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From the 10/15/2021 release of VAERS data:

Found 800,916 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 62 out of 8,010

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VAERS ID: 1757126 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 3 LA / IM

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

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

Write-up: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1757139 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Hyperaesthesia, Hyperhidrosis, Pain, Pyrexia, Sensitive skin
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tetanis booster, 25. It had only been a few years since my previous booster, and I was nauseous, feverish, achy for three day
Other Medications: Synthroid, Cytomel, zoloft, vitamin D, culterelle for women
Current Illness: none
Preexisting Conditions: hashimoto''s hypothyroidism, psoriasis
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Body aches & pains, starting about 12 hours after booster shot. This seemed like a normal reaction. 23 hours after... was exhausted & experiencing a bit of brain fog (left my lunch bag & purse in my classroom, decided I didn''t need either since I had my keys & was too tired to walk down the steps to get them). Day 3: taught in the morning, slept all afternoon. Skin was very sensitive to touch/movement, still had body aches. Day 4: still off a bit- took another nap. Went for a mile walk & was sweating. Sweat all night like I had a fever (I did not). Day 5: Feeling normal, just a little tired.


VAERS ID: 1757152 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A LA / IM

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

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

Write-up: Pt was here to receive his vaccination. I went to give him the vaccine. I inserted the needle and began to inject. Patient pulled away because it hurt to bad. He was only given .3cc out of the .5cc that needed to be given. Pt was very angry he had to get the vaccine in the first place.


VAERS ID: 1757172 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-11
Onset:2021-09-30
   Days after vaccination:231
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Cough, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Guillain-Barre 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: Asprin; Smivastatin, Amlodipine; Metorprolo; Furosemide; Fluconionide
Current Illness: none
Preexisting Conditions: hypertension; hyperlipidemia, chronic kidney disease, stage 3; hyperthyroidism;peripheral vascular disease
Allergies: tamsulosin
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient has tested positive for Covid. Only symptoms, small non-productive cough, and slightly weak. symptoms starting 9/29/21


VAERS ID: 1757215 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Seizure
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? 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: per pt partner pt had seizure day after receiving 2nd dose of moderna, no history of seizures, is ok now


VAERS ID: 1757232 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Decreased appetite, Diarrhoea, Dizziness, Fatigue, Headache, Injection site pain, Myalgia, Nausea, Pain, Palpitations, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamin, vitamin D3 supplements
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA. Starting around 8pm after receiving the vaccine about 5 pm, I started getting severe chills. The chills were causing vigorous full body shivers. My body temp began to rise and I maintained a fever of over 101 degrees until after 1pm the following day. All through the night I had diarrhea, nausea, a headache, and dizzyness with a racing heart rate when I tried to stand. I had muscle aches through the night, particularly in my calves and soles of my feet. After taking 800mg of ibuprofen, my fever dropped below 100 degrees and my body aches subsided until about 6 pm day after injection, then fever began to rise again, chills and nausea returned. So I took another 800 mg ibuprofen before returning to bed and going back to sleep. Major symptoms were gone by the second morning after injection with some lingering fatigue, loss of appetite, and mild body aches. Injection site in arm is also still tender and sore.


VAERS ID: 1757240 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Decreased appetite, Diarrhoea, Dry mouth, Erythema, Fatigue, Lymphadenopathy, Migraine, Nausea, Oropharyngeal pain, Pain, Pain in extremity, Peripheral swelling, Pyrexia, Rhinorrhoea, Thirst, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Influenza vaccine at age 39. Unsure of exact date and brand name. Had fatigue, migraine, body aches, light sensitivity, poor app
Other Medications: Atenolol, Adderall XR, Protonix, Zoloft, Claritin, Pseudoephedrine, Benadryl, Tylenol PM, Elder Berry with Zinc & Vitamin C
Current Illness: n/a
Preexisting Conditions: Heart palpitations/irregular heart rate, GERD, ADHD, Anxiety, Depression, OCD
Allergies: Sulfa, Morphine
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Sore arm, Redness and swelling in upper arm, Migraine, Body aches, Joint pain, Fatigue, Decreased Appetite, Dry mouth/increased thirst, Nausea/Vomiting, Diarrhea, Nasal drainage, Sore throat, swollen lymph nodes & Fever. Took Ibuprofen, Tylenol, Excedrin, and Benadryl. Lots of rest and cold compress applied to upper arm. Symptoms lasted approximately 48 hours.


VAERS ID: 1757275 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-21
Onset:2021-09-30
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Atrial flutter, Chest pain, Electrocardiogram abnormal, Heart rate increased, Rash, Throat tightness, Ventricular extrasystoles
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Ventricular tachyarrhythmias (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: With first moderna vaccine only
Other Medications: None
Current Illness: The day I received the first dose I had a tachycardia 5 minutes layers after receiving the vaccine (reported) The day I received the second dose my throat closed up And next day I had a rash on face and neck (reported)
Preexisting Conditions: Cluster headaches
Allergies: None
Diagnostic Lab Data: EKG - atrial fluter
CDC Split Type:

Write-up: I?m a doctor so I can use medical terms . Since dose 2 of moderna vaccine I started experiencing PVCs . On 9/30 around 10:00 pm I get the PVCs we?re more frequent. Then I felt a burning sensation on my chest and after that my heart rate jumped all of the sudden to 155. I took 50 mg of Metoprolol from my husband and started to slow down after 15 minutes . I recorded the EKG on my Apple Watch and showed to my friend who is a cardiologist and she said it was an atrial flutter episode . I?m on metoprolol 25 mg bid now and Asa 81 mg. I will see her at the clinic on 10/5 to get an echo and holter monitor. I don?t have any h/o arrhythmia.


VAERS ID: 1757281 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-24
Onset:2021-09-30
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Mango, cortisone
Diagnostic Lab Data: I have not gotten tested yet. I have a doctors appointment this monday.
CDC Split Type:

Write-up: The days following the vaccine I began experiencing tingling in my cheeks and some eye blurriness.It bothered me but did not think too much of it. It was a special week so I was excited about all the week events I was going to do with family. Then finally, on Thursday September 30th around 1 pm I felt the tingling return to my cheeks, then to my nose and forehead. I was also At around 3:30 pm, my face had gone numb. The entirety of it. I would touch my face and lightly slap it and I still couldn''t feel. I immediately called the doctors office to schedule an appointment asap. I had done some research into the vaccine and this had been a side effect reported by people. The feeling came back to my face around 5:30 ish. My right cheek lost feeling the next morning around 8:30 am.l but was back around 12 pm. Today is sunday and I have not experienced any more numbness since friday.


VAERS ID: 1757282 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA EXP: 11 / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Chills, Decreased appetite, Diarrhoea, Fatigue, Hallucination, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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: Amiodarone, Xarelto, Furosemide, Klor-Con Potassium, Fish Oil, Vit D34, Magnesium Oxide, Levothyroxine, Galantamine,
Current Illness: none known
Preexisting Conditions: none
Allergies: Pamipexole
Diagnostic Lab Data: No tests but reported to Dr. and spoke with nurse at his office as well as nurse at Health. Nurse at Dept said she had same reaction on her 2nd dose. Both nurses assured us that is this ''normal'' reaction and would go away in 24-48 hours. Had a major ''fever break'' event on 10/1/21 about 6 am. Several other friends have had similar problems, BUT they probably don''t take the time to report.
CDC Split Type:

Write-up: Fever, weakness/exhaustion, hallucinations (playing game that didn''t exist), chills, feeling unwell, decreased appetite, loose bm,


VAERS ID: 1757290 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-25
Onset:2021-09-30
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paraesthesia, Pruritus, Sleep disorder, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Extreme onset of hives. From mid chest down. Welts the size of a quarter to some size. Clustered in some areas or approx 6-9 inches apart. Very random. It was like all my skin in those areas was growing in intensity from 2pm? to about 2am (10/01) when it started to finally calm. I could not where my jeans because my skin was so irritated. It was all I could do to not scratch through my skin. I was unable to sleep as the tingling and itchiness was so intense. I was shocked when I woke up at 6am and it had all gone away. The only remnant we?re the few places that I had scratched and left a mark that had bled. So far I have not experienced this again? something I am truly thankful for!


VAERS ID: 1757297 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-12
Onset:2021-09-30
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER, FC3180 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER, FF8839 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstruation delayed, Pregnancy test negative
SMQs:, Fertility 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: Birth Control
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: I took a pregnancy test and it is negative.
CDC Split Type:

Write-up: Missing my period. I am 3 days late to my period, I have never been late before. I have a consistent period.


VAERS ID: 1757300 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 - / SYR

Administered by: School       Purchased by: ?
Symptoms: Cough, Headache, Respiratory tract congestion, Rhinorrhoea, Sneezing
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)

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

Write-up: I received the vaccine at 4:55 pm and my symptoms started at 11pm sneezing and running nose the next day I had a really bad headache and congested day 3 oct 3rd 2021 congested nd coughing.


VAERS ID: 1757306 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Feeling abnormal, Feeling cold, Hyperhidrosis, Inflammation, Injection site pruritus, Injection site swelling, Injection site urticaria, Joint swelling, Pain, Paraesthesia, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ivermectin/Stock Metronidazole Stock Niacinamide, Cerave, Topical face medicine for Rosacea Estradiol Vaginal Cream USP 0.01% Dotti Estradiol Transdermal System USP patch 0.1MG Levothyroxine Sodium 100 MCG Nature Made Vit C Gummies 250 mg
Current Illness: None
Preexisting Conditions: UTI infections
Allergies: Sulfur
Diagnostic Lab Data: 10/01/2021 meds given and monitored blood pressure and heart rate. No lab tests taken.
CDC Split Type:

Write-up: COVID Vaccine administered 10:00 09/29/2021. Symptoms started 2:00 am in morning following COVID vaccine. Fever, trembling, chills, profuse sweating, pins and need sensation in right hand side of back from shoulder to hip. Intense pain in lower back. Zaps of pain all over the body. 10/01/2021: hives started around injection site and raised itchy area where injection was given. Went to local ER. Benadryl and Prednisone given. Prescription given for Prednisone for four days. 10/03/2021 experiencing pins and needle sensation still in right side of body, pins and needle sensation in face, legs, extreme back pain and zaps of pain from head to toes. Knee is swollen and feels inflamed. Feel like have brain extreme brain fog.


VAERS ID: 1757315 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Decreased appetite, Erythema, Fatigue, Feeling hot, Headache, Myalgia, Pruritus, Pyrexia, Swelling, Vaccine positive rechallenge
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (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: Same side effects on dose 2 of Moderna Covid vaccine
Other Medications: Levoxyl, collagen, vit D
Current Illness:
Preexisting Conditions: Autoimmune disorder, prediabetic, hypothyroidism
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Severe Chills onset 11pm on 9/30/21, muscle/joint pain/fever/loss of appetite/fatigue onset 10/01/21 AM and lasting through 10/02/21 11pm, headache onset 10/02/21 and lasting 12 hours, covid arm onset 10/03/21 itching, swelling, redness, and warm to the touch.


VAERS ID: 1757322 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Fatigue, Hyperhidrosis, Hypoaesthesia, Migraine, Nausea, Paraesthesia, Pyrexia, Tremor, Vertigo, Vision blurred, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Setraline 50 mg per day
Current Illness: NA
Preexisting Conditions: NA
Allergies: sulfa antibiotics
Diagnostic Lab Data: Did not go to the ER
CDC Split Type:

Write-up: Fever of 102.9 Uncontrollable shaking Terrible migraine Numb arm on and off tingling N/V extreme fatigue Severe dizziness /vertigo Excessive sweating Blurry vision


VAERS ID: 1757371 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-09
Onset:2021-09-30
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cough, Fatigue, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Paralyzed due to spinal cord injury suffered during a MVA. A heart infection many years ago.
Allergies: unknown
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Cough, wheezing and fatigue


VAERS ID: 1757392 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-26
Onset:2021-09-30
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ischaemic stroke, Magnetic resonance imaging head abnormal
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: MRI brain
CDC Split Type:

Write-up: ischemic stroke


VAERS ID: 1757432 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Upper Back/Neck muscle spasms Liver adenomas
Allergies: Cirprofloxin Morphine Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Enlarged lymph nodes in armpit on right side. Enlarged and painful lymph nodes above collar bone and neck. Swelling and pain to right arm to shoulder blade area.


VAERS ID: 1757433 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Fatigue, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodopine, Statin, Calcium, Multivitamin, Vitamin D
Current Illness: None
Preexisting Conditions: Skin Cancer Porphyria Cutanea Tarda (Remission)
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Evening of shot: High fever approx. 102?+, extreme fatigue, muscle aches, headache Next day: Fever of 101?, fatigue, muscle aches, headache Following day: Fever 99?, some fatigue and weakness


VAERS ID: 1757460 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anosmia, Chest discomfort, Chills, Cough, Decreased appetite, Heart rate increased, Nausea, Pain, Productive cough, Pyrexia, Respiratory tract congestion, Sneezing, Somnolence, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily multivitamin w/ iron (whole foods brand)
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Next day: Fever Chills Dizziness Nausea Vomiting Body aches Drowsiness 2 days after: Congestion Phlem Coughing Sneezing Loss of appetite 3 days after: Loss of smell Tightness in chest Increased heart rate


VAERS ID: 1757465 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acne, Anxiety, Arthralgia, Chills, Depression, Extrasystoles, Fatigue, Menstrual disorder, Myalgia, Nightmare, Palpitations, Pyrexia, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tachyarrhythmia terms, nonspecific (narrow), Depression (excl suicide and self injury) (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: bupropion
Current Illness:
Preexisting Conditions:
Allergies: sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Same night of vaccination (9/30) I had fever, chills, heart pounding, muscle aches, joints aching, extreme fatigue. Next day (10/1) I had muscle aches, joints aching, extreme fatigue, heart pounding, feeling of depression and anxiety. I also had very vivid nightmares that woke me up at night. Day after that (10/2) I woke up with several pimples (I haven''t had acne since I was a teenager). This acne won''t go away and is getting worse each day. I also had severe depression and anxiety and my heart was skipping a beat. I had severe fatigue again. Today 10/3 my acne has gotten worse, I feel like my menstrual cycle was affected and I have severe depression and anxiety and my heart is still skipping a beat.


VAERS ID: 1757477 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076C21A / 1 - / IM

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

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

Write-up: Patient under 18 years old was administered Moderna vaccine on9/30/2021


VAERS ID: 1757483 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301558A / 3 LA / IM

Administered by: Senior Living       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: Protonix Wellbutrin
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Swollen lymph nodes in left armpit and collar bone approximately 48 hours post vaccine.


VAERS ID: 1757501 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / UNK RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, 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: Lisiniprol
Current Illness:
Preexisting Conditions: Hypertension
Allergies: clyndimycine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Difficulty breathing. Heaviness in chest and between shoulderblades.


VAERS ID: 1757513 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3014587 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site reaction, Injection site warmth, Rash erythematous, Rash pruritic
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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot in 2003 at Clinic
Other Medications: Multaq, Toprol, Synthroid, Rebeprazole, Eliquis, Vitamin D3, Vitamin C, Multivitamin
Current Illness:
Preexisting Conditions:
Allergies: Mold, dog fur, cat fur, rabbit fur, chicken feathers, ragweed, dust, horse hair, crab, mushrooms, penicillin, darvon, gentamicin, I?ve dye, floro dye, lactose intolerance, vancomycin, vicomycin, Percocet, sulfur drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: I woke up with a red rash about 3 inches long and 1 inch across below the injection site. The injection site was blood red. The rash has been itching for the last three days. It is hot to the touch. I have been putting Benadryl cream on the site.


VAERS ID: 1757542 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Myalgia, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamins
Current Illness: Nausea
Preexisting Conditions: None
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm ache, chills, severe headache, fever, muscle aches for 2 days; then headaches and muscles aches 2 days after.


VAERS ID: 1757551 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site pain, Nasopharyngitis, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair 250mg Allopurinol 300mg Montelukast Sodium 10mg Tylenol OTC
Current Illness: Seasonal Allergies
Preexisting Conditions: Gout Lower Back Issues
Allergies: NSAIDS Dairy Shell Fish
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pain at injection site Pain in legs Very Tired Feeling like being stung by a bee. This lasted about 15 minutes Cold or Allergy like feelings Most of these issues unless time was about a day. By Saturday I was still a bit tired but started to get back to normal. Treatment was lots of rest, Drink water and Gatorade. Please note: states the vaccine was given in my left arm. I requested my right arm as that I am left handed. This request was granted.


VAERS ID: 1757552 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Decreased appetite, Dizziness, Headache, Night sweats, Restlessness
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Akathisia (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol 25mg, One-A-Day vitamin, Osteo Bi-Flex
Current Illness: None
Preexisting Conditions: Asthma, lower back pain
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: After restless night of sleep, I woke with a severe headache, lower backache, both knees ached, night sweats, dizziness and loss of appetite. Stayed home. Symptoms lessened the following day. Next day symptoms nearly gone.


VAERS ID: 1757568 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Axillary pain, Chills, Headache, Injection site pain, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Quetiapine 12 mg at night
Current Illness: None
Preexisting Conditions: AS
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I became feverish with chills, nausea, sever headache and body ache that left me unable to leave my bed except to use a commode next to my bed for approximately 60 hours. After 24 hours I developed significant pain at the injection site as well as in the arm pit of the arm where I received the injection. The fever, chills, nausea, sever headache and body ache have resolved however the pain at the injection site and in the arm pit have not. A bruise has formed at the injection site . Though I have not visited a health care provider because it of it being the weekend, if the pain in my arm and in the arm pit do not subside, I will attempt to get an appointment.


VAERS ID: 1757583 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PF2589 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Headache, Inflammation, Lymph node pain, Lymphadenopathy, Myalgia, SARS-CoV-2 test negative, Sinus disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Effexor, Cetirizine, Multivitamin, Migrelief, Relpax, Omeprazole
Current Illness: Osteoarthritis, migraine without aura
Preexisting Conditions: Osteoarthritis
Allergies: Morphine
Diagnostic Lab Data: Rapid COVID test - Negative (10-2-21)
CDC Split Type:

Write-up: after 17 hours of receiving the vaccine I developed joint pain, muscle aches, severe sinus inflammation requiring inhaled steroid spray, dizziness, headache and lymphadenopathy to left supraclavicular lymph nodes and posterior cervical lymph nodes which are still tender, enlarged, and sore currently.


VAERS ID: 1757654 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Epistaxis, Headache, Injection site warmth, Nervousness, Pain, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: amlodipine, banzapril
Current Illness:
Preexisting Conditions: high blood pressure
Allergies: penicillin, asprin, bactrim
Diagnostic Lab Data: none
CDC Split Type:

Write-up: I received my second dose last Thursday, September 30, 2021. That evening, my arm swelled up and was hot at the injection site. The swelling has gone half way down my arm and is burning hot the touch. Tomorrow will be day 4 since I''ve gotten the vaccine. My temperature has not been below 101.1, I''m shaky, have chills, headache, and a nosebleed several times. My fever continues to worsen, as does my body aches.


VAERS ID: 1757714 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-09-30
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, Wrong technique in product usage process
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: USJNJFOC20211000540

Write-up: PUNCTURED VIAL DOSE ADMINISTERED; WRONG TECHNIQUE IN DRUG USAGE PROCESS; This spontaneous report received from a health care professional concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1822809 expiry: 07-MAR-2022) dose was not reported, administered on 30-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 30-SEP-2021, the patient experienced punctured vial dose administered. On 30-SEP-2021, the patient experienced wrong technique in drug usage process. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the punctured vial dose administered and wrong technique in drug usage process was not reported. This report was non-serious.


VAERS ID: 1757882 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-28
Onset:2021-09-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Electrocardiogram normal, Fatigue, Full blood count normal, Metabolic function test, Migraine, Palpitations, Thyroid function test normal
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (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: Pfizer
Other Medications: Nurtec; Fish oil; Multivitamin.
Current Illness:
Preexisting Conditions: Autoimmune disease-hashimotos thyroiditis; Chronic migraines.
Allergies: Penicillin.
Diagnostic Lab Data: EKG (normal), CBCD, CMP, thyroid labs (all normal.)
CDC Split Type:

Write-up: Shortness of breath, heart palpitations, extreme fatigue, migraine.


VAERS ID: 1757895 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Chills, Injection site pain, Injection site pruritus, Lymph node pain, Pain, Pyrexia, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Claritin, multi vitamin, probiotic
Current Illness: None
Preexisting Conditions: Obesity Pre-diabetes
Allergies: None
Diagnostic Lab Data: Nonr
CDC Split Type:

Write-up: Red arm rash size of baseball. Itching and pain at injection site, pain in lymp node under arm, body aches, fever and chills. Still not resolved after 4 days


VAERS ID: 1757899 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Hypoaesthesia, Induration, Lymphadenopathy, Muscular weakness, Oral herpes, Skin warm, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Sexual dysfunction (broad)

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

Write-up: Extreme swelling to left underarm(lymph node) hardness and swelling noted first evening of shot. Tenderness to left groin area Numbness and weakness to left hand and fingers especially fifth finger. Fever blister formed On bottom lip. Underarm swollen and warm. No low grade temp notes but I do not experience elevated temps when sick as a general rule.


VAERS ID: 1758576 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-21
Onset:2021-09-30
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood gases, Chest X-ray, Electrocardiogram, Full blood count, General physical health deterioration, Hypoxia, Laboratory test, Metabolic function test
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Protonix, tylenol, allopurinol, amlodipine, aspirin, lipitor, calcuim, cefdinir, plavix,lasix, losartan, metoprolol, Mycophenolate mofetil, nitroglycerin, miralax, flomax, tresiba, Zinc, melatonin, vitamin b12
Current Illness:
Preexisting Conditions: HTN, CKD stage 3, CAD,ischemic cardiomyopathy, MI,PVD, hyperlipidemia, DVT,DM,
Allergies: NKA
Diagnostic Lab Data: ABG, CBC, CMP, Cardiac Profile, CXR, EKG
CDC Split Type:

Write-up: patient recieving COVID antibody infusion decompensated and became hypoxic


VAERS ID: 1758596 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-20
Onset:2021-09-30
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Hypoxia, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: hypoxia & positive covid test 10/01/21


VAERS ID: 1758603 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-20
Onset:2021-09-30
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Oropharyngeal pain, Respiratory tract congestion
SMQs:, Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Exactly 2 weeks after my second shot: sore throat, congestion, loss of taste/smell for a few hours.


VAERS ID: 1758614 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: HEADACHE FOR 3+ DAYS ON 1ST COVID-19 MODERNA VACCINE
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: HEADACHE, LEFT SIDED NUMBNESS IN HEAD, FACE, NECK AND BILATERAL HANDS. HAS LASTED 4 DAYS CONTINUOUSLY. ZERO TREATMENTS AS THIS IS TO BE DOCUMENTED WITHIN FACILITY FIRST


VAERS ID: 1758663 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-01
Onset:2021-09-30
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Loss of consciousness, Urticaria
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Methimazole.
Current Illness: Tourette''s syndrome, Graves'' disease.
Preexisting Conditions: Tourette''s syndrome, Graves'' disease.
Allergies: olives, penicillin, Benadryl.
Diagnostic Lab Data: None, pt was not seen until symptoms mostly resolved.
CDC Split Type:

Write-up: Pt passed out and then developed hives several hours after the vaccine.


VAERS ID: 1758671 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-27
Onset:2021-09-30
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Exposure during pregnancy, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroid armour and T3, magnesium, multi vitamins and vitamin D3
Current Illness: None
Preexisting Conditions: None
Allergies: Ceclor
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Chest pains, sharp and random. High resting heart rate. Seeing OB today.


VAERS ID: 1758672 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Injection site erythema, Injection site swelling, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: All cillins - hives and itching
Other Medications: Junel Nortriptyline Valtrex Biotin
Current Illness: None
Preexisting Conditions: Previous PE Pituitary microadenoma with hyperprolactinemia Chronic non-specific white matter lesions on MRI Migraines Endometriosis
Allergies: Meds: All the cillins ( Penicillin, Amoxicillin etc.) Vaccines: PPD injection Foods: Peaches, plums, nectarines, pears, apples, cherries, strawberries, pecans, almonds, walnuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe itching, hives, pressure on my chest, red circle around injection site and raised bump


VAERS ID: 1758706 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Chest X-ray normal, Chest discomfort, Chest pain, Dyspnoea, Electrocardiogram normal, Heart rate increased, Immediate post-injection reaction, Troponin T normal, Urine analysis normal, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (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 (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Dupixent, Dulera, Spiriva, Singulair, Levothyroxine, Myrbectriq, Celebrex, Seroquel, Ativan, Risperdal, Tegretol ER, Lamictal, Zonegran, Melatonin, B12 supplement.
Current Illness: None
Preexisting Conditions: Asthma, allergies, fibromyalgia, Bipolar I, hypothyroidism, overactive bladder, migraine headaches, chronic fatigue, anemia, chronic pain.
Allergies: Mobic, Xolair, Thiothixene, Amoxicillin, Tylenol 3, seasonal allergies, dust, pollen, mold, some chemicals used in beauty products and perfumes, and some metals.
Diagnostic Lab Data: The medical tests included a chest x-ray, EKG, troponin T test, urine test, listening to my heart and checking my blood pressure. Fortunately all the results came back negative except my blood pressure was elevated and my pulse was elevated. All of the test to place the same day that I received my vaccine and this happened within a few hours of receiving the vaccine.
CDC Split Type:

Write-up: I had chest pressure, chest pain, shortness of breath and wheezing immediately following the third vaccine. I brought my symptoms to the vaccine clinics attention and they ignored my symptoms. It was necessary for me to go to the emergency room, because of how I reacted to the third vaccine. My symptoms of chest pressure, chest tightness, wheezing, shortness of breath started within a few minutes of receiving the third vaccine. Because the vaccine site staff did not take my symptoms seriously, I waited around to see if they would improve, which they did not they worsened. At that point, an hour later when I was unable to breathe without much difficulty, I brought myself to the emergency room. At the emergency room, I was not given much medication until many tests were ran. The tests included a chest x-ray, a blood test called troponin T, an EKG, a urine test as well as listening to my heart and measuring my blood pressure and measuring my pulse. Fortunately all tests came back normal, except my pulse was elevated and my blood pressure was elevated. I was given two inhalers Atrovent and Ventolin, after which my breathing improved and my chest pain improved. I was sent home the same evening as when I received the vaccine and I left the hospital about 9 PM.


VAERS ID: 1758712 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-30
Onset:2021-09-30
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER98737 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, COVID-19, Fall, Muscular weakness, Neck pain, SARS-CoV-2 test positive, Urinary incontinence, Vaccine breakthrough infection
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Arthritis (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, HLD, COPD, GERD, CVA, DM, Gout, Neuropathy, SJS.
Allergies: allopurinol, lisinopril
Diagnostic Lab Data: Sars Covid + on 10/1/2021
CDC Split Type:

Write-up: Breakthrough covid + on 10/1/2021. First vaccine dose 4/9/2021, possible error with Lot # listed, correct number could be ER8737? A 67 YO F presented to the ED on 09/30 with complaints of multiple ground level falls in the past 2 days. Pt says that episodes feel like weakness where she sinks into the ground and her legs give out from underneath her. Pt endorses +urinary incontinence, neck pain, and ankle pain.


VAERS ID: 1758713 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-12
Onset:2021-09-30
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 2 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Hypotension, SARS-CoV-2 test positive, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: ;tested positive at a nursing home, symptoms include hypotension and tachycardia, unclear onset date Patient admitted to the hospital on 10/01/2021


VAERS ID: 1758728 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / IM

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

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

Write-up: Rash and itching all over body, patient took BENADRYL oral 50mg and improved.


VAERS ID: 1758732 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: prozac 20 mg once daily, gabapentin 300 mg 3 x day, Ditropan 5mg 2 x day, propranolol 40 mg 2 x day, trazodone 50 mg once daily, ezetimibe 10 mg once a day, low dose aspirin 81 mg, multivitamin
Current Illness:
Preexisting Conditions: diabetes not on medication just diet controlled, migraines, arthritis
Allergies: latex
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I was sitting out in my sun porch with my dogs in my lap, it started as a trembling and it just got worse and worse. I tried putting a blanket and jacket on and I could barely speak because I was trembling. I went to closest Hospital. We had a good 45 minute wait. The physician came in did vitals and i was getting exhausted from the shaking. They put heated blankets on and i was still shaking and then they gave me Tylenol and Motrin. I was told to follow up with my primary care doctor.


VAERS ID: 1758740 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-03
Onset:2021-09-30
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NA / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Dyspnoea, Haemoglobin decreased, Iron deficiency anaemia
SMQs:, Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Chronic conditions include HLD, iron deficiency anemia.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This case meets criteria for vaccine breakthrough review. Patient had SOB, no other COVID SxS. Presented for low hgb/iron deficiency anemia.


VAERS ID: 1758776 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chills, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: ciprofloxacin, erythromycin, metronidazole, sulfa, gabapentin, lorazepam, gabapentin
Diagnostic Lab Data: ER visit and hospitalized starting on 9/30/21 to 10/4/21
CDC Split Type:

Write-up: 8 hours after the vaccination patient experienced extreme chills, N/V and temperature of 104. Patients'' husband reported that an ambulance was called and she was brought to the ER where they gave her oxygen therapy, potassium and started antibiotics as a precaution. She has been the hospital for 4 day and is expecting to be released today 10/4/21.


VAERS ID: 1758797 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-08-30
Onset:2021-09-30
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939906 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Chest pain, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: CTA chest
CDC Split Type:

Write-up: Chest pain resulting in hospitalization do to pulmonary embolism


VAERS ID: 1758888 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Chills, Decreased appetite, Fatigue, Headache, Hot flush, Lymphadenopathy, Presyncope, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho tri-cyclen (birth control), multi vitamin, elderberry.
Current Illness: No
Preexisting Conditions: No
Allergies: Penicillin, Azithromycin, Ceclor
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received my Pfizer booster at 2pm on Thursday, started having intense intermittent chills and hot flashes around midnight through the morning. When I woke up, I felt as though taking a shower would help and when I was in the shower, I felt as though I was going to pass out and quickly rushed to the toilet and vomitted. I had intense chills, fatigue, hot flashes, loss of appetite, and a minor headache on Friday. At around 3pm on Friday, I started to develop joint pains in my hips and knees making it almost impossible to walk up a flight of stairs. I still had chills on Friday night, into Saturday morning. My joint pain has almost subsided nearly 4 days later, but I developed lymphedema (swelling of lymph nodes) in the armpit of the injection side (right arm). This has continued since Saturday evening and is ongoing. I am also still feeling fatigued.


VAERS ID: 1758892 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dizziness, Pruritus, Vision blurred
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data: Still waiting to hear from primary health care provider
CDC Split Type:

Write-up: Chest pain, itching from my head to top of my feet. Lightheaded and when I focus everything words run together.


VAERS ID: 1758938 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051E21A / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Diarrhoea, Fatigue, Headache, Injection site pain, Injection site swelling, Nausea, Pain, Pain in extremity, Peripheral swelling, Presyncope, Vaccination site mass
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: I got sick on 8/30/21. Felt like the flu and pneumonia at the same time. Lasted til 9/13/21
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: I have none. I bought some ibuprofen and slept
CDC Split Type:

Write-up: Injection site pain-still sore Tiredness Whole body was in pain Injection site swelling Nausea Decreased appetite Headache Diarrhea Arm pain Almost fainted when I got injected My hand got swollen I?m still dealing with headaches arm pain site pain. I have a lump where I got vaccine


VAERS ID: 1758948 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 1508597-0525 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Feeding disorder, Headache, Injection site erythema, Injection site pruritus, Injection site swelling, Nausea, Pain, Pain in extremity, Pyrexia, Tinnitus
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hearing impairment (narrow), Vestibular disorders (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: HIgh blood pressure medication
Current Illness: None
Preexisting Conditions: High blood pressure, Afib
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Terrible headaches, nausea, dizzyness, left arm-swollen, red, itchy, weakness, can''t eat, ringing in the ear (left ear), weakness and pain in legs, severe body aches all over, fever, chills.


VAERS ID: 1758959 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-28
Onset:2021-09-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Electrocardiogram abnormal, Eye movement disorder, Head discomfort, Hyperhidrosis, Hypoaesthesia oral, Pallor, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), 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: Ritalin
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: EKG (multiple) Bloodwork 2x CT scan
CDC Split Type:

Write-up: Pressure in head, lips going numb Profusely sweating; colour drained from face and lips went white, as eyes started rolling back and heart was pounding. Called Paramedics. EKG?s showed heart stress. Ambulance drive to ER.


VAERS ID: 1759003 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Feeding disorder, Feeling cold, Headache, Illness, Lymphadenopathy, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shingles, flu vaccine and every covid vaccine
Other Medications: Methotrexate, Celebrex, folic acid, hydrochlorothiazide, atorvastatin, multi-vitamin, vitamin D, Calcium
Current Illness:
Preexisting Conditions: Rheumatoid arthritis
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I received the first shot March 6, 2021. I was sick the whole next day. I received my second shot on April 3, 2021. I was sick for 3 days after that one. I had swollen glands that lasted for 2-3 weeks. I got my third shot on September 29, 2021 and I was sick for just over 3 days. I had severe muscle aches starting in early morning after the shot that lasted about 2 days. I had swollen glands on the collarbone on the injection side. I had chills , fevers and weakness for almost 4 days during that time I slept in my winter coat under my bedcovers. When I got out of bed I felt dizzy. I couldn?t eat for the first 3 days. I had severe headaches for the first 2 days after the shot.


VAERS ID: 1759028 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-05
Onset:2021-09-30
   Days after vaccination:237
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Covid-19 test
CDC Split Type:

Write-up: Employee tested positive for Covid-19 after being fully vaccinated


VAERS ID: 1759063 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-21
Onset:2021-09-30
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cold sweat, Cough, Furuncle, Headache, Hyperhidrosis, Oropharyngeal pain, Pain, Pyrexia, Rhinorrhoea, Secretion discharge, Sneezing, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish Oil, Vitamin D3, Zinc, Vitamin C, Prostate Pill, Garlic Pill
Current Illness: Back Pain and Groin Pain
Preexisting Conditions: Arthritis and Back Pain
Allergies: Shell Fish, Iodine
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Boils, Hives, Sore Throat, Cold and Hot Sweats, Coughs, Sneezing, Headache, Body aches, Mucus, Runny Nose, Chills, Fever,


VAERS ID: 1759112 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-12
Onset:2021-09-30
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute myocardial infarction, Acute respiratory failure, COVID-19, Hyperglycaemia, Insulin-requiring type 2 diabetes mellitus
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Myocardial infarction (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Acute respiratory failure with hypoxia; COVID-19; NSTEMI, T2DM with hyperglycemia with long-term use of insulin


VAERS ID: 1759143 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 RA / IM

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

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

Write-up: Patient received Moderna vaccine for primary series (dose 1 & 2), given PFIZER for booster.


VAERS ID: 1759145 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood culture, Motor dysfunction, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Xarelto, Allopurinol, Acetazolamide, Omperazole
Current Illness: No other illnesses
Preexisting Conditions: Heart Disease
Allergies: No Known Drug Allergies
Diagnostic Lab Data: Blood cultures
CDC Split Type:

Write-up: Lost motor function and fever over 102F, hospital admission next day after injection, currently still hospitalized.


VAERS ID: 1759184 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Chills, Flank pain, Headache, Pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Diarrhea and nausea after dose one of pfizer/bioNtech vaccine
Other Medications: prenatal vitamin, vitamin D, Krill oil
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills, body aches, right flank/abdominal pain, GI upset, Headache that has lasted multiple days. Still currently have a waxing and waning headache.


VAERS ID: 1759190 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Confusional state, Delirium, Dizziness, Fatigue, Headache, Loss of consciousness, Mobility decreased, Motion sickness, Motor dysfunction, Pain in extremity, Rash, Skin warm
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: Safryal Levothyroxin
Current Illness: Not any known
Preexisting Conditions: None
Allergies: Shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1st day Confusion and hot face; difficultly with motor function Delirium while sleeping Arm pain in the evening 2nd day Severe arm pain Severe dizziness at 3pm followed by passing out Woke up with extreme fatigue, chills, onset of headache Rash on thighs all day 3rd day Bedridden from weakness and terrible headache Rash spread to back of lower legs Headache could not be relieved with Tylenol or aleve 4th day Woke up feeling normal Motion sickness set in at 11am followed by weakness and persistent headache Felt ok between between 5:45-7:45 Headache and weakness returned 5th day Body weakness moderate to severe


VAERS ID: 1759208 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Hypersomnia, Injection site pain, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (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: vit d, coumadin, procardia, lisinopril
Current Illness: no
Preexisting Conditions: blood clots
Allergies: sulfa drugs, gabapentin, lorsartan, vit k, augmentin, levofloxacin
Diagnostic Lab Data:
CDC Split Type:

Write-up: The evening after having the vaccine she started having uncontrollable chills and a high fever. At the injection site she was having pains, she was having headaches and nausea also the feeling of being extremely tired. She slept for 2 days.


VAERS ID: 1759214 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Asthenia, Diarrhoea, Feeding disorder, Headache, Myalgia, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lyrica, 200 mg. 2X per day; medical marijuana 1X per day; Tylenol, calcium, vitamins
Current Illness: some kind of virus which had Covid-like symptoms, nausea, vomiting, runny nose, stomach cramps, cough, sore throat, headache - I had a Covid test, which came back negative, and the symptoms had been gone for several days before the vaccine on the 29th
Preexisting Conditions: chronic, severe back pain from bad discs, for many years
Allergies: allergic to certain fabric dyes (itching), Celebrex (hives), dishwasher detergent (phosphates) (sneezing, runny nose)
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Received vaccine at 1:00 pm on 29th; woke up at 4:45 am on 30th with nausea, vomiting, diarrhea (similar to food poisoning, violent and crampy, miserable), headache, muscle aches and weakness. This went on every 20-30 minutes for a few hours before it began to improve; I took 4 Immodium and 2 Tylenol. I could not eat the rest of the day. On October 1st, I felt better, and on October 2nd I felt pretty good, although still with muscle aches bad enough that I did not exercise.


VAERS ID: 1759230 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, levothyroxine, naproxen
Current Illness:
Preexisting Conditions: Diabetes, hypothyroidism, arthritis
Allergies: Codeine, guaifenesin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever not exceeding 100. Severe fatigue. Symptoms subsided approximately 42 hours later.


VAERS ID: 1759236 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Headache, Injection site pruritus, Injection site vesicles
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

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

Write-up: Headache, dizziness, blisters at injection site, itchiness at injection site.


VAERS ID: 1759250 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-02
Onset:2021-09-30
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 1759356 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-05
Onset:2021-09-30
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 UN / UN
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 1 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Acute respiratory failure, COVID-19, Cardiac failure acute, Myocardial infarction, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Anaphylactic reaction (broad), Myocardial infarction (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Acute respiratory failure with hypoxia; COVID-19 virus infection; acute heart failure, unspecified; acute kidney injury; type 2 myocardial infarction


VAERS ID: 1759386 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Enlarged uvula, Erythema, Hypertension, Hypoaesthesia oral, Lip swelling, Paraesthesia oral, Pruritus, Tongue disorder
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypertension (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: flu vaccine 40 year old, hin1
Other Medications: allegra prempro nexium multi vitamin vid d
Current Illness: none
Preexisting Conditions: gerd
Allergies: flu vaccine latex country time lemonaide
Diagnostic Lab Data: none
CDC Split Type:

Write-up: On arrival to facility I pre medicated with 1000mg tylenol and 10 mg allegra. I was given the Pfizer-BioNTech covid 19 Vaccine EUA in my left arm. Within about 5 minutes of injection I noticed bilateral arm redness an itching. The PA observed. I then proceeded to note numbness and tingling to inside of mouth, lips and tongue. The staff nurse came in to assess me, epi at bedside ready. I then started to develop a area of swelling across the bottom of my lower lip and note thickness sensation to tongue and uvula. RN notified the on staff physician who came in and assessed me. The redness on arms was improving but other symptoms remained unchanged. On staff doctor recommended that I go be assessed in ER. I called for a ride to ER and was brought in to department and given 60 mg steroid orally. My initial VS were abnormally high 170/109 bp. I was then observed until improved symptoms. Upon leaving ER I had mild generalized itching, small swelling to lower lip and small amount of tingling to tongue and lip. I was instructed to take Benadryl 50 MG once home and pick up prescription for additional steroids and epi pen. I have continued to use the steroids as instructed. I notice that the numbness to tip of tongue and is still there prior to scheduled dose of steroids. I have not had to use the epi pen


VAERS ID: 1759421 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-24
Onset:2021-09-30
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 AR / IM
FLUC4: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT) / SEQIRUS, INC. - / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Medformin 1000MG, Simvastatin 20MG, Baby Aspirin 59mg, Glipiside 5 MG
Current Illness: Diabetes
Preexisting Conditions: Diabetes, Asthma
Allergies: NONE until 9/30
Diagnostic Lab Data: physician exam
CDC Split Type:

Write-up: Approx 1 week after receiving both vaccines, hives started on ankles and proceeded up body. Last two nights could not sleep account hives itching. Ruled out bugs account spouse sleeping in same bed with no hives.


VAERS ID: 1759436 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-04-08
Onset:2021-09-30
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Nasal congestion, Rhinorrhoea, SARS-CoV-2 test, Upper-airway cough syndrome
SMQs:, 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: LOSARTAN
Current Illness: NONE
Preexisting Conditions: HTN, HYPERLIPIDEMIA
Allergies: NKA
Diagnostic Lab Data: 09/30/21: POC SARS COVID RAPID ANTIGEN
CDC Split Type:

Write-up: 09/30/21: NASAL CONGESTION, RUNNY NOSE, POSTNASAL DRAINAGE


VAERS ID: 1759438 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-02-04
Onset:2021-09-30
   Days after vaccination:238
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Polymerase chain reaction positive
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: PCR collected 9-30-2021, resulted positive on 10-1-2021
CDC Split Type:

Write-up: unknown


VAERS ID: 1759444 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21AEXP8/14/ / 3 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Ear pain, Headache, Nasal congestion, Nausea, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pravastatin 10 mg Amlodipine/benazepril. 5/20 mg
Current Illness:
Preexisting Conditions:
Allergies: Bactria Clindamycin Tramdol Nitrofurantoin Hycodine,hydroxyzine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Started about 6 to 7 hours after shot and lasted to around 12 next day. Had headache, ear ache,nausea, congestion,legs and feet ached, a slight fever of 101.2, and a sore arm.


VAERS ID: 1759474 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076CZ1A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Device connection issue, No adverse event, Syringe issue, Underdose
SMQs:, Medication errors (broad)

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

Write-up: While administering the vaccination, the syringe separated from the needle. It appears less than half of the dose went into the arm. Pt reported no effects. We will administer the second dose per CDC guidelines since it appears it was less than half the dose.


VAERS ID: 1759495 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute myocardial infarction, Blood pressure increased, Chest X-ray, Disorientation, Dyspnoea, Echocardiogram, Electrocardiogram, Hyperhidrosis, Metabolic function test, Seizure, Syncope, Troponin, Unresponsive to stimuli, Urine analysis
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (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: Taking ZyrTEC 10 mg tablet, Sig: 1 tab(s) orally once a day Taking ofloxacin ophthalmic 0.3% solution, Sig: 1 gtt in each affected eye 4 times a day Taking prednisoLONE ophthalmic acetate 1% suspension, Sig: 1 gtt in each affected eye 4
Current Illness:
Preexisting Conditions: I10 Hypertension E78.5 Hyperlipidemia F03.90 Dementia N40.0 BPH (benign prostatic hyperplasia) Z91.09 Environmental allergies F41.8 Depression with anxiety E55.9 Vitamin D deficiency R26.81 Gait instability D50.9 Anemia, iron deficiency I48.92 Atrial flutter K59.01 Slow transit constipation E78.00 Hypercholesteremia R93.89 Abnormal chest x-ray J44.9 COPD (chronic obstructive pulmonary disease) G25.81 Restless leg syndrome M16.7 Other secondary osteoarthritis of left hip D50.9 Iron deficiency anemia, unspecified iron deficiency anemia type I10 Elevated blood pressure
Allergies: Imddur and Statin
Diagnostic Lab Data: CXR, Echo and EKG were ordered CMP, Blood cx, BNP, Troponin, Urine w/reflex and a CBCD were ordered for today. (EKG resulted today one of the findings was Inferior infarction, probably acute, pt was sent to the ER)
CDC Split Type:

Write-up: Pt had a syncopal episode that evening of vaccination, the following morning he had 2 episodes of syncope. The last one that happened on Friday morning at 7am the patient was reportedly convulsing, diaphoretic and disoriented- blood pressure was 220/100. Son also reported he was not responsive to sound or voice and his breathing became labored for a short time after the convulsing stopped.


VAERS ID: 1759501 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO168 / 3 LA / IM

Administered by: Work       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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Spironolactone 25MG daily.
Current Illness: none.
Preexisting Conditions: PCOS
Allergies: Sulfa antibiotics, Cinnamon
Diagnostic Lab Data: n/a ongoing
CDC Split Type:

Write-up: The night after receiving my COVID booster my left axillary lymph node began to swell and become sore to the touch. % days later the swelling and soreness is still present.


VAERS ID: 1759506 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram abdomen normal, Diarrhoea, Full blood count normal, Metabolic function test normal, Nausea, SARS-CoV-2 test negative, Tachycardia, Ultrasound pelvis normal, Urine analysis normal
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Dehydration (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol MDI, Benzonatate 200 mg TID PRN, Bupropion 300 mg QD Cetirizine 10 mg QD, Benzaclin gel BID, Dupilumab 300 mg Q2Weeks, Lidex ointment BID, Wixela Inhub BID, Flonase Nasal QD, Hydroxyzine 10 mg BID PRN Anxiety, DUOneb PRN, Metaxolo
Current Illness:
Preexisting Conditions: Obesity, Anxiety, Asthma, GERD, Acne, Seasonal Allergies
Allergies: Hydrocodone (Itching)
Diagnostic Lab Data: NOTE: Patient had positive COVID-19 test on 7/24/2021 using the Hologic Panther System platform utilizing PCR or equivalent nucleic acid amplififcation technology.
CDC Split Type:

Write-up: Pfizer BioNTech COVID-19 Vaccine EUA: Hospitalization Patient received Pfizer Vaccines on 9/8/2021 and 9/30/2021. Presented to ED on 9/30/2021 with severe crampy abdominal pain, diarrhea, nausea after receiving her second COVID-19 vaccine earlier in the day. On arrival the patient was tachycardic up to 120s (states tachycardic at baseline). Covid test was negative. UA negative. CMP and CBC WNL. US of pelvis and CT A/P were negative. Patient was treated with zofran, morphine x1, LR and atarax. Abdominal pain resolved by the morning of 10/1/2021 and patient was discharged.


VAERS ID: 1759519 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-02
Onset:2021-09-30
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 2 LA / IM

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

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

Write-up: Tested positive for COVID on 9/30/21 after being fully vaccinated.


VAERS ID: 1759528 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache, Insomnia, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: synthroid multivitamin livalo aspirin protonix
Current Illness: none
Preexisting Conditions: reflux thalassemia
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Fever 99.5, onset 8 hours after shot, 10:30 pm Difficulty sleeping that night Fever 100.7 next morning, headache, muscle aches, fatigue Symptoms subsided 36 hours after shot, disappeared 48 hours after shot


VAERS ID: 1759579 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 was given a booster dose of the pfizer COVID19 vaccine on 9/30/21. The vaccine was taken out of ultra cold on 8/30/2021 brought to us on 9/1/2021. It was missed that the vaccine must be moved to the refrigerator storage after 2 weeks for an additional 30 days. The vaccine was in the freezer for 1 month.


VAERS ID: 1759597 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Uknown
Current Illness: CORONAVIRUS COVID-19 DISEASE, PNEUMONIA
Preexisting Conditions: Hyperlipidemia, Iron Deficiency, Reactive Airway Disease
Allergies: Shellfish Derived Products
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient presented for her 2nd dose of the Pfizer Covid 19 vaccine. When going through the vaccination assessment the patient made it known that she tested positive for Covid in August. The nurse then asked if she was treated for Covid in which the patient replied that she was given antibodies in the hospital. The patient then went on to say she was never asked if she had been treated with a monoclonal antibody when she presented for her first dose of the Pfizer vaccine.


VAERS ID: 1759599 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820096 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acoustic stimulation tests abnormal, Deafness, Immediate post-injection reaction, Tinnitus
SMQs:, Hearing impairment (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Hearing test at ENT confirmed hearing loss 10/4/2021. Record on file.
CDC Split Type:

Write-up: Immediate onset of Tinnitus in both ears. Very loud.


VAERS ID: 1759604 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Lymphadenopathy, Neck pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Lymph nodes in the neck and under the armpit have swelled up. Tingling sensation in the arm. Neck is sore. Alleviated by ibuprofen. Swelling seems to be subsiding.


VAERS ID: 1759656 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK OT / IM

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

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

Write-up: pt received expired Janssen covid vaccine


VAERS ID: 1759678 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Fatigue, Headache, Injection site erythema, Injection site induration, Injection site mass, Injection site warmth, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (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: Amlodipine, vitamins, calcium
Current Illness: None
Preexisting Conditions: Htn
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, fatigue, next. Morning heaviness in chest, severe muscle and joint pain two-3 days later. Large red hard, hot lump in injected arm


VAERS ID: 1759679 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK UN / IM

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

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

Write-up: patient received expired dose of Janssen covid vaccination


VAERS ID: 1759685 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK UN / IM

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

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

Write-up: patient received expired dose of janssen covid vaccine


VAERS ID: 1759687 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Injection site bruising, Injection site erythema
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), 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: Eliquis, Flecainide, Metoprolol, Budesonide, Levothyroxine, & Trazodone (at bedtime), Prolia injection last dose May 24, 2021 OTC $gCalcium Max , Vitamin d3, Turmeric, Cosamin DS
Current Illness: None
Preexisting Conditions: AFIB, Mastectomy due to cancer, some COPD, urinary incontinence
Allergies: Droperodol$g anaphylaxis Zosin &
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I received only the Pfizer booster vaccine at this location on 9/30/21. About 2 hours after receiving my booster shot, a rather large patch of redness appeared just below the injection site . Returned to pharmacy today 10/4/21 & showed it to vaccinator. He noticed a good-sized black & blue mark at vaccine site & said he noted same effect on another who was also on a blood thinner. I reported I was there not about the black & blue mark but rather patch of redness. He said he''d never seen that before. Recommended I file this report & he was reporting it also on his end. Redness still there but getting lighter each day. No treatment was offered nor given. I was expecting that. I just felt it should be reported.


VAERS ID: 1759693 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-28
Onset:2021-09-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Chills, Condition aggravated, Differential white blood cell count normal, Disorientation, Dizziness, Electrocardiogram normal, Fatigue, Feeling abnormal, Full blood count normal, Headache, Metabolic function test, Nasopharyngitis, Presyncope
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sotalol, Lisinopril, Pamelor, Prilosec, Valtrex, Eliquis, Aspirin, Meteoprolol, Lipitor, Levothyroxine, Cardizem, Fish Oil, Womens Gummies,
Current Illness: none
Preexisting Conditions: afib, thyroid, migraines, acid reflux
Allergies: shellfish, betadine, contrast dye
Diagnostic Lab Data: CBC with auto differential 9/30/21 normal Comprehensive Metabolic Panetl 9/30/21 normal ECG12-lead 9/30/21 normal EKG 9/30/21 normal
CDC Split Type:

Write-up: evening of 9/28/21 just tired; 9/29/21 felt like a head cold and tired 9/30/21 got dizzy, very tired, disoriented, went into afib, and almost passed out at work. Coworkers had to call ambulance to take me to hospital. Tests were ran, everything came back normal except me having the vaccine on the evening of 9/28/21, was discharged same day 10/1/21 still a little dizzy, a little disoriented, tired, chills and headache 10/2/21 still a little dizzy, a little disoriented, tired and chills 10/3/21 still not feeling like myself and tired 10/4/21 finally starting to feel like myself


VAERS ID: 1759703 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-26
Onset:2021-09-30
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysstasia, Full blood count, Gait inability, Hypoaesthesia, Scan
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Sjogren''s, fibromyalgia
Allergies: Codeine, penicillin, keflax, prednisone, topamax, sulfa
Diagnostic Lab Data: Cbc panel and scan of my back and legs preformed at hospital on September 30th
CDC Split Type:

Write-up: Received the second dose Sunday, by Thursday I have lost the ability to walk/stand. Legs are consistently numb and feel like they are sleep.


VAERS ID: 1759732 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 3 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Anion gap, Blood lactic acid, Chest X-ray abnormal, Chills, Computerised tomogram abdomen abnormal, Cough, Gallbladder enlargement, Lung opacity, Nausea, Pain, Scan with contrast abnormal, Tachycardia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gallbladder related disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations: After 1st Moderna vaccine he felt cold and had chills
Other Medications: Aranesp (Billable) 20 mcg /Every week Aspir-81 1 tab /81 mg Every day/ Atorvastatin Calcium 1 tab /80 mg Every day/ Calcitriol 1 cap /0.5 mcg 3 times per week/very meal/ Carvedilol 4 tab /3.125 mg Every 12 hours/ EMLA 1 cream /2.
Current Illness: no illnesses noted
Preexisting Conditions: End Stage Renal Disease-Hemodialysis Dependent Hypertension Anemia of Chronic Kidney Disease Hypocalcemia Hyperphosphatemia Vitamin D Deficiency Secondary hyperparathyroidism of renal origin History of coronary artery disease History of acidosis, perhaps renal tubular acidosis
Allergies: no known allergies
Diagnostic Lab Data: Labs were significant for lactate 7.88 and anion gap 27. Chest x-ray showed "reticular interstitial opacity likely chronic" CT abd/pelvis with contrast showed gallbladder wall thickening
CDC Split Type:

Write-up: The patient presented to the ER @ 1:22 am complaining of cough, chills, body aches, nausea, and vomiting post-COVID booster, approximately 7 hours after receiving the booster. The patient was afebrile but tachycardic with HR in the 120''s. BP normal.


VAERS ID: 1759751 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-27
Onset:2021-09-30
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Feeling abnormal, Muscle spasms, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Dementia (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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

Write-up: 74hrs post vaccination - nausea and muscle spasms. Couldn?t control the rapid muscle flexing throughout. Especially in lower half. Went to ER and was given Ibuprofen and zofran as subdued. 100hrs plus post vaccination - nausea and fog when moving around on days 4,5,6, and 7 post vaccination. When sitting idle nausea goes away. Mid-day a chest tightness and breathing shortness becomes prevalent and continues through the afternoon and evening


VAERS ID: 1759786 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-30
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: Severe left arm pain arthritis feeling on left 3 finger middle , ring and pinky. Deep ache in arm


VAERS ID: 1759802 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

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

Write-up: Passed-out and had the runs.


VAERS ID: 1760003 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-03
Onset:2021-09-30
   Days after vaccination:211
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Metabolic encephalopathy, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalopathy/delirium (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen PRN, atorvastatin, vitamin D3, divalproex DR, furosemide, lisinopril, loperamide PRN, melatonin, metoprolol tartrate, MVI, olanzapine, rivaroxaban, vancomycin PO
Current Illness:
Preexisting Conditions: schizoaffective disorder, bipolar, chronic diastolic heart failure, atrial fibrillation on rivaroxaban, and morbid obesity
Allergies: aminophylline
Diagnostic Lab Data: COVID status positive on 9/30/21.
CDC Split Type:

Write-up: Patient received Moderna COVID vaccine on 2/3/21 and 3/3/21. Her AVF is having a COVID outbreak and on 9/30/21, patient is admitted to our facility with acute metabolic encephalopathy, low grade temperature, and COVID positive result (no respiratory symptoms). As of 10/4/21, patient is still admitted in our med/surg unit.


VAERS ID: 1760011 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Chest X-ray, Chest pain, Dyspnoea, Electrocardiogram, Hypersensitivity, Laboratory test, Oropharyngeal pain, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: L-thyroxine, Liothyronine, Naltrexone, Fluoxetine, Deplin, Trazodone, Glatiramer, Meloxicam, Amlodipine, Lisinopril, vit D, multivitamin, fish oil, probiotic, Zyflamend Whole Body (supplement)
Current Illness: none
Preexisting Conditions: Hashimoto''s Disease, hypertension, arthritis, psoriasis, endometriosis, MS
Allergies: sulfa, aspirin, Flexoril
Diagnostic Lab Data: EKG, chest xray, lab work, oxygen levels, signs of allergic reaction, blood pressure - all normal.
CDC Split Type:

Write-up: Over 4 hours, gradual tightness in throat followed by pain at base of throat and pain in center, upper chest. Asymmetric, high blood pressure in left and right arms over an hour. (220/? on right; 180/? on left) Throat tightness subsided but pain remained at base of throat and pain increased in center of chest and was followed by tightness of breath within 24 hours. Pain in chest and shortness of breath was identical to symptoms I experienced for 4 or 5 months following contracting COVID-19 in March, 2020. No fever. No signs of allergic reaction. Pain and shortness of breath lasted over 72 hours and began to improve in the 24 hours following that. Approx. 5 days of symptoms.


VAERS ID: 1760026 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3013084 / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Headache, Injection site erythema, Injection site warmth, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (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: Synthroid. 75 mcg Rosuvastatin 20mg Tambacor 50 mg 2X/day Xarelto 15mg
Current Illness: None
Preexisting Conditions: A-fib
Allergies: Sulfa
Diagnostic Lab Data: Visual check by doctor
CDC Split Type:

Write-up: Headache, loose bowel, nausea. Felt good the next day. But Saturday (10/1) am woke with sore arm, very red and hot below the injection site


VAERS ID: 1760256 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

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

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

Write-up: Fever, headache, body aches, chills, nausea. Too ill to go to work. All children in the household also experienced fevers up to 102 degrees as well as body aches. Treated with ibuprofen and rest.


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