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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 65 out of 8,010

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VAERS ID: 1776954 (history)  
Form: Version 2.0  
Age: 73.0  
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 (MODERNA)) / MODERNA 006D211A / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood test, Computerised tomogram, Echocardiogram, Electrocardiogram, Magnetic resonance imaging, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations: low-grade fever & muscle aches for 24 hours
Other Medications: duloxetine, metoprolol, amlodipine, vitamin D, Biotin, Cal-mag-D, magnesium, Tylenol
Current Illness: moderate to severe pain in left hip & lower back: Steroid injection given in hip Sept17, 2021. by Doctor.
Preexisting Conditions: depression, anxiety, cervical disc disease, arthritis, motion sickness, hip pain
Allergies: metroridazole, ciprofaxin, sulfonomide,erythromycin, gabapentin, Ativan, benzocaine, Vicodin following anesthesia). Toradol
Diagnostic Lab Data: blood tests. CAT, MRI, EKG , echogram,
CDC Split Type:

Write-up: Vomiting , high fever, weakness requiring ambulance to the hospital.


VAERS ID: 1777010 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-04-07
Onset:2021-09-30
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Blood potassium decreased, Blood test, Chest X-ray normal, Dizziness, Electrocardiogram abnormal, Limb discomfort, Palpitations, Red blood cell count normal, Sinus tachycardia
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins Prenatal; Women''s health probiotics
Current Illness: No
Preexisting Conditions: Wolff-Parkinson-White syndrome
Allergies: No
Diagnostic Lab Data: EKG sinus tachycardia. Blood work nothing alarming, potassium level were 3.4, red blood cells were 5.27. Chest X-ray normal.
CDC Split Type: vsafe

Write-up: Started in Sep 2021 for 45 mins. I felt light headed and heart raced and home alone with my daughter it sparked my anxiety. My left arm was dull and went to the ER on 30Sep2021.


VAERS ID: 1777027 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Wyoming  
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 FF2587 / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Eliquis 5 mg bd atorvastatin 5 mg od xyzal 10 mg od centrum silver vitamin od Caltrate bd
Current Illness: no
Preexisting Conditions: atrial fibrillation breast cancer
Allergies: no
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: On 09/30/2021, I noticed left arm axial lymph node swelling. I contacted the doctor on 10/04/2021. The swelling had not resolved, he said to just give it time and it resolved a couple of days later without any treatment.


VAERS ID: 1777603 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-17
Onset:2021-09-30
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding
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: Heavy and prolonged period after second vaccine with very large clots.


VAERS ID: 1778518 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling
SMQs:, 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? 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: Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Additional Details: Patient''s arm was swollen, red to the touch, itchy, patient states it started the day of vaccine administration and progressivley got worse. Looks like cellulitis.


VAERS ID: 1778780 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Military       Purchased by: ?
Symptoms: Aphasia, Asthenia, Differential white blood cell count, Dissociation, Eosinophil count decreased, Fine motor skill dysfunction, Full blood count abnormal, Haemoglobin normal, Injection site rash, Metabolic function test normal, Muscular weakness, Platelet count normal, Rash, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Haematopoietic leukopenia (narrow), Peripheral neuropathy (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: allegra/Fluticasone
Current Illness: no.
Preexisting Conditions: no
Allergies: NKDA
Diagnostic Lab Data: 10/5/2021 CMP all results within normal limits. CBC- abnl findings (mild) Hg 16.6 (ref high 16.5) Platelets 162K (ref 166-407) WBC 6.4 no other abnormalities. Eos 0.3, normal diff.
CDC Split Type:

Write-up: Pfizer COVID-19 Vaccine 2nd dose 9/29. On 9/30 Rash appeared on abdomen that continued to spread R mid abdomen, then to R back and small rash on L anterior abdomen. Also developed rash at site of injection. On 10/2 4 days post vaccination had 4 hour episode of loss of motor skills, difficulty finding words and felt like he did not have control of arms and legs and sensation of dissociation, weakness. Next day woke up fine. Pt was not seen until 10/5 for rash. Given triamcinolone cream with no effect per phone f/u on 10/12.


VAERS ID: 1778815 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-04
Onset:2021-09-30
   Days after vaccination:149
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, COVID-19, Chills, Fall, Neck pain, Pain, Pyrexia, SARS-CoV-2 test positive, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Arthritis (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol; bictegravir-emtricitabine-tenofovir ALAFENAMIDE; famotidine; fluticasone; LEVOthyroxine; loratadine; montelukast; ondansetron; pregabalin; promethazine; warfarin
Current Illness: 4/19/21 Acute bilateral deep vein thrombosis (DVT) of femoral
Preexisting Conditions: Hypothyroidism; HIV; Factor V Deficiency; Gastric Bypass; Obese; stomal stenosis; thrombocytopenia; Chronic venous embolism and thrombosis of deep vessels; History of DVT (deep vein thrombosis); History of pulmonary embolism; Normochromic normocytic anemia; Essential hypertension; Anxiety; TIA (transient ischemic attack); Warfarin toxicity / Warfarin-induced coagulopathy; Blood loss anemia; Acute renal failure; Stroke (cerebrum)
Allergies: Ace Inhibitors; Codeine; Dabigatran; Dicloxacillin; Erythromycin; Fentanyl; Hydrocodone-acetaminophen; Ketorolac Tromethamine; Oxycodone-acetaminophen; Penicillins; Sulfa Antibiotics; Tramadol; Tramadol-acetaminophen; Bentyl; Penicillins; Rivaroxaban; Eliquis [Apixaban]
Diagnostic Lab Data: Contains abnormal data SARS-COV-2 (COVID-19)
CDC Split Type:

Write-up: 9/30/21 COVID Test Resulted Positive, tested due to fever spike. 10/2 ED Visit: Pt to ED via EMS c/o generalized body aches and chills, + COVID, pt reports he was standing and began shaking all over with chills causing him to fall, unknown LOC, pt reports posterior neck and back pain. C-Collar applied at time of triage.


VAERS ID: 1778821 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Arthralgia, Blood test, Insomnia, Loss of personal independence in daily activities
SMQs:, Dementia (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Complete blood work taken on 10/04/21 due to employment requirements with no outliers or reason for ongoing pain starting after second dose.
CDC Split Type:

Write-up: Moderate to severe pain in joints to include wrists, elbows, ankles, and knees. No previous history of ongoing pain in any joint. Lingering pain causing difficulty completing common tasks and the inability to sleep through a night.


VAERS ID: 1778834 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-13
Onset:2021-09-30
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 1 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Acute respiratory failure, Agitation, Anticoagulant therapy, Blood lactic acid, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Confusional state, Dyspnoea, Fatigue, Fibrin D dimer increased, Hypoxia, Intensive care, Lactic acidosis, Lung consolidation, Metabolic function test, Metabolic function test abnormal, Oxygen saturation decreased, Procalcitonin increased, Pyrexia, Respiratory failure, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Lactic acidosis (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (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), Dementia (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad), Sepsis (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, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL 8 HOUR) 650 MG extended release tablet albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler fluticasone (FLONASE) 50 MCG/ACT nasal spray Fluticasone-Umeclidin-Vilant (TRELEGY ELLIPTA)
Current Illness:
Preexisting Conditions: A-fib (HCC) heart shock Alcohol abuse Allergic Anemia Anxiety Arthritis Backache Chronic Baker''s cyst of knee Right Cataract Chicken pox Chronic bronchitis, simple Colitis COPD (chronic obstructive pulmonary disease) Coronary artery disease Cough Depression Emphysema lung Fracture COMPRESSION FX T SPINE Fracture of T9 vertebra Newer T9 compression fracture Gall stone GERD (gastroesophageal reflux disease) H/O back injury Heart attack History of adenomatous polyp of colon History of smoking Hx of tear of meniscus of knee joint Right Ileostomy status Inflammatory bowel disease Menopause Morbid obesity Osteoporosis PAD (peripheral artery disease) Pneumonia Poor circulation RLS (restless legs syndrome) Shortness of breath at rest Tubular adenoma of colon UC (ulcerative colitis) Vitamin B12 deficiency
Allergies: Prednisone, Reclast, Lialda, Lipitor, Pravastatin, Tudorza Pressair, Diphenhydramine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized 09/30/2021; COVID-19 positive 09/30/2021; fully vaccinated Patient is a 72-year-old female presents the chief complaint of fever, fatigue, shortness of breath. Upon initial evaluation she is hypoxic to 86%. Placed on 2 L nasal cannula with good response. COVID-19 testing is positive. She has an AKI evident on CMP. Lactic acid slightly elevated 2.2. She is given 2 L IV fluids for her AKI and lactic acidosis. She does not have a history of decreased EF. Chest x-ray is consistent with COVID-19 pneumonia. She is given 6 mg IV Decadron. I spoke with the hospitalist who agrees to admission and further management of this patient. Assessment/Plan DIAGNOSIS at time of disposition: 1. Pneumonia due to COVID-19 virus 2. Hypoxia 3. Respiratory insufficiency 4. AKI (acute kidney injury) 5. Lactic acidosis 10/3/2021 note: ASSESSMENT / PLAN: Pneumonia due to COVID-19 virus Assessment & Plan Continue remdesivir, inhaled steroid, inhaled beta stimulant, inhaled Spiriva, supplemental oxygen, empirical antibiotic coverage as well given the presence of elevated procalcitonin. She received dexamethasone on hospital day 1 when she was still in ER and then she became confused and agitated, she threatened to leave AMA on hospital day 2 at 7a.m., she was agitated. She did calm down subsequently and I have found out that she does tolerate small amounts of inhaled steroids but not oral steroids. Therefore I switched to the available in the hospital equivalent of Trelegy she takes as an outpatient specifically Dulera and Spiriva plus p.r.n. albuterol. Vitamin C, zinc are also being given. DVT prophylaxis Acute respiratory failure with hypoxia Assessment & Plan Continue high-flow nasal cannula oxygen, she is saturating 93 up to 95% on 60 L, plus non-rebreather, FiO2 is 100%. If she worsens then next step would be intubation 10/8/2021 note: Assessment/Plan: Pneumonia due to COVID-19 virus Assessment & Plan Will continue with present medical regimen. Will give a dose of Lasix today 10/05/2021 will give dose of Lasix today. Also talked her about the steroid issue. She wants to try it again. I thought I had given to her orally my diet have the same subjective feelings that she has been getting with the IV steroids 10/06/2021 her D-dimers markedly elevated at 11,000 thousand. I have empirically started her on heparin drip. Will send her down for a CT angiogram. Will also schedule her for upper lower extremity Dopplers. Clinically she says she feels better today than she did yesterday. 10/07/2021 initially she had an elevated procalcitonin question of an infiltrate. Procalcitonin has normalized but there is consolidation at the mention on her CT scan. I decided to continue broad-spectrum antibiotics for now. In light of her declining respiratory status will move her to the intensive care unit 10/08/2021 she finished remdesivir, she is refusing the empirical antibiotic coverage. Will check a procalcitonin in the morning. She is on the inhaled steroid but she refused the intravenous Solu-Medrol. 10/08/2021 the patient stated to me and also she stated in no uncertain terms to the previous physician that she does not desire intubation in case that she deteriorates to that point. I do intend to honor this and she is therefore a do not resuscitate. However it should be noted that she is now maxed out on nasal cannula high-flow oxygen plus non-rebreather and she is saturating marginally in the low 90s at best. I made her daughter aware of these and I also discussed extensively with the daughter when the that the prognosis is guarded in this patient with COVID pneumonia and pre-existing severe chronic obstructive pulmonary disease. Note from 10/11/2021: 10/09/2021 the patient is saturating marginally on 60 L of oxygen per nasal cannula plus non-rebreather however now she is pleasant and cooperative with the medication therefore this is a bit plus compared to yesterday 10/10/2021 the patient is doing a bit better oxygen saturation wise on the same supplemental oxygen she was on yesterday. She is conversational and speaks in longer sentences before being short of breath. She refused the Lovenox therapeutic but she is okay with the heparin drip. Afebrile. 10/11/2021 I consulted virtual intensive care unit, I appreciated very much their input, the patient is not a candidate for intubation given her chronic obstructive pulmonary disease history. She in fact refused intubation as a concept this morning but then she reconsidered that however after discussing with the pulmonologist the patient again admitted to not wanting intubation and this is in fact inappropriate decision given the advanced emphysema that the patient is suffering from. Noted 30% of predicted DLCO 2 years ago. Noted persistent oxygen needs of 100% via high-flow nasal cannula 70 liters/minute. Noted marginal saturation. As per pulmonologist''s recommendation will decrease the steroids to twice daily. She is off antibiotics since she completed course. Right now I have her on heparin drip, twice daily steroids, supplemental oxygen. Prognosis is guarded.


VAERS ID: 1778850 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Cold sweat, Fear, Headache, Mobility decreased, Pain, Pain in extremity, Therapeutic response unexpected
SMQs:, Parkinson-like events (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Duloxetine; Singulair; Soflax
Current Illness: n/a
Preexisting Conditions: Costochondritis, born with cleft palate
Allergies: Peppers; Dairy; Anti-inflammatory medications; Bactrim; Tramadol; Augmentin
Diagnostic Lab Data: n/a
CDC Split Type: vsafe

Write-up: The day of the vaccine I had a sore arm. The following day after the vaccine I got body aches all over my body, severe joint pain in my hands where I could barely open a door, slight headache and cold sweats and that was happening throughout the day for an entire week. I went to a walk in clinic on 10/07/2021 and they put me on 20mg of Prednisone to help alleviate some of the symptoms my costochondritis is now out of remission as well. I am still in pain and I have to get my second dose, and I am worried about that as well.


VAERS ID: 1778860 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-09-28
Onset:2021-09-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Feeling abnormal, Headache, Pain, Pharyngeal disorder
SMQs:, Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: None.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: He got his vaccine, he was fine, sat in the office for 15-20 minutes, did fine and went back to work. Everything was fine, he went home and had some chills around 9:00 PM, and woke up a few times during the night with chills, and kind of weird, but went back to work the next day. The next day during the night he had a headache, and took some Tylenol and went back to sleep. The following morning he had a severe headache, and took 2 Tylenol and came to work and the headache was still there. He then took some more a few hours later and had a severe headache that he had never had before, and all day he had the headache all the time despite taking the Tylenol. It would subside some, but did not completely go away. It is strong in the front part of his head. It was bad for about 2 days, and then stopped and then yesterday it started back again and he still has it, and has some throat issues he feels from the pain. He has never had headache like this before. He has not taken anything other than the Tylenol. He does not take pain medication of any kind, and is a very healthy person.


VAERS ID: 1778869 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-10
Onset:2021-09-30
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002B21A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Decreased appetite, Diarrhoea, Dry mouth, SARS-CoV-2 test positive
SMQs:, Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Dehydration (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, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: atorvastatin, cholecalciferol, dilTIAZem CR, metoprolol, omeprazole, magnesium, tamsulosin, warfarin, zinc sulfate
Current Illness: N/A
Preexisting Conditions: TIA (transient ischemic attack), Atrial fibrillation status post cardioversion, Right facial numbness, Hyperlipoproteinemia type II, S/P triple vessel bypass, Essential hypertension, Dupuytren''s contracture of right hand, Mitral valve insufficiency, Tricuspid valve insufficiency, Coronary artery, disease involving native coronary artery of native heart, Pulmonary valve insufficiency, Mixed hyperlipidemia, Hypokalemia.
Allergies: N/A
Diagnostic Lab Data: SARS-COV-2 (COVID-19).
CDC Split Type:

Write-up: 9/30 Pt reports weakness, decreased appetite, and dry mouth ongoing x 2 weeks, diarrhea COVID Results + Acute COVID 19 infection. No evidence of pneumonia.


VAERS ID: 1778902 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-28
Onset:2021-09-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Mobility decreased, SARS-CoV-2 test negative
SMQs:, Dementia (broad), Parkinson-like events (broad), Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Vitamin D3, Preservision vitamin, Multivitamin, Fluticasone Nasal, Hydrochlorothiazide-triamterene 25MG, Atorvastatin 10mg
Current Illness: n/a
Preexisting Conditions: Benign blood pressure (controllable)
Allergies: Neo- drugs such as Neosporin
Diagnostic Lab Data: Covid test - 10/01/2021- negative
CDC Split Type: vsafe

Write-up: I had the vaccine, just a minute now, I started feeling really badly like terribly tired and like I hardly move. The whole thing is complicated because I had oral surgery three days after the vaccine as well. I had extreme pain from that as well, because it is the mouth. I just felt awful beginning the day after the vaccine though, extreme fatigue I''ve never had in my life. I attributed it to the mouth surgery but my grandson had the same symptoms when he had Covid so it is confusing. I had a virtual DR visit on Friday afternoon 10/01/2021.


VAERS ID: 1779054 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-16
Onset:2021-09-30
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Hydrocephalus, Magnetic resonance imaging
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: Lisonpryl atorvasatin escitalopram
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfur
Diagnostic Lab Data: Mri 10/10/2021
CDC Split Type:

Write-up: Massive Headache Diagnosed with hydrocephalus Being referred now to neurologist


VAERS ID: 1779105 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Lymph node pain, Lymphoedema, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Received vaccine on the 29th. That night I had a fever, body aches, and headache. On the 30th I woke up to my left arm being swollen underneath. It was painful and very large, fluid filled. I was told it was lymphedema by Dr. who was in my department, the OR, at the time. It last about two weeks and has finally subsided. Nobody knew exactly why this happened after my vaccine.


VAERS ID: 1779114 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-22
Onset:2021-09-30
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / -

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

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

Write-up: feather


VAERS ID: 1779142 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-11
Onset:2021-09-30
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19 pneumonia, Confusional state, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: SOB, confusion, COVD-19 pneumonia


VAERS ID: 1779170 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-05
Onset:2021-09-30
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19
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? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fully vaccinated and admitted to the hospital with COVID.


VAERS ID: 1779199 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-09
Onset:2021-09-30
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / 2 AR / SYR

Administered by: Other       Purchased by: ?
Symptoms: Ageusia, Anosmia, Back pain, Blood urine present, COVID-19, Cough, Dyspnoea, Nasal congestion, Nasopharyngitis, Nephrolithiasis, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive, Urinary tract infection, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin; biotin; fish oil; B complex; magnesium; selenium; Synthroid; Armour; bupropion; Celebrex; Cetirizine; trazodone; inhaler; Flonase
Current Illness: None
Preexisting Conditions: Asthma; Hypothyroidism; Depression
Allergies: Pollen
Diagnostic Lab Data: 10/02/2021 Covid test, positive. Kidney stone and UTI.
CDC Split Type: vsafe

Write-up: On 09/30/2021 I started with a sore throat. The next morning, I woke up with a really bad cold. I was supposed to go on a trip with friends. I got tested for Covid on Saturday. On Sunday the doctor called and said it was positive. I had cough, stuffiness, a lot of congestion, I lost my sense of smell and taste, I had a low-grade fever. Last week I got the infusion and right away my lungs got better. I was having trouble breathing before that. The same week I got sick, I woke up on Monday with blood in my urine and back ache. I went to the doctor and he gave me a referral for a specialist and they determined I had a kidney stone. They discovered I had a UTI. I have recovered from the UTI and kidney stone. I still have symptoms of Covid. My doctor told me that I am not contagious anymore.


VAERS ID: 1779280 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Appendicectomy, Appendicitis perforated, Blood test, Computerised tomogram abdomen, Pyrexia, SARS-CoV-2 test negative
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (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:
Other Medications: Nora-be (contraceptive) Iron Probiotic Zinc Vitamin-D Claritin
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: I had a COVID test (negative) and did blood work on 10/6. I had an abdominal CT scan on 10/7.
CDC Split Type:

Write-up: I started experiencing abdominal pain and fever on 10/1. I was told to take ibuprofen for the fever and Pepcid and Pepto Bismol for the abdominal pain. I was admitted to the hospital for an appendectomy on 10/8. The doctors found my appendix had completely ruptured.


VAERS ID: 1779304 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-31
Onset:2021-09-30
   Days after vaccination:242
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Cough, Dysstasia, Fall, Limb injury, Urinary tract infection, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

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

Write-up: feeling generally weak, slid out of bed while trying to get up and use her walker, landed on the floor, sat there for several hours, not wanting to disturb her family. Did not hit her head, no LOC. Did not feel "hurt", other than a scratch on her left hand, but had a hard time getting up on her own. She was diagnosed with a urinary tract infection as an outpatient and was started on Duricef yesterday. Denies fevers or chills. She has a nonproductive cough, can hear herself wheezing, states this isn''t normal for her. No chest pain, no difficulty breathing.


VAERS ID: 1779327 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Influenza like illness, 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Bees, penicillin
Diagnostic Lab Data: Tested positive for Covid 19 on 10/6/21
CDC Split Type:

Write-up: After receiving vaccine, I became sick with flu like symptoms. These symptoms have not gone away. It has been 12 days. In the past 2 years I have come in contact with several people with Covid. No issues, but once I got vaccine I have been sick.


VAERS ID: 1779366 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-07
Onset:2021-09-30
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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? 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: Covid positive contact unknown


VAERS ID: 1779407 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-23
Onset:2021-09-30
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 3 RA / IM

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

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

Write-up: Patient was seen in the regulatory authority for a one week follow up on 9/23/21. He was asked if he would like to receive a third dose of the covid vaccine as he is eligible based on being immunocompromised. The patient stated he wanted to receive the vaccine. Medical Assistant asked all of the screening questions prior to administration. Patient said Yes to ever having a positive Covid-19 test. Patient said No to convalescent plasma or monoclonal antibody infusion in the past 90 days. Dose of Moderna Covid vaccine was administered on 9/23/21. Patient returned to the clinic on 9/30/21 for another 1 week follow up. During this appointment, he stated that he doesn''t think he should have received this third vaccine last week because he received a monoclonal antibody infusion. Upon chart review, patient received casirivimab-imdevimab on 8/31/21. Medical Oncologist was notified and stated no intervention was needed. Clinical Research Associate was notified as this patient is currently on a clinical trial and CRA stated no intervention was needed from a clinical trial standpoint. Nurse Supervisor was notified of the error. Patient was aware of all of this.


VAERS ID: 1779421 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Electrocardiogram, Pain in extremity
SMQs:, Anaphylactic reaction (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG
CDC Split Type:

Write-up: Left leg pain, chest tightness


VAERS ID: 1780151 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series


VAERS ID: 1780157 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-27
Onset:2021-09-30
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Feeling hot, Hypersensitivity, Inflammation, Pain in extremity, Pruritus, Rash macular
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Covid arm, delayed hypersensitivity, red blotchy spot, inflamed, warm, itchy, painful


VAERS ID: 1780445 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-11
Onset:2021-09-30
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Anti-neutrophil cytoplasmic antibody positive vasculitis, Cardiac failure, Laboratory test, Pain, Renal failure
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), 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), Cardiomyopathy (broad), Vasculitis (narrow), Chronic kidney disease (narrow), Hypersensitivity (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune 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? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lipitor, Ibprofen
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: various, blood work was completely normal prior to vaccine. Currently in renal and heart failure.
CDC Split Type:

Write-up: Various body pain which turned into ANCA Vasculitis


VAERS ID: 1780472 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-23
Onset:2021-09-30
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast tenderness, Crying, Emotional disorder, Postmenopausal haemorrhage, Premenstrual syndrome
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Depression (excl suicide and self injury) (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: I take Coreg and Lisinopril on a daily basis. I didn''t take my normal vitamins, herbs, or even acetaminophen before receiving my second Pfizer vaccination
Current Illness: I have hypermobile Ehlers Danlos Syndrome.
Preexisting Conditions: I have hypermobile Ehlers Danlos Syndrome, morbid obesity, high blood pressure, and congestive heart failure.
Allergies: None that I know of
Diagnostic Lab Data: I have an appointment scheduled for Oct. 22. I haven''t had any tests to determine my hormone levels.
CDC Split Type:

Write-up: On September 30, 2021, approximately one month after receiving my second dose of the Pfizer Covid-19 vaccination, I had a period. I had been in menopause and my last period before September 30 ,2021, occurred in November 2019. I had a full period for a week and this was not vaginal bleeding. A week before I had the period, my breasts became full and tender...so much so that I was googling "breast pain, breast soreness, post menopausal". This tells me that what I experienced was hormonal in nature and not just bleeding. This wasn''t spotting either...it was as if something in my body that controlled ovulation clicked back on. The period lasted one week and was exactly like my former regular periods. I fully believe that the Pfizer vaccine "kicked" me out of menopause and I have many questions. Am I fertile again? Could I get pregnant? Am I producing estrogen again (hence the sore breasts before the period)? Will I go through menopause again? Will I experience hot flashes, crashing estrogen levels? How could I have a period if my estrogen levels were low? It seems to me that there had to be significant estrogen production to create sore breasts. My classic PMS symptoms were back as well, including feeling extremely emotional and crying at the drop of a hat. I have only had one period since becoming fully vaccinated. At this point, I do not know if I will have another one.


VAERS ID: 1780484 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-09-01
Onset:2021-09-30
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PF100R PF8841 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest pain, Electrocardiogram, Multisystem inflammatory syndrome
SMQs:, Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Toxic-septic shock conditions (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? Yes
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 81 mg aspirin
Current Illness: None
Preexisting Conditions: Degenerative heart disease
Allergies: None
Diagnostic Lab Data: EKG Blood test
CDC Split Type: L

Write-up: Multisystem inflammatory syndrome, treatment none, Outcome chest pain still ongoing


VAERS ID: 1782217 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Influenza like illness, Mobility decreased, Muscle spasms
SMQs:, Dystonia (broad), Parkinson-like events (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole Ketotifen Eye Drops Montelukast Hydrocodone-Acetaminophen Baclofen Cyclobenzaprine Naratriptan Escitalopram
Current Illness:
Preexisting Conditions: Fibromyalgia Endometriosis Rheumatoid Arthritis Endometriosis Migraines
Allergies: Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient experienced flu-like symptoms the next day, but also muscle spasms. The muscle spasms continued to worsen over the next few days, until on 10/3 the patient said they could not move at all. The muscle spasms lessened after that, but continue to occur.


VAERS ID: 1782244 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-03
Onset:2021-09-30
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Illness, Immediate post-injection reaction, Parosmia, Pyrexia, Taste disorder
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: So I took my second dose got sick as usual then took Tylenol for the 2 days I was sick with chills,fever,headache everything I expected. Then after I felt better I had gotten parosmia/foul smell right after and it mainly affects my food taste and smell, but on some other items it?s just smell like some soaps/dog food/laundry detergent and etc.


VAERS ID: 1782253 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 2024214 / 3 AR / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: No adverse event occurred. However, the vaccine was given after expiration. Expiration date 09/21/21. Vaccine given 09/30/21.


VAERS ID: 1782257 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A1A / 2 AR / IM

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

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

Write-up: No adverse event occurred. However, the vaccine was given after expiration. Expiration date 09/21/21. Vaccine given 09/30/21.


VAERS ID: 1782401 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Patient presented to the pharmacy to get a covid vaccine and told this reporter that he hadn''t been vaccinated yet. It turns out that he had already received a dose of the Janssen vaccine at a different pharmacy. Therefore the vaccination on 9/30/21 was unnecessary.


VAERS ID: 1782446 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Throat irritation, Throat tightness, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (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: FLOVENT,
Current Illness: ASTHMA
Preexisting Conditions: ASTHMA
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: throat was closing and itchy had to take Benadryl for two days. Vomiting the whole weekend after the vaccine.


VAERS ID: 1782474 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Oropharyngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I got the shot on Wednesday Sep 29th and by 1:45 in the morning on Thursday the 30th I woke up with a fever, chills, a sore throat, and a loss of energy.


VAERS ID: 1782926 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, Headache, Hypertension, Impaired work ability, Insomnia, Malaise, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Hypertension (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair Diskus, albuterol, levothyroxine, montelukast, pantoprazole, Xyzal
Current Illness:
Preexisting Conditions: Asthma, vitamin D deficiency, hypothyroidism, hyperlipidemia, elevated liver enzyme, steatosis of liver, GERD
Allergies: Phentermine, Qsymia?All non-allergic reaction, mostly intolerance to the medication
Diagnostic Lab Data: None other than COVID-19 testing 10/1/2021
CDC Split Type:

Write-up: Patient had loss of taste, loss of sense of smell after getting the vaccine. She also started having headaches from 9/30/2021?10/11/2021. Patient had difficulty sleeping and felt really ill despite intake of Motrin, Advil, Excedrin. She noted blood pressure to be high at 141/91. She was tested for COVID-19 10/1/2021 and resulted negative. Reaction was severe enough that patient could not go to work for that entire time. She was able to go back to work 10/12/2021.


VAERS ID: 1783031 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-17
Onset:2021-09-30
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Iclusig, Aspirin, Metoprolol, Chlorthalidone, Spirinolactone, Advair, Lisinopril, Norvasc, Crestor, Montelukast, Miralax
Current Illness: None
Preexisting Conditions: Chronic Myeloid Leukemia, Hypertension, Dyslipidemia, Asthma
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Right Sided Bell''s Palsy


VAERS ID: 1783138 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 RA / IM

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

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

Write-up: there was no adverse reaction. Patient was erroneously given a second Pfizer dose when they were of ineligible age (11 years). Also got the first dose in error here.


VAERS ID: 1784865 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Computerised tomogram normal, Condition aggravated, Electrocardiogram normal, Fall, Hyperhidrosis, Injection site pain, Injection site swelling, Loss of consciousness, Nausea, Paraesthesia, Pyrexia, Syncope, X-ray limb normal
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pfizer Dose 2- I had a headache for like 3 hours and injection site pain
Other Medications: levothyroxine 50 mcg od rosuvastatin 20 mg od Xarelto 10 mg od Vitamin D
Current Illness: no
Preexisting Conditions: no
Allergies: not that I am aware of
Diagnostic Lab Data: On Monday 10/04/2021 - EKG- normal x-ray of my foot and ankle ( due to fainting and catching my toe on something when I fell) - normal CAT scan of my head -normal
CDC Split Type: vsafe

Write-up: 09/30/2021, Thursday, the evening of the vaccination- I had chills. On 10/01/2021, Friday, I went to the bathroom around 07:30 AM and the next thing I know I was on the floor, and sweating a ton, I realized I passed out I had nausea, I never vomited, diarrhea, fever, the highest temperature was 100.5. I didn''t take anything for the fever because I was nauseas. And I had tingling in both hands, but it only lasted like 5 minutes. On Monday 10/04/2021 I went to the Immediate care due to fainting. They had to do a CAT scan on my head due to taking blood thinners. Everything was normal. On Saturday 10/02/2021- everything was okay. I had no more symptoms, nausea, fever, chills, vomiting, were all gone. I just had injection site pain, it was not excessive. It was swollen but it never got red and that lasted for like 4 days.


VAERS ID: 1785058 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-27
Onset:2021-09-30
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3014SRA / UNK LA / IM

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

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: Extreme fatigue following COVID-19 vaccination #2 on 03/02/2021 at age 81 years. Pfizer Brand
Other Medications: Colace Stool Softener
Current Illness: None
Preexisting Conditions: Atrial Fibrillation corrected by ablation
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme Fatigue all day long


VAERS ID: 1785098 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-28
Onset:2021-09-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bronchospasm, Chills, Computerised tomogram thorax abnormal, Condition aggravated, Cough, Pneumonia, Pyrexia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ALBUTEROL, FINASTERIDE,TAMSULOSIN, TIZANIDINE , RIVAROXABAN
Current Illness: Blood Clot right lower lung , Pneumonia 9/ 06/2021
Preexisting Conditions: Hairy Cell Leukemia- Remission 15 years
Allergies: Apixaban
Diagnostic Lab Data:
CDC Split Type:

Write-up: 9/28/2021 Low grade fever 100.7 9/28/2021 Chills 9/30/2021 Low grade fever 100.6 9/30/2021 EMERGENCY ROOM VISIT @00:36 Fever/bronchspastic cough, CT Scan showed pneumonia in both lungs


VAERS ID: 1785179 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ENC 202 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 3 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Dizziness, Electrocardiogram, Extra dose administered, Malaise, Pain
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Vestibular 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: Lisinopril 20-12.5 1 daily Multi vitamin
Current Illness: None
Preexisting Conditions: Back Fusion - arthriis
Allergies: None
Diagnostic Lab Data: EKG 10-13-21
CDC Split Type:

Write-up: No problem at all with the 1st two covid vaccines, couldn''t even tell that I''d received either shot. Problem with the booster shot on 09/29/2021: In the evening the day after the shot, I experienced dizziness, pain & malaise in my shoulders, ear, jaw and chest area. Next morning no symptoms for the 1st part of the day, in the afternoon while sitting in the sun at our local state park a severe painful attack lasted a few hours. (Myocarditis?) Back pain due to past surgeries intensified for 10 days. Followed up w/ family Doctor on 10-13-21. Normal EKG


VAERS ID: 1785221 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Axillary pain, Fatigue, Injection site mass, Injection site pain, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Guillain-Barre syndrome (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Rosuvatsatin, Montelukast and Claritin
Current Illness: none
Preexisting Conditions: Asthma
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Painful swelling of the lymph nodes in the arm pit of the arm that received the shot. It lasted for a week and a half. Tired and weak for 3 days following shot. Soreness and lump at the injection spot lasted about a week.


VAERS ID: 1785350 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dehydration, Hyperhidrosis, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Hypoglycaemia (broad), Dehydration (narrow)

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

Write-up: The next morning I had chills and sweats. The sweating became excessive and I became dehydrated and lost 8 lbs over the 2 days that I had the symptoms.


VAERS ID: 1785442 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-10
Onset:2021-09-30
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Diarrhoea, Dyspnoea, Fatigue, Myalgia, Nausea, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: a very long time ago to FLU shot more then 10 years ago, neurological response
Other Medications: multivitamin
Current Illness: none
Preexisting Conditions: monitor for migraines and seizure activity for migraines.
Allergies: aspirin, sulfates, Bactrim,
Diagnostic Lab Data: covid 19 positive 10/07/2021 chest x-ray- clear
CDC Split Type: vsafe

Write-up: I did not have a fever, my blood oxygen level was fine , I did have nausea and diarrhea, lots of congestion, runny nose , ringing in my ear, lot of shortness of breath which I did go to urgent care, lots of muscle aches and fatigue. I still have no smell or taste. Mainly dry coughing. I felt at first like it was just my allergies. At urgent care they gave me IV fluids, some meds to help with inflammation and sent me home with albuterol. I still am very winded from walking or an exertion, I feel like my symptoms were mild but they felt pretty rough, I''m so thankful I was vaccinated because it could have been worse.


VAERS ID: 1785556 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products, 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: Benztropine 1mg BID, haloperidol decanoate 100mg IM q4weeks, olanzapine 10mg po HS
Current Illness:
Preexisting Conditions: schizophrenia, GERD
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient unintentionally received a dose of Moderna Covid vaccine 35 days after, it is believed, completing the Pfizer series in August 2021 (#1- 8/5 or 8/6 #2- 8/26/21) at another facility. Per current medical consultant - patient did not experience any adverse effects associated with the Moderna vaccination.


VAERS ID: 1785585 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-24
Onset:2021-09-30
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Autoimmune disorder, Blood test, Condition aggravated, Extra dose administered, Purpura
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Eliquis 5 mg bd azelastine .1% nasal solution Celebrex 100 mg bd vitamin D-3 1800 units od Lasix 20 mg Metoprolol succinate 25 mg od multivitamin potassium chloride 20 meq ER aciphex 20 mg
Current Illness: no
Preexisting Conditions: autoimmune disease 2011 it was under control 09/09/2021 - I had an fusion of Reclast- zoledronic acid
Allergies: no
Diagnostic Lab Data: all different kinds of blood work/ standard procedure for people who have auto immune disease, but we caught it fast.
CDC Split Type: vsafe

Write-up: On 09/30/2021, Friday, my legs broke out in a purpura. On the following Tuesday, I went to see a rheumatologist. He prescribed an immediate introduction of prednisone 60 mg for 5 days, 40 mg for 5 days, then 20 mg for 2 weeks, then reduced by 2.5 mg every 2 weeks until reaching 0. I have taken all the doses of 60 mg, I am taking the dosage of 40 mg, and on Saturday I start the 20 mg for 2 weeks. I will be done taking this medication on 02/05/2022. My autoimmune disease was in remission since 2011. 2 weeks after the 3rd dose of Pfizer it flared it up. I am not attributing this to the vaccine. I am just reporting my experience.


VAERS ID: 1785605 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Neck pain
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Arthritis (broad)

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

Write-up: Patient c/o neck pain and being lightheaded s/p dose #1 of Pfizer vaccine. Patient''s first recorded B/P at 1735 on 9/30/2021 s/p vaccination was 130/75. At time patient was sent out by EMS VS 81- 20- 205/109- 99% RA. Called patient X3 and left VM. Unable to get a hold of this patient to find out specifics of incident and what hospital said to her.


VAERS ID: 1785666 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / UNK - / -

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

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

Write-up: Expired Moderna vaccine administered to patient. Vaccine expiration date was 9/28/21 per manufacturer.


VAERS ID: 1785674 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / UNK - / -

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? 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: Expired Moderna vaccine administered to patient. Vaccine expiration date was 9/28/21 per manufacturer.


VAERS ID: 1785678 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 RA / IM

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

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

Write-up: Vaccine administered to patient on day 35 of refrigeration. Patient reports body aches x1 day following vaccine. Patient will repeat vaccine on 10/21/21 per Pfizer and CDC guidelines.


VAERS ID: 1785680 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / UNK - / -

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? 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: Expired Moderna vaccine administered to patient. Vaccine expiration date was 9/28/21 per manufacturer.


VAERS ID: 1785715 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-09-30
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 AR / SYR

Administered by: Military       Purchased by: ?
Symptoms: COVID-19, Feeling abnormal, Headache, Increased upper airway secretion, Nasal congestion, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Injection Repatha; Lexapro; Zetia; Benicar; omega 3; COQ10; vit D3; aspirin
Current Illness: None
Preexisting Conditions: High blood pressure; high cholesterol
Allergies: None
Diagnostic Lab Data: 2 Covid test both positive
CDC Split Type: vsafe

Write-up: I had a sore throat that gradually that got worse and worse. I had a little bit of stuffiness, runny nose. I got an at home covid test and was shocked when it came back positive on Oct 1 and on Monday the October 4th I looked into getting a monoclonal antibody treatment on the October on the 6th then the next day felt worse, I had a horrible headache and a fever that did not respond to tylenol and within 24 hours I started improving. I still have congestion and drainage in my throat. I have tested negative now with a home test.


VAERS ID: 1785747 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-28
Onset:2021-09-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Balance disorder, Dizziness, Oral pain, Palatal swelling
SMQs:, Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Dr. visit to review bump on roof of mouth and continued dizziness and balance issues on Oct 1, 2021. Dr. examined and advised to give it a few more days.
CDC Split Type:

Write-up: 2 days after small bump on roof of mouth. Very tender and painful for 6-7 days. Continued dizzy and balance issues. No injection site soreness but 5 days post injection shoulder joint in injection arm incredibly sore for 6+ days


VAERS ID: 1785787 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-01-11
Onset:2021-09-30
   Days after vaccination:262
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Diarrhoea, Malaise, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (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: Positive Home Covid-19 test as well as positive PCR Covid-19 test.
CDC Split Type:

Write-up: Complaint of runny nose/congestion, loss of taste and smell, malaise and diarrhea.


VAERS ID: 1786663 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-09-28
Onset:2021-09-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood iron decreased, Blood test abnormal, Chest pain, Dyspnoea, Echocardiogram normal, Electrocardiogram normal, Fatigue
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: 9/30/2021 EKG showed Left Ventricular Hypertrophy 10/08/2021 Blood tests showed low iron levels (unrelated) 10/14/2021 Normal EKG 10/14/2021 Normal Echocardiogram
CDC Split Type:

Write-up: I had chest pain on my left side. I went to facility and they did an EKG. It was determined that my chest pain was muscular but the EKG showed Left Ventricular Hypertrophy that was not on a prior EKG. This EKG was done two days after the third dose. On 10/14/2021 I went to see a cardiologist and they did an echocardiogram and another EKG. It was determined that my heart was fine and nothing was wrong on both tests. The doctor stated that it could have either been inflammation caused by the vaccine or just a false positive on the first EKG. During this I also had some blood tests because I was feeling very tired and short of breath. It was determined that my iron lever was low and I needed to take iron supplements.


VAERS ID: 1757006 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site paraesthesia, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Decline, tingling, pain at injection site for more than 48 hours, redness and oversized marking on the vaccine site.


VAERS ID: 1763923 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-30
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210930; Test Name: COVID-19 antigen test; Result Unstructured Data: positive
CDC Split Type: USJNJFOC20211001252

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a consumer concerned a 25 year old male. The patient''s weight was not reported and height was 170 centimeters. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204A21A, and expiry: unknown) dose was not reported, 1 total, administered on 16-JUN-2021 to left arm for prophylactic vaccination. No concomitant medications were reported. On 30-SEP-2021, the reporter stated that the patient was tested positive for COVID-19 (suspected clinical vaccination failure and suspected covid-19 infection). Laboratory data included: COVID-19 antigen test (NR: not provided) positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the suspected clinical vaccination failure and suspected covid-19 infection was not reported. This report was serious (Other Medically Important Condition). This report was associated with a product quality complaint: 90000195424.; Sender''s Comments: V0:20211001252-covid-19 vaccine ad26.cov2.s-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1770981 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
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 (UNKNOWN)) / UNKNOWN MANUFACTURER UNK / 1 - / -
TDAP: TDAP (NO BRAND NAME) / UNKNOWN MANUFACTURER UNK / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Hypotonia, Oxygen saturation, Oxygen saturation decreased, Respiratory disorder, Unresponsive to stimuli
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210930; Test Name: Oxygen saturation decreased; Result Unstructured Data: (Test Result:not saturating,Unit:unknown,Normal Low:,Normal High:)
CDC Split Type: CLGLAXOSMITHKLINECL2021AM

Write-up: respiratory problems; weak muscle tone; he is not saturating; he is not reacting; This case was reported by a consumer via interactive digital media and described the occurrence of oxygen saturation decreased in a 8-year-old male patient who received DTPa (Reduced antigen) (dTpa vaccine) for prophylaxis. Co-suspect products included COVID-19 VACCINE INACTIVE (SINOVAC ANTI COVID-19 VACCINE) for prophylaxis. On 30th September 2021, the patient received dTpa vaccine and the 1st dose of SINOVAC ANTI COVID-19 VACCINE. On 30th September 2021, less than a day after receiving dTpa vaccine, the patient experienced oxygen saturation decreased (serious criteria hospitalization) and unresponsive to stimuli (serious criteria GSK medically significant). On an unknown date, the patient experienced respiratory disorder (serious criteria hospitalization) and decreased muscle tone (serious criteria hospitalization). On an unknown date, the outcome of the oxygen saturation decreased, respiratory disorder and decreased muscle tone were recovering/resolving and the outcome of the unresponsive to stimuli was unknown. It was unknown if the reporter considered the oxygen saturation decreased, respiratory disorder, decreased muscle tone and unresponsive to stimuli to be related to dTpa vaccine. Additional details were provided as follows: This case was reported by patient''s mother via local news. The age at vaccination was not reported. The patient received the first dose of Sinovac and the dTpa vaccine (Diphtheria, Tetanus and Pertussis) in his educational campus within the framework of a regulatory authority. The patient was hospitalized after being vaccinated with dTpa vaccine and Sinovac The patient''s mother stated that one day before reporting, the patient was vaccinated against the Coronavirus, Sinovac, he was not reacting, he was not saturating, and he could get intubate him. On the next day, the patient was admitted to the hospital after he had respiratory problems and weak muscle tone. The patient was stable and under observation. It was unknown if the reporter considered the oxygen saturation decreased, respiratory disorder, muscle tone decreased and unresponsive to stimuli to be related to Sinovac Anti Covid-19 Vaccine.


VAERS ID: 1775893 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-30
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816024 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: KRJNJFOC20211014715

Write-up: ACUTE PARALYSIS; This spontaneous report received from a health care professional via a Regulatory Authority concerned a 4 decade old male of unspecified race and ethnicity. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1816024, and expiry: 1-JUL-2021) dose was not reported, 1 total administered on 12-JUN-2021 to deltoid, for an unspecified indication . No concomitant medications were reported. On 30-SEP-2021, the patient experienced acute paralysis, and was hospitalized (date unspecified). The patient received inpatient treatment The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of acute paralysis was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20211014715-covid-19 vaccine ad26.cov2.s -Acute paralysis. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1782107 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-30
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Headache, Injection site reaction, Malaise, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (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? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: BEJNJFOC20211021903

Write-up: Fatigue; Shivering; Injection site reaction; Fever; Myalgia; Headache; Malaise; Nausea; Arthralgia; This spontaneous report received from a consumer via a Regulatory authority (regulatory authority, BE-FAMHP-DHH-N2021-107347) on 12-OCT-2021 and concerned a 28 year old female. The patient''s weight was 62 kilograms, and height was 167 centimeters. The patient''s pre-existing medical conditions included: None. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown and expiry: Unknown) dose was not reported, 1 total, first dose administered on 30-SEP-2021 for covid-19 immunisation. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 30-SEP-2021, the patient experienced fatigue, shivering, injection site reaction, fever, myalgia, headache, malaise, nausea and arthralgia. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from fatigue, shivering, injection site reaction, fever, myalgia, headache, malaise, nausea, and arthralgia, however end date for fatigue, shivering, injection site reaction, fever, myalgia, headache, malaise, nausea, and arthralgia was reported as 01-OCT-2021. This report was serious (Disability Or Permanent Damage).; Reporter''s Comments: Treatment - Yes Paracetamol for headache on day 2 Evolution of the ADR - Improving


VAERS ID: 1784478 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-30
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: LVJNJFOC20211021296

Write-up: SYNCOPE; This spontaneous report received from a health care professional by a Regulatory Authority (LV-SAM-2021106681) on 12-OCT-2021 concerned a 23 year old female patient of an unspecified race and ethnic origin. The patient''s weight was 78 kilograms, and height was not reported. No past medical history or concurrent conditions were reported. The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: ACA4541 expiry: unknown) 0.5 ml, 01 total (first dose), administered on 30-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 30-SEP-2021 at 11:20, the patient experienced syncope. The action taken with Covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from syncope. This report was serious (Other Medically Important Condition).


VAERS ID: 1786557 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-09-29
Onset:2021-09-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Feeling abnormal, Headache, Memory impairment, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (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: Nil
Current Illness: Nil
Preexisting Conditions: Scoriasis, diverticula.
Allergies: Pork, shellfish, pethidine
Diagnostic Lab Data: Nil
CDC Split Type:

Write-up: Headache, heart palpitations, brain fog & memory issues


VAERS ID: 1787264 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-09-30
Submitted: 0000-00-00
Entered: 2021-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: ROJNJFOC20211021830

Write-up: Chills; This spontaneous report received from a health care professional via Regulatory Authority (RO-NMA-2021-SPCOV12776) on 12-OCT-2021 and concerned a 36 year old female of unspecified race and ethnic origin. The patient''s weight was 60 kilograms, and height was 152 centimeters. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number was not reported) 1 dosage forms, frequency 1 total administered on 30-SEP-2021 for covid-19 immunisation. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 30-SEP-2021, the patient experienced chills. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from chills. This report was serious (Life Threatening).


VAERS ID: 1743399 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fever chills headache, 27, 9/7/21, shot, Pfizer
Other Medications: Hydrochlorothiazide and Lisinopril
Current Illness:
Preexisting Conditions: High blood pressure
Allergies: Ceclor
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever (102) chills headache muscle aches/soreness dizziness


VAERS ID: 1743797 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301558 / 3 RA / IM

Administered by: Pharmacy       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: Metoprolol, statin
Current Illness:
Preexisting Conditions: Recovering from spinal surgery
Allergies: Walnuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue


VAERS ID: 1744146 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 2 - / SYR

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

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

Write-up: Headache, fever, some body aches , lack of energy


VAERS ID: 1744274 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-24
Onset:2021-09-29
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oedema peripheral, Tenderness
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Armpit swollen and tender on injection arm


VAERS ID: 1744277 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011F21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Headache, Neck pain, Pruritus, Vision blurred
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NO
Current Illness: NO
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lower Back Pain; Blurry Vision; Sides of head temple and neck Pain; Itchy legs and arms; Throbbing''s behind ears


VAERS ID: 1744299 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

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

Write-up: Patient came in 15 days after receiving the first dose and was vaccinated before the normal 21 days.


VAERS ID: 1744306 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 UN / SYR

Administered by: Private       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: ONDANSETRON PRN OMEPRAZOLE PRN
Current Illness: ETOH ABUSE
Preexisting Conditions: SMOKER
Allergies: nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: EXPIRED VACCINE GIVEN PER SLIP RECEIVED WITH VACCINE LOT 201A21A AND EXP 21SEP WHICH LED PHARMACIST TO BELIEVE EXPIRATION WAS 9/30/21 WHEN EXPIRED ON MFR WEBSITE WAS 9/21/21.


VAERS ID: 1744312 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Extra dose administered, Nausea, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Medication errors (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 10 days of fever, body aches, chills, nausea/vomiting following second dose of Pfizer vaccine.
Other Medications: None
Current Illness: Adverse reaction to second dose of Pfizer
Preexisting Conditions: Elevated blood pressure without diagnosis of hypertension
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient stated that she felt "woozy", had shakes, and nausea/vomiting x1. The patient''s vitals 167/108 L arm 92HR at 0759 and 154/99 R arm 87HR at 0802. The patient was given 25mg of Diphenhydramine oral solution at 0805. The patient was also reclined. The blood pressure was rechecked 188/116 L arm 88HR at 0833 and 172/92 R arm at 0835. The patient''s supervisor was then notified to come. The patient gave permission for information to be shared with supervisor. The patient voiced understanding that she should go seek medical attention and treatment from hospital or her own personal doctor. The patient also voiced understanding that she cannot drive herself due to Diphenhydramine intake. The patient''s supervisor is witness to patient voicing understanding on both occasions.


VAERS ID: 1744333 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Migraine, Nausea
SMQs:, Acute pancreatitis (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: Na
Current Illness: Na
Preexisting Conditions: Na
Allergies: Na
Diagnostic Lab Data: Na
CDC Split Type:

Write-up: Nausea migraine


VAERS ID: 1744334 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-24
Onset:2021-09-29
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Discoloured vomit, Dizziness, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), 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: multivitamin plus vitamin D and zinc
Current Illness: none
Preexisting Conditions: none
Allergies: sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: 4 and a half days (108 hours) after receiving a first dose of the Pfizer vaccine, I woke up at 12:30 a.m. and upon sitting up in bed experienced vertigo-like dizziness, which continued for about a half hour until I realized I was likely to vomit, though I had no feeling of nausea. I had no fever. In the 4 and a half days leading up to last night?s adverse reaction, I had neither eaten nor done anything whatsoever unusual. The vomit itself was very dark in color. I was able to fall back asleep after a half hour or so, and on awakening around 7 a.m. felt dizzy again upon sitting up in bed and began experiencing tinnitus, which is as yet ongoing as of 7 a.m.


VAERS ID: 1744347 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Headache, Injection site pain, Malaise, Myalgia, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Pain at injection site, pain in arm of injection, muscle aches, head ache, malaise/ weakness, chills, fever of 100.8.


VAERS ID: 1744355 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Decreased appetite, Dizziness, Fatigue, Headache, Injection site pain, Injection site pruritus, Malaise, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Itching, injection site pain 14 hrs. after injection, tiredness, headache, muscle pain, chills, nausea, feeling unwell, decreased appetite and felt like fainting. Temp 97.7 at 10:00 am 09/29/21.


VAERS ID: 1744400 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:2021-09-23
Onset:2021-09-29
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / SYR

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was administered vaccine on 9/23/21. Vaccine expiration was 9/21/21. No adverse events reported by individual.


VAERS ID: 1744404 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: New York  
Vaccinated:2021-02-12
Onset:2021-09-29
   Days after vaccination:229
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Pyrexia, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: hypokalemia, hypothyroidism, anxiety, tracheostomy, scoliosis, microcephalus, mental retardation, epilepsy, dysphagia, narcolepsy
Allergies: cipro and tequin
Diagnostic Lab Data: Positive COVID-19 test 9/29/21
CDC Split Type:

Write-up: Patient admitted with a positive COVID-19 breakthrough case. Presented with cough, fever, SOB. Nonverbal patient. Staff state that symptoms began on 9/28/21.


VAERS ID: 1744407 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Headache, Hypoaesthesia, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Sexual dysfunction (broad)

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

Write-up: Numbness in right hand fingers, short of breath, chest pain, weakness in legs, headache


VAERS ID: 1744413 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:2021-09-23
Onset:2021-09-29
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

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

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

Write-up: Patient was administered vaccine on 9/23/21. Vaccine expiration was 9/21/21. No adverse events reported by individual.


VAERS ID: 1744423 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:2021-09-23
Onset:2021-09-29
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was administered vaccine on 9/23/21. Vaccine expiration was 9/21/21. No adverse events reported by individual.


VAERS ID: 1744428 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:2021-09-23
Onset:2021-09-29
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was administered vaccine on 9/23/21. Vaccine expiration was 9/21/21. No adverse events reported by individual.


VAERS ID: 1744433 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:2021-09-23
Onset:2021-09-29
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was administered vaccine on 9/23/21. Vaccine expiration was 9/21/21. No adverse events reported by individual.


VAERS ID: 1744439 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:2021-09-23
Onset:2021-09-29
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

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

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

Write-up: Patient was administered vaccine on 9/23/21. Vaccine expiration was 9/21/21. No adverse events reported by individual.


VAERS ID: 1744445 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:2021-09-23
Onset:2021-09-29
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was administered vaccine on 9/23/21. Vaccine expiration was 9/21/21. No adverse events reported by individual.


VAERS ID: 1744453 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 202A21A / 1 LA / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was administered vaccine on 9/23/21. Vaccine expiration was 9/21/21. No adverse events reported by individual.


VAERS ID: 1744460 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient administered vaccine on 9/23/2021. Vaccine expiration was 9/21/2021. No adverse events reported by individual.


VAERS ID: 1744461 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044A21A / 3 LA / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mesalamine, Simvastatin, Humira, Trazodone
Current Illness:
Preexisting Conditions: UC
Allergies: Bactrim
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Vaccine was found to be expired as of 8-31-21. Contacted State Health. They then followed up with Moderna. Received confirmation from Moderna that vaccine given was still considered viable. No adverse outcomes noted.


VAERS ID: 1744469 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was administered vaccine on 9/23/21. Vaccine expiration was 9/21/21. No adverse events reported by individual.


VAERS ID: 1744478 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was administered vaccine on 9/23/21. Vaccine expiration was 9/21/21. No adverse events reported by individual.


VAERS ID: 1744484 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was administered vaccine on 9/23/21. Vaccine expiration was 9/21/21. No adverse events reported by individual.


VAERS ID: 1744496 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was administered vaccine on 9/23/21. Vaccine expiration was 9/21/21. No adverse events reported by individual.


VAERS ID: 1744514 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was administered vaccine on 9/23/21. Vaccine expiration was 9/21/21. No adverse events reported by individual.


VAERS ID: 1744566 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Pruritus, Skin warm, 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: High blood pressure controlled by medication- Valsartin HCL
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itching, swelling, redness, warm


VAERS ID: 1744580 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19 immunisation
SMQs:, 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: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received moderna vaccine in April but came in today with a different date of birth and received pfizer vaccine.


VAERS ID: 1744617 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-25
Onset:2021-09-29
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction, Chills, Computerised tomogram, Extradural haematoma, Full blood count, Headache, Metabolic function test, Myocardial necrosis marker, Troponin increased
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Myocardial infarction (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Accidents and injuries (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: Lactobacillus Vitamin D Vitamin D Klor-Con Xarelto
Current Illness: Unknown new to our facility
Preexisting Conditions: HTN Headaches
Allergies: codiene
Diagnostic Lab Data: 9/29/2021 CT scan, CBC, Cardiac Enzymes, CMP
CDC Split Type:

Write-up: Occipital headache, denies vision changes Epidural hematoma Non-STEMI elevated troponin Rigors


VAERS ID: 1744636 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP: 128/98mmHg left arm, sitting
CDC Split Type:

Write-up: About 10 minutes after vaccination the patient experienced lightheadedness and tingling along the right side of her body (the side which was injected) from face to foot. After another 20 minutes the patient said she was starting to feel better but definitely still tingly. Recommended she see doctor to evaluate.


VAERS ID: 1744664 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
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: Client came in today to receive the pfizer vaccine. After receiving the vaccine, it was noted that she changed her date of birth. She previusly used 01/20/1997 instead of 01/30/1997 which she used today. She previously got moderna on 04/06/2021. No side effects reported here presently.


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