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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 64 out of 8,010

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VAERS ID: 1768220 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 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: Patient previously received Jansen dose on 3/8/21 & shouldn''t have received Pfizer


VAERS ID: 1768282 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-27
Onset:2021-09-30
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Headache, Hypoaesthesia, Injection site pain, Malaise, Musculoskeletal stiffness, Pain, Paraesthesia, Photophobia, SARS-CoV-2 test negative
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (narrow), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Arthritis (broad), COVID-19 (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: none
Current Illness: none
Preexisting Conditions: amenorrhea since being positive covid in 12/2020
Allergies: seasonal allergies vomited after demerol X1
Diagnostic Lab Data: none yet - completed routine covid antigen testing on 9/27 9/29, 10/4 7 10/6 as per work policy also tested 10/5 due to symptoms per work policy all antigen tests were negative.
CDC Split Type:

Write-up: receive vaccine on 9/27 on 9/28 experienced pain and burning at injection site with headache and general malaise with photophobia on 9/30 in the evening notice hands and finger with tingling and numbness next morning on 10/1 also noticed it in both of my feet . on 10/2 mid day noticed neck stiffness, It didn''t go away contacted my PCP on 10/5, at this time no other treatment recommended except monitor for worsening symptoms and advised to contact my Occupation health as Ii received it from work . on 10/6 woke up with a headache in notified my practitioner advised to continue to monitor and Tylenol for headache I also contacted occ health on 10/6 only recommendation given was this website and told to complete this form and to continue to follow up with my PCP. As of today 10/7 I still have numbness and tingling, pins and needles in my hand and feet, stiff neck, mild headache and pain and burning at the site of the injection and unable to lift my arm without pain in my shoulder and armpit.


VAERS ID: 1768290 (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: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D211A / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood culture, Body temperature increased, Computerised tomogram, Electrocardiogram, Laboratory test, Lethargy, Magnetic resonance imaging, Sepsis, Urine analysis, Vomiting, X-ray
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations: Low-grade fever & body aches for 24 hours, 3/05/21, Covid 19 2nd shot
Other Medications: duloxetine, metoprolol, amlodipine, magnesium, vitamin D, biotin, Cal-mag-D tablet, daily vitamin, Tylenol
Current Illness: inflammation of hip & lower back (left side)
Preexisting Conditions: depression, arthritis, cervical disc disease, high blood pressure
Allergies: Vicodin following anesthesia, metroridazole, ciprofaxin, sulfonomide, erythromycin, gabapentin, lorazepam, Toradol
Diagnostic Lab Data: x-ray, cat scan, MRI, ECG 12 Lead EKG, blood culture, urine test, micro respiratory specimen
CDC Split Type:

Write-up: continuous vomiting, temp of 103.7, extremely lethargic, needed an ambulance to hospital, sepsis


VAERS ID: 1768345 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-16
Onset:2021-09-30
   Days after vaccination:226
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chest X-ray normal, Condition aggravated, Dysstasia, Fatigue, Gait disturbance, Loss of personal independence in daily activities, Pyrexia, SARS-CoV-2 test positive
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet aspirin EC 81 MG enteric coated tablet citalopram (CELEXA) 40 MG tablet cycloSPORINE (RESTASIS) 0.05 % ophthalmic emulsion Ferrous Sulfate (IRON) 325 (65 Fe) MG TABS furosemide (LASIX) 20 MG tablet Gluc
Current Illness: NA
Preexisting Conditions: Obstructive sleep apnea treated with BiPAP OA (osteoarthritis) Peripheral neuropathy Allergic rhinitis Hypercholesterolemia Essential hypertension Morbid obesity (HCC) Insomnia Alcohol abuse Dry eye syndrome, bilateral Persistent atrial fibrillation and atypical atrial flutter Diabetes mellitus type 2 without retinopathy (HCC) Regular astigmatism, bilateral Substance abuse (HCC) History of GI bleed Nonischemic cardiomyopathy Depression, major, recurrent, mild (HCC) PMR (polymyalgia rheumatica) (HCC) Lower extremity edema Primary osteoarthritis of left hip SSS (sick sinus syndrome) (HCC) Status post biventricular cardiac pacemaker insertion, 02/05/2019 Chronic coronary artery disease Chronic obstructive pulmonary disease (HCC) Chronic pain Central sleep apnea Nocturnal hypoxia Ocular hypertension, bilateral Former smoker 100 pack year history Right upper Lung nodule Unable to ambulate Lactic acidosis Prolonged Q-T interval on ECG Choledocholithiasis Cholangitis Mild left ventricular systolic dysfunction (EF 0.50) Status post catheter radiofrequency ablation of atrial fibrillation x 2 History of multiple cardioversions S/P AV (atrioventricular) nodal ablation, 02/05/2019 Deep vein thrombosis bilateral gastrocnemius veins, 02/02/2020 Obesity (BMI 30-39.9) Presence of Watchman left atrial appendage closure device 02/13/2018 Hepatic steatosis Moderate protein-calorie malnutrition (HCC) Multiple lung nodules on CT Biventricular cardiac pacemaker in situ Squamous blepharitis of upper and lower eyelids of both eyes Type 2 diabetes mellitus with hyperglycemia (HCC) Gastroesophageal reflux disease without esophagitis Alcohol-induced chronic pancreatitis (HCC) Atherosclerosis of aorta (HCC) Polyneuropathy in other diseases classified elsewhere (HCC) Major depressive disorder, recurrent episode, moderate (HCC) Ataxic gait Chronic bilateral low back pain without sciatica Generalized weakness COVID-19
Allergies: Lisinopril Swelling
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized (9.30.21); COVID-19 positive (9.30.21); fully vaccinated Discharge Provider: DO Primary Care Provider at Discharge: MD Admission Date: 9/30/2021 Discharge Date: 10/02/2021 PRESENTING PROBLEM: Weakness [R53.1] Generalized weakness [R53.1] COVID-19 [U07.1] HOSPITAL COURSE: Patient is a 76 year old male with history of NICM, SSS s/p PPM, A-Fib/Flutter s/p Watchman, prior DVT, HTN, HLD, T2DM with chronic neuropathy, alcohol use with hepatic steatosis, pancreatic insufficiency, COPD, OSA, depression and RLS who presented to the ER with generalized weakness. Patient reported normally performing ADLs with occasional assistance from family, however lately had been so weak he had difficulty standing and ambulating. He denied subjective fevers/chills, however noted to have fever by EMS. In the ER, he was febrile, not hypoxic, and tested positive for COVID 19. CXR was negative for infiltrate. He was admitted under observation for further monitoring. Patient qualified for monoclonal antibody infusion which was given. He did not qualify for Remdesivir or Decadron with negative CXR and no hypoxia. Patient worked with PT/OT who did not identify any needs for him at home. The following day, patient felt much better. He denied shortness of breath, fever. He continued to have fatigue, but overall improved. He was ambulated multiple times by PT and found to not be hypoxic/needing home O2. He was discharged to home in improving condition on 10/3/21.


VAERS ID: 1768365 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-09-28
Onset:2021-09-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not reported.
Current Illness: Not reported.
Preexisting Conditions: Not reported.
Allergies: Not reported. No history of allergy event with any vaccine.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dose received on 9/28/21. On 9/30/21, patient reported a "golf ball size" swelling and redness. On 10/1/21, patient reported swelling resolved, but redness had increased to the size of a "silver dollar." Patient took Tylenol and Benadryl. Patient was instructed to mark redness with a pen/marker and monitor for changes in size (increase or decrease). Patient reported redness resolved.


VAERS ID: 1768411 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 3 RA / IM
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Extra dose administered, Headache, Injection site induration, Injection site mass, Injection site pain, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (narrow)

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

Write-up: sx onset 9/30/21. Sx started with headache, chills, pain at injection site, warmth at injection site, burns, itching. Hard lump noted at injection site which progressed to swelling. Swelling spread to 4 inches above elbow.


VAERS ID: 1768475 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Brain stem thrombosis, Facial paralysis, Magnetic resonance imaging, Neck mass, Paralysis, Swelling face, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: hypertension medication-controlled unknown meds thyroid-medication controlled, unknown meds
Allergies: unknown
Diagnostic Lab Data: I do not have access to her medical records, but she told me on the phone that they did MRI''s and possible CT scans.
CDC Split Type:

Write-up: Pt called back to mobile clinic to report she had a swelling tongue and side of her face, 2 hours after injection. The staff she spoke to referred her to the nearest ER which was Medical Center. I called to check on her and she stated they had admitted her to their hospital for testing and she would call me when she had a clear idea of what was wrong. She also reported facial paralysis and neck and shoulder paralysis as well as a "knot that came up in a matter of seconds, the size of a golfball in her neck". She called back today 10/7/2021 to tell me she was discharged from hospital and was told she had suffered "a blood clot on the brain stem". She said she is better now. Not d/c home on any anticoagulants or new meds. Was told not to take another Covid vaccine.


VAERS ID: 1768500 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-20
Onset:2021-09-30
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angioedema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient developed urticaria and angioedema 10 days after first shot


VAERS ID: 1768608 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-11
Onset:2021-09-30
   Days after vaccination:231
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 2 RA / IM

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

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

Write-up: Pt had a positive COVID test on 9/30/2021


VAERS ID: 1768628 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-02
Onset:2021-09-30
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 2 LA / IM

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

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

Write-up: Patient had Positive COVID test on 09/30/2021


VAERS ID: 1768665 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-20
Onset:2021-09-30
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Anticoagulant therapy, Asthenia, C-reactive protein increased, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Cough, Critical illness, Deep vein thrombosis, Diarrhoea, Fibrin D dimer increased, Full blood count, Immunology test, Lung disorder, Lung opacity, Metabolic function test, Pneumonia bacterial, Procalcitonin increased, SARS-CoV-2 test positive, Sepsis, Superficial vein thrombosis, Superinfection, Tachycardia, Tachypnoea, Ultrasound Doppler abnormal, Vomiting, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: allopurinol (ZYLOPRIM) 300 MG tablet aspirin 325 MG tablet Barberry-Oreg Grape-Goldenseal (BERBERINE COMPLEX PO) Cholecalciferol (VITAMIN D3) 1000 UNITS TABS fish oil-omega-3 fatty acids (FISH OIL) 1000 MG capsule Lactobacillus (PROBIOTIC A
Current Illness:
Preexisting Conditions: OSA (obstructive sleep apnea), moderate to severe, positional Chronic gout Pneumonia due to COVID-19 virus TIA (transient ischemic attack) Nephrolithiasis IFG (impaired fasting glucose) MG (myasthenia gravis) (HCC) Hx of Tubular adenoma Diverticulosis Vitamin D deficiency History of basal cell carcinoma (BCC) of skin RBBB
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized 9/30/2021; COVID-19 positive 09/30/2021; fully vaccinated CHIEF COMPLAINT: Pneumonia due to COVID-19 virus Weakness, found down at home Assessment/Plan ASSESSMENT/PLAN: Principal Problem: Pneumonia due to COVID-19 virus Sepsis due to COVID 19 PNA with concern for superimposed bacterial pneumonia Positive Test: 9/30 Symptoms Onset: 9/23 First Date of Eligible clearing of covid restrictions: pending review Symptoms: weakness, cough, emesis and diarrhea Tachycardic, tachypnic, WBC 27, LA 2.1 Treatment: Started on Decadron 6 mg and Remdesivir Supplemental O2, wean as able. Worsening tachypnea with RR 30s. STAT VBG pending. There was a question of a possible bacterial component in the ED and vanc cefepime ordered. CXR seems viral. Procal added and elevated - will cover for superimposed bacterial pneumonia with Rocephin/Zithromax Supportive Care with PRN anti-emetics, anti-tussives, anti-pyretics. Isolation and prone as much as possible and as frequently as possible. Daily CMP, daily complete blood count and D-dimer x3. VTE prophylaxis with Lovenox. Current oxygen requirement: SpO2: 94 % O2 Flow Rate (l/min): 2 l/min Note from 10/4/2021: Note from 10/4/2021: CHIEF COMPLAINT: Pneumonia due to COVID-19 virus Assessment/Plan ASSESSMENT / PLAN: Acute Hypoxic Respiratory Failure COVID19 Pneumonia Sepsis secondary to above S/P vaccination earlier this year Symptom onset was on 9/23, tested positive on 9/30 Initial CXR with diffuse abnormal parenchymal opacities, left greater than right Follow up CXR on 10/4 with increase bilateral airspace disease and less likely vascular congestion Currently requiring HFNC with 100 % FiO2 at rest- increased in past 24 hours Immune labs including CRP and D-dimer very elevated but improving Patient also with elevated Procalcitonin On Decadron 6 mg daily x 10 days Remdesivir started on 9/30 x 5 days Continue with antibiotics for superimposed bacterial pneumonia coverage x 5 total days Give one time dose if Diuril with findings of possible CHF component on follow up CXR Encourage proning Continue with anti tussive medication PRN Follow immune labs which are improving Lovenox SQ increased to treatment dose due to high d dimer and superficial thrombus seen on venous US Note from 10/7/2021: CHIEF COMPLAINT: Pneumonia due to COVID-19 virus Assessment/Plan ASSESSMENT / PLAN: Acute Hypoxic Respiratory Failure COVID19 Pneumonia Sepsis secondary to above S/P vaccination earlier this year. Symptom onset was on 9/23, tested positive on 9/30 Initial CXR with diffuse abnormal parenchymal opacities, left greater than right. Follow up CXR on 10/4 with increase bilateral airspace disease and less likely vascular congestion Currently requiring HFNC with 100 % FiO2 at rest Patient also with elevated Procalcitonin On Decadron 6 mg daily x 10 days Remdesivir 9/30 x 5 days Completed abx course x 5 total days Encourage proning. Lovenox 1mg/kg BID for DVT. Patient remains critically ill and receiving maximum non-invasive oxygen support. DNR/DNI


VAERS ID: 1768675 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 1 - / SC
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 061E21A / 2 - / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Fatigue, Headache, Nausea
SMQs:, Acute pancreatitis (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tramadol Tylenol Meloxicam Metaxalone
Current Illness: None
Preexisting Conditions: Arthritis
Allergies: Medication Allergies: Levaquin, Leflunomide, Omnicef
Diagnostic Lab Data:
CDC Split Type:

Write-up: The first shot on 09/02/2021 Lot number 058E21A - I Had no side effects, The second shot number 061E21A on 09/30/2021, Headache started 30 minutes after injection, Headaches continues thru today 10/07/2021 along with nausea and tiredness. I did have chest pain on the second thru fifth day 10/01/2021 thru 10/05/2021.


VAERS ID: 1768722 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3529 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chills, Dizziness, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (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)

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: atorvastatin prilosec multivitamin kril oil vitamin d 3 turmeric
Current Illness: none
Preexisting Conditions: high cholesterol type 2 diabetes fatty liver
Allergies: none
Diagnostic Lab Data: NONE
CDC Split Type: vsafe

Write-up: FEVER CHILLS BODY ACHE JOINT PAIN MUSCLE PAIN DIZZYNESS


VAERS ID: 1768746 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered, Vaccine positive rechallenge
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: ibuprofen
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: developed upper back pain and numbness in left arm after 2 dose--after few days of 2 nd dose and resolved after 4-5 months . symptoms restarted again with in 2 hours of 3 rd dose


VAERS ID: 1768816 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-23
Onset:2021-09-30
   Days after vaccination:219
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9263 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Cough, Diarrhoea, Fatigue, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tramadol; Fosamax; Folic acid; Vitamin D; Adderall XR; Losartan; Metoprolol; HCTZ; Methotrexate; vitamin B-12
Current Illness: none
Preexisting Conditions: rheumatoid arthritis; osteopenia; HTN; tricuspid valve insuffiency, osteoarthritis
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Cough, loss of smell/taste, fatigue, runny nose, diarrhea starting on 9/30/21


VAERS ID: 1768884 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Hives all over my body. Hives were worsening for the first 3 days following vaccination. oral steroids prescribed.


VAERS ID: 1768912 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-21
Onset:2021-09-30
   Days after vaccination:252
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

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

Write-up: PATIENT HAD PFIZER VACCINE ON 01/21/2021 and 02/11/2021, AND TESTED POSITIVE TO COVID.


VAERS ID: 1768949 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: she stated that she has allergic reactions to the flu shot
Other Medications: Benadryl
Current Illness: No
Preexisting Conditions: No
Allergies: Latex & to flu shots
Diagnostic Lab Data: no
CDC Split Type:

Write-up: complained of left arm numbness that occurred the day after vaccination that has spread to the fingers, which has continued to this date.


VAERS ID: 1769021 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / UNK - / -

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

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

Write-up: Booster dose was given to a 17 year old with parent present.


VAERS ID: 1769074 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pfizer (rash) at age 67
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: levofloxacin (anaphylactic)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received her first Pfizer dose on February 2, 2021 and reported an itchy rash that developed shortly after receiving the vaccine. She said she took Benadryl after the rash developed but it did not relieve her symptoms. Patient received her second dose of Pfizer on February 20, 2021 and did not report any reaction after that dose. Within 10 minutes of receiving her third Pfizer vaccine, she reported red itchy areas on her inner arms. As she was describing this, the rash began to develop around her neck and chest and became more red and itchy. She did not report any trouble breathing or swelling of lips or tongue. Patient did not want to take Benadryl because she said it did not work after having similar symptoms after her first dose. Per Pharmacy protocol for vaccines, the emergency service was called because of the generalized reaction. Patient sat in a chair at the pharmacy for approximately 15 minutes until the emergency services came, they monitored her for approximately 15 more minutes, then she left to go home with her husband to drive her home.


VAERS ID: 1769087 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Unknown  
Location: Kansas  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure increased, Eye movement disorder
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow), Ocular motility disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Qvar inhaler, Fluoxetine, Xolair, ProAir inhaler, Allegra
Current Illness: Unknown
Preexisting Conditions: Asthma, GERD, Hypertension
Allergies: Corn, Medrol dose pack
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 9/30/21 Felt "eyes not keeping up with her head" and blood pressure increased to 160/105. Went to the ED at 1607 - monitored by staff. Ruled out stroke or any other issues. Released from care at 1719.


VAERS ID: 1769089 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Unknown  
Location: Kansas  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure increased, Eye disorder
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow), Corneal disorders (broad), Retinal 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: Qvar inhaler, Fluoxetine, Xolair, ProAir inhaler, Allegra
Current Illness: Unknown
Preexisting Conditions: Asthma, GERD, Hypertension
Allergies: Corn, Medrol dose pack
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 9/30/21 Felt "eyes not keeping up with her head" and blood pressure increased to 160/105. Went to the ED at 1607 - monitored by staff. Ruled out stroke or any other issues. Released from care at 1719.


VAERS ID: 1769236 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Unknown  
Location: Missouri  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Atrial fibrillation, Atrial flutter, Computerised tomogram thorax abnormal, Condition aggravated, Dyspnoea, Echocardiogram abnormal, Endotracheal intubation, Fatigue, Lung infiltration, Mechanical ventilation, Nausea, Palpitations, Pleural effusion, Respiratory distress, Right ventricular dysfunction, Right ventricular enlargement
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Hx of Atrial Fib, ETOH dependence
Allergies: Penicillin
Diagnostic Lab Data: CT of chest: bilateral pleural effusions, patchy infiltrates in right lung on 10/2/21. Echo on 10/2/21:Enlarged right ventricle, reduced RV systolic function.
CDC Split Type:

Write-up: 9/30/21 Reported feeling nauseous the evening after vaccination. 10/1/21: shortness of breath, Fatigue, felt like heart was racing. Went to the ED on 10/1/21. Found to be in atrial fib, shortness of breath continued until respiratory distress increased to him being intubated on a ventilator. Possible sepsis. Cardiac rhythm converted to Atrial Flutter. Extubated by 10/4/21. 10/7/21 Walking in hallway.


VAERS ID: 1769288 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-28
Onset:2021-09-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Laboratory test abnormal
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Carvedilol; Lisinopril; Nifedipine; Atorvastatin; Finasteride; C gummies; Probiotic Tea Green tea
Current Illness: Stomach bug; Unknown kind caused Diarrhea.
Preexisting Conditions: Kidney disease; Enlarged Prostate
Allergies: NKA
Diagnostic Lab Data: (11/1/2021) Battery of test and Renal ordered. No other test done or planned.
CDC Split Type: vsafe

Write-up: (9/29/20210), Lab work done at Urgent Care, MRG dropped by 14 points. No other show of symptoms. Scheduled a appointment with Nephrologist on 10/01/2021. No treatment given other than diet and exercise.


VAERS ID: 1769485 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-15
Onset:2021-09-30
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstrual disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Her menstrual cycle is abnormal, heavier bleeding than usual, has been going on for 8 days which is also longer than normal for her cycle.


VAERS ID: 1769506 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: The vaccine was not diluted and the patient received 6 times the dose. The patient was contacted and notified of the error. No adverse events were reported.


VAERS ID: 1769685 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-26
Onset:2021-09-30
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 2 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001A21A / 1 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Arthralgia, COVID-19, Condition aggravated, Cough, Dyspnoea, Hypoxia, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler carbidopa-levodopa (SINEMET) 25-100 MG per tablet dexamethasone (DECADRON) 6 MG tablet diclofenac sodium 1 % gel dip
Current Illness: 9.28.21 - office visit - orthopedics - chronic right hip & knee pain 9.30.21 - ED - fever and cough - COVID-19
Preexisting Conditions: COPD (chronic obstructive pulmonary disease) BPH (benign prostatic hyperplasia) Prostate cancer Impotence of organic origin Epiretinal membrane, left eye RBBB with left anterior fascicular block Dyspnea on exertion Snoring Nasal congestion Essential (primary) hypertension Secondary malignant neoplasm of bone Acute hypoxemic respiratory failure due to COVID-19 Parkinson disease
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized (10.1.21); COVID-19 positive (9.30.21); fully vaccinated Admission Date: 10/1/2021 Discharge Date: 10/03/2021 PRESENTING PROBLEM: Acute respiratory failure with hypoxia Acute hypoxemic respiratory failure due to COVID-19 COVID HOSPITAL COURSE: 77-year-old male presented to Hospital with increased shortness of breath. He was recently on a trip when the person ahead of him in the above was noted to be ill. He began developing symptoms after returning home from the bus trip with cough fever shortness of breath. On the day prior to admission he had been started on oral Decadron. Upon admission he was found to be COVID positive and admitted for treatment of hypoxemia. He was continued on IV dexamethasone and remdesivir. He generally felt well but did have continued oxygen requirements. He was set up for home oxygen therapy prior to discharge. He is to complete 10 days of dexamethasone post discharge. At the time of discharge he should utilize 1-2 L of oxygen at rest and increased to 5 L with activity. It is hoped that over the next week he can wean off to no subsequent oxygen.


VAERS ID: 1769696 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dysstasia, Feeling abnormal, Feeling cold, Nausea, Tremor, Vision blurred, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Zinc, One A Day Multi-Vitamin, EmergenC powder packet
Current Illness: N/A
Preexisting Conditions: High blood pressure, cholesterol, Aortic aneurysm
Allergies: Penicillin, Ciprofloxacin, Gatifloxacin, Gemifloxacin, Levofloxacin, Moxifloxacin, Lydocaine, Norfloxacin, Ofloxacin, possible allergy to steroids, Escitalopram
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: The order of symptoms in the order they occurred starting at 7:00pm on 9/30/21: very cold - entire body; tremors in legs and arms; worse in legs; couldn''t stand, very nauseous, brain fog, couldn''t see clearly, throwing up everything she ate an drank


VAERS ID: 1770387 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-09-30
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Diarrhoea, Fatigue, Feeling abnormal, Gastrointestinal sounds abnormal, Hyperhidrosis, Hypoaesthesia, Influenza like illness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211008802

Write-up: SWEATING; CHEST TIGHTNESS; FATIGUE; JOINT ACHES; NUMBNESS IN BOTH HANDS; EXPLOSIVE DIARRHEA; VERY BAD FLU/FELT VERY SICK ALL DAY/FEVER/DIFFICULTY BREATHING/POUNDING HEADACHE/MUSCLE ACHES/ACHY ALL DAY; FELT WEIRD AND DIFFERENT; GUT STARTED RUMBLING; This spontaneous report received from a patient concerned a 43 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 211A21A expiry: UNKNOWN) dose was not reported, administered on 30-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 30-SEP-2021, the patient experienced felt weird and different. On 30-SEP-2021, the patient experienced gut started rumbling. On 30-SEP-2021, the patient experienced very bad flu/felt very sick all day/fever/difficulty breathing/pounding headache/muscle aches/achy all day. On 30-SEP-2021, the patient experienced joint aches. On 30-SEP-2021, the patient experienced numbness in both hands. On 30-SEP-2021, the patient experienced explosive diarrhea. On 01-OCT-2021, the patient experienced fatigue. On an unspecified date, the patient experienced sweating, and chest tightness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from gut started rumbling, and explosive diarrhea on 30-SEP-2021, joint aches on 02-OCT-2021, and numbness in both hands on 01-OCT-2021, was recovering from felt weird and different, had not recovered from chest tightness, very bad flu/felt very sick all day/fever/difficulty breathing/pounding headache/muscle aches/achy all day, and fatigue, and the outcome of sweating was not reported. This report was non-serious.


VAERS ID: 1770403 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-09-30
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211011585

Write-up: FEELING TIRED; BAD MUSCLES ACHES; This spontaneous report received from a consumer concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 30-SEP-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 30-SEP-2021, the patient experienced bad muscles aches. On an unspecified date, the patient experienced feeling tired. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from bad muscles aches, and had not recovered from feeling tired. This report was non-serious. This case, from the same reporter is linked to 20211011458.


VAERS ID: 1770405 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Louisiana  
Vaccinated:0000-00-00
Onset:2021-09-30
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211011706

Write-up: EXPIRED VACCINE ADMINISTERED; This spontaneous report received from a patient concerned a 57 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1808982, and expiry: 21-SEP-2021) dose was not reported, administered on 30-SEP-2021 10:00 for prophylactic vaccination. No concomitant medications were reported. On 30-SEP-2021, the patient experienced expired vaccine administered. The action taken with covid-19 vaccine was not applicable. The outcome of expired vaccine administered was not reported. This report was non-serious.


VAERS ID: 1770407 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-09-30
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211011738

Write-up: DOSE OF EXPIRED VACCINE ADMINISTERED; This spontaneous report received from a health care professional concerned a 59 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808982 expiry: 21-SEP-2021) dose was not reported, administered on 30-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 30-SEP-2021, the patient experienced dose of expired vaccine administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of dose of expired vaccine administered was not reported. This report was non-serious.


VAERS ID: 1770418 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Colorado  
Vaccinated:0000-00-00
Onset:2021-09-30
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211012383

Write-up: EXPIRED DOSE OF VACCINE WERE ADMINISTERED; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A expiry: 21-SEP-2021) dose was not reported, administered on 30-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 30-SEP-2021, the patient experienced expired dose of vaccine were administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of expired dose of vaccine were administered was not reported. This report was non-serious. This case, from the same reporter is linked to 20211012114, 20211012141 and 20211012209.


VAERS ID: 1770520 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: tingling in right leg; pain in right leg; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA (tingling in right leg) and PAIN IN EXTREMITY (pain in right leg) in a 25-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 29-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Sep-2021, the patient experienced PARAESTHESIA (tingling in right leg) and PAIN IN EXTREMITY (pain in right leg). At the time of the report, PARAESTHESIA (tingling in right leg) and PAIN IN EXTREMITY (pain in right leg) outcome was unknown. Concomitant medication of the patient was not reported. On 30-Sep-2021, the patient woke up and started driving her son to school. She started having tingling and pain in her right leg. It hurt and tingles even when she was sitting still. No treatment information was provided by the reporter. This case was linked to MOD-2021-338511 (Patient Link).


VAERS ID: 1770523 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / 2 - / -

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

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

Write-up: This spontaneous case reported by a physician, describes the occurrence of administered expired product (expired vaccine administered to a patient) in an 85-year-old female patient who received mRNA-1273 (Moderna COVID-19 vaccine, batch/lot# 032B21A) for COVID-19 immunization. No medical history reported. On Sep 30, 2021, patient received the second dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On Sep 30, 2021, patient administered expired product (expired vaccine administered to a patient). On Sep 30, 2021, administered expired product (expired vaccine administered to a patient) resolved. The reporter did not provide any causality assessments, concomitant medications or treatment information. Originally when the reporter looked-up the expiration date for the Moderna COVID-19 vaccine, it stated it was good until Oct 5, 2021. After administration when the reporter looked-up the expiration date, the website stated the vaccine expired on Sep 24, 2021.


VAERS ID: 1770528 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Confusional state, Fatigue, Feeling abnormal, Nasopharyngitis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Multiple sclerosis
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: kind of bad; thought she was coming down with a cold; very confused; fatigue/tiredness; This spontaneous case was reported by an other health care professional and describes the occurrence of FEELING ABNORMAL (kind of bad), NASOPHARYNGITIS (thought she was coming down with a cold), CONFUSIONAL STATE (very confused) and FATIGUE (fatigue/tiredness) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 022C21A) for COVID-19 vaccination. The patient''s past medical history included COVID-19. Concurrent medical conditions included Multiple sclerosis. On 29-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Sep-2021, the patient experienced FEELING ABNORMAL (kind of bad), NASOPHARYNGITIS (thought she was coming down with a cold), CONFUSIONAL STATE (very confused) and FATIGUE (fatigue/tiredness). The patient was treated with PARACETAMOL, PHENIRAMINE MALEATE, PHENYLEPHRINE HYDROCHLORIDE (THERAFLU [PARACETAMOL;PHENIRAMINE MALEATE;PHENYLEPHRINE HYDROCHLORIDE]) for Adverse event, at an unspecified dose and frequency. At the time of the report, FEELING ABNORMAL (kind of bad), NASOPHARYNGITIS (thought she was coming down with a cold), CONFUSIONAL STATE (very confused) and FATIGUE (fatigue/tiredness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant concomitant medications were reported.


VAERS ID: 1771112 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, 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: USMODERNATX, INC.MOD20213

Write-up: A patient that received a dose from a vial that had been punctured more than 12 hours; Received dose from vial punctured more than 12 hours before/punctured for more than 12 hours (about 11 hours after the 12 hour period).; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (A patient that received a dose from a vial that had been punctured more than 12 hours) and PRODUCT STORAGE ERROR (Received dose from vial punctured more than 12 hours before/punctured for more than 12 hours (about 11 hours after the 12 hour period).) in a 37-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 062E21A) for COVID-19 vaccination. No Medical History information was reported. On 30-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (A patient that received a dose from a vial that had been punctured more than 12 hours) and PRODUCT STORAGE ERROR (Received dose from vial punctured more than 12 hours before/punctured for more than 12 hours (about 11 hours after the 12 hour period).). On 30-Sep-2021, EXPIRED PRODUCT ADMINISTERED (A patient that received a dose from a vial that had been punctured more than 12 hours) and PRODUCT STORAGE ERROR (Received dose from vial punctured more than 12 hours before/punctured for more than 12 hours (about 11 hours after the 12 hour period).) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were provided. No treatment medications were reported.


VAERS ID: 1771117 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Chills, Heart rate, Heart rate increased, Nasopharyngitis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Stent placement.
Allergies:
Diagnostic Lab Data: Test Date: 20210930; Test Name: Body temperature; Result Unstructured Data: fever of 100.8 ? F; Test Date: 20210930; Test Name: Heart rate; Result Unstructured Data: 105 bpm, not much
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Heart is racing a little, not much, 105 bpm; cold chills; cold chills; Fever of 100.8 ? F; This spontaneous case was reported by a consumer and describes the occurrence of HEART RATE INCREASED (Heart is racing a little, not much, 105 bpm), NASOPHARYNGITIS (cold chills), CHILLS (cold chills) and PYREXIA (Fever of 100.8 ? F) in a 52-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 047C21A) for COVID-19 vaccination. The patient''s past medical history included Stent placement. On 29-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Sep-2021, the patient experienced HEART RATE INCREASED (Heart is racing a little, not much, 105 bpm), NASOPHARYNGITIS (cold chills), CHILLS (cold chills) and PYREXIA (Fever of 100.8 ? F). At the time of the report, HEART RATE INCREASED (Heart is racing a little, not much, 105 bpm), NASOPHARYNGITIS (cold chills), CHILLS (cold chills) and PYREXIA (Fever of 100.8 ? F) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 30-Sep-2021, Body temperature: 100.8 (High) fever of 100.8 ? F. On 30-Sep-2021, Heart rate: 105 (High) 105 bpm, not much. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. It was reported that the patient was not having a history of COVID infection and myo/pericarditis. No concomitant medication information was provided. No treatment medication information was provided.


VAERS ID: 1771155 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-30
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, 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: USMODERNATX, INC.MOD20213

Write-up: patient received Moderna COVID-19 vaccine after Beyond Use Date; A Moderna COVID-19 vaccine vial was removed from the refrigerator yesterday; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (patient received Moderna COVID-19 vaccine after Beyond Use Date) and PRODUCT STORAGE ERROR (A Moderna COVID-19 vaccine vial was removed from the refrigerator yesterday) in a 35-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 049E21A and 007C21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Oct-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 30-Sep-2021 at 8:45 AM, the patient experienced PRODUCT STORAGE ERROR (A Moderna COVID-19 vaccine vial was removed from the refrigerator yesterday). On 01-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (patient received Moderna COVID-19 vaccine after Beyond Use Date). On 01-Oct-2021, EXPIRED PRODUCT ADMINISTERED (patient received Moderna COVID-19 vaccine after Beyond Use Date) and PRODUCT STORAGE ERROR (A Moderna COVID-19 vaccine vial was removed from the refrigerator yesterday) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant was not reported. No treatment medication was reported. The vial was left out at room temperature until 01OCT2021 when a dose was given at 8:33AM.


VAERS ID: 1771163 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-05
Onset:2021-09-30
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 1 - / OT

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

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

Write-up: Received the 4th dose; This spontaneous case was reported by a nurse and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received the 4th dose) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 058E21A, 019B21A, 048B21A and 017B21A) for COVID-19 vaccination. No Medical History information was reported. On 05-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 30-Sep-2021, received fourth dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 30-Sep-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received the 4th dose). On 30-Sep-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received the 4th dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. Treatment information was not provided by the reporter.


VAERS ID: 1771408 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-03
Onset:2021-09-30
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain lower, Blood test, Computerised tomogram, Fatigue, Headache, Heart rate increased, Lymphadenopathy, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Headache, Muscle Pain after first Shingles Shot in 2020
Other Medications: Synthroid, Cholesterol Medication, Vitimans C, D, E & Zinc, Selenium
Current Illness: None
Preexisting Conditions: Asthma, Arthiritis
Allergies: None
Diagnostic Lab Data: Physical exam, Bloodwork and CT scan
CDC Split Type:

Write-up: Multiple side effects such as headache, tiredness, muscle pain, rapid heartbeat, and swollen lymph nodes throughout. On evening of the third week after second shot, severe abdominal pain in lower right. Next morning went to urgent care, and was tested for appenditicitis.


VAERS ID: 1771421 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyskinesia
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (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, duloxetine, fenofibate, gabapentin, levothyroxine, Mobic , trazodobe
Current Illness: None
Preexisting Conditions: Hypertension, wernicke- korsakoff encephalopathy, fibromyalgia, obesity, depression, hypothyroidism
Allergies: Asa, pcn
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Abnormal movements of torso- back and forth when at rest


VAERS ID: 1771484 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-28
Onset:2021-09-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Generalised tonic-clonic seizure, Pain in extremity, Partial seizures, Pyrexia, Road traffic accident
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Generalised convulsive seizures following immunisation (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Keppra 2000 mg 2 x day
Current Illness:
Preexisting Conditions: Epilepsy
Allergies: Clindamycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Later at night following the vaccine experienced fever-like symptoms and chills and pain in arm. 2 days later experienced a grand mal seizure while driving and had multi-vehicle car accident and was taken to hospital. Have never blacked out while driving before and it had been several months since I had experienced a partial seizure.


VAERS ID: 1771523 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3186 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Fatigue, Headache, Insomnia, Limb discomfort, Pain in extremity, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol, Gabapentin, baby aspirin, Plavix, magnesium OTC, Zolpidem, insulin 23 1/2 units, Tylenol. Allegra D.
Current Illness: None.
Preexisting Conditions: Type I diabetes, CVA, Tachycardia, insomnia, CRPS in right foot.
Allergies: Codeine and bees.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: She got her vaccine, about 12 hours later initially started with soreness in the left arm, heavy feeling. Throbbing headache, fatigue and then throughout the night she could not sleep at all, shaking from not being at all. Her DKA blood sugars around 411, checked every 45 minutes, checked her ketones every couple of hours and they were large, and was drained from energy. Had highest blood sugar was 411. Kept monitoring this and if she cannot resolve the issue on her own then she has to seek medical help. She kept increasing her doses of insulin until it started to decrease. On Friday around 7:00 PM is when she got it down to normal parameters, and checked it every 45 minutes to make sure that it did not go up. The ketones were at the highest level that they could go. Her blood sugars were under good control prior to the vaccine with normal being 90-130.


VAERS ID: 1771921 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chills, Condition aggravated, Extra dose administered, Fatigue, Feeling hot, Headache, Induration, Malaise, Mobility decreased, Neck pain, Pain in extremity, Pain in jaw, Peripheral swelling, Pruritus, Pyrexia, Renal pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metoprolol. montelukast,
Current Illness: None
Preexisting Conditions: none
Allergies: Sulfa
Diagnostic Lab Data: I did not go to the doctor.
CDC Split Type:

Write-up: Couldn?t get out of bed for 3 days. Chills, fever x2, aches and pains in every spot I have been hurt before. knees, back, leg, neck, jaw, kidney. Headaches every day, exhaustion, After I thought I was better, it went again to my back one day, my knees another day, my back another day etc. General malaise returned! Arm was swollen the size of a baseball, hot, hard like a rock, itchy as well as painful! That went on for a week! My reaction was so severe, I am not sure I will want to receive another booster next time. And I believe thoroughly in shots!


VAERS ID: 1771934 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC2589 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphonia, Chills, Eye pain, Gait inability, Headache, Pharyngitis, Pyrexia, Sinusitis, Wheezing
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: next day got severe chills, 104 fever, voice left from coughing, barely could walk, severe headache, eyed hurting, and wheezing: sinusitis, pharyngitis


VAERS ID: 1771947 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-01
Onset:2021-09-30
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Chills, Cough, Dyspnoea, Myalgia, Pyrexia, Vaccine breakthrough infection, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: This case meets criteria for vaccine breakthrough review. SxS include cough, SOB, chills, fever, chest pain, myalgia, wheezing.


VAERS ID: 1771958 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-01-08
Onset:2021-09-30
   Days after vaccination:265
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH N/A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Malaise
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? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient hospitalized with COVID-19 symptoms after receiving the vaccination.


VAERS ID: 1772017 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-09-27
Onset:2021-09-30
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Amnesia, Blood pressure increased, Chest X-ray normal, Computerised tomogram head, Confusional state, Electrocardiogram, Electroencephalogram, Heart rate increased, Seizure like phenomena, Tremor, Troponin
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), 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: cholecalciferol, vitamin D3, 1,000 unit Oral Tablet multivitamin Oral Tablet ondansetron (ZOFRAN) 4 mg Oral Tablet oxyCODONE-acetaminophen (PERCOCET) 5-325 mg Oral Tablet Tamoxifen (NOLVADEX) 20 mg Oral Tablet venlafaxine (EFFEXOR XR) 75 mg
Current Illness: knee replacement one month prior
Preexisting Conditions: Endocrine Hypothyroidism Ophthalmologic Wears glasses Obstetrics/Gynecology Family history of breast cancer and ovarian cancer in MAunt x 2, Endometrial polyp Other Fibroid 9.5mm Menorrhagia Squamous cell carcinoma Obesity
Allergies: Ginger High Nausea/ Vomiting GINGER ALE (POP) Severe N/V Celery Medium Rash Adhesive Tape-silicones Not Specified Skin tears, Can use paper tape Keflex [cephalexin] Not Specified Other Adverse Reaction (Add comment) Blisters Norco [hydrocodone] Not Specified Rash, Itching Welts and felt like bugs crawling on her skin
Diagnostic Lab Data: o ECG, CT brain, troponin, CXR WNL o Consulted neurology for transient amensia; They ordered EEG due to concern for seizure-like activity. BP: (!) 160/86 All 9/30
CDC Split Type:

Write-up: Tremors (onset this morning when driving to work, acute confusion, rapid HR, tremors mostly on the right side. States she got to work and could not remember driving there, BP was high and she was very shakey.


VAERS ID: 1772028 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Chills, Lymphadenopathy, 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: levothyroxine, Lexapro, ibuprofen
Current Illness: none
Preexisting Conditions: hypothyroid, hysterectomy due to fibroids
Allergies: NKA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Did have chills, fever, muscle aches and temp Had no redness but very painful and swelling in the arm pit, side of left breast (felt like a tennis ball under my arm). No numbness of pain down the arm. Lasted for 5 days


VAERS ID: 1772105 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye pain
SMQs:, Glaucoma (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: Left eye pain x 8 days and going


VAERS ID: 1772160 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-26
Onset:2021-09-30
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Myocarditis
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: furosemide 80mg metoprolol tartrate 100mg calcitrial 0.25mcg
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: myocarditis


VAERS ID: 1772169 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (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:
Preexisting Conditions: PMH: Gall Bladder Disease, Anemia
Allergies: Allergies: Tramadol (shaking/cold feeling)
Diagnostic Lab Data:
CDC Split Type:

Write-up: 15mins post vaccinattion, pt reported throat tightness. Vitals: @17:05 BP 104/66, HR 68, RR 18, O2 Sat 95% -- $g @17:15 111/61, 76, 18, 99% -- $g@17:22 91/76, 74, 20, 97% -- $g @17:24 108/68, 77, 100% 17:07 - Pt reassessment no SOB/wheezing (audiable). Continue to monitor. VSS No temp, resp even and unlabored. 17:19 - pT STATED HER THROAT FELT BETTER. Lungs clear to Aus. regular pulse 1725 PA cleared pt d/c to home with family. Pt d/c in stable condition


VAERS ID: 1772272 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Interchange of vaccine products, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad), Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 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 initial COVID-19 vaccine, which was Johnson & Johnson. She received a Pfizer vaccine as a booster. Complaint of sore arm and dull headache. Spoke with health department and no revaccination required.


VAERS ID: 1772380 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-25
Onset:2021-09-30
   Days after vaccination:217
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Acute kidney injury, Asymptomatic COVID-19, Blood bicarbonate increased, Blood creatinine increased, COVID-19, Cancer fatigue, Chronic kidney disease, Condition aggravated, Constipation, Decreased appetite, Dehydration, Fatigue, Flatulence, Gastrostomy, Hypertension, Hypokalaemia, Insomnia, Intestinal obstruction, Nausea, Pain, Portogram, SARS-CoV-2 test positive, Urine output decreased, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Malignancy related conditions (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (narrow), Hypokalaemia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet HYDROcodone-acetaminophen (HYCET) 7.5-325 MG/15ML solution ondansetron (ZOFRAN-ODT) 4 MG disintegrating tablet Spacer/Aero-Holding Chambers (AEROCHAMBER) MISC temazepam (RESTORIL) 30 MG capsule
Current Illness: 9.8.21 - office visit - chronic fatigue related to cancer; insomnia; chronic pain 9.28.21 - vomiting, abdominal pain, decreased urine output, constipation continued dehydration
Preexisting Conditions: Secondary hypertension Rheumatoid arthritis Hypothyroidism Nerve pain Vaginal wall prolapse Dyslipidemia Hyperlipidemia Renal insufficiency Large bowel obstruction Serous carcinoma of female pelvis Carcinoma of abdominal wall Attention to colostomy Unspecified severe protein-calorie malnutrition Polycystic kidney disease Pelvic mass Fallopian tube carcinoma, right Chemotherapy-induced neutropenia On antineoplastic chemotherapy Thrombosis of ovarian vein LBO from Ovarian CA s/p LAR with DLI 1/4/18, now s/p ileostomy takedown with ND 6/21/18. UTI (urinary tract infection) Neoplastic malignant related fatigue AKI (acute kidney injury) Elevated alkaline phosphatase level Shortness of breath Thrombocytopenia due to drugs Anemia in chronic kidney disease Insomnia due to medical condition Encounter for monitoring cardiotoxic drug therapy Port-A-Cath in place Chronic pain Constipation Hot flashes At risk for injury from chemotherapy Chronic diastolic congestive heart failure Chronic fatigue Neuropathy due to chemotherapeutic drug Embolism and thrombosis of unspecified artery Chronic renal disease, stage IV IVC thrombosis Other specified disorders of adrenal gland Platelets decreased Stage 3 chronic kidney disease, unspecified whether stage 3a or 3b CKD Chronic renal disease, stage V Bowel obstruction
Allergies: AntihistaminesRash, Asthma/Shortness of Breath, Unknown HistamineRash, Asthma/Shortness of Breath MorphineOther, Unknown OxycodoneHallucinations, Confusion Alcohol AtorvastatinOther, Unknown CodeineConfusion, Unknown Lisinopril [Ace Inhibitors]Cough StatinsMyalgia
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized (9.30.21); COVID-19 positive (); fully vaccinated BRIEF OVERVIEW: Admission Date: 9/30/2021 Discharge Date: Oct 7, 2021 Brief history and medical decision making: 77 y/o female hx of Fallopian tube cancer with recurrent SBO. Came in with another SBO. Was responding poorly to non-surgical management. After discussion with gyn onc, patient and husband elected to go to hospice care. Had decompressive G tube placed 10/6 and went home with hospice. Does have asymptomatic COVID 19 infection. Discharge Disposition: home with hospice/medical facility Active Issues Requiring Follow-up: Hospice admission in patient''s home 10/7/21 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Dehydration Bowel obstruction Acute kidney injury Intractable vomiting with nausea, unspecified vomiting type COVID-19 HOSPITAL COURSE: Patient is a 77 y.o female with PMHx of fallopian tube serous adenocarcinoma stage IIIc s/p chemotherapy and multiple surgeries, recurrent bowel obstruction, diastolic heart failure EF 63%, and CKD stage 4 presents with a 5-day history of nausea, vomiting, anorexia, and constipation. In the ED she was found to be hypertensive, have Bicarb of 29, Cr of 4.14, s/p 3L fluid, Reglan, Zofran. She was admitted for fluid resuscitation for dehydration and investigation of bowel obstruction. Ctap with evidence of high grade small bowel obstruction with transition point in pelvis. This is likely due to adhesions from extensive intraabdominal surgeries, however Gyn/Onc was consulted with concern for extension of malignancy. She was initially treated with medical management with antiemetics, NGT decompression, and IV fluids. She initially had BM and flatulence on 10/2, however did not tolerate NG clamping and clear liquid diet, thus NG decompression resumed. Gyn/Onc discussed treatment options with patient, and ultimately reached the decision to pursue hospice. A G-tube was placed for decompression per IR. Hospice was coordinated for home and discharge on 10/7. Her hospital course was complicated by AKI on CKD and hypokalemia, which improved with IV fluid maintenance. Additionally, she was incidentally found to be COVID-19 positive, intermittently required 2L NC however mostly asymptomatic from a respiratory standpoint throughout her stay.


VAERS ID: 1772386 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Work       Purchased by: ?
Symptoms: Asthenia, Condition aggravated, Cough, Decreased appetite, Hypoaesthesia, Influenza like illness, Injection site reaction, Migraine, Myalgia, Nasopharyngitis, Nausea, Pain, Pyrexia, Rash, Sneezing, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: HPV, elevated thyroid antibodies, low progesterone, chronic migraines
Preexisting Conditions: HPV, elevated thyroid antibodies, low progesterone, chronic migraines
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received J&J vaccine at 7:45am on Thursday 9/30/21, by 9:00am extreme muscle soreness in left arm (site of injection) and nausea/vomiting. Throughout the day experienced increased muscle soreness concentrated in lower back, hips, neck and jaw causing debilitating pain. At 8:00pm spiked a fever of 102 and developed a rash on back and shoulders. Also developed a migraine that night. Rash, fever and migraine continued throughout the night. Also had intermittent numbness in fingers on both hands that night. Still had a fever of 102 the next morning (Friday). On Saturday fever resolved but developed cold/flu like symptoms (body aches, coughing, sneezing, loss of appetite, vomiting) which lasted until Monday. Rash disappeared on Monday.


VAERS ID: 1772563 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid; Lisinopril; Furosemide; Spironolactone; Tylenol; Calcium
Current Illness: None
Preexisting Conditions: Heart failure; Over weight; Arthritis; Meningioma; Hypertension; Hypothyroidism
Allergies: Penicillin; Tetracycline; Amlodipine; NSAIDS
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: About an hour after my vaccine I noticed what looked like spider bites on my right thigh. It later turned into hives. I was not very big. They were itchy and still there the following day. I then noticed more hives on my left wrist so I went to Urgent Care about 24 hours after my vaccine. The doctor confirmed it was hives and gave me a prednisone injection. She also gave me a 5 day prednisone script. The hives cleared up after a couple of days.


VAERS ID: 1772570 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Headache, Hypoaesthesia, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (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: anaphylaxis x 2 post allergy shots
Other Medications: multivitamin. Krill oil.
Current Illness:
Preexisting Conditions: Antiphospholipid Syndrome
Allergies: SULFA
Diagnostic Lab Data:
CDC Split Type:

Write-up: both hands numb then tingling within 15-30 min post vaccination. about 40 min post, right arm went completely numb briefly then tingling and feeling back within 2 minutes. days 2 and 3 post vaccination, full body joint and muscle aching. all symptoms resolved until 5 days post, horrible headache for 24 hrs. no issues since.


VAERS ID: 1772757 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-24
Onset:2021-09-30
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, Headache, Malaise, Pyrexia, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: vial was placed in fridge on 8/19/21, and therefore expired on 9/18/21. Box was only marked with 9/18, which was the date it was received in the store. pt received dose outside of the known effective storage window of 30 days. Pt was contacted and stated she had full immune response to the vaccination, including fever, malaise, headache, and slept all day. Pt declined re-vaccination recommendation.


VAERS ID: 1772761 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-27
Onset:2021-09-30
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad), 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: vaccine was placed in fridge on 8/19, and therefore expired 9/18. date was not marked appropriately on the box, and was administered to the patient past it''s beyond use date. contacted pt, stated she experienced a sore arm. explained what happened and that cdc recommends repeating her dose. pt returned on 10/1 and received replacement dose.


VAERS ID: 1772779 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-28
Onset:2021-09-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Condition aggravated, Dizziness, Fatigue, Feeling abnormal, Feeling hot, Heart rate increased, Loss of consciousness, Mobility decreased, Nausea, Pain, Visual impairment, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Other ischaemic heart disease (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (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: Standard Process all natural vitamins and supplements.
Current Illness: Leaky gut has been treated for months with positive changes and dietary improvement.
Preexisting Conditions: Food allergies and neurological assessment in 2020 for MS like symptoms with tingling and exhaustion linked to metals toxicity (aluminum and mercury build up in test) and leaky gut.
Allergies: Peanut and tree nut. Gluten intolerance.
Diagnostic Lab Data: Chiropractic adjustment and symptom reporting at Functional Medicine doc on October 4.
CDC Split Type:

Write-up: At 5pm on Sept 28 I felt body aches come on suddenly, a temperature of 99.6 with Tylenol began at 7pm. Strong nausea and exhaustion with 99.6 temp continued throughout the night. The next morning I woke up to teach from home and at 5:20am I apologized to my student as my field of vision became narrow and dizziness came over me I passed out on to the floor and my husband found me and gave me water. I stayed in bed from 5:30am until 8pm. I ate two bites of a gluten free waffle at 10am and threw up at 11am and returned to bed. My temperature finally regulated at 9pm on September 29. All symptoms subsided by 10:30pm on September 29. I then began experiencing daily strong heartbeats and a warming sensation under y skin beginning September 30th. This sensation is constant and unusual. Yesterday I went with my family to the zoo and pushing my sons stroller made my heart hurt in my chest, so my husband took over pushing the stroller. I am an active mom and this is very abnormal for me. My resting heart rate is 74 tonight as I''m feeling off.


VAERS ID: 1773389 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-24
Onset:2021-09-30
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA D48F21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Balance disorder, Feeling abnormal, Ocular discomfort, Vertigo
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Vestibular disorders (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Experiencing severe vertigo; Eyes feel like they are flying back and forth; She feels off balanced/ When she''s up and moving around is when she feels the worst; feels the worst,head feels weird; This spontaneous case was reported by a consumer and describes the occurrence of VERTIGO (Experiencing severe vertigo) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. D48F21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 24-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Sep-2021, the patient experienced VERTIGO (Experiencing severe vertigo) (seriousness criterion disability), OCULAR DISCOMFORT (Eyes feel like they are flying back and forth), BALANCE DISORDER (She feels off balanced/ When she''s up and moving around is when she feels the worst) and FEELING ABNORMAL (feels the worst,head feels weird). At the time of the report, VERTIGO (Experiencing severe vertigo), OCULAR DISCOMFORT (Eyes feel like they are flying back and forth), BALANCE DISORDER (She feels off balanced/ When she''s up and moving around is when she feels the worst) and FEELING ABNORMAL (feels the worst,head feels weird) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication information were provided. No treatment information were provided. Company comment: This case concerns a 42-year-old, female patient with no relevant medical history, who experienced the unexpected events of Vertigo, Ocular discomfort, Balance disorder, and feeling abnormal. The events occurred approximately 6 days after the first dose of Moderna CoviD-19 Vaccine. The rechallenge was unknown as the events occurred after the first dose and no information about second dose is available.The benefit-risk relationship of Moderna CoviD-19 Vaccine is not affected by this report. The event Vertigo was considered Serious as the source document described the event resulted in a Disabling/Incapacitating outcome.; Sender''s Comments: This case concerns a 42-year-old, female patient with no relevant medical history, who experienced the unexpected events of Vertigo, Ocular discomfort, Balance disorder, and feeling abnormal. The events occurred approximately 6 days after the first dose of Moderna CoviD-19 Vaccine. The rechallenge was unknown as the events occurred after the first dose and no information about second dose is available.The benefit-risk relationship of Moderna CoviD-19 Vaccine is not affected by this report. The event Vertigo was considered Serious as the source document described the event resulted in a Disabling/Incapacitating outcome.


VAERS ID: 1773450 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-20
Onset:2021-09-30
   Days after vaccination:222
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023H20A / 1 LA / OT

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

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

Write-up: I just felt real tired; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (I just felt real tired) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 023H20A) for COVID-19 vaccination. No Medical History information was reported. On 20-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In March 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 30-Sep-2021, the patient experienced FATIGUE (I just felt real tired). At the time of the report, FATIGUE (I just felt real tired) outcome was unknown. No concomitant medications were reported. No treatment medications were reported.


VAERS ID: 1773510 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-06-23
Onset:2021-09-30
   Days after vaccination:99
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043D21A / 2 - / OT

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

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

Write-up: Pfizer and then the Moderna; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Pfizer and then the Moderna) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 043D21A) for COVID-19 vaccination. Previously administered products included for COVID-19 vaccination: COVID-19 Vaccine (She receive the Pfizer vaccine on 26APR2021 (lot number EX0438)) on 26-Apr-2021. On 23-Jun-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Sep-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Pfizer and then the Moderna). On 30-Sep-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Pfizer and then the Moderna) had resolved. Concomitant medication details were not reported by the reporter. Treatment details was not reported by the reporter. Reporter stated that patient received the Pfizer vaccine on 26APR2021 (lot number EX0438) and then the Moderna vaccine on 23JUN2021 (lot number 043D21A). They received these vaccines from a health authority, but recently moved. They wanted to travel, and do not want to be "grounded" due to their vaccination status. She has not experienced any symptoms or received any treatments since receiving the vaccine.


VAERS ID: 1773519 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Myalgia, Pain in extremity, Paraesthesia, Vaccination site pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Chest pain; Left arm pain; Tingling and sore in the injection site; sore in the injection site; Muscle pain; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (Chest pain), PAIN IN EXTREMITY (Left arm pain), PARAESTHESIA (Tingling and sore in the injection site), VACCINATION SITE PAIN (sore in the injection site) and MYALGIA (Muscle pain) in a 29-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 046C21A) for COVID-19 vaccination. No Medical History information was reported. On 29-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Sep-2021, the patient experienced CHEST PAIN (Chest pain), PAIN IN EXTREMITY (Left arm pain), PARAESTHESIA (Tingling and sore in the injection site), VACCINATION SITE PAIN (sore in the injection site) and MYALGIA (Muscle pain). At the time of the report, CHEST PAIN (Chest pain), PAIN IN EXTREMITY (Left arm pain), PARAESTHESIA (Tingling and sore in the injection site), VACCINATION SITE PAIN (sore in the injection site) and MYALGIA (Muscle pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant product information was provided. No treatment information was provided.


VAERS ID: 1773523 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-02
Onset:2021-09-30
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939906 / 1 - / OT

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

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

Write-up: Pfizer COVID-19 shot administered for the second dose; This spontaneous case was reported by a nurse and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Pfizer COVID-19 shot administered for the second dose) in a 61-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939906) for COVID-19 vaccination. No Medical History information was reported. On 02-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Sep-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Pfizer COVID-19 shot administered for the second dose). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Pfizer COVID-19 shot administered for the second dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.


VAERS ID: 1773526 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Unknown  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-09-30
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Fatigue, Illness, Interchange of vaccine products, Nasopharyngitis, Pain, Pyrexia, SARS-CoV-2 test, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Medication errors (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210930; Test Name: body temperature; Result Unstructured Data: 103 Degree F; Test Date: 20211001; Test Name: body temperature; Result Unstructured Data: 100 Degree F; Test Date: 20210930; Test Name: COVID-19 test; Test Result: Negative ; Result Unstructured Data: negative
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Sleepy; Achy; Felt a little bit sick; Got a J&J vaccine a couple of months ago and then got the Moderna first dose; Tired; Fever of 103?F/temperature dropped to 100?F; Felt they had a cold; This spontaneous case was reported by a consumer and describes the occurrence of SOMNOLENCE (Sleepy), PAIN (Achy), ILLNESS (Felt a little bit sick), NASOPHARYNGITIS (Felt they had a cold) and INTERCHANGE OF VACCINE PRODUCTS (Got a J&J vaccine a couple of months ago and then got the Moderna first dose) in a 23-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Previously administered products included for an unreported indication: COVID-19 VACCINE NRVV AD26 (J&J vaccine a couple of months ago). On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Sep-2021, the patient experienced NASOPHARYNGITIS (Felt they had a cold) and PYREXIA (Fever of 103?F/temperature dropped to 100?F). On an unknown date, the patient experienced SOMNOLENCE (Sleepy), PAIN (Achy), ILLNESS (Felt a little bit sick), INTERCHANGE OF VACCINE PRODUCTS (Got a J&J vaccine a couple of months ago and then got the Moderna first dose) and FATIGUE (Tired). The patient was treated with PARACETAMOL (TYLENOL) on 30-Sep-2021 at an unspecified dose and frequency. At the time of the report, SOMNOLENCE (Sleepy), PAIN (Achy) and FATIGUE (Tired) had not resolved, ILLNESS (Felt a little bit sick), NASOPHARYNGITIS (Felt they had a cold) and PYREXIA (Fever of 103?F/temperature dropped to 100?F) outcome was unknown and INTERCHANGE OF VACCINE PRODUCTS (Got a J&J vaccine a couple of months ago and then got the Moderna first dose) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 30-Sep-2021, Body temperature: 103 deg f 103 Degree F. On 30-Sep-2021, SARS-CoV-2 test: negative (Negative) negative. On 01-Oct-2021, Body temperature: 100 degree f 100 Degree F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were mentioned since Patient 1(Reporter) was not aware of any medication Patient 2 may be taking regularly. Patient''s historical vaccine included J&J vaccine taken a couple of months ago with No indication mentioned.


VAERS ID: 1773546 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Diarrhoea, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Regular aches and pains; Nausea; Stomach issues; Diarrhea and stuff like that; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL DISCOMFORT (Stomach issues), DIARRHOEA (Diarrhea and stuff like that), MYALGIA (Regular aches and pains) and NAUSEA (Nausea) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 035C21A) for COVID-19 vaccination. No Medical History information was reported. On 30-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 30-Sep-2021, the patient experienced ABDOMINAL DISCOMFORT (Stomach issues), DIARRHOEA (Diarrhea and stuff like that) and NAUSEA (Nausea). On an unknown date, the patient experienced MYALGIA (Regular aches and pains). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. At the time of the report, ABDOMINAL DISCOMFORT (Stomach issues), DIARRHOEA (Diarrhea and stuff like that), MYALGIA (Regular aches and pains) and NAUSEA (Nausea) had not resolved. No concomitant medication was mentioned. This case was linked to MOD-2021-339316, MOD-2021-339288 (Patient Link).


VAERS ID: 1773552 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-24
Onset:2021-09-30
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 - / OT
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 2 - / OT

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

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

Write-up: First dose Moderna, second dose Pfizer; This spontaneous case was reported by a pharmacist and describes the occurrence of INTERCHANGE OF VACCINE PRODUCTS (First dose Moderna, second dose Pfizer) in a 37-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 053E21A) for COVID-19 vaccination. Co-suspect product included non-company product TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) for COVID-19 vaccination. No Medical History information was reported. On 24-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Sep-2021, the patient received second dose of TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) (unknown route) 1 dosage form. On 30-Sep-2021, the patient experienced INTERCHANGE OF VACCINE PRODUCTS (First dose Moderna, second dose Pfizer). On 30-Sep-2021, INTERCHANGE OF VACCINE PRODUCTS (First dose Moderna, second dose Pfizer) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No treatment and concomitant medications were provided.


VAERS ID: 1773559 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy, Facial paralysis, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hearing impairment (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: XANAX; ESTROGEN
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by the reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: She felt it as bell''s palsy; Early this morning, she noticed that her left side of her face was dripping/ She reports that when she smiles, her left side doesn''t move properly; Next day, she noticed that her neck was little swollen; This spontaneous case was reported by a consumer and describes the occurrence of FACIAL PARALYSIS (Early this morning, she noticed that her left side of her face was dripping/ She reports that when she smiles, her left side doesn''t move properly) and BELL''S PALSY (She felt it as bell''s palsy) in a 37-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 046C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. Concomitant products included ALPRAZOLAM (XANAX) and ESTRADIOL (ESTROGEN) for an unknown indication. On 29-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 milliliter. On 30-Sep-2021, the patient experienced SWELLING (Next day, she noticed that her neck was little swollen). On 01-Oct-2021, the patient experienced FACIAL PARALYSIS (Early this morning, she noticed that her left side of her face was dripping/ She reports that when she smiles, her left side doesn''t move properly) (seriousness criterion medically significant). On an unknown date, the patient experienced BELL''S PALSY (She felt it as bell''s palsy) (seriousness criterion medically significant). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, FACIAL PARALYSIS (Early this morning, she noticed that her left side of her face was dripping/ She reports that when she smiles, her left side doesn''t move properly), BELL''S PALSY (She felt it as bell''s palsy) and SWELLING (Next day, she noticed that her neck was little swollen) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Company comment: This case concerns a 37year-old, female patient with no relevant medical history, who experienced the expected events of Facial paralysis and Bell''s palsy, and the unexpected event of Swelling. The event Swelling and Facial paralysis occurred 1-2 days after first dose of mRNA-1273 (Moderna COVID-19 Vaccine). On an unknown date Bell''s Palsy occurred.The rechallenge was unknown as the events occurred after the first dose and no information about second dose is available. The benefit-risk relationship of Spikevax is not affected by this report.; Sender''s Comments: This case concerns a 37year-old, female patient with no relevant medical history, who experienced the expected events of Facial paralysis and Bell''s palsy, and the unexpected event of Swelling. The event Swelling and Facial paralysis occurred 1-2 days after first dose of mRNA-1273 (Moderna COVID-19 Vaccine). On an unknown date Bell''s Palsy occurred.The rechallenge was unknown as the events occurred after the first dose and no information about second dose is available. The benefit-risk relationship of Spikevax is not affected by this report.


VAERS ID: 1773563 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 - / OT

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

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

Write-up: red bumps that itched and felt like they were burning; red bumps that itched and felt like they were burning; red bumps that itched and felt like they were burning; hives; allergic reaction spread throughout the torso, neck, behind the ears and down the arms; This spontaneous case was reported by a consumer and describes the occurrence of RASH ERYTHEMATOUS (red bumps that itched and felt like they were burning), PRURITUS (red bumps that itched and felt like they were burning), BURNING SENSATION (red bumps that itched and felt like they were burning), URTICARIA (hives) and HYPERSENSITIVITY (allergic reaction spread throughout the torso, neck, behind the ears and down the arms) in a 39-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939902) for COVID-19 vaccination. Concurrent medical conditions included Nail infection and Sleep problem. Concomitant products included HYDROCHLOROTHIAZIDE for Blood pressure management, TERBINAFINE for Nail infection, GABAPENTIN for Sleep problem, ETANERCEPT (ENBREL) for an unknown indication. On 29-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Sep-2021, the patient experienced RASH ERYTHEMATOUS (red bumps that itched and felt like they were burning), PRURITUS (red bumps that itched and felt like they were burning), BURNING SENSATION (red bumps that itched and felt like they were burning), URTICARIA (hives) and HYPERSENSITIVITY (allergic reaction spread throughout the torso, neck, behind the ears and down the arms). The patient was treated with PREDNISONE for Hives, at an unspecified dose and frequency. At the time of the report, RASH ERYTHEMATOUS (red bumps that itched and felt like they were burning), PRURITUS (red bumps that itched and felt like they were burning), BURNING SENSATION (red bumps that itched and felt like they were burning), URTICARIA (hives) and HYPERSENSITIVITY (allergic reaction spread throughout the torso, neck, behind the ears and down the arms) had not resolved. Patient started getting red bumps that itched and felt like they were burning. This allergic reaction spread throughout the torso, neck, behind the ears and down the arms. Those symptoms are ongoing.


VAERS ID: 1773566 (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: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 3 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Feeling hot, Induration, Pain in extremity, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: side effects; 1 inch by 1 inch area of redness/one can visibly see the area of redness; That area was also hard/the tissue in that area feels hard; hot to the touch/the tissue in that area feels hot; pain in the whole arm; This spontaneous case was reported by a nurse and describes the occurrence of VACCINATION COMPLICATION (side effects), ERYTHEMA (1 inch by 1 inch area of redness/one can visibly see the area of redness), INDURATION (That area was also hard/the tissue in that area feels hard), FEELING HOT (hot to the touch/the tissue in that area feels hot) and PAIN IN EXTREMITY (pain in the whole arm) in a 39-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 048C21A) for COVID-19 vaccination. Concurrent medical conditions included Psoriasis and Psoriatic arthritis. Concomitant products included APREMILAST (OTEZLA) for Psoriasis and Psoriatic arthritis. On 30-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Sep-2021, the patient experienced PAIN IN EXTREMITY (pain in the whole arm). On 01-Oct-2021, the patient experienced ERYTHEMA (1 inch by 1 inch area of redness/one can visibly see the area of redness). 01-Oct-2021, the patient experienced INDURATION (That area was also hard/the tissue in that area feels hard) and FEELING HOT (hot to the touch/the tissue in that area feels hot). On an unknown date, the patient experienced VACCINATION COMPLICATION (side effects). At the time of the report, VACCINATION COMPLICATION (side effects), INDURATION (That area was also hard/the tissue in that area feels hard), FEELING HOT (hot to the touch/the tissue in that area feels hot) and PAIN IN EXTREMITY (pain in the whole arm) outcome was unknown and ERYTHEMA (1 inch by 1 inch area of redness/one can visibly see the area of redness) was resolving. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. The 1 inch by 1 inch area of redness, was not exactly at the injection site but adjacent to it. The redness was still there but fading now. No treatment information was provided by the reporter. This case was linked to MOD-2021-340988 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 04-Oct-2021: Additional events, concomitant medication and medical history were added. Dosing details, reporter details and patient details were updated.


VAERS ID: 1773569 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-01
Onset:2021-09-30
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness
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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: IRON; MULTIVIT [VITAMINS NOS]; B12 [CYANOCOBALAMIN]
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by the reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: dizzy; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (dizzy) in a 43-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 003c21a and 003c21a) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included IRON, VITAMINS NOS (MULTIVIT [VITAMINS NOS]) and CYANOCOBALAMIN (B12 [CYANOCOBALAMIN]) for an unknown indication. On 01-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 29-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 30-Sep-2021, the patient experienced DIZZINESS (dizzy). The patient was treated with IBUPROFEN (ADVIL 12 HOUR) for Adverse event, at an unspecified dose and frequency. At the time of the report, DIZZINESS (dizzy) had not resolved. On the 30th Sep patient started to feel dizzy and now she continues to feel dizzy but "not the same as before.


VAERS ID: 1774915 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Chest discomfort, Electrocardiogram, Insomnia, Lymph node pain, Lymphadenopathy, Neck pain, Pain, Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG performed but after waiting almost 4 hours in waiting room and the. Taken back to a shared room with an incontinent patient I walked out of hospital and took my chances at home.
CDC Split Type:

Write-up: Neck pain the day after injection with swelling/lump appeared at base of neck with pain lasting 4 days. Pain in neck changed to swollen lymph nodes is collar bone protruding through collar bone, lymph nodes in breast swollen and painful. Swelling, tightness and burning sensation throughout left upper chest, collar bone, breast, ribs and shoulder blade. Pain and swelling still occurring. Having trouble sleeping due to issues. Have been applying warm compresses to areas and taking over the counter pain meds. Starting to worry that sus tons aren?t subsiding.


VAERS ID: 1774955 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-28
Onset:2021-09-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pruritus, Mobility decreased, Pain in extremity
SMQs:, Parkinson-like events (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: None
CDC Split Type:

Write-up: Severe soreness throughout entire right arm, so strong that I was unable to use it for a full 24 hours. Followed by itching, bad itching at injection site and left shoulder that lasted around 36 hours.


VAERS ID: 1775058 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-09-01
Onset:2021-09-30
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / -

Administered by: Private       Purchased by: ?
Symptoms: Balance disorder, Blood test normal, Computerised tomogram normal, Head discomfort, Headache, Nausea, Vertigo
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin d, b12, peptides, hormones
Current Illness: No
Preexisting Conditions: No
Allergies: Sulfa
Diagnostic Lab Data: 9/11 ct scan and blood work at facility ...all good...
CDC Split Type:

Write-up: Vertigo, motion in brain, loss balance, headache, nausea. Been over a month.


VAERS ID: 1775300 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test normal, Chest pain, Chills, Dizziness, Electrocardiogram normal
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Butterbur Migrelief Aller-tec Garlic Berberine Myrrh Forte
Current Illness: IBS and possible Sibo anxiety
Preexisting Conditions: IBS and possible Sibo anxiety
Allergies:
Diagnostic Lab Data: Bloodwork, blood pressure, and ECG came back normal
CDC Split Type:

Write-up: 2 minutes following vaccine I had chest pain, stomach pain, zaps throughout body, light headed. 20 minutes after vaccine had had chills that lasted about 30 minutes. Still have chest pain 10 days later. Went to urgent care. Bloodwork and ECG came back normal. 4 days following event I went to primary care. They believe the vaccine triggered a stress response in my body. While different than any panic attack I have ever had, my body had been in fight or flight mode for much of the past month. So the vaccine just might have tipped my body over. Still working to calm my body 10 days later.


VAERS ID: 1775315 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse event, Injection site oedema, Injection site pain, Loss of personal independence in daily activities, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: injection site edema and pain for + 2 weeks since injection. Unusual time frame for long term pain at site and localized muscle pain making it difficult to use arms for regular occupational activities required daily since that injection . This is an adverse event reaction for me since I have had COVID injections prior to this 2nd dosing and many other vaccines for polio, MMR, DTaP, pneumonia,etc.....


VAERS ID: 1775395 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-27
Onset:2021-09-30
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 2 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Blood pressure increased, Exposure during pregnancy, Foetal growth restriction, Gestational hypertension, Induced labour
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow)

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

Write-up: Patient was pregnant at time of vaccination with estimated due date of 28Oct. All vital signs normal throughout antenatal course. 2nd dose of covid vaccine received 27September. First elevated blood pressure reading 30Sep, second elevated BP reading 01Oct- diagnosed with gestational hypertension. Diagnosed intrauterine growth restriction 05Oct. Induced at 37 weeks, delivered at 37+1 weeks. Infant weight at birth: 2487g.


VAERS ID: 1775416 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Fatigue, Injection site pain, Malaise, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Severe pain at the injection site, Nausea and vomiting, Malaise and fatigue as well as severe weakness


VAERS ID: 1775662 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-20
Onset:2021-09-30
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18200095 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disturbance in attention, Electrocardiogram, Magnetic resonance imaging, Sleep disorder, Tinnitus
SMQs:, Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Hearing impairment (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Non
Diagnostic Lab Data: mRI EKG steroids you pick I consider this to be permanent until someone can treat me for it
CDC Split Type:

Write-up: My left ear has been ringing nonstop. I have been to urgent care, an audiologist and an ENT. I have had an EKG and a an MRI. I wad totally healthy 38 year old woman until I did this and now I cant sleep or focus due To the ringing. This should absolutely be listed as a side effexf.


VAERS ID: 1775785 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-10
Onset:2021-09-30
   Days after vaccination:204
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Janssn 3/10. Positive on 10/6


VAERS ID: 1775837 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arrhythmia, Arthralgia, Chest pain, Heart rate irregular, Muscle spasms, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 12-16-20 COVID PFIZER 1st dose, numb and tingling right side of face 1day, age 59
Other Medications: None
Current Illness: None
Preexisting Conditions: Non-allergic rhinitis
Allergies: Bleach
Diagnostic Lab Data: Pending
CDC Split Type:

Write-up: About 24 hours after I received the vaccine I started experiencing severe muscle and joint pain which lasted for at least a week, and I am still having residual joint pain. Body aches included hands feet legs neck back arms, also I experienced painful leg cramps. But then on October 8th my wrist was hurting and I felt it and at the same time noticed my pulse was irregular. I have been having arrhythmias ever since. My heart is missing beats and I have mild aching chest pain. I have no history of heart troubles or any risk factors other than perhaps my age.


VAERS ID: 1775854 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-19
Onset:2021-09-30
   Days after vaccination:103
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 1 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052C21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes virus infection, Herpes zoster
SMQs:, Opportunistic infections (broad)

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

Write-up: Herpes and Shingles outbreak simultaneously. Herpes sores on outside of mouth L side and Shingles outbreak on back of L calf.


VAERS ID: 1775945 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-01
Onset:2021-09-30
   Days after vaccination:213
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Vaccination site pain
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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Rheumatic fever (as a kid)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Mild soreness at the injection site; I was really, really tired & fatigued; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Mild soreness at the injection site) and FATIGUE (I was really, really tired & fatigued) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Rheumatic fever (as a kid). In March 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Sep-2021, the patient experienced VACCINATION SITE PAIN (Mild soreness at the injection site) and FATIGUE (I was really, really tired & fatigued). At the time of the report, VACCINATION SITE PAIN (Mild soreness at the injection site) and FATIGUE (I was really, really tired & fatigued) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication information was provided. No treatment medication information was provided. Patient hip replacement surgery scheduled in October and doctors had recommended it. the patient experiencing mild soreness at the injection site and was really, really tired and fatigued. Most recent FOLLOW-UP information incorporated above includes: On 30-Sep-2021: Upon follow-up source document contain future surgery details updated in Inarrative supplement.


VAERS ID: 1775965 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Wisconsin  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / UNK - / OT

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

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

Write-up: Expired vaccine given last 30 Sept; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Expired vaccine given last 30 Sept) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025C21A) for COVID-19 vaccination. No Medical History information was reported. On 30-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Expired vaccine given last 30 Sept). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Expired vaccine given last 30 Sept) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant products were reported. No treatment information was reported by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 03-Oct-2021: Added drug start date and updated event verbatim.


VAERS ID: 1775967 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019F21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Breast pain, Lethargy, Lymphadenopathy, Vaccination site pain
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Lipodystrophy (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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (believed he already had COVID 2 1/2 months ago.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: sore in his left arm which moved to his right breast; underneath arm lymph nodes are swollen; sore in his left arm; severe joint pain; lethargic; This spontaneous case was reported by a consumer and describes the occurrence of LETHARGY (lethargic), BREAST PAIN (sore in his left arm which moved to his right breast), ARTHRALGIA (severe joint pain), LYMPHADENOPATHY (underneath arm lymph nodes are swollen) and VACCINATION SITE PAIN (sore in his left arm) in a 54-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 019F21A) for COVID-19 vaccination. The patient''s past medical history included COVID-19 (believed he already had COVID 2 1/2 months ago.). On 29-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Sep-2021, the patient experienced LETHARGY (lethargic) and ARTHRALGIA (severe joint pain). On 01-Oct-2021, the patient experienced BREAST PAIN (sore in his left arm which moved to his right breast), LYMPHADENOPATHY (underneath arm lymph nodes are swollen) and VACCINATION SITE PAIN (sore in his left arm). The patient was treated with PARACETAMOL (TYLENOL) ongoing since an unknown date for Symptomatic treatment, at an unspecified dose and frequency. At the time of the report, LETHARGY (lethargic), BREAST PAIN (sore in his left arm which moved to his right breast), ARTHRALGIA (severe joint pain), LYMPHADENOPATHY (underneath arm lymph nodes are swollen) and VACCINATION SITE PAIN (sore in his left arm) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient reported not being on any medications prior to getting vaccine.


VAERS ID: 1776282 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939901 / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Haematocrit decreased, Haemoglobin decreased, Pain, Platelet count increased
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin and omeprazole
Current Illness: None
Preexisting Conditions: Anxiety and depression, GERD, Celiac Disease
Allergies: Almonds and wheat
Diagnostic Lab Data: Labs from 10/07/2021: Hgb 7.8 g/dL Hct 30.3% Platelet 500 thousand/uL
CDC Split Type:

Write-up: Patient was complaining of severe fatigue on the day following vaccination. She did not feel it was necessary to visit a doctors office until 10/06/2021 because the fatigue was still severe as well as accompanying body aches and mild SOB. Labs were ordered and Hgb came back at 7.8 g/dL; Hct 30.3%, and platelets 500 thousand/uL.


VAERS ID: 1776285 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-24
Onset:2021-09-30
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / 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: 1776343 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Asthenia, Balance disorder, Body temperature increased, Chills, Dysphonia, Hypoacusis, Mobility decreased, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (narrow), Vestibular disorders (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 2nd Covid shot
Other Medications: acetaminophen 500 mg Tablet Commonly known as: TYLENOL Learn more Take 500 mg by mouth Four times a day This medication isn''t available for renewal at this time. ipratropium bromide 42 mcg (0.06 %) Spray, Non-Aerosol Commonly known as: A
Current Illness: None
Preexisting Conditions: None
Allergies: Shell fish
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/30/21 6pm. Cold chills, shivering, temp. 100, weakness, uneasy on feet. 9/1/21 In bed all day, temp. 102, weak, uneasy on feet, lost taste, voice high pitched, hearing diminished, slept all day. 9/2/21 Feeling better, temp. 100.4, walking better, voice cleared up, hearing better, still showing signs of weakness


VAERS ID: 1776359 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-28
Onset:2021-09-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding, Intermenstrual bleeding, Menstrual disorder, Menstruation irregular, Oligomenorrhoea
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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: Dr. Stewart''s DS Multivitamin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Started unusual menstrual cycle after receiving shot. I have regular cycles at about 27 to 28 days apart and last about 6 days. I started 9 days early with prolonged spotting and light bleeding that lasted 12 days and extremely heavy bleeding with blood clots about 2 inches in diameter at day 13. The cycle has not stopped as of yet. Did not start having menstrual cramps until day 13 when the heavy bleeding started.


VAERS ID: 1776365 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 212AUA / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Headache, Injection site pain, Malaise
SMQs:, Dementia (broad), Extravasation events (injections, infusions and implants) (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: All vaccines (flu, etc,)
Other Medications: N/A
Current Illness: None
Preexisting Conditions: Spine issues
Allergies: I always feel bad after vaccinations - which is why I stopped getting them after my military service completed. And I?ve felt the best I ever have since stopping vaccinations. Now I?m forced to take one or get fired ! Sucks - now I feel bad again
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Sore arm at injection site for 5 days. Headache for approximately 5 days. Brain fog (could not think clearly) for approximately 5 days. 12 days later I?m now having a small headache again and I just feel weird, like I?m more susceptible to illness - slight headache cold coming on.


VAERS ID: 1776408 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered, No adverse event
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: Acyclovir, Aleve, sildenafil
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID vaccine was administered on day 35 of refrigeration, 5 days after fridge shelf life date. Patient denies any symptoms from vaccine.


VAERS ID: 1776463 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 3 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Back pain, Fatigue, Muscle spasms, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shingrix 03/03/2021
Other Medications: Tamoxifen, XYZAL, Mucinex, NAC, Lecithin, Multivitamin, Magnesium Glycinate, Docusate sodium, Polyethylene glycol
Current Illness: None
Preexisting Conditions: Pollen allergies, IBS, Sinus problems
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Onset of reaction at 11 hours after injection. Fever (100.8? F), body aches and pains. Seemed to abate 24 hours after injection, but then, 48 hours after injection, a wave of extreme fatigue with back ache began, accompanied by a low grade fever (98.4? F). This lingered for the next 6 days, at which point I saw a physician. He was not concerned. "You''re building some very strong antibodies!" HA! In fact, on that day, my temperature fell below 98? F, which is normal for me and the extreme fatigue abated to mild fatigue. I asked if I should get a Covid test, but he saw no reason because I wasn''t actually sick. It''s now 5 days since I saw the doctor. My energy is slowly returning but the back ache had morphed into back spasms, which continue to bother me somewhat.


VAERS ID: 1776485 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-26
Onset:2021-09-30
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Adverse reaction, Arthralgia, Condition aggravated, Diarrhoea, Furuncle, Herpes zoster, Muscle spasms, Rash papular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bio-Identical hormones. Bi-est and progesterone and Famotidine 20mg as needed for GERD
Current Illness: NONE.
Preexisting Conditions: Inflammation. Higher than normal SED rate. No know cause. Checked for all immunological diseases.
Allergies: None known. Except for COVID 19 vaccine. Developed hives and systemic reaction to vaccine approximately 10 days after 1st vaccine on 2/5/2021 and on second vaccine 2/26/2021. Reported to VAERS.
Diagnostic Lab Data: Visited family doctor, who viewed outbreak and suggested I still take second dose. Did so. Visit specialist recommended by my pcp, after second dose (allergist) and he said he had a second patient who also exhibited these symptoms or HE WOULDN''T HAVE BELIEVED ME. Even though I presented him with photos and he examined me. Visited pcp again after out break of spots on my neck and chest. He diagnosed SHINGLES and I''m currently taking Valacyclovir 1gr 3X for 7 days and my dermatologist has given me Prednisone 10mg 3x day for 3 days 2 X a day for 3 days and 1 x day for 3 days. Needless to say the shingles are very painful especially in my occipital region and my right neck and shoulder. I AM REPORTING THIS BECAUSE I SEE THAT OTHER PEOPLE ARE REPORTING OUTBREAKS OF SHINGLES IN OTHER COUNTRIES.
CDC Split Type:

Write-up: After first vaccines developed large raised hives (more solid and hard) on back of LEFT forearm and sever stomach cramps and diarrhea, urticaria over my stomach and body and aches and pains. With the second vaccine I received in the RIGHT arm had COVID arm. A very large 4-5 inch oval raised patch and the same bodily reactions. Hives or boils on arms, knees,, urticaria over body and WORSE cramping and diarrhea. NOW I HAVE SHINGLES on my right neck from my occipital lobe and ear to my back, chest, and chin. Very painful right shoulder pain.


VAERS ID: 1776620 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Aphonia, Chest discomfort, Cough, Dyspnoea, Oropharyngeal pain, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse
Current Illness: none
Preexisting Conditions: none
Allergies: Penicillin, amoxicillin, ceclor, sulfa, estrogen, levaquin , cephalosporin,
Diagnostic Lab Data:
CDC Split Type:

Write-up: chronic coughing, sore throat, SOB, chest tightness, congestion, losing my voice. This all started at 5:00 AM on 9/30/2021. I still have a sore throat, chronic cough, some SOB, and losing my voice, so now my voice is deep because of that. I saw a doctor and she gave me tessalon for the cough, and albuterol inhaler. She does not think it is Covid-19.


VAERS ID: 1776724 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 3 LA / SC

Administered by: Work       Purchased by: ?
Symptoms: Limb mass, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: swelling and lump in arm that lasted 6 days after vaccine was given


VAERS ID: 1776776 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Audiogram abnormal, Bell's palsy, Deafness unilateral
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Audiogram done 10/05/21 confirmation of decreased hearing of left side
CDC Split Type:

Write-up: Bell''s Palsy of Left side of Face with Hearing loss of Left ear


VAERS ID: 1776864 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-28
Onset:2021-09-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Haematoma, Injection site swelling, Joint range of motion decreased, Muscle spasms, Muscular weakness, Ultrasound scan
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Valium, hydrocodone, Tylenol, ibuprofen, muscle relaxers,
Current Illness: Na
Preexisting Conditions: Hypertension
Allergies: Latex
Diagnostic Lab Data: Ultrasound
CDC Split Type:

Write-up: Hand weakness, swelling at injection site, large hematoma, spasm in arm, neck, and shoulder blade and radiating in head. Loss of full range of motion in shoulder.


VAERS ID: 1776941 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-20
Onset:2021-09-30
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Laboratory test abnormal
SMQs:

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

Write-up: no adverse effects, only tested positive due to exposure


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