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

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



Case Details (Reverse Sorted by Onset Date)

This is page 68 out of 5,069

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VAERS ID: 1457486 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-01-15
Onset:2021-07-01
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2, Nucleic acid test, Respiratory symptom, SARS-CoV-2 test positive, Sick relative
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: na
Current Illness: none
Preexisting Conditions: DM htn hyperlipidemia
Allergies: asa pcn
Diagnostic Lab Data: 7/2/21 sars-cof 2 qualititaeive NAA detected.
CDC Split Type:

Write-up: pt tolerated vaccine well. 7/1 pt had uri symtoms after exposure to family member with + covid.


VAERS ID: 1457498 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dry throat, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pfizer Vaccine
Other Medications: Benadryl Solumedrol
Current Illness:
Preexisting Conditions:
Allergies: Ferrous Sulfate Hydrocodne- acetaminophen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Staff notified RN that Pt was in the triage room and she needed help. Patient ID x 2, on assessment, Pt stated her throat feels dried up and she cannot breath appropriately. V/S was done and Pt''s BP was 116/69, Pulse 81, R 22, Oxygen saturation 100%. Pt stated she had just recently gotten her second shot of the COVID-19 vaccine, Pfizer. She stated she had a rxn to the first dose. Pt was placed on 2liters of oxygen and Provider was informed. Provider, NP ordered Solumedrol and benadryl. Medications were given at 0835am IM. Pt was continued to be monitored. BP at 0840 was 113/58, oxygen 100%, pulse 79, R 20. Pt was informed she is having a rxn to the vaccine and would be monitored before she could go home. After 0910, Pt''s BP was taken manually and BP was 110/72, Pulse 78, R 18, and Oxygen saturation 100%. Pt was observed for about an hour before been discharged. Provider asked RN to schedule Pt for a telehealth appointment for tomorrow. Pt was scheduled for the appointment. Pt stated she feels much more better and alright and she can breath well. Pt''s husband at bedside. Patient aware and verbalized understanding of all instructions and patient to return PRN to the clinic. BSN, RN/PHN


VAERS ID: 1457502 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Pallor, Paraesthesia, Posture abnormal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: At 1845 EMT noticed client leaning to the side of her chair and family member alerted staff she needed help. EMT and RN responded at 1845. Site Manager informed lead PHN . PHN arrived at 1849. Upon arrival client sitting on chair, pale, awake and questioning why so many people were surrounding her. First vitals at 1849 by EMT Anthony: blood pressure 120/70, pulse 61, oxygen sat 99%. Client reported "I felt dizzy and tingling of my legs" and "then I remember being surrounded by staff". Family member reported he "saw her faint for a few seconds". Client alert and oriented x4. Reports history of syncope with blood draws, no other medical history, no medications and no known allergies. Client able to transfer to anti-gravity chair without assistance. Vitals at 1855: blood pressure 110/70, pulse 65, oxygen sat 98%. Client denied headache, blurred vision, nausea, chest pain, or shortness of breath. Client also reports tingling sensation below knees in addition to dizziness. RN assessed legs and client with full sensory and motor intact. Vitals at 1902: blood pressure 120/68, pulse 72, oxygen sat 95%. Per client tingling sensation and dizziness improving. Vitals at 1913: blood pressure 108/68, pulse 76, oxygen sat 99%. Per client dizziness and leg tingling resolved. Client sat in upright position in anti-gravity chair for remainder of observation time. Client stated family would drive her home. PHN advised client to follow up with provider and gave ER precautions. RN had client stand at 1918 from chair to assess for dizziness. Client stated feeling fine. Client left facility with steady gait at 1920.


VAERS ID: 1457528 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dry throat, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Dehydration (broad)

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

Write-up: notified RN that Pt was in the triage room and she needed help. Patient ID x 2, on assessment, Pt stated her throat feels dried up and she cannot breath appropriately. V/S was done and Pt''s BP was 116/69, Pulse 81, R 22, Oxygen saturation 100%. Pt stated she had just recently gotten her second shot of the COVID-19 vaccine, Pfizer. She stated she had a rxn to the first dose. Pt was placed on 2liters of oxygen and Provider was informed. Provider ordered Solumedrol and benadryl. Medications were given at 0835am IM. Pt was continued to be monitored. BP at 0840 was 113/58, oxygen 100%, pulse 79, R 20. Pt was informed she is having a rxn to the vaccine and would be monitored before she could go home. After 0910, Pt''s BP was taken manually and BP was 110/72, Pulse 78, R 18, and Oxygen saturation 100%. Pt was observed for about an hour before been discharged. Provider asked RN to schedule Pt for a telehealth appointment for tomorrow. Pt was scheduled for the appointment. Pt stated she feels much more better and alright and she can breath well. Pt''s husband at bedside. Patient aware and verbalized understanding of all instructions and patient to return PRN to the clinic.


VAERS ID: 1457542 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-07-01
   Days after vaccination:83
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / PUBLI / UNK LA / IM

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

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

Write-up: Patient became COVID-19 positive after being fully vaccinated. Patient is also not asymptomatic.


VAERS ID: 1457566 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-06-14
Onset:2021-07-01
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 1 LA / IM

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

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

Write-up: pt experienced delayed body rash on back/arms/legs- beginning 7/5/21- advised pt to try Benadryl and consult with physician regarding 2nd dose of Moderna


VAERS ID: 1457582 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-02
Onset:2021-07-01
   Days after vaccination:90
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Macular degeneration
SMQs:, Retinal 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: I was taking thyroid medication and Wellbutrin.
Current Illness: None
Preexisting Conditions: I have high blood pressure.
Allergies: I''m allergic to Codeine.
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I went to the eye doctor on 07/01/2021 and was diagnosed with macular denegeneration.


VAERS ID: 1457584 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-05
Onset:2021-07-01
   Days after vaccination:87
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / SYR

Administered by: Public       Purchased by: ?
Symptoms: Electrocardiogram, Full blood count, Hypertension, Thrombosis
SMQs:, Neuroleptic malignant syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Hypertension (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: Metformin
Current Illness: No
Preexisting Conditions: Diabetes
Allergies: No
Diagnostic Lab Data: EKG, CBC
CDC Split Type: vsafe

Write-up: Blood clots, high blood pressure


VAERS ID: 1457866 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-29
Onset:2021-07-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood thyroid stimulating hormone, Bronchitis, Chest X-ray, Chest discomfort, Cough, Diarrhoea, Discomfort, Dysphonia, Fatigue, Full blood count, Heavy menstrual bleeding, Hypertension, Immature granulocyte count increased, Laryngitis, Metabolic function test, Myalgia, Nausea, Ocular hyperaemia, Pain, Paraesthesia, Pregnancy test negative, Respiratory tract congestion, SARS-CoV-2 test negative, Tinnitus, Urine analysis normal, White blood cell count decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Haematopoietic leukopenia (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Hypertension (narrow), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Graves Disease
Allergies: Allergic to penicillin
Diagnostic Lab Data: lab tests completed in ER: CBC with diff (WBC elevated to 11.3, immature granulocytes elevated), CMP (all WNL), pregnancy test urine (negative) , urinalysis (no abnormalities), chest x-ray (no abnormalities), TSH lab (WNL), COVID test (negative)
CDC Split Type:

Write-up: 6/29/21: 2nd COVID19 (Moderna) vaccine on 6/30/21: fatigue, muscle aches, cough, congestion, heavy menstrual cycle began, diarrhea 7/1/21: unproductive/dry cough, voice became hoarse, congestion, diarrhea, extreme fatigue and body aches in PM 7/2/21: laryngitis/voice completely gone, continued unproductive cough, congestion, diarrhea 7/3/21: continued unproductive cough, chest tightness, diarrhea, went to urgent care and was diagnosed with bronchitis and prescribed prednisone 7/4/21: continued all symptoms as noted above 7/5/21: continued symptoms as noted above + nausea 7/6/21: continued symptoms as noted above, continued nausea, progressively worsening cough 7/7/21: continued all symptoms as noted above 7/8/21: woke up feeling extremely fatigued, eyes red, global feeling of weakness, new onset of tingling and pressure sensation left side of face, neck, and left upper arm, new onset tinnitus, high BP prompted ER visit and diagnosis of adverse effects of vaccine


VAERS ID: 1457886 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram abdomen, Lymphadenitis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown.
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: as above. 7/1/2021
CDC Split Type:

Write-up: Moderate to severe Abdominal Pain. CT Abdomen completed with + mesenteric adenitis


VAERS ID: 1457891 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-29
Onset:2021-07-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Condition aggravated, Fatigue, Injection site erythema, Injection site pain, Injection site reaction, Injection site swelling, Injection site warmth, Insomnia, Limb discomfort, Rash macular, Rheumatoid arthritis
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Embrel Injection but I have not taken it for one week before Lisinopril 20mg, Hydrochlorothiazide 50mg Levothyroxine 100mcg, Pravastatin 20mg Vitamin D
Current Illness:
Preexisting Conditions: Rheumatoid Arthritis Hypothyroidism Hypertension Kidney Disease
Allergies:
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I got my first dose of the vaccine on the advice of my Rheumatologist. I have not been able to see him yet. Two days after the first dose my left arm was really bothering me. My arm was red below the injection site and it was hot, raised up and painful. I couldn?t sleep on that side. I was very tired that week. I used antibiotic ointment and alcohol pads with a cold washcloth. I went back to the pharmacy. It looks better now after eight days. It is a little splotchy now, but the pain has gone down. I have also had more joint pain since I got the vaccine but that may be because I have not had any Embrel for two weeks. It feels like my Rheumatoid Arthritis is flared up.


VAERS ID: 1457906 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Fatigue, Neck pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: SULFA ANTIBIOTICS
Diagnostic Lab Data: Was treated at Medical Center on 7/3. Tests and treatment are unknown to pharmacy at this time.
CDC Split Type:

Write-up: Patient called on 7/7 and let us know that she had been treated in the ER for HR $g100, on and off fever, dizziness, shortness of breath when lying down, fatigue, and neck pain since receiving her second dose of the vaccine. She is following up with a cardiologist and will let us know of the outcome of this appointment.


VAERS ID: 1458142 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Mobility decreased, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro Volnea
Current Illness: N/a
Preexisting Conditions: Endometriosis
Allergies: Erythromycin
Diagnostic Lab Data: N/a only COVID vaccine
CDC Split Type:

Write-up: Shoulder and muscle pain has not dissipated. Challenging to raise left arm.


VAERS ID: 1458361 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-06-24
Onset:2021-07-01
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angina pectoris, Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (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:
CDC Split Type:

Write-up: Heartache started about a week after getting 2nd shot of Pfizer. Never had heart issues before in my life. I''ve noticed sharp, pulsing pain in the left side of my chest while in store. There pain pulses lasted for about a minute, then subsided. Since it subsided, I though it might have been muscle pain. However, I had the same pain happening 2 days later. Now it has been 2 weeks since my 2nd shot of Pfizer and I continue to get pulsing pain in heart area almost daily. It usually last anywhere from 1-3 minutes and then subsides. The pain is sharp, but tolerable, hence I did not go to a doctor with this issue yet. Again, I have never ever had this kind of pain in my life ago, nor I ever had any heart-related medical condition. I really hope it is temporary and will pass. For now I will continue to monitor and observe the symptoms.


VAERS ID: 1458362 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Headache, Pain
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

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

Write-up: Chills Body aches Headache Dizziness Exhaustion


VAERS ID: 1458368 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

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

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

Write-up: Rash all over my legs


VAERS ID: 1458374 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Itching, lump in arm


VAERS ID: 1458479 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Gastrointestinal disorder, Headache, Injection site pain, Menstruation delayed, Musculoskeletal stiffness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Fertility disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Symptoms after my second dose of Pfizer is a missed period, armpit pain (like a popping sensation), neck stiffness, muscle aches, headache, vaccination site soreness, and gastrointestinal changes. 2nd shot took place on July 5, 2021 at 3-3:15pm.


VAERS ID: 1458768 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210704358

Write-up: VIAL INITIALLY PUNCTURED AND HAD BEEN MAINTAINED IN THE REFRIGERATOR FROM THE TIME OF INITIAL PUNCTURE; This spontaneous report received from a pharmacist concerned a 41 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1816022, expiry: 15-AUG-2021) dose was not reported, administered on 01-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-JUL-2021, the subject experienced vial initially punctured and had been maintained in the refrigerator from the time of initial puncture. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of vial initially punctured and had been maintained in the refrigerator from the time of initial puncture was not reported. This report was non-serious. This case, from the same reporter is linked to 20210703146.


VAERS ID: 1459699 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

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

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

Write-up: An incorrect DOB was provided for the individual receiving the vaccine in the presence of an adult who claimed to be the legal guardian.


VAERS ID: 1459709 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: tumeric, kealnor birth control pills.
Current Illness: hemochromatosis and solar dermatitis
Preexisting Conditions: hemochromatosis and solar dermatitis
Allergies: myroxylon pereirae resin, nickel, bacitracin, disperse orange 3, methyldibromo glutaronitrile, propolis, benzophenone-3, goldsodiumthiosulfate, cobalt ii chloride hexahydrate, 2-n-octyl-4-isothiazolin-3-one
Diagnostic Lab Data:
CDC Split Type:

Write-up: just sore left arm i was numb head to toe only on my right side. it''s been 9 days i am not bck to 1005, my right side of my face doesn''t feel rigth and still has numbness feeling.


VAERS ID: 1459727 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None- not applicable
CDC Split Type:

Write-up: Administered 1st dose of Moderna vaccine to 13 year old


VAERS ID: 1459732 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 2 RA / IM

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

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

Write-up: 13 year old received one dose of Moderna vaccine


VAERS ID: 1459734 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

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

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

Write-up: diffuse itching, rash near site of injection


VAERS ID: 1459771 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-06
Onset:2021-07-01
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram, Blood test, Computerised tomogram, Echocardiogram, Magnetic resonance imaging, Optic ischaemic neuropathy, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (narrow), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: MRI, CAT scan, Echo, MRA, Bloodwork - admitted to hospital on July 6, released July 8, 2021.
CDC Split Type:

Write-up: Had sudden ?eye? stroke. Neurologist at hospital could not rule out this being an adverse affect from vaccine since there were no underlying health issues or past history of any health issues. Lost 25% vision in right eye due to sudden stroke.


VAERS ID: 1459797 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-06
Onset:2021-07-01
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011120A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dizziness postural, Dyspnoea, Fatigue, Flushing, Palpitations
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Childhood vaccine; this vaccine caused me to feel nauseous and experience flu-like symptoms.
Other Medications:
Current Illness:
Preexisting Conditions: Lung damage from radiation treatment for breast cancer, pre-existing non calcified lung nodules and mucus plugs.
Allergies:
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I have been experiencing this month more fatigue than usual. My face also feels flushed occasionally which I did not have before and I get very dizzy. When getting up from a bed I get extremely dizzy and I have to sit down. I continue with SOB that comes and goes and my heart palpitations are still present but not as frequent as before.


VAERS ID: 1459799 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse, Lexapro, Montelukast, Breo Ellipta, Pepcid A/C
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: On the back and side of my left leg and knee, a strong itchy rash developed which has left small little blisters for over a week now.


VAERS ID: 1459805 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-20
Onset:2021-07-01
   Days after vaccination:103
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Acute respiratory failure, Asthenia, Bilevel positive airway pressure, Brain natriuretic peptide increased, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Dyspnoea, Hypercapnia, Hyperkalaemia, Hyponatraemia, Intensive care, Lung infiltration, SARS-CoV-2 test positive, Sepsis, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (broad), Anaphylactic reaction (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Tumour lysis syndrome (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown.
Current Illness: unknown
Preexisting Conditions: emphysema, BPH, and recurrent UTI, hypertension
Allergies: No known drug allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: received Moderna COVID-19 vaccine on 2/21/21 and 3/20/2021 7/4/21: 75 y/o male with PMHx of emphysema, BPH, and recurrent UTI who presented to the emergency department via EMS due to concerns from family that patient appeared to have worsening dyspnea over the past 3 days. Workup in ED revealed positive COVID-19 status, WBC 12.9, BNP 4900, and CXR with infiltrates consistent with possible pneumonia. continued as inpatient: azithromycin and ceftriaxone prescriptions that were started on 7/3. Has COVID-19 viral pneumonia, acute respiratory failure with hypoxia, hypercarbia, hyponatremia, hyperkalemia, acute kidney injury, and sever sepsis. 7/5: patient admitted to the ICU. on BiPAP support. started remdesivir.


VAERS ID: 1459956 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / 2 RA / IM
VARZOS: ZOSTER (SHINGRIX) / GLAXOSMITHKLINE BIOLOGICALS 393C7 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Nausea, Renal disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: The patient presented to the ER the day following the vaccines. She reported to her primary provider that she was experiencing fatigue, nausea, and vomiting since she received the vaccine. She received IV fluids and ondansetron. When contacted by the pharmacy the patient stated she had kidney damage as well. As of 7/9 /21, she is still experiencing side effects.


VAERS ID: 1460041 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: Client received Pfizer 05/2021 is overdue for second vaccine and currently is unable to seek second dose and is requesting a second vaccine


VAERS ID: 1460055 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Site: Pain at Injection Site-Severe, Additional Details: left arm is hurting 9 days after injection patient said doctor has but her on gabapentin with diagnoses of hitting nerve with injection


VAERS ID: 1460123 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pantoprazole 40mg daily Lisinopril 10mg daily Multi Vitamin
Current Illness: Barretts Esophagus Lymphodema on left side of body
Preexisting Conditions: Barretts Esophagus Lymphodema on left side of body
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Aching in left leg, pricking needles feeling through out body


VAERS ID: 1460139 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-04
Onset:2021-07-01
   Days after vaccination:88
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphonia, Head discomfort, Oropharyngeal pain, Sinusitis, Upper-airway cough syndrome
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: Last week, I woke up on Thursday morning, with a sore throat and head pressure. Also my voice was gone. I went to Urgent Care and had a visual exam. I was diagnosed with a sinus infection - they saw the post nasal drip. They prescribed me amoxicillin and Prednisone that I took for five days and I''m still on amoxicillin (had a 10 day course of that).


VAERS ID: 1460145 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Cough, Depression, Fatigue, Headache, Inflammation, Vaccination site rash
SMQs:, Anaphylactic reaction (broad), Depression (excl suicide and self injury) (narrow), Hypersensitivity (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 Medications: Ascorbic Acid 500mg PO daily Ca-Vit D3 500mg-200Unit PO BID Duloxetine 60mg PO QAM and 30mg PO QPM APAP, Ibuprofen PRN Pain Miconazole 2% cream. Apply to affected areas BID. Zolpidem CR 12.5mg PO PRN QHS for Sleep
Current Illness:
Preexisting Conditions: PMH: ? Anxiety disorder ? Bipolar 1 disorder ? Cancer 2016 Skin CA under eyes ? Depression ? Depressive disorder ? Fractures ? Hypertension ? Manic depression
Allergies: Pt w/ allergies to Poison Oak (anaphylaxis), Poison Ivy (anaphylaxis), Lidocaine topical (rash), Blackberries (hives/rash), Shellfish (hives/rash), lactose (intolerance)
Diagnostic Lab Data:
CDC Split Type:

Write-up: "Pt w/ allergies to Poison Oak (anaphylaxis), Poison Ivy (anaphylaxis), Lidocaine topical (rash), Blackberries (hives/rash), Shellfish (hives/rash), lactose (intolerance) Reports receiving Moderna vaccine on 7/1/21 @ pharmacy and developed a rash within 10 min to R arm where the vaccine was administered. Pt took own supply of benadryl but otherwise no medical care rendered. Denies s/s of anaphylaxis. Pt developed cough, fatigue, HA the next day. On 7/8 pt reported an increase in depression symptoms and increase of ongoing pain 2/2 inflammation from vaccine. PMH: ? Anxiety disorder ? Bipolar 1 disorder ? Cancer 2016 Skin CA under eyes ? Depression ? Depressive disorder ? Fractures ? Hypertension ? Manic depression Current Medications: Ascorbic Acid 500mg PO daily Ca-Vit D3 500mg-200Unit PO BID Duloxetine 60mg PO QAM and 30mg PO QPM APAP, Ibuprofen PRN Pain Miconazole 2% cream. Apply to affected areas BID. Zolpidem CR 12.5mg PO PRN QHS for Sleep


VAERS ID: 1460152 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / UNK UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

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

Write-up: Palpitations


VAERS ID: 1460209 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 1 LA / IM

Administered by: Pharmacy       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: Unknown
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderna COVID 19 vaccine administered to patient under 18 years of age. No adverse reaction reported.


VAERS ID: 1460230 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Seizure, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Systemic lupus erythematosus (broad), Convulsions (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: amitritylaine, quetiapine, diazepam, lamotrigine, montelukast, hydrocortisone, ritalin, tizanidine, trintellix
Current Illness: n/a
Preexisting Conditions: Ehlders Danlos syndrome, Mast cell activation syndrome, currently being worked up for MS due to neurologic symptoms
Allergies: liquid benadryl (only liquid form), hydrocodone, cipro
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Within a few minutes of receiving the vaccine the patient started convulsing and her tongue began to protrude from her mouth and was visibly swollen and she was struggling to breathe. Administered epinephrine and benadryl per standard anaphylaxis protocol and symptoms started to resolve but then resumed, repeated dose approx 5 minutes later and EMS system activated. Pt transported to the hospital and was monitored for approx 2 hours and given lorazepam and discharged home.


VAERS ID: 1460258 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-28
Onset:2021-07-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Hypoaesthesia, Pain, Paraesthesia, Vascular injury
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow)

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

Write-up: Burst blood vessel in left palm. Pinky and ring finger bruising and numbness, and sudden strong pain similar to a Charlie horse felt throughout said areas. Dull tingling in fingers.


VAERS ID: 1460318 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039C21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Invalid 3rd dose administered. Patient is under nursing supervision in a skilled facility. Per nurses at the facility, patient has exhibited no adverse reactions to this dose.


VAERS ID: 1461687 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-06-07
Onset:2021-07-01
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Computerised tomogram, Condition aggravated, Electrocardiogram normal, Seizure, Urine analysis normal
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: epilepsy- stable/ seizure-free for past 4 years before having the seizure, off medication (lamictal) for past 6 months
Allergies:
Diagnostic Lab Data: cat scan -clean urine sample -clean blood work- clean ekg -normal
CDC Split Type:

Write-up: a tonic clonic seizure, 2 min 30 second long


VAERS ID: 1461778 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Nausea-Medium, Additional Details: Patient''s blood pressure was 114/80 pulse 68. Symptoms resolved after 15 minutes.


VAERS ID: 1461992 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

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

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

Write-up: Sore Arm for a couple days then the pain went away then after a couple days the pain came back so bad she couldn''t move her arm. Patient is going to speak with md as well.


VAERS ID: 1462009 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-07-10
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 RA / SYR

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

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

Write-up: Vial of vaccine improperly reconstituted. Patient''s mother notified. Patient re-vaccinated with proper dosing of 0.3ml on 7/10/2021 at 1310. RN observed for 20 minutes post vaccination. No problems.


VAERS ID: 1462052 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-10
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / UNK RA / IM

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

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

Write-up: Vaccine improperly reconstituted and administered on 7/8/2021. Patient made aware on 7/9/2021. Patient was re-vaccinated with appropriate 0.3 ml dose on 7/10/2021. Patient was observed for 20 minutes and no adverse reaction noted.


VAERS ID: 1462063 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-07-10
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / UNK RA / IM

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

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

Write-up: Vial of vaccine reconstituted improperly and administered on 07/08/2021. Patient''s mother notified on 07/09/2021 and home visit was conducted on 07/10/2021 to re-vaccinate with appropriate dose of 0.3ml.


VAERS ID: 1462069 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood pressure increased, Disturbance in attention, Fatigue, Headache, Heart rate irregular, Inflammation, Neck pain
SMQs:, Neuroleptic malignant syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Cardiac arrhythmia terms, nonspecific (narrow), Depression (excl suicide and self injury) (broad), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: Rather intense headache and fatigue night of vaccination, but that was expected. Since then (from day 2 up till now), persistent headache (dull at the back of the head), neck and shoulder ache. Very annoying and makes it difficult to think and/or concentrate. Also having strange inflammation (both in the head and cardiac) and erratic heartbeat, likely contributing to increased blood pressure.


VAERS ID: 1462072 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-08
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / UNK RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Immunisation, Product preparation issue
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: None.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Vial of vaccine improperly reconstituted and administered on 07/08/2021. Patient contacted on 07/09/2021. Home visit conducted on 07/10/2021 and correct dose of 0.3ml administered.


VAERS ID: 1462076 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-08
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / UNK RA / IM

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

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

Write-up: Vial of vaccine improperly reconstituted and administered on 07/08/2021. Patient contacted on 07/09/2021. Home visit conducted on 07/10/2021 and correct dose of 0.3ml administered.


VAERS ID: 1462079 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Pallor, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: no illnesses day of or up to one month prior
Preexisting Conditions: no long-standing conditions
Allergies: no allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient became lightheaded, pale, and dizzy several minutes after vaccine. She vomited into a trash can and had fainted into her chair during the minutes following the husband alerting the pharmacy team she was having a reaction (we were there to witness and aid the patient.) After vomiting and having water, the patient recovered quickly. We monitored her one on one in the vaccine room for about 10 to 15 additional minutes and also took her blood pressure and temperature (both normal.) Patient remarked that she felt completely fine thereafter.


VAERS ID: 1462151 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-18
Onset:2021-07-01
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW01818/21 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Dyskinesia, Insomnia, Loss of personal independence in daily activities, Panic attack, SARS-CoV-2 antibody test negative, Self-injurious ideation, Soliloquy, Suicidal ideation, Tachyphrenia
SMQs:, Suicide/self-injury (narrow), Neuroleptic malignant syndrome (broad), Dementia (broad), Dyskinesia (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Teen girl vitamins - 1 a day
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: On July 4th, Hospital gave her COVID antibody test. They reported it came back negative. What happened? Is it all attacking her brain?
CDC Split Type:

Write-up: 3 days after dose 1, which was given on 05/28/21, PT reported feeling not herself. She was experiencing brain fog and not able to focus on her school work. She was worried about not being able to finish up the school year. We figured it was just "burnout", but knew this was strange behavior for PT who is usually very focused and has no problem getting good grades. We let her get the 2nd vaccine on June 18th. About 10 days later, PT reported feeling like her mind was racing and she could not sleep for 5 nights. She was very anxious and having panic attacks. On July 4th, PT came to us and told us, "the only way to stop the thoughts is to hurt myself." We immediately took PT to the Hospital ER. We have NEVER seen PT like this and she has NEVER had thoughts like this. She was talking to herself, making strange body movements and this frightening behavior came out of nowhere. They kept her overnight and sent her home with referrals to other doctors. She is still having suicidal thoughts and cannot function. We have had to cancel all trips, summer camps and check her out of soccer for the next month. There is no way she is going to be able to go to anything.


VAERS ID: 1463013 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821287 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Decreased appetite, Hyperhidrosis, Nausea, Pain of skin
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Arthritic pains
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210709209

Write-up: SWEATING; STOMACH ACHE; STING ON THE RIGHT SIDE OF FACE; NAUSEA PREVENTED FROM EATING ANYTHING; NAUSEA; This spontaneous report received from a patient concerned a 64 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included aches every day due to history of arthritis.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821287, expiry: UNKNOWN) dose was not reported, administered on 30-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-JUL-2021, the subject experienced sweating. On 01-JUL-2021, the subject experienced stomach ache. On 01-JUL-2021, the subject experienced sting on the right side of face. On 01-JUL-2021, the subject experienced nausea prevented from eating anything. On 01-JUL-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sting on the right side of face on 01-JUL-2021, was recovering from sweating, nausea, and stomach ache, and the outcome of nausea prevented from eating anything was not reported. This report was non-serious.


VAERS ID: 1463032 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Abdominal pain upper, Injection site bruising
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Diabetes; Spider bite
Preexisting Conditions: Medical History/Concurrent Conditions: Liver transplant
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210717625

Write-up: STARTED TO FEEL LIKE SOMEONE IS STANDING ON MY STOMACH IN THE MORNING/HE THOUGHT HE WAS CONSTIPATED/ PAIN THEN STARTED TO MOVE FROM THE LEFT SIDE THEN IN HIS BACK; BLACK AND BLUE AT THE INJECTION SITE; This spontaneous report received from a patient concerned a 71 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included liver transplant, and concurrent conditions included diabetes, and spider bite. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A, expiry: 05-AUG-2021) dose was not reported, administered on 01-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-JUL-2021, the subject experienced black and blue at the injection site. On 06-JUL-2021, the subject experienced started to feel like someone is standing on my stomach in the morning/he thought he was constipated/ pain then started to move from the left side then in his back. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from black and blue at the injection site on JUL-2021, and had not recovered from started to feel like someone is standing on my stomach in the morning/he thought he was constipated/ pain then started to move from the left side then in his back. This report was non-serious.


VAERS ID: 1463342 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-29
Onset:2021-07-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021828873

Write-up: Severe Allergic Reaction; Developed a Severe Rash; Severe Allergic Reaction; Developed a Severe Rash; This is a spontaneous report from a contactable consumer (patient). A 58-year-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection; Lot number: FA6780) via an unspecified route of administration in left arm on 29Jun2021 as dose 2 single for COVID-19 immunization. Patient had no medical history and was not taking any other Products. Concomitant medications of the patient were not reported. Patient previously received historical first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection; Lot number: ER8735) via an unspecified route of administration on 08Jun2021 as dose 1st single for COVID-19 immunization. On 01Jul2021, 48 hours after receiving second dose of vaccination, patient experienced severe allergic reaction; developed a severe rash. Patient received treatment with Antihistamine. Outcome of the event not recovered/not resolved. Follow-up attempts are needed. Further information is expected.


VAERS ID: 1463490 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Ageusia, Nausea, Pain, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: rash, stomach pain, fever, body aches, nausea, loss of taste.


VAERS ID: 1463561 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-01-01
Onset:2021-07-01
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Muscular weakness, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (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: Tetnus
Other Medications: Several, took all for years before vaccination
Current Illness: No
Preexisting Conditions: Hypothyroid, increased BP
Allergies: Tetnus, morphine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pain and muscle weakness in opposite arm from 2nd vaccination until now


VAERS ID: 1463626 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-23
Onset:2021-07-01
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Dizziness, Erythema, Injection site rash, Peripheral swelling, Rash, Rash papular, Rash pruritic
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (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: Venlafaxine Adderal
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: On June 23, my arm was swollen; very red and i could see tiny raised bumps around the injection site and i felt dizzy now and again. When i woke on july 1st i noticed a rash with raised very itchy bumps on my chest, neck and face including my eyelid, and they were extremely itchy. The next few days i continued finding more red itchy bumps my shoulds all around my neck my left arm mostly my wrist, my stomach on the left side and my left thigh. This is a servere very inflamed rash. I am still dizzy and the rashes are huge. Ans my left side stomach just started hurting today


VAERS ID: 1463634 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Cough, Decreased appetite, Dizziness, Headache, Hypotension, Malaise, Nausea, Oropharyngeal pain, Pain, Rhinorrhoea, Vertigo
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Dehydration (broad), Hypokalaemia (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: I was taking an antibiotic for bacterial vaginosis and previous to that I took antibiotic for a bladder infection. I was not taking vitamins
Current Illness: I was just passing some bladder stones and was given antibiotic and than the week I got the vaccine I was taking the other antibiotic for bacteria vaginosis. I took the antibiotic that morning and had the vaccine at 2 pm but than I didn?t want to continue with antibiotic
Preexisting Conditions: No
Allergies: No I am not allergic to any medication
Diagnostic Lab Data: No I didn?t go to see a dr.
CDC Split Type:

Write-up: The following day in the morning, I felt weak and my blood pressure was low, than same day I felt nauseated and felt like my head was spinning inside. It was like that all day. 2nd day I felt nauseated and also my head was like spinning inside and than had a very terrible headache later in the day &I was not hungry. I was just in bed. 3rd day, all my body felt sick, had mild running nose, mild cough, mild soar throat and just felt ache, I felt like that all day and till the 4th day. I started feeling myself in the evening of the 4th day. 5 th & 6th day, I just felt on and of light headed and nauseated. It was the most miserable days I?ve had.


VAERS ID: 1463696 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-28
Onset:2021-07-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure measurement, Blood test, Echocardiogram, Electrocardiogram, Myocarditis, Ultrasound scan
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ibuprofen
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: 7/2/2021 - EKG, Ultra sound, echocardiogram, blood pressure, blood tests, oxygen level 7/3/2021 - EKG, echocardiogram, blood pressure, blood tests, oxygen level 7/2/2021 - EKG, echocardiogram, blood pressure, blood tests, oxygen level 7/2/2021 - EKG, echocardiogram, blood pressure, blood tests, oxygen level 7/2/2021 - EKG, echocardiogram, blood pressure, blood tests, oxygen level
CDC Split Type:

Write-up: PT had myocarditis as a result of the second dose of the vaccine. He spent 5 days at Hospital.


VAERS ID: 1463715 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood bilirubin increased, Dizziness, Dyspnoea, Haematocrit normal, Haemoglobin normal, Headache, Heart rate increased, Pain in extremity, Peripheral swelling, Pyrexia, Rash, Red blood cell count normal, Tinnitus, Vertigo, Vision blurred
SMQs:, Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (narrow), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Breo 200mg Zyrtec-D Flonase
Current Illness: None
Preexisting Conditions: Cerebellar Pilocytic Astrocytoma - Successfully Removed Spontaneous Pneumo Thorax - Successfully repaired Chronic Allergies
Allergies: Levoquin Vicodine Codine
Diagnostic Lab Data: July 7th High RBC - 5.7m Hemoglobin - 17.5 HEMATOCRIT - 50.8 Bilirubin - 2.2mg
CDC Split Type:

Write-up: Rapid Heart Beat Blurry Vision High Fever - Approaching 2 weeks Strong Dizziness/Vertigo Rashes Week long Headaches Hard to breath Ringing in ears Deep ache/pain in leg & arm with leg swelling


VAERS ID: 1463719 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-01-18
Onset:2021-07-01
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Fatigue, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Nauseous, dizzy, tired


VAERS ID: 1463747 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW018S / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram normal, Myocarditis
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Autism
Allergies:
Diagnostic Lab Data: EKG - 7/2/21 - NSR
CDC Split Type:

Write-up: Chest pain, Myocarditis, seen in ED on 7/2/21 (2 days after vaccine) with diagnosis confirmed. no EKG changes, treated with toradol and ibuprofen 600mg TID x 5 days, symptoms resolved by 7/9/21


VAERS ID: 1463924 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (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: Multi-vitamin
Current Illness: none
Preexisting Conditions: none
Allergies: Penicillin, Titanium Dioxide
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bell''s Palsy that lasted for 28 hours


VAERS ID: 1463966 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-31
Onset:2021-07-01
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

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

Write-up: Numbness and tingling of right side arm, hand, leg, foot


VAERS ID: 1463986 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-15
Onset:2021-07-01
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoxia, Pneumonia, Pyelonephritis, SARS-CoV-2 test negative, Sepsis
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID19 Negative test 6/30/21
CDC Split Type:

Write-up: Patient admitted for sepsis/pyelonephritis/pneumonia/hypoxemia. COVID 19 negative.


VAERS ID: 1464003 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-01-11
Onset:2021-07-01
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1253 / 2 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Back pain, COVID-19, Headache, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: na
Current Illness: none known
Preexisting Conditions: none
Allergies: none known
Diagnostic Lab Data: COVID- 19 rapid 7/5 positive COVID-19 PCR 7/6 saliva - positive
CDC Split Type:

Write-up: On July 1 traveling back from another state, developed headache and back ache on 7/3 developed fever 102. + test for COVID-19. Symptoms resolved by Mon 7/5


VAERS ID: 1464026 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-06-01
Onset:2021-07-01
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Neck pain
SMQs:, Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan 50ng, Ibuprofen
Current Illness:
Preexisting Conditions: Hypertension, osteoarthritis
Allergies: Iodine dye
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 2 weeks after vaccination and still continuing, head and neck pain. Running up neck to the back of head all the way to the top of head in the back.


VAERS ID: 1464106 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia, Skin irritation
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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:
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Since getting the vaccine continuous arms/legs falling asleep/numb/pins and needles/feeling like sharp pricks and irritation


VAERS ID: 1464168 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-17
Onset:2021-07-01
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Parosmia, SARS-CoV-2 test negative
SMQs:, Taste and smell disorders (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Plantival (Melissa and Valerian extract) Ginseng Ginkgo Biloba Vitamin C and D
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: On Thursday 8th I consulted with an otolaryngologist, he asked me for a PCR COVID-19 test, which was negative. As a result of the above, he suggested me to contact you and inform of this. As a treatment, he asked me to do olfactory retraining smelling lemon, rose water, cloves and eucalyptus in series, 4 times a day for 2 weeks.
CDC Split Type:

Write-up: From the second week of the vaccination I began to perceive a smell of burning or smoke. It started gradually on Thursday July 1st with low intensity of the odor and few events per day. AS of Sunday July 4 the smell reached its maximum and the events per day were prolonged. On Monday July 5 and Wednesday July 7 the events were similar to that of July 4. On Tuesday 6 and Thursday 8, the intensity of the odor remained but the events decreased. As of Friday the 9th the events have been few (1 to 3 a day) with less odor intensity than past events, and the duration periods have decreased. On Thursday 8th I consulted with an otolaryngologist, he asked me for a PCR COVID 19 test, which was negative. As a result of the above, he suggested me to contact you and inform of this. As a treatment, he asked me to do olfactory retraining smelling lemon, rose water, cloves and eucalyptus in series, 4 times a day for 2 weeks.


VAERS ID: 1464186 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-02-10
Onset:2021-07-01
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Decreased appetite, Dyspnoea, Nasal congestion, Pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), 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), 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: Kenalog (local), Amlodipine, Wixela, Albuterol, Gabapentin, Meloxicam, Spiriva, Duloxetine
Current Illness: None
Preexisting Conditions: ADHD, Osteoarthritis, HTN, Allergic Rhinitis, moderate depression, neuropathy, COPD, bilateral hearing loss, bilateral knee pain
Allergies: Animal hair, Trees
Diagnostic Lab Data: 07/01/21: Positive SARS-COV-2-RNA
CDC Split Type:

Write-up: 07/01/21: cough, fever, runny nose, nasal congestion, shortness of breath, body aches, loss of taste and smell, loss of appetite


VAERS ID: 1464313 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: CSF protein increased, Discomfort, Fibrin D dimer, Gait disturbance, Hypoaesthesia, Immunoglobulin therapy, Impaired driving ability, Laboratory test, Lumbar puncture abnormal, Magnetic resonance imaging head normal, Magnetic resonance imaging neck, Magnetic resonance imaging thoracic normal, Mobility decreased, Muscular weakness, Orthosis user, Paraesthesia, Peripheral swelling, Platelet count normal, Sitting disability, Spinal X-ray, Ultrasound Doppler normal, Walking aid user
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: multivitamin, Vit D, Vit B, MTHF, Neuro-Mag, NAC
Current Illness: none
Preexisting Conditions: none
Allergies: Amoxicillan
Diagnostic Lab Data: June 22: labwork per doctor''s order -- Vit B looked good, platlettes looked good; negative for DIMMER (blood clot) June 24: unable to sit in chair; spending most of the day horizontal on bed or sofa; visited Dr. x-rays on lumbar spine (negative for tumors and cysts); given crutches and ankle brace and prednisone prescription June 24: visited for Doppler on leg (negative for blood clot) June 25: started taking prednisone, which alleviated discomfort/swelling, although leg still numb with limited mobility and circulation and still unable to sit in chair or walk well June 25: visited for MRI of lumbar (negative for pinched nerve and herniated disc) June 29: consultation at Neurology June 30: weakness/tingly in both hands, both feet; right leg getting weaker; not able to drive safely July 1: visited Wake med ER and admitted to hospital July 2: MRIs of brain, cervical, and thoracic spine (all looked good) July 2: lumbar puncture, revealing elevated proteins (77); started IVIG treatment in hospital July 6: finished IVIG treatment; discharged from hospital July 12: awaiting follow-up appts with out-patient PT and Neurology
CDC Split Type:

Write-up: May: tingly/pins-and-needles in hands June: loss of feeling/numbness in left lower leg; quickly followed by acute weakness and loss of feeling/mobility in right leg and both hands and forearms


VAERS ID: 1464445 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-22
Onset:2021-07-01
   Days after vaccination:129
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray normal, Cough, Electrocardiogram, Hyperhidrosis, Night sweats, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant 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? No
Previous Vaccinations:
Other Medications: cetirizine (ZyrTEC) 10 mg tablet irbesartan-hydroCHLOROthiazide (AVALIDE) 150-12.5 mg per tablet
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Updated Procedure 07/08/21 1148 POCT COVID-19 PCR Collected: 07/08/21 1148 | Final result | Specimen: Swab from Nares POC COVID-19 PCR DetectedAbnormal Lot # 1000265155 Point of Care COVID-19 PCR Testing Method Cepheid Lot Expiration Date 05/15/22 Study Result Narrative & Impression XR CHEST 2 VW IMPRESSION: No acute findings or significant interval change. END OF IMPRESSION: INDICATION: Cough. Exposure to Covid. TECHNIQUE: Upright PA and lateral chest COMPARISON: 4/23/2012 FINDINGS: No diffuse or focal airspace disease, pleural effusion or pneumothorax. Heart, mediastinum and bones are within baseline normal limits. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. Result History X-ray chest 2 views on 7/8/2021 - Order Result History Report
CDC Split Type:

Write-up: Office Visit 7/8/2021 Family Medicine COVID-19 virus infection +2 more Dx Covid-19 Screening Reason for Visit Progress Notes (Nurse Practitioner) ? ? Family Medicine ? ? Encounter Date: 7/8/2021 ? ? Addendum Nontoxic 65 y.o. male presenting with viral symptoms for a week with known exposure to COVID-19 household member. Reports periods of diaphoresis without chest pain or palpitations. On exam hemodynamically stable without respiratory distress or hypoxia. Appears well-hydrated with clear breath sounds. Chest x-ray-no acute process. EKG sinus rhythm ventricular rate 75 bpm. No ischemic changes. COVID-19 testing completed. Instructed to quarantine at home according to Department of Health guidelines. Symptomatic treatments reviewed. Red flag symptoms for follow-up reviewed. Addendum: Covid 19 result positive. Patient was contacted with test results. Again encouraged symptomatic management with over-the-counter cough and cold medication, Tylenol or ibuprofen, stay hydrated. Follow-up with PCP for shortness of breath, uncontrolled fever, uncontrolled vomiting. Symptoms began July 6. Last day of isolation is July 16th 2021. Monoclonal antibody infusion discussed with patient but he feels that his symptoms are not severe enough at this point. States he will call back if symptoms worsen. 1. COVID-19 virus infection 2. Night sweat 3. Cough Patient was seen today for covid-19 screening. Diagnoses and all orders for this visit: COVID-19 virus infection - X-ray chest 2 views; Future - POCT COVID-19 PCR Night sweat - ECG 12-lead: URGENT CARE - POCT COVID-19 PCR Cough - X-ray chest 2 views; Future - POCT COVID-19 PCR


VAERS ID: 1464519 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-08
Onset:2021-07-01
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: none
Allergies: No known allergies
Diagnostic Lab Data: Multiple lab tests completed at hospital on 7/2. He also had chest x-ray, echocardiogram and ECG.
CDC Split Type:

Write-up: This patient had his first mRNA vaccines when he was under 12 years old from a pharmacy outside of hospital. . He had his second mRNA vaccine on 6/30/21 also from an outside pharmacy. He had post-vaccine myocarditis and was treated at hospital.


VAERS ID: 1464530 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 122128 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Heavy menstrual bleeding, Pelvic pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Arthritis (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 the first day of my menstrual cycle. About two hours after getting the shot, I experienced excessive bleeding for the next seven hours. For four of those hours I bled through a Tampon every half hour. In addition, to the bleeding, there was a lot of lower back pain, pain in the hips and general pelvic region.


VAERS ID: 1464710 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose normal, Cold sweat, Dizziness, Hyperhidrosis, Pallor, Retching
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BG 116
CDC Split Type:

Write-up: Pt received his Covid vaccine and as was scheduling his second dose, pt stated he started to feel dizzy. patient was reclined and gavin juice and called for assistance from the LVN . Pt was pale, clammy/sweaty, and dry heaving.; call for Rapid Response. They were in the pt''s room within the minute and proceeded to take vitals and treated the pt with a bag of IV fluid while having the pt be observed by an RN for an additional amount of time. After the nurse observed the pt walking on his own, she gave pt permission to leave. Patient was discharged 1601 after receiving a liter of NS IV.


VAERS ID: 1464748 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-08
Onset:2021-07-01
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow)

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: I took 20mg Simvastatin taken daily for high cholesterol.
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Not applicable
CDC Split Type: vsafe

Write-up: I experienced high blood pressure reading and made an appointment with my doctor one week later because it continued to be extremely high. He stated that my blood pressure swings erratically often and that he was not concerned because of my age and the foods, caffeine, and alcohol could have attributed to the elevation in blood pressure. He also asked me to continue tracking it and to contact him if I experienced any headaches, light headedness or if my blood pressure became too erratically high again.


VAERS ID: 1464804 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-12
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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: Unknown
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: About 5 minutes after receiving the vaccination patient fainted and was unconscious for about a minute. Patient''s eyes remained open even though he was not conscious. Patient was transported by paramedic to the emergency room


VAERS ID: 1464839 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-15
Onset:2021-07-01
   Days after vaccination:47
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Amenorrhoea
SMQs:, Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, topimax, wellbutrin , fish oil, vitamin d, probiotic
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Missed period, period stopped. Pregnancy tests all negative. Have had 28 day cycle of 3-5 days until now.


VAERS ID: 1465351 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-14
Onset:2021-07-01
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Lethargy, Neuralgia
SMQs:, Peripheral neuropathy (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Promethazine, Protonix, Lexapro, Klonopin, Flexiril, Dycyclomine
Current Illness: Gallbladder Sludge, Cysts on Liver
Preexisting Conditions: Back pain, depression, anxiety
Allergies: Levoquin, Ceftin
Diagnostic Lab Data: CT scan - 7/12/2021 Blood work- 7/12/2021
CDC Split Type:

Write-up: I?ve had extreme lethargy and most recently excruciating nerve pain for over two weeks.


VAERS ID: 1465379 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-15
Onset:2021-07-01
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroxine 75ug, Vitamin B Complex
Current Illness:
Preexisting Conditions: Hypothyroid
Allergies: Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA Moderate case of shingles, left flank. Vesicular rash appeared July 1, visited urgent care to confirm and was treated with antivirals.


VAERS ID: 1465594 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-01
Onset:2021-07-01
   Days after vaccination:91
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Computerised tomogram, Hypoaesthesia, Magnetic resonance imaging, Neurological symptom, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Propanolol,
Current Illness: none
Preexisting Conditions: treated for high blood pressure
Allergies: none
Diagnostic Lab Data: Initial concern was symptoms due to stroke. three days hospitalization, and multiple tests showed no evidence of stroke, MRI, Multiple CT scans, but Guillian-Barre was never mentioned. Still not confirmed.
CDC Split Type:

Write-up: Severe symptoms of Guillain-Barre syndrome. Began July 1. Admitted to hospital July 2, Numbness on left side began as tingling in both legs. Outcome still in doubt this is ongoing.


VAERS ID: 1465599 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-09
Onset:2021-07-01
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site abscess
SMQs:

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

Write-up: Patient reported an abscess at the injection site occurring one month after his second dose. Patient reported having to go to the hospital to have it drained and is currently on antibiotics for it.


VAERS ID: 1465669 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Headache, Heart rate, Heart rate increased, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202107; Test Name: Body temperature; Result Unstructured Data: not reported; Test Date: 202107; Test Name: Heart rate; Result Unstructured Data: rapid
CDC Split Type: USJNJFOC20210713243

Write-up: RAPID HEARTBEAT; SORE ARM; HEADACHE; FEVER; This spontaneous report received from a patient concerned a 20 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 203A21A expiry: UNKNOWN) dose was not reported, administered on 02-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On JUL-2021, the subject experienced rapid heartbeat. On JUL-2021, the subject experienced sore arm. On JUL-2021, the subject experienced headache. On JUL-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) not reported, and Heart rate (NR: not provided) rapid. Treatment medications (dates unspecified) included: acetylsalicylic acid. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from rapid heartbeat, headache, and fever on JUL-2021, and had not recovered from sore arm. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure as the case assessed as non-serious.


VAERS ID: 1465672 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210716868

Write-up: VACCINE ADMINISTERED TO TWO PATIENTS WAS AT ROOM TEMPERATURE FOR FOUR HOURS; INCORRECT PRODUCT STORAGE; This spontaneous report received from a health care professional concerned multiple patients. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and expiry: 04-AUG-2021) dose was not reported, administered on 01-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-JUL-2021, the subject experienced vaccine administered to two subjects was at room temperature for four hours. On 01-JUL-2021, the subject experienced incorrect product storage. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vaccine administered to two patients was at room temperature for four hours and incorrect product storage was not reported. This report was non-serious.


VAERS ID: 1466453 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-07-13
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002B21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, CSF protein increased, Condition aggravated, Demyelination, Electromyogram abnormal, Gait disturbance, Guillain-Barre syndrome, Hypoaesthesia, Immediate post-injection reaction, Immunoglobulin therapy, Limb discomfort, Lumbar puncture abnormal, Nerve conduction studies abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Optic nerve disorders (broad), Demyelination (narrow), Hypersensitivity (narrow), Hypoglycaemia (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? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Simvasatin Levothyroxin Losartan
Current Illness: None. Was totally well before and immediately after vaccination. Guillian Barre began suddenly in early April.
Preexisting Conditions: High blood pressure (treated)
Allergies: None.
Diagnostic Lab Data: EMG Nerve Conduction Study Lumbar Puncture Full range of blood tests
CDC Split Type:

Write-up: Immediately after injection, my arm was numb for more than 15 minutes. I waited 30 minutes before leaving. After that, all seemed good. In early April, my legs seemed heavy for a day. The next morning, I would barely walk. After visiting an orthopedic surgeon, I was sent to have an EMG and nerve conduction study which showed demylinatization in my legs and somewhat in my arms, especially my right arm. I visited a neurologist who completed extensive blood work and a lumbar puncture. The EMG, nerve conduction study, and very elevated protein in my spinal fluid confirmed Guillian Barre. I had to undergo IVIG treatments, which helped. I continue to suffer from effects today (July 2021), but am now able to walk better. I support the vaccine still. It appears to be saving millions. I just "hate" that I was adversely impacted by the vaccine personally.


VAERS ID: 1466515 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-21
Onset:2021-07-01
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Chest pain


VAERS ID: 1466662 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-06-23
Onset:2021-07-01
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: I have been very fatigued since getting the shot. Far more than normal and it has been over 3 weeks.


VAERS ID: 1466781 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-30
Onset:2021-07-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Pt states she has burning in her chest substernal about 24 hrs after getting the vaccine. Pt states the pain was about 7/10 and subsides about an hour or so later. Pt denies sob, radiating pain, n/v, fever, chills, GI upset, vision change, skin reaction, h/a, acid taste in mouth. Pt says she has been fine ever since without any residual symptoms. Symptoms: CHEST PAIN, UNSPECIFIED(R079).


VAERS ID: 1466824 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-29
Onset:2021-07-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lasix 40 mg, Losartan 25mg, Wellbutrin 300mg
Current Illness: poison ivy rash on right wrist
Preexisting Conditions: Stage 3 Renal Dx
Allergies: PNC, Erythromycin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Itchy rash started by July 1 on inside elbow of right arm. Then surfaced on left arm and right groin area. There is a small patch on her back and between her breast. Ice packs help with itching. Seen in UC and at primary care. Taken Hydroxyzine 25mg and Methyprednisone 4 mg. Zanfel ointment - no help. Oatmeal baths - help some. Benadryl cream makes it worse.


VAERS ID: 1467195 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-01
Onset:2021-07-01
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 5521 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Problems with breathing


VAERS ID: 1467237 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-29
Onset:2021-07-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Aphthous ulcer, Candida test negative, Genital discolouration, Genital discomfort, Genital rash, Sexually transmitted disease test, Urinary tract infection, Urine analysis abnormal, Vulval disorder, Vulvovaginal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: none
Preexisting Conditions: none
Allergies: Sensitivity to omnicef antibiotics
Diagnostic Lab Data: UTI and yeast infection test. 7/1 - positive for UTI, negative for yeast 7/5 STD test - negative on all STDs.
CDC Split Type:

Write-up: She woke up in pain around 6am thinking maybe she had scratched her Labia major. She went back to bed. Throughout the day the pain and discomfort grew. Around 5pm she told me that she was hurting a lot and she needed help. I examined her and it looked like a bruise about the size of a dime but long. I asked if she fell or hurt herself, no. I called the pediatrician and informed them and they suggested seeing them the following day. Took her to the ER later that night due to significant pain. They thought she might have yeast infection or herpes. Gave her some antibiotics and sent her home her pain level was a 7 and she now looked like she chemical burn. The next day I took her to pediatrician. She felt like it could be herpes or something else. Prescribed different meds and sent us home. Nothing for pain. The antibiotics worked a little, but by Monday everything was horrible. She was covered in sores from the labia major to her vulva. Took her to ER where they felt like it was herpes. She was asked about her sexual experience or being molested. They immediately admitted her to the hospital where we stayed for 4 days. With antibiotics, steroids and pain meds. She saw her Gynecologist Tuesday morning where she determined PT was suffering from aphthous ulcers, a side effect that she was aware of from the covid19 vaccine.


VAERS ID: 1467277 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-10
Onset:2021-07-01
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Arthralgia, Blood test, Ear congestion, Ear pain, Fatigue, Feeling abnormal, Feeling cold, Headache, Hyperhidrosis, Influenza like illness, Lymph node pain, Lymphadenopathy, Malaise, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lysine pro; Lantus insulin; Glimepiride; Lexapro; Wellbutrin; Vitamin C; Goli Apple Cider Vinegar gummy supplements
Current Illness: None
Preexisting Conditions: Diabetic; Blood Pressure; Hypertension; PTSD
Allergies: Sulfa; Penicillin; Gluten
Diagnostic Lab Data: Standard blood panel 07/06/2021. Standard blood panel 07/12/2021.
CDC Split Type: vsafe

Write-up: So, I had flue like symptoms chills, body, sweats, join, paint, headaches, nausea and fatigue like crazy. Like feeling overall awful and that was the start as soon as I got it within the next 48 hours. The issue I''ve had since then that sent me to the UC was that I felt like I had a left ear infection. My left ear hurt which was on the same side that I had my shot on. Throbbing and painful and clogged left ear. I felt like I had an ear infection. A few days after that I found right behind my ear, I had a big swelling lymph node and that was before 07/01 and it is still there. I also have a large lymph node under my left armpit. They''ve swollen and they''re painful and that''s ultimately why I went in because I was feeling sick with a lot of fatigue and not feeling good. Because of the ear and lymph nodes behind the ear I wanted to make sure nothing was wrong. When I went to the UC I let them know that I didn''t know if it was because of the vaccine. They tested and said I had some kind of infection and they put me on Augmentin it was a 10-day dose twice a day and that''s what I began to become allergic to since I was prescribed that. I''ve had every side effect from Augmentin that you can have. I''ve had extreme diarrhea, bloating, stomach cramps, joint pains, nausea, lack of appetite and lack of sleep. As of yesterday, the doctor said, "oh yeah you''re having reaction to that", and she switched me to Keflex 4 times a day for 10 days. Six days after my follow, my white blood cell count actually went up. Even though I was on antibiotics my infection increased instead of getting better.


VAERS ID: 1467321 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Wrong 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: pt is not currently on any medications
Current Illness: URI Symptoms
Preexisting Conditions:
Allergies: Non listed
Diagnostic Lab Data:
CDC Split Type:

Write-up: The pt was supposed to receive dexamethasone, however was administered Moderna in error.


VAERS ID: 1468358 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-06
Onset:2021-07-01
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH CVS 03569 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Antinuclear antibody negative, Arthralgia, C-reactive protein normal, Fatigue, Hypoaesthesia, Inflammation, Musculoskeletal pain, Paraesthesia, Rheumatoid factor negative, Tryptase
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamictal, luvox, Lisinopril
Current Illness: None
Preexisting Conditions: Hypertension and depression
Allergies: Bactrim
Diagnostic Lab Data: Labwork for ANA, RF, CRP and tryptase done and WNL. Started on prednisone to calm inflammatory process but still with butt tingling and numbness and joint pain.
CDC Split Type:

Write-up: I began allergy shots for fire ants and on the second shot, I started developing rare tingling and numbness in the buttocks and severe musculoskeletal pain as well as extreme fatigue. Allergist said they have never seen this. Could Covid Vaccine make immune system overrespond to antigens?


VAERS ID: 1468973 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oropharyngeal pain, Tonsillar hypertrophy
SMQs:, 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: Allergies
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Sore throat and englarged tonsils both sides. Feels like strep.


VAERS ID: 1469617 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Chronic obstructive pulmonary disease
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210715832

Write-up: NOT BEING ABLE TO BREATH; RIGHT LEG AND FOOT VERY SWOLLEN; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. The patient''s concurrent conditions included chronic obstructive pulmonary disease. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose was not reported, administered on 05-JUL-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On JUL-2021, the subject experienced not being able to breath. On JUL-2021, the subject experienced right leg and foot very swollen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from not being able to breath, and right leg and foot very swollen. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard operating procedure as the case is assessed as Non-serious.


VAERS ID: 1469627 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210722862

Write-up: ONE DOSE WAS INADVERTENTLY ADMINISTERED THIS MORNING FROM PUNCTURED VIAL THAT WAS LEFT IN REFRIGERATOR YESTERDAY; THE VIAL WAS LEFT IN THE FRIDGE PUNCTURED FOR AROUND 12 HOURS; This spontaneous report received from a pharmacist concerned a 30 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821286 expiry: 06-SEP-2021) dose was not reported, administered on 09-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On JUL-2021, the subject experienced the vial was left in the fridge punctured for around 12 hours. On 09-JUL-2021, the subject experienced one dose was inadvertently administered this morning from punctured vial that was left in refrigerator yesterday. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the the vial was left in the fridge punctured for around 12 hours and one dose was inadvertently administered this morning from punctured vial that was left in refrigerator yesterday was not reported. This report was non-serious.


VAERS ID: 1469629 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Pain, Poor quality sleep, Venous injury
SMQs:, Accidents and injuries (narrow), Depression (excl suicide and self injury) (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: Comments: The patient was healthy and had no previous conditions.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210722944

Write-up: SAFENA VEIN DAMAGED; CONSTANT PAIN; VERY LITTLE SLEEP FOR FEW DAYS; This spontaneous report received from a patient concerned a 39 year old female. The patient''s height, and weight were not reported. The patient was healthy and had no previous conditions. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported, expiry: UNKNOWN) dose was not reported, 1 total administered on 10-JUL-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 10-JUL-2021 immediately after vaccination, the patient felt pain in the left leg and her veins began to feel inflamed, the inflammation began to show in the foot and developed upwards. On an unspecified date in JUL-2021, the patient experienced constant pain and very little sleep for few days until then the patient visited the physician''s office and was told that the patient had her safena vein damaged for which she had to undergo unspecified treatment and potentially surgery. The patient reported that her leg was just fine prior to the vaccine and that the treatment would last for 3 months. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the very little sleep for few days, safena vein damaged and constant pain was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0:20210722944-JANSSEN COVID-19 VACCINE Ad26.COV2.S- venous injury-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: 1469651 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Contusion, Diarrhoea, Dyspepsia, Fatigue, Headache, Oedema peripheral
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Gastrointestinal disorder
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210725253

Write-up: STOMACH PAIN; DIARRHEA; BURNING FEELING IN STOMACH; HEADACHE; FATIGUE; MILD REDDISH BRUISE ON RIGHT HAND; RIGHT CALF A LITTLE SWOLLEN VERY MINUTE; This spontaneous report received from a patient concerned a 31 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included previous gastric issues. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821288, and expiry: UNKNOWN) dose was not reported, administered on 05-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On JUL-2021, the subject experienced right calf a little swollen very minute. On 06-JUL-2021, the subject experienced mild reddish bruise on right hand. On 06-JUL-2021, the subject experienced fatigue. On 07-JUL-2021, the subject experienced stomach pain. On 07-JUL-2021, the subject experienced diarrhea. On 07-JUL-2021, the subject experienced burning feeling in stomach. On 07-JUL-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from mild reddish bruise on right hand, and fatigue, and had not recovered from right calf a little swollen very minute, stomach pain, diarrhea, burning feeling in stomach, and headache. This report was non-serious.


VAERS ID: 1469658 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use; Non-smoker
Preexisting Conditions: Comments: The patient had no known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210725476

Write-up: NUMBNESS IN THE ARMS AND LEGS; TINGLING OF LEFT ARM; This spontaneous report received from a patient concerned a 36 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included alcohol use, and non-smoker, and other pre-existing medical conditions included the patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808982 expiry: 07-AUG-2021) dose was not reported, administered on 06-JUL-2021 15:15 for prophylactic vaccination. No concomitant medications were reported. On JUL-2021, the subject experienced tingling of left arm. On 06-JUL-2021, the subject experienced numbness in the arms and legs. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from numbness in the arms and legs, and the outcome of tingling of left arm was not reported. This report was non-serious.


VAERS ID: 1470213 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-03-11
Onset:2021-07-01
   Days after vaccination:112
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Musculoskeletal stiffness, Neck pain, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Rx: lisinopril/hctz tabs 10/12/.5 1 p/day ; atenolol 50 mg 1 p/day ; simvistatin 40 mg 1 p/day; folic acid 1 mg 1 p/day; sulfasalazine 500mg 4 p/day. otc: calcium+D ; multivitamin; turmeric ; fish oil; D3 1000mg; probiotoc ( all are 1 p/da
Current Illness: No
Preexisting Conditions: High Blood pressure High cholesterol Psoriatic Arthritis
Allergies: Tylenol and Keflex
Diagnostic Lab Data: None so far. Have been seeing chiropractor almost every day since July 14 for what I thought was vertabrae out of whack. So far minimul relief. Went to Urgent Care July 10 for prescription anti-inflammatory and muscle relaxer.
CDC Split Type:

Write-up: Began with rash on torso that still keeps spreading to more spots. Within 2-3 days of rash beginning, started with a stiff neck. Within 24 hours stiff neck became extremely painful. Swelling of neck on right side.


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