whole night. And in the morning - The sides of my feet were itchy. My legs - from knees down were full of redness and hives and a few patches on my inner thigh. By two pm I was better yesterday, and I haven''t seen any rashes since then.


VAERS ID: 1443716 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-18
Onset:2021-06-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Exposure during pregnancy, Injection site pruritus, Injection site rash, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (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: Prenatal vitamin
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: I am currently pregnant with my 5th child, due 01/22/2022. A week after receiving the first dose of the moderna vaccine, my right arm became swollen and itchy ( with a rash present) at the injection site.


VAERS ID: 1443913 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Facial pain, Headache, Neuralgia, Pain, Pain in jaw, Pyrexia, Trismus
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (narrow), Glaucoma (broad), Osteonecrosis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Plaquenil, Sulfasalazine, Folic Acid, multi vit, Vit D, Biotin
Current Illness: Bite wound cellulitis resolving at the time of vaccine L arm
Preexisting Conditions: Lupus
Allergies: Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: By 5:30pm I became febrile at 101.4 and had severe pain on the left side of my face. When I woke up in the morning, I couldn''t open my mouth (trismus). Fever continued throughout Saturday with continued severe facial pain (along the facial nerve and axillary n. pathways). By Sunday, fever had resolved but facial pain and trismus continued. Was seen by primary care doctor on Monday who started me on a prednisone taper. Facial pain has improved but but still significant. I can open my mouth but if pushed I get shooting pains down along my jaw and up along the L side of my face extending caudally past my hairline onto my head.


VAERS ID: 1443931 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Limb discomfort, Mobility decreased, Pain in extremity
SMQs:, Parkinson-like events (broad), 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: Tramadol 50mg, Meloxicam 15mg Alprazolam 0.25mg prn Tylenol 650mg
Current Illness: none
Preexisting Conditions: Arthritis of knees Bulging disc in back
Allergies: no allergies
Diagnostic Lab Data: no
CDC Split Type:

Write-up: The patient presented at the pharmacy on 7/2/2021 and reported having continuous arm pain and discomfort since the shot was given on 6/25/2021. The arm pain seems to be mostly focused in the joint and she has difficulty raising her arm overhead. The pain has subsided some but she was concerned because its been over a week. The discomfort is affecting her job and has not completely resolved.


VAERS ID: 1444148 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-18
Onset:2021-06-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Diarrhoea, Discomfort
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (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: baby aspirin
Current Illness: none
Preexisting Conditions: none
Allergies: sulfa drugs, doxycycline, silicone
Diagnostic Lab Data: none. really... what tests should be run? i have to simply spend 1/3 of my life in the bathroom. Hopefully none of the severe scenarios in item 21 will occur...but I do risk dehydration with the amount of fluid leaving from the wrong place.
CDC Split Type:

Write-up: began to have intestinal distress which has worsened each day since. Severe diarrhea has developed, along with constant discomfort. The vaccine is really the only thing different in my life.


VAERS ID: 1444177 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-22
Onset:2021-06-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Echocardiogram normal, Troponin
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: NKA
Diagnostic Lab Data: CC: Chest pain Troponin: 0.06 Repeat Troponin: 0.03 after receiving SoluMedrol 125mg and Ketorolac 30mg ECHO ok EF 61% Cleared by Cardiology to discharge home
CDC Split Type:

Write-up: 6/22/21 first dose of Pfizer Vaccine 6/25/21 Chest Pain 7/2/21 Seek medical attention at ER/Urgent


VAERS ID: 1446102 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-06-01
Onset:2021-06-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Diarrhoea, Electrocardiogram, Headache, Laboratory test, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Iron tablet
Current Illness: NA
Preexisting Conditions: Restless leg syndrome, anxiety
Allergies: NA
Diagnostic Lab Data: 06/28/21 went to family Dr had ekg test and lab work done. Then June 30 emergency room sent by family dr had complete work up labs, ekg, chest pe protocol.
CDC Split Type:

Write-up: First 2 days fever, chills, headache, aching. Then soa, headache, diarrhea, nausea vomiting still going on as of 07/03/2021


VAERS ID: 1446179 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphasia, Nervous system disorder, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Waiting on head CT scans and multiple other tests
CDC Split Type:

Write-up: An hour after vaccine 6/25/21 fell into extreme and uncontrollable nervous system tremors, unable to talk for 20 minutes, went to emergency room. Same event occurred on 6/30/21 and 7/1/21 in which I had to go to the emergency room and now referred to neurologist for further testing.


VAERS ID: 1446203 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO212 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: 100+ Fever & Headache for 6 days. Fatigue & Aches for 8 days and continuing.


VAERS ID: 1446228 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-24
Onset:2021-06-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dry eye, Eye pruritus, Hypersensitivity, Immune system disorder, Lacrimation increased, Pain in extremity, Pruritus, Scratch, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Corneal disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: QUETIPINE 25 MG X 3 FLUOXETINE 20 MG X 1 AMPHET/DEXTR 30 MG X 1
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: DEMEROL
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Within a day of getting the first shot, my eyes became very itchy, particularly my left eye. It is either really dry and itchy or watering, this goes on all day. I got the shot on the 24 of June, and I am still dealing with this to this day July 3. As well it''s like my immune system is less robust, as I have gotten insect bites and scratches from gardening, where I have instant welts and the bites were intensely itchy for almost a week, as for the scratches from gardening I got welts on my skin where the scratches were. Eye drops, Antihistamines that usually work very well, have pretty much no effect. Including the anti- ich cream for the bites all not effective or very minimal. The only other issue was an extremely sore arm the third to fifth day after the shot. These reactions are extreme by my experience and the fact that the remedies I usually use for minor seasonal allergies are of no use. If the eye issues don''t resolve by next week I will be seeing the doctor.


VAERS ID: 1446271 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blepharospasm, Dysgeusia, Hypoaesthesia, Vision blurred, Visual impairment
SMQs:, Peripheral neuropathy (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), 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: 1. Lisinopril-HCTZ 20-12.5mg qd 2. Pantoprazole 40mg bid
Current Illness: None
Preexisting Conditions: 1. blood pressure 2. acid reflux
Allergies: 1. Soma -blotchy red spots
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 1. Odd taste in mouth -metallic taste 5 minutes after the vaccine -still experiencing this symptom. No treatment has not call primary care provider. 2. Left eye started twitching and visual issues including blurry vision and seeing three images. Started 5 minutes after vaccine -still experiencing symptom. No treatment has not call primary care provider. 3. Left hand is numb, this started a couple days after the vaccine -not sure of date and is still experiencing this symptom. No treatment has not call primary care provider.


VAERS ID: 1446330 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Pt did not experience any adverse events. Pt was given vaccine that was stored at freezer temperature for 3 days greater than advised per Pfizer''s storage requirements.


VAERS ID: 1446339 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Pt did not experience any adverse events. Pt was given vaccine that was stored at freezer temperature for 3 days greater than advised per Pfizer''s storage requirements.


VAERS ID: 1446347 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Pt did not experience any adverse events. Pt was given vaccine that was stored at freezer temperature for 3 days greater than advised per Pfizer''s storage requirements.


VAERS ID: 1446352 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Pt did not experience any adverse events. Pt was given vaccine that was stored at freezer temperature for 3 days greater than advised per Pfizer''s storage requirements.


VAERS ID: 1446470 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Induration, Rash, Rash erythematous, Rash papular
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (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: Atomoxetine, Zoloft
Current Illness: Anorexia nervosa
Preexisting Conditions: N/a
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Raised, hard, red rash on upper arm, approximately 2 inches long and 1 inch wide. Began day of vaccine and still present 8 days later.


VAERS ID: 1446478 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Cardiac monitoring, Chest X-ray, Chest pain, Computerised tomogram, Dyspnoea, Headache, Injection site pain, Nausea, Neck pain, Nitrite urine present, Pain, Protein urine present, Rash, SARS-CoV-2 test, Urinary tract infection
SMQs:, Acute renal failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Arthritis (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT scan for PE 6/26, XR chest 6/26, cardiac monitoring 6/26, COVID test 6/26, positive nitrate 6/26, 30 MG protein in urine 6/26, nitrate in urine 6/26, large leukocytes 6/26, rash on arms
CDC Split Type:

Write-up: Chest pain, upper back pain, shortness of breath, O2 at 90% on room air, pain radiating from injection site down arm, headache, pain down left side of neck, nausea, UTI, rash


VAERS ID: 1446480 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-04
Onset:2021-06-25
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-07-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Discomfort, Dyspnoea, SARS-CoV-2 test negative, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Cipro; Lyrica; Pennsaid
Diagnostic Lab Data: Sought a rapid Covid test at the Pharmacy in town on Monday, 6/26/21, around 10:40AM EST, which came back Negative. On Thursday, 7/2, spoke with my GP to explain symptoms since they were persistent; he agreed we should monitor over the weekend, and I will connect back on Tuesday, 7/6 to update him. If adverse event occurs between now and then, I will seek ER care.
CDC Split Type:

Write-up: Beginning on Friday, 6/25/21, began to feel like lungs were ''heavy,'' and that normal oxygenation wasn''t occurring even with a deep breath. I had attended a memorial visitation the evening of June 6/22/21 at the Funeral Home in town and it was the first time post-vaccination that I attended a gathering (small) without a mask; others were also unmasked. I suspect the issue emanates from this interaction. As of this writing, I feel that I am not getting a full, deep and fully-oxygenated breath when I breath. This morning, around 1AM EST, I had slight wheezing on my inhales, which seems to have subsided after I walked the dog down the block and back (slowly). No other discernable Covid-related symptoms to report.


VAERS ID: 1446613 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-22
Onset:2021-06-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

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

Write-up: Swollen and painful lymph nodes around collar bone and neck lasting for 2 weeks and ongoing


VAERS ID: 1446614 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-01
Onset:2021-06-25
   Days after vaccination:85
Submitted: 0000-00-00
Entered: 2021-07-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER 8730 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood test, Computerised tomogram abnormal, Dyspnoea, Electrocardiogram, Palpitations, Pulmonary thrombosis, Thrombosis, Ultrasound scan abnormal
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Simvastatin, pantrapozole
Current Illness: None
Preexisting Conditions: None
Allergies: Contrast iodine
Diagnostic Lab Data: Numerous blood draws on June 26, 27 and 28.
CDC Split Type:

Write-up: June 26, shortness of breath and a heart palpitations. No indication that anything was coming on. Tests performed. Findings, blood clots in left leg and both lungs. Admitted to hospital on June 26. Discharge on June 28. Currently on blood thinners. Sonogram of both legs. Clots found in left leg. EKG, ECG of heart, CT scan found clots in both lungs. Numerous blood draws. Dr. advised I would not have made it to June 27 if I did not come in on June 26. States worst he?s ever seen for blood clots and lungs.


VAERS ID: 1446689 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-01
Onset:2021-06-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-07-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

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

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

Write-up: I have been having soreness in my left lower leg.. I am concerned it has to do with the vaccine


VAERS ID: 1446775 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-22
Onset:2021-06-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test normal, Electrocardiogram normal, Pain, X-ray normal
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Had a cold a few weeks prior
Preexisting Conditions: None
Allergies: Amoxicillin, Seroquel, Tamiflu
Diagnostic Lab Data: I went to the emergency room on June 29th 2021. My tests came back all good. Blood, EKG and xray. They gave me Motrin and lidocaine patches.
CDC Split Type:

Write-up: I''ve been experiencing joint pain in the left shoulder that started a couple days after the vaccine. I went to the emergency room because it was very painful and the pain was radiating to my collar bone. I was worried that something was seriously wrong.


VAERS ID: 1447038 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-22
Onset:2021-06-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: I am not aware of any tests.
CDC Split Type:

Write-up: The patient reported that she began to break out in small hives. She could not remember the exact day that they began. She said approximately 2 to 4 days after her second dose. She said she was not aware of any other changes that might explain the break out. She said they did spread some and complained of itching. We talked about her taking Benadryl which she said she was already. We also talked about using some Hydrocortisone cream to help also with the itching. She does not have a dr and therefore; did not want to go to a dr. We did tell her she should be seen if they continued to spread in spite of how she was treating them.


VAERS ID: 1447103 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 2 LA / IM

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

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

Write-up: Patient had appointment scheduled at another facility for 21 day interval because it scheduled based on Pfizer, his first dose was moderna, they almost gave him Pfizer. He came here and all our safety check failed and he received the mderna vaccine 21 days from 1st dose. We realized after a few dates the error. Patient was contacted and reported no issue or side effect more than after the first dose.


VAERS ID: 1447138 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-06-22
Onset:2021-06-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphthous ulcer, Oral disorder, Oral pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown. Only service we have given this pt is covid vaccine #1 & #2
Current Illness: none
Preexisting Conditions: none
Allergies: Penicillins, codeine
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Started developing canker sores and raw spots on oral mucosa, tongue and gums approximately three days after injection, peaking in severity 7/3/2021. Started improving yesterday and nearly cleared up by today. **In retrospect, patient recalls having a sore mouth with no visual lesions after first dose for a few days**


VAERS ID: 1447164 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Suppressed lactation
SMQs:, Functional lactation disorders (narrow)

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

Write-up: I was 5 weeks post c-section. I has been pumping since my child was born. At time of second vaccine, I was getting 5 to 6 oz of breast milk during each pumping session. Also immediately after receiving the 2nd shot, my milk production drastically decreased to 2 to 3 oz a session and never picked back up. I decided to ween off pumping altogether due to low supply 7 weeks post c-section.


VAERS ID: 1449732 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Seizure, Vaccination complication
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), 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: Medical History/Concurrent Conditions: No adverse event
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Convulsions; Patient is experiencing a possible vaccine reaction; This spontaneous case was reported by a nurse and describes the occurrence of SEIZURE (Convulsions) in a 25-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included No adverse event. On 25-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Jun-2021, the patient experienced SEIZURE (Convulsions) (seriousness criterion medically significant). 25-Jun-2021, the patient experienced VACCINATION COMPLICATION (Patient is experiencing a possible vaccine reaction). The patient was treated with LORAZEPAM (ATIVAN) 25-Jun-2021 for Convulsion, at a dose of 2 mg. At the time of the report, SEIZURE (Convulsions) was resolving and VACCINATION COMPLICATION (Patient is experiencing a possible vaccine reaction) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not provided. Lab Data: results pending. It was reported that in the emergency room they have treated the patient with 2mg of Ativan, with improving results, from convulsing to subtle shakes. 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: 1450061 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-18
Onset:2021-06-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site induration, Injection site nodule, Injection site reaction, Injection site swelling, Injection site warmth, Rash erythematous, Rash pruritic
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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Verapamil; multi-vitamin;
Current Illness: None
Preexisting Conditions: hypertension
Allergies: n/k/a
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: A week after her first dose of the Pfizer vaccine her arm swelled at the injection site and developed a red, itchy rash. She also had a hard knot / nodule at the site and the area was very warm to the touch. It took about 5 days for the nodule to decrease in size. As of July 6 she still has some redness and a rash on her arm.


VAERS ID: 1450072 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-09
Onset:2021-06-25
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (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:
CDC Split Type:

Write-up: D69.6 - Thrombocytopenia


VAERS ID: 1450082 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-19
Onset:2021-06-25
   Days after vaccination:126
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Appendicitis
SMQs:

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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: K35.80 - Acute appendicitis, unspecified acute appendicitis type


VAERS ID: 1450396 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Neuralgia
SMQs:, Peripheral neuropathy (narrow)

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

Write-up: Patient reports that he felt like the needle hit the nerve and experienced uncomfortable nerve pain after asked about how was his experience with his first dose of Pfizer. He states that he still feel it a bit till today 7/6/21. But, when ask him if its painful and affecting him significantly, he mentioned he was fine.


VAERS ID: 1450449 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-05-26
Onset:2021-06-25
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood loss anaemia, Exposure during pregnancy, Foetal non-stress test, Full blood count, Gestational diabetes, Haemorrhage in pregnancy, Metabolic function test, Pre-eclampsia, Protein urine, Ultrasound antenatal screen, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Hypertension (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Proteinuria (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Protonix 20mg once daily, Prenatal Vitamin once daily, vitamin D 400iu daily, aspirin 81mg daily, tums 750mg chewable 2 tabs as needed for heartburn, acetaminophen 650mg every 6 hours as needed.
Current Illness: none
Preexisting Conditions: none
Allergies: zithromax
Diagnostic Lab Data: 24 hour urine, CBC, CMP, blood pressure monitoring, ultrasound, fetal non stress test weekly
CDC Split Type:

Write-up: Estimated delivery date of August 5th, 2021. Currently 35 weeks. Development of preeclampsia, gestational diabetes at 34 weeks. 2 episodes of heavy vaginal bleeding during pregnancy, one at 30 weeks (just after 2nd dose of moderna vaccine) and one at 34 weeks. Currently being monitored for worsening preeclampsia with plans to deliver at 37 weeks (July 15, 2021) if stable. Gestational diabetes managed with diet and exercise at this time. Bleeding resolved within 2 or 3 days. Developed anemia after second bleeding episode.


VAERS ID: 1450494 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Headache, Magnetic resonance imaging, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: My body aches, serve headaches. Joint pain, fever


VAERS ID: 1450531 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-24
Onset:2021-06-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Dyspnoea, Fatigue, Feeling abnormal, Headache, Insomnia
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

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

Write-up: Headache, shortness of breath, burning sensation in chest, joint pain, fatigue, brain fog, trouble sleeping. Began one day after first dose and still present 12 days later.


VAERS ID: 1450610 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

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

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

Write-up: At 1:25pm patient reported that she felt slight itching (on-and-off) mostly occurring on upper extremities. V/S monitored - BP 117/91, P-85, RR-17, 02 Sat 98% RA Patient given oral Bendryl 25mg. No shortness of breath noted, no coughing or throat itching. No redness on skin (hives) noted. Patient reported less itching after taking Benadryl. Advised patient to see help from physician is symptoms worsen. Vital signs BP 118/89, RR-17, P-85, 02 Sat 98% RA


VAERS ID: 1450681 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-23
Onset:2021-06-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012MZOA / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ear, nose and throat examination, 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: Simvastatin, Metoprolol, Valsartan, Prilosec
Current Illness: None
Preexisting Conditions: Heart Disease
Allergies: Ceclor
Diagnostic Lab Data: Had an ear test performed by ENT
CDC Split Type:

Write-up: Tinnitus in right ear two days after first shot Continues to hear hissing sound.


VAERS ID: 1450704 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-20
Onset:2021-06-25
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

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

Write-up: I26.99 - Pulmonary embolus (CMS/HCC)


VAERS ID: 1450907 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Heart rate increased, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (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: Ergocalciferol 1.25 MG (50000 UT) Capsule 1 capsule Orally weekly
Current Illness:
Preexisting Conditions: Vitamin D deficiency
Allergies: beef, lamb, alcohol, pork, chicken
Diagnostic Lab Data: None
CDC Split Type:

Write-up: During her observation time, patient complained of a rapid heart beat, shortness of breath, she had an episode of vomiting, and a syncopal episode. She was referred to a primary care physician for further evaluation. Her condition stabilized prior to discharge.


VAERS ID: 1450945 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-27
Onset:2021-06-25
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Dyspnoea, Exposure during pregnancy, Panic reaction
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: progesterone; prenatal vitamin; iodine supplement; Vit D and Vit C
Current Illness: no
Preexisting Conditions: Depression and anxiety in the past
Allergies: latex; tomatoes
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: Shortness of breath and panic - feeling of loss of control; worry and anxiety. The severe symptoms lasted about five hours. And then management symptoms I am still experiencing. I saw my social worker/licensed. She recommended that I recommend to go to a Psychiatrist to talk about medication for the symptoms. The only thing I''m using for treatment is yoga, deep breathing and meditation and that seems to help. Pregnancy history -2nd pregnancy - 1st pregnancy - successful live birth; estimated date of delivery for this 10/10/2021.


VAERS ID: 1453604 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Connecticut  
Vaccinated:0000-00-00
Onset:2021-06-25
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821281 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Herpes virus test, Injection site pain, Therapeutic response unexpected
SMQs:, Extravasation events (injections, infusions and implants) (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: Allergy; Bipolar disorder; Bone spur; Herpes infection; Migraine; Non-smoker
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Name: Herpes virus test; Result Unstructured Data: unknown
CDC Split Type: USJNJFOC20210708323

Write-up: GOING TO BATHROOM FINE SINCE VACCINATION, NO NEED OF TAKING LAXATIVE THAT WERE PRESCRIBED; PAIN IN THE LEFT ARM WHERE SHE HAD THE INJECTION; TIRED; This spontaneous report received from a patient concerned a 55 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included bipolar disorder, bone spurs, migraines, herpes types 1/2, quit smoking prior to vaccination, and grass mold mushrooms allergy.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821281, expiry: UNKNOWN) dose was not reported, administered on 25-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 25-JUN-2021, the subject experienced going to bathroom fine since vaccination, no need of taking laxative that were prescribed. On 25-JUN-2021, the subject experienced pain in the left arm where she had the injection. On 25-JUN-2021, the subject experienced tired. Laboratory data (dates unspecified) included: Herpes virus test (NR: not provided) unknown. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from tired on 26-JUN-2021, and the outcome of pain in the left arm where she had the injection and going to bathroom fine since vaccination, no need of taking laxative that were prescribed was not reported. This report was non-serious.


VAERS ID: 1454070 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0125 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Asthenia, Chest discomfort, Computerised tomogram, Cough, Dysstasia, Fatigue, Feeling hot, Migraine, Nausea, Temperature intolerance, Throat irritation, Vision blurred
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), 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 (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (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:
Current Illness:
Preexisting Conditions:
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: My throat was itchy, and I was coughing. Then, I had an anxiety attack. I stayed at the vaccination location for 40 minutes until I felt better. When I got home, the first and second day I felt tired and nauseated. Sunday, I felt normal and on Monday I woke with a migraine, very nauseated, really dizzy, had blurry vision, and I couldn''t stand without holding onto the wall. Tuesday, I had the exact same side effects plus an itching/burning throat. I went to the ER on Tuesday, and everything was normal. CT scan was taken on Tuesday. I no longer have headaches, and I am no longer nauseated. Throughout the whole ordeal I had no energy. I can no longer tolerate the heat, I always get really hot.


VAERS ID: 1454147 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Contusion, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Hypothyroidism, ARF, CAD
Allergies: Simvastatin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left arm bruising. Patient had hives prior to ED admission that resolved at home. Received Benadryl and Tylenol.


VAERS ID: 1454163 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 - / IM

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

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

Write-up: Syncope episode. Patient received 1,000 ml NS bolus


VAERS ID: 1454265 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oral pruritus, Palpitations, Pruritus, Throat irritation
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: mouth itching, then throat, arms itching, heart palpitations , used benedryll


VAERS ID: 1454409 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-01
Onset:2021-06-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Breast pain, Dizziness, Dyspnoea, Electrocardiogram, Fatigue, Feeling abnormal, Nausea, Oropharyngeal pain, Pain in extremity, Palpitations, Pyrexia, Temperature intolerance, Thinking abnormal
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Lipodystrophy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Klonopin 0.5 - 2 x a day
Current Illness:
Preexisting Conditions: Low ferritin, fatigue
Allergies: Gluten, MSG, quinoa
Diagnostic Lab Data: EKG, vitals Tues June 29 2021
CDC Split Type:

Write-up: Barely felt anything for 48 hours other than a slightly sore arm. As Sunday progressed, I became weak, lightheaded, very nauseous, extremely fatigued and had heart palps, shortness of breath with walking, a very sore breast (opposite side of shot) and a fever of 99.5. Day 4 was less intense but all the symptoms remained minus the fever. On Day 5 I went to urgent care... Sore throat, weakness, lightheaded, unable to think, tired to the core, heart palps, racing heart with little exersion, and sore breasts. Day 6 onward still feeling off. A LOT of brain fog and fatigue. Shortness of breath when doing light movement like walking. VERy sensitive to heat.


VAERS ID: 1454417 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-19
Onset:2021-06-25
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure measurement, Chest discomfort, Electrocardiogram normal, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: Amoxicillin, penicillins
Diagnostic Lab Data: EKG- normal BP- 160/101
CDC Split Type:

Write-up: Patient states he received his 2nd COVID vaccine last week and the day after he developed a fever, chest tightness myalgias. States that he has a device at home and checks his heart rate and monitors an EKG and states that it told him he had PVCs at that time.


VAERS ID: 1454455 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-22
Onset:2021-06-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bleeding varicose vein, Feeling hot, Skin discolouration
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Skin dark and warm spots on both hands. Deep vein bursts. Several veins exploded on legs which later faded away. Hands dark spots still persist and continue to darken. A sensation of warmness to whole skin in the body especially the facial area. The sensation of warmth will come and go. it does not last all day but when creams or other neutral products are applied on the skin, such as body lotion or body soap.


VAERS ID: 1454478 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Oropharyngeal discomfort, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad)

Life Threatening? Yes
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: Synthroid
Current Illness: None
Preexisting Conditions: None, had thyroid removed many years ago
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I felt like my throat was closing up and I had a lot of pressure in my throat and chest and felt like I couldn''t breathe. I used my mother''s albuterol asthma inhaler and took allergy medication, which didn''t help much. Then I feel asleep (passed out?) and didn''t wake up until the next day. My throat still felt tight but I was able to breathe the next day.


VAERS ID: 1454516 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-06-20
Onset:2021-06-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bladder spasm, Blood test, Computerised tomogram, Ultrasound scan, Urine analysis
SMQs:

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: DIETARY SUPPLEMENTS; OMOXYCYLLIN; TAMSULOSIN; OXICODONE
Current Illness: KIDNEY STONES
Preexisting Conditions: ATRO VALVLE; MITRO VALVE
Allergies: SHRIMP
Diagnostic Lab Data: ULTRASOUND; URINE TEST; BLOOD TEST; CT SCAN
CDC Split Type: vsafe

Write-up: SEVERE BLADDER SPASM FREQUEST RESTROOM VISITS STARTED SLOWLY AND PROGRESSED AND WORSENED.


VAERS ID: 1454517 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-06-23
Onset:2021-06-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol ER 50mg, Levothyroxine 88mcg
Current Illness:
Preexisting Conditions: WPW, trigemeny, High Bp
Allergies: Bactrim, sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen lymph nodes in neck (both left and right sides) and at right collar bone. Warm compresses and massage. Alternating ibuprofen and Tylenol to ease discomfort.


VAERS ID: 1454537 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-03
Onset:2021-06-25
   Days after vaccination:83
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN-6207 / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Retinal artery occlusion
SMQs:, Embolic and thrombotic events, arterial (narrow), Retinal disorders (narrow)

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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Gabapentin, Meloxicam, Lisinopril, Vitamin D3, Famotidine
Current Illness: Parkinsonian Tremors
Preexisting Conditions:
Allergies: Silace
Diagnostic Lab Data: Contact Dr.
CDC Split Type:

Write-up: Branch Arterial Retina Occlusion


VAERS ID: 1454733 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-06-18
Onset:2021-06-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204AZIA / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Haemorrhoid operation, Haemorrhoids thrombosed
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

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: na
Current Illness: na
Preexisting Conditions: na
Allergies: na
Diagnostic Lab Data: Excision of thrombosed external hemorrhoid on June 27 at 11:06 am
CDC Split Type:

Write-up: Perianal venous thrombosis/blood clots


VAERS ID: 1454887 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-30
Onset:2021-06-25
   Days after vaccination:87
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Erythema, Headache, Swelling, Tenderness
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol ER, Losartan potassium, Anastrozole, Pepcid, Loratadine, Vitamin C, Calcium +D3, Zinc, Multi-vitamin, Vitamin D3
Current Illness:
Preexisting Conditions: Osteoarthritis, breast CA survivor, hypertension, myofascial pain
Allergies: Penicillin, Sulfa, Azithromycin, Cephalosporin, Morphine, Cocaine from surgery, avocados, antibiotic given at a hospital but do not know the name, Fizzing (gave me rash), mold, dust, cats, dogs, horses, feathers
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I experienced after my vaccine, I had little swelling, redness and a little tender. I also had a slight headache that came and went. My symptoms cleared pretty fast within a few days.


VAERS ID: 1454900 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Oral pruritus, Paraesthesia, Paraesthesia oral, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: At 1249, patient reported tingling and itchiness in lips and left arm. Patient denied difficulty swallowing, breathing, itchiness, rashes, and hives. Patient given water. Patient able to swallow water. Patient reported allergies to olive trees. Patient reported history of hypertension and took her medication in the morning. Lead nurse offered 911. Patient refused 911. At 1254, EMT assessed patient vitals: blood pressure 160/90 mmHg and pulse rate 67 beats/minute. At 1255, lead nurse administered intramuscular diphenhydramine 50 mg/1 ml in patient''s right arm. Patient advised to wait for further observation. At 1305, EMT reassessed patient vital signs: blood pressure 158/82 mmHg and pulse rate 66 beats/minute. At 1318, EMT reassessed patient vital signs: blood pressure 162/86 mmHg and pulse rate 69 beats/minute. At 1328, EMT reassessed patient vitals: blood pressure 168/86 mmHg and pulse rate 68 beats/minute. Lead nurse assessed patient. Patient denied tingling and itchiness in lips and left arm. Patient denied drowsiness. Patient offered transportation. Patient refused transportation. Lead nurse educated patient on signs/symptoms of when to seek care, to sign up on v-safe, and to follow up with primary care provider. At 1333, patient left facility with unlabored respirations and steady gait.


VAERS ID: 1456642 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Seizure, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: still has shakes on and off; Had a seizure/basically started seizing and couldn''t stop/by the time when she arrived at the hospital, she was still convulsing but could talk/duration of seizures to be 1 or 1.5 hours long/still has shakes on and off; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of SEIZURE (Had a seizure/basically started seizing and couldn''t stop/by the time when she arrived at the hospital, she was still convulsing but could talk/duration of seizures to be 1 or 1.5 hours long/still has shakes on and off) in a 25-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 25-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Jun-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced SEIZURE (Had a seizure/basically started seizing and couldn''t stop/by the time when she arrived at the hospital, she was still convulsing but could talk/duration of seizures to be 1 or 1.5 hours long/still has shakes on and off) (seriousness criterion medically significant). On an unknown date, the patient experienced TREMOR (still has shakes on and off). At the time of the report, SEIZURE (Had a seizure/basically started seizing and couldn''t stop/by the time when she arrived at the hospital, she was still convulsing but could talk/duration of seizures to be 1 or 1.5 hours long/still has shakes on and off) was resolving and TREMOR (still has shakes on and off) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were provided. Patient was treated with IV medication in emergency room that helped her stop the seizures. She was discharged from the emergency room once she stopped having tremors. She still had shakes on and off and saw her primary care provider who had referred her to a neurologist. Company Comment: 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: 1456707 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210625; Test Name: Covid; Result Unstructured Data: Test Result:Positive; Comments: all positive tested individuals were symptomatic.
CDC Split Type: USPFIZER INC2021805358

Write-up: Four of my colleagues (including myself) have contracting COVID within a week despite all having been vaccinated; Four of my colleagues (including myself) have contracting COVID within a week despite all having been vaccinated; This is a spontaneous report from a contactable consumer A patient of unspecified age and gender received BNT162B2 (Formulation: Solution for injection; Batch/Lot number: unknown), via an unspecified route of administration on an unspecified date of Jun2021 as single dose (dose number unknown) for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. Customer reported that four of my colleagues (including myself) have contracting COVID within a week despite all having been vaccinated. Exposure could not have occurred before Monday 21Jun2021 and symptom onset (all positive tested individuals were symptomatic) was by 25Jun2021. They were all researchers and recognize the impossibility of this not being a variant. Patient was totally willing to participate in any studies that might help understand variants and the efficacy of the vaccine on them. On 25Jun2021 the patient underwent lab tests and procedures which included sars-cov-2 test: positive. The outcome of the events was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1457174 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse reaction, Chest pain, Dyspnoea
SMQs:, Anaphylactic reaction (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cymbolta, Propanolol, Valacyclovir, Celeloxib, Escitalopram, Clovapam, Cyclobenzapreme, Rizatripatan, Percocet, Tramdol
Current Illness:
Preexisting Conditions:
Allergies: Penacillin, Loratab, Latex gloves,
Diagnostic Lab Data:
CDC Split Type:

Write-up: When I had the vaccine, two nights later I couldn''t breathe and my chest was hurting. I got the shot about 2 weeks ago, and patient stated that she did not go see doctor about Adverse Reaction.. Patient has recovered from Adverse Reaction.


VAERS ID: 1457209 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Palpitations
SMQs:, Anaphylactic reaction (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: about 2 hours afterwards i had slight problem breathing. Chest pains have been on and off ever since. Sometime i feel like my heart is thumping.


VAERS ID: 1457214 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-17
Onset:2021-06-25
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PAA165969 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Catheterisation cardiac, Chest discomfort, Chest pain, Chills, Diarrhoea, Echocardiogram, Fatigue, Feeling of body temperature change, Nausea, Troponin increased, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Myocardial infarction (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin; Crestor'' Testosterone Cypionate
Current Illness: none
Preexisting Conditions: MI, GERD, Hernia, hyperlipidemia, hypogonadism
Allergies: Wellbutrin
Diagnostic Lab Data: on 6/29/21--increasing troponin; Cardiac ECHO; Cardiac Cath
CDC Split Type:

Write-up: Reports hot/cold shivering started 6/25 then started with nausea, vomiting & Diarrhea. Chest pain/pressure started 6/29 and went to hospital. MD reports increasing Troponin so admitted to hospital for ECHO & Cardiac Cath. Discharged on 6/30. Still reports Fatigue


VAERS ID: 1457256 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-05
Onset:2021-06-25
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anticoagulant therapy, Computerised tomogram thorax abnormal, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Beta Blocker Aspirin BP Med
Current Illness: None
Preexisting Conditions: Type 1 Diabetic
Allergies: None
Diagnostic Lab Data: CT Scan or chest.
CDC Split Type:

Write-up: Pulmonary embolism treated with blood thinner. NO prior history of clotting.


VAERS ID: 1457327 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-24
Onset:2021-06-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Headache, Hyperhidrosis, Injection site induration, Injection site swelling, Injection site warmth, Nausea, Pain, Pyrexia, SARS-CoV-2 test negative, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Yeast
Diagnostic Lab Data: 07-01-2021 - Covid test administered - Results of the test were negative
CDC Split Type:

Write-up: Swelling at injection site and extremely hot to touch and formed a hard mass for over one week and started within an hour of injection. 24 hours later, fatigue, fever, shakes, headache and aches set in. The second night all the previous mentioned symptoms continued but at an elevated state. This integrity lasted for three days. One week post injection, still suffering headaches, nausea, fatigue, shortness of breath, aches and sweats. Two weeks post injection, still suffering from previously mentioned symptoms.


VAERS ID: 1457485 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-01
Onset:2021-06-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Feeling abnormal, Headache, Influenza, Influenza A virus test positive, Mononucleosis heterophile test negative, Neck pain, Pain, Pyrexia, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (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: Tetanus combo vaccine (unknown combo) - very exhausted and ill feeling, unknown date/age
Other Medications: Human Growth Hormone nightly
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Morphine & morphine derivative; gluten
Diagnostic Lab Data: Tests on June 29/30, 2021, Flu A test positive, Mono test negative, COVID rapid negative
CDC Split Type: vsafe

Write-up: I got the Flu A with throbbing head pain almost constantly in the right side of my head and neck. No stuffy nose or anything like that. Just general pain and feeling terrible. I was bed ridden from Friday 25th June to Wednesday 30th June. My fever was up to 102 and was generally high throughout that time as well. I took ibuprofen and ate healthily, when I could eat though I had no appetite. I went to the DR and got a flu test on the 29th or 30th of June.


VAERS ID: 1457487 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-06-25
Onset:2021-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 LA / IM

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

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

Write-up: Spotty rash formed on her entire body by the evening of the same day. Still has some rash remaining.


VAERS ID: 1458632 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-21
Onset:2021-06-25
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Chest pain, Dizziness, Dyspnoea, Electrocardiogram normal, Pain in extremity, Paraesthesia, X-ray normal
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zinc and men''s daily gummies
Current Illness: None
Preexisting Conditions: Currently have broken tibial plateau and fibular head
Allergies: None
Diagnostic Lab Data: Blood came back ok. X-ray looked ok.
CDC Split Type:

Write-up: About 4 hours post injection ring finger nerves became painful at tip with pins and needles feeling. Still present, but not as painful. About 1 week post injection, began getting chest pains, difficulty breathing, and dizziness/lightheadedness. We to urgent care 1 week after symptoms started to appear as they got worse. EKG ran showing potential heart attach in past, but I don''t think I''ve had one before. Was noted and told might have been due to crutches. Symptoms got worse next day so went to urgent care at different facility. Brought to ER for x-ray, blood , and EKG. Told no myocarditis, but potentially pericarditis.


VAERS ID: 1459686 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-06-22
Onset:2021-06-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 2037217 / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Feeling abnormal, X-ray normal
SMQs:, Anaphylactic reaction (broad), Dementia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Allergy related asthma specifically in the northeast region. No asthma in state where I lived for years and received vaccination. Issue started in state.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Inability to take a full breath. Asthma inhalers, including steroidal ones do nothing for the first time ever. Condition persisted past 2 weeks, so visited ER. ER prescribed strong steroids as x-rays came back clean. Feeling better but not good.


VAERS ID: 1459728 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-05
Onset:2021-06-25
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Blood immunoglobulin M increased, Blood test, C-reactive protein increased, Chest X-ray normal, Electrocardiogram normal, Gastric disorder, Iron binding capacity total decreased, Muscle spasms, Pain in extremity, Stool analysis normal, White blood cell count increased
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine, vitamin D, vitamin C, zinc, biotin
Current Illness: N/a
Preexisting Conditions: High BP
Allergies: Azithromycin, Bactrim, K-Flex, Biaxin, penicillin
Diagnostic Lab Data: Blood work - 6/30/2021 - white blood count high, c reactive high, High levels of IgM, TIBC iron bind low; Stool Samples - 6/30/2021 - all negative; EKG - 4/8/2021 - normal; Chest xray - 4/26/2021 - normal
CDC Split Type: vsafe

Write-up: So on Friday at 10:30PM On the Friday 25th of June, I had GI issues and a lot of stomach pain. I also had cramping and pain in the back of my legs as well. I went to the DR and she put me on antibiotics, Cipro and something else I cannot remember. I went to the DR on Wednesday the 30th of June. The GI problems have been happening for about 2 weeks. I also saw my cardiologist on 4/8/2021 and he saw I was ok, the pulmonary DR also said my lungs looked fine on 4/26/2021.


VAERS ID: 1459789 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-23
Onset:2021-06-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Body temperature increased
SMQs:, Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin Calcium Tablet 80 MG, , Ferrous sulfate(65 Fe) MG , Ergocalciferol Capsule 50 MCG (2000 UT) Tablet 325 ,Multivitamin Tablet (Multiple Vitamin) ,Aspirin Tablet Chewable 81 MG ,Omeprazole Capsule Delayed Release 20 MG
Current Illness: n/a
Preexisting Conditions: cva, , duodenal ulcer, ATOH dependence, hemiplegia/hemiparesis, dysarthria, dysphagia all secondary to stroke.
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: second day after vaccine on 6/25/21 100.3


VAERS ID: 1459906 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-02
Onset:2021-06-25
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Gallbladder disorder
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gallbladder related disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: no
Preexisting Conditions: COPD
Allergies: some antibiotics
Diagnostic Lab Data: not yet
CDC Split Type: vsafe

Write-up: Pain in abdomen area. Dr thinks it is the gall bladder. Dr has ordered an ultrasound an August 2nd. No treatment yet.


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