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

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



Case Details (Reverse Sorted by Onset Date)

This is page 71 out of 8,010

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VAERS ID: 1753901 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Groin pain, Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Osteonecrosis (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: Baby aspirin
Current Illness: None
Preexisting Conditions: None
Allergies: Aleve, milk
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injection sight soreness, all over body aches. Groin pain


VAERS ID: 1753903 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA NONE / N/A RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Injection site erythema, Injection site pain, Injection site swelling, Lethargy, Nausea, Pain, Pyrexia, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Systemic: Body Aches Generalized-Mild, Systemic: Exhaustion / Lethargy-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Fever-Mild, Systemic: Headache-Medium, Systemic: Joint Pain-Mild, Systemic: Nausea-Mild, Additional Details: ***report is for flu shot, not covid*** forced me to select covid info


VAERS ID: 1753947 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Arthralgia, Cardioactive drug level, Chest X-ray, Chest pain, Chills, Diarrhoea, Differential white blood cell count, Dyspnoea, Electrocardiogram, Fatigue, Fibrin D dimer, Full blood count, Headache, Injected limb mobility decreased, Injection site pain, Loss of personal independence in daily activities, Metabolic function test, Musculoskeletal stiffness, Myalgia, Nasal congestion, Nausea, Neck pain, Pain in extremity, Palpitations, Paranasal sinus discomfort, Prothrombin level, Prothrombin time, Pyrexia, Rhinorrhoea, Sneezing, Troponin T
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Pseudomembranous colitis (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pregabalin 100 mg/day Vitamin D
Current Illness: None
Preexisting Conditions: Recently diagnosed with asthma post-Covid 19 positive diagnosis in December 2020 & March 2021
Allergies: Budesonide Montelukast Symbicort
Diagnostic Lab Data: See above
CDC Split Type:

Write-up: Pounding, racing heartbeat; sharp chest pain in center and slightly left of sternum; severe pain radiating/throbbing from injection site all the way down my left arm and up my left neck which has significantly limited movement of neck, shoulder and left arm; severe headache beginning the night of the injection up until now (time of reporting it is still occurring); extreme fatigue (same timeline as headache) to the point I can?t perform daily functions; sinus pressure w/stuffy nose and runny nose; sneezing; shortness of breath; slight nausea and diarrhea; joint pain, especially in cervical spine; muscle aches; chills; fever. Adviser by doctor to visit local ER where CBC with diff, comprehensive metabolic panel, d dimer quantitative, digoxin, ekg ed, pt ptt group, troponin t hs, and xr chest 1 view were all performed, subsequently discharged and medically advised to follow up with my physician for reaction to Moderna COVID-19 vaccination. At home, I have been taking prescribed 325 mg acetaminophen (2 tablets as needed for pain) but it has only been minimally helpful in decreasing pain, I have also taken OTC pseudoephedrine hydrochloride (one tablet 120 mg) to decrease sinus pressure and it was helpful in doing so, I also take a prescription (previously prescribed for a separate condition) pregabalin 50 mg twice per day for pain and it has been minimally helpful.


VAERS ID: 1753950 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-11
Onset:2021-09-29
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003A20A / 2 RA / IM

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

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

Write-up: Tested positive for COVID 19 09/29/2021


VAERS ID: 1753953 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chills, Decreased appetite, Headache, Nausea, Pain in extremity, Pyrexia, SARS-CoV-2 antibody test positive
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CLOBETASOL PROPIONATE CREAM; LOSARTAN POTASSIUM
Current Illness: None
Preexisting Conditions: Low to moderate high blood pressure
Allergies: None
Diagnostic Lab Data: I contacted my PCP and was told to take OTC acetaminophen and Advil. The side effects of the vaccine affected me worse than when I actually had covid. Prior to getting the 1st dose of the Pfizer vaccine I had been tested 3 times for covid IGG antibodies. The most recent test for antibodies was the day of getting the 1st dose of the Pfizer vaccine. All 3 tests said I was positive for covid IGG antibodies.
CDC Split Type:

Write-up: Starting at 3:00AM on Sept 29 I began to have SEVERE lower back pain, chills, nausea, headache, fever, loss of appetite for 3 days, and severe left arm pain.


VAERS ID: 1754012 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-09-23
Onset:2021-09-29
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PAA165969 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Cardiac pacemaker insertion, Chest X-ray, Chills, Dyspnoea, Palpitations, Panic attack, Ventricular extrasystoles
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamins, Zinc, Fish Oil. Ambien as needed for sleep.
Current Illness: None
Preexisting Conditions: None
Allergies: Mushrooms, shellfish, some antibiotics like Avelox
Diagnostic Lab Data: All performed on 9-29-21, blood work, chest xray
CDC Split Type:

Write-up: Heart pain, trouble breathing, chills, heart palpitations, panic attack, additional heartbeats


VAERS ID: 1754042 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO171 / 3 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Feeling abnormal, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Elioqis, diamipsan, synthroid
Current Illness: Afib, chronic kidney disease, Pulmonary Hypertention
Preexisting Conditions: See above list
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Several hours after injection I spiked a fever of 100.9. All joints and muscles ached. Felt awful!


VAERS ID: 1754045 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Impaired work ability, Rash, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: RASH ON FEET AND HANDS, WENT TO URGERNT CARE AND THEY DIDN''T DO ANYTHING. HAND TREMORS, HAVING A HARD TIME DOING MY WORK WITHOUT MY HANDS SHAKING.


VAERS ID: 1754061 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / N/A AR / IM

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

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

Write-up: Vaccine affected by temperature excursion administered to the patient


VAERS ID: 1754094 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / N/A AR / IM

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

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

Write-up: Vaccine affected by temperature excursion administered to the patient


VAERS ID: 1754095 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 2 AR / IM

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

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

Write-up: Vaccine affected by temperature excursion administered to the patient.


VAERS ID: 1754096 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 2 AR / IM

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

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

Write-up: Vaccine affected by temperature excursion administered to the patient


VAERS ID: 1754102 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / N/A AR / IM

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

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

Write-up: Vaccine affected by temperature excursion administered to the patient


VAERS ID: 1754108 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / N/A AR / IM

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

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

Write-up: Vaccine affected by temperature excursion administered to the patient


VAERS ID: 1754109 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / N/A AR / IM

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

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

Write-up: Vaccine affected by temperature excursion administered to the patient


VAERS ID: 1754121 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / N/A AR / IM

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

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

Write-up: Vaccine affected by temperature excursion administered to the patient.


VAERS ID: 1754142 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / N/A AR / IM

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

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

Write-up: Vaccine affected by temperature excursion administered to the patient


VAERS ID: 1754144 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2020-12-22
Onset:2021-09-29
   Days after vaccination:281
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Patient fully vaccinated, tested positive 9/29/21


VAERS ID: 1754145 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / N/A AR / IM

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

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

Write-up: Vaccine affected by temperature excursion administered to the patient


VAERS ID: 1754157 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Ear pain, Headache, Hypoaesthesia, Injection site pain, Injection site swelling, Lymphadenopathy, Malaise, Neck pain, Pain in extremity, Palpitations
SMQs:, Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Patient reports received Moderna covid vaccination #1 in RT arm a Clinic on 9/29/21, reports RT arm and RT neck pain day 9/29. Reports 9/30 and 10/1 symptoms include headache; RT upper arm injection site pain and swelling; RT neck and ear pain; numbness Rt face and from RT upper arm to RT hand; swollen lymph nodes RT side of neck; not feeling well. EE reports palpitations and anxiety secondary to symptoms. EE denies difficulty breathing, speaking, or swallowing. EE advised to seek medical care and notify clinic. outcome pending


VAERS ID: 1754213 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Epistaxis, Fall, Head injury, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: "NO PMH, Allergies, or medications on file. 8mins post vaccination, pt experienced a syncopal event. Pt fell from his chair and hit his head. Pt also had a nosebleed. ED Called immediately. Vitals: BP 108/70, HR 72, RR 18, O2 Sat 99% -- $g 111/72, 80,18. Pt transported to the ED. No ED information available to this writer."


VAERS ID: 1754214 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Malaise, Body Aches, Temp 100.3. Headache


VAERS ID: 1754223 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Aspirin, levothyroxine, clopidogrel, atorvastatin, Amlodipine besylate, humalog, lantus, furosemide, metoprolol, anastrozole, losartan, Prednisone, mycophenolate
Current Illness: None
Preexisting Conditions: Diabetes, hypertension, breast cancer, rpf, hyperlipidemia, hypothyroidism,
Allergies: Latex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Nausea, body pain, tiredness


VAERS ID: 1754231 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Pain
SMQs:

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

Write-up: Chills and body aches


VAERS ID: 1754235 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (broad)

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

Write-up: I ask what vaccine he was receiving Pfizer, and he said yes. Then I proceeded to give him Pfizer vaccine. It was later that he came back to complain that he had received Moderna vaccine for his first dose. He was monitored for 30 minutes and there was no adverse reaction noted.


VAERS ID: 1754245 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 2 AR / IM

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

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

Write-up: Vaccine affected by temperature excursion administered to the patient.


VAERS ID: 1754247 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821821 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: Asthma
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: heavy menstrual clotting reported. Advised to seek care with Primary Care Provider


VAERS ID: 1754248 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / N/A AR / IM

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

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

Write-up: Vaccine affected by temperature excursion administered to the patient.


VAERS ID: 1754252 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 2 AR / IM

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

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

Write-up: Vaccine affected by temperature excursion administered to the patient.


VAERS ID: 1754259 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Flushing, Hyperhidrosis, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: "No PMH, Allergies, or medications on file. 9mins post vaccination pt c/o flushing/sweating, dizziness/lightheadedness, clammy skin. Pt was notably pale. Vitals: @10:39 BP 95/57, HR 55, RR 18, O2Sat 96% -- $g @10:45 107/60, 54, 18, 100% (0 symptoms reported) -- $g @10:54 107/57, 56, 99% Pt given water, juice and crackers. Pt reportes relief of adverse symptoms and states he is feeling better. Pt reports prior anxiety w/ needle sticks. Pt did not eat before vaccination and was feeling anxious before vaccination. @10:54 pt denies any symptoms. Educated pt on prevention of vasovagal symptoms in the future @10:57 Pt ambulates independently, gait steady. Pt stable and released from the vaccination site. Pt left accompanied by friend."


VAERS ID: 1754261 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / N/A AR / IM

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

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

Write-up: Vaccine affected by temperature excursion administered to the patient


VAERS ID: 1754279 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 2 AR / IM

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

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

Write-up: Vaccine affected by temperature excursion administered to the patient.


VAERS ID: 1754280 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 2 AR / IM

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

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

Write-up: Vaccine affected by temperature excursion administered to the patient


VAERS ID: 1754298 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Hypoaesthesia oral, Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Upon receiving dose 1 of the COVID-19 Pfizer vaccine, patient shortly afterwards began to c/o of numbness to the mouth and having a scratchy throat. A Person In Distress was called overhead, where staff and the physician on-duty wheeled the patient into a treatment room. After an IV line was secured, patient was given 25 mg Benadryl IVP, 500 mL of NS, along with receiving an Epi pen 0.3 IM. Patient responded well, and was ultimately transported by Paramedics to the ED for further evaluation.


VAERS ID: 1754340 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Work       Purchased by: ?
Symptoms: Chest pain, Dizziness, Dyspnoea, Feeling cold, Hypoaesthesia, Pallor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Sexual dysfunction (broad)

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

Write-up: Client reports he got his 2nd dose of Pfizer vaccine on 09/29/2021 approximately 1600. He started having chest pain, lightheadedness, and shortness of breath around 2230 while at work. Client reports he felt that he couldn''t breathe well so he put his arms above his head but he then had numbness in both arms. Client reports informed him he was very pale. Client left work due to symptoms. Client reports he isn''t currently experiencing these symptoms while at rest, but they occurred when he is being active at work. Client reports he woke up really cold today. Strongly recommended for client to be evaluated by a physician regarding these symptoms.


VAERS ID: 1754506 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE QUADRIVALENT) / SANOFI PASTEUR - / 1 RA / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS - / 1 LA / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 LA / IM
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. - / 1 RA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / 1 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 LA / SC
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR - / 1 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 1 RA / SC

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

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

Write-up: Youth presented with Hives on both arms on the vaccinated area with warmth to touch.


VAERS ID: 1754757 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-11
Onset:2021-09-29
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Headache, Oropharyngeal pain, Pyrexia, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol; Aspirin; Multivitamins; Estrace; Alendronate
Current Illness: none
Preexisting Conditions: osteoporosis; tobacco abuse, meniere''s; polyarthritis; pulmonary nodules; lipid disorder
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 100.5, fever, cough, sneezing, headache, sore throat. Starting 9/29/21.


VAERS ID: 1754957 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chills, Decreased appetite, Diarrhoea, Fatigue, Headache, Myalgia, Nausea, Palpitations, Paraesthesia oral, Pyrexia, Stomatitis, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Hives, after receiving MMR as a child.
Other Medications: Lasik Pristique Beta blocker Aspirin Vit. D Zinc
Current Illness: None
Preexisting Conditions: Congenital heart disease Diastolic heart failure
Allergies: Sulfa drugs Iv contrast dye
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Chills, fever, joint pain, severe muscle aches, headache, Shaking, fatigue, pounding heart, tongue tingling, roof of mouth very hot, diarrhea, small amount of nausea, Diminished appetite.


VAERS ID: 1755126 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Fatigue, Headache, Nausea, Respiratory tract congestion, SARS-CoV-2 test negative
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Had mild side effects x 1 day after second COVID vaccine.
Other Medications: Wellbutrin, Prilosec, Bentyl
Current Illness: None
Preexisting Conditions: IBS, GERD
Allergies: None
Diagnostic Lab Data: Rapid Covid test on 9-29-21 was negative.
CDC Split Type:

Write-up: Severe weakness, persistent headache, nausea, joint pain, congestion, tiredness lasting almost 3 days.


VAERS ID: 1755609 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA MODERNA 014E21A / 2 RA / SYR

Administered by: Unknown       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? 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: 18 hrs after vaccination i had severe shortness of breath Condition lasts for about 2 hrs 30 mints.


VAERS ID: 1755613 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / SYR

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

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

Write-up: Severe rash/hives lasting 2 days as of thisreporting


VAERS ID: 1755736 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-09-29
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210959620

Write-up: ADMINISTRATION OF AN EXPIRED VACCINE; This spontaneous report received from a health care professional concerned a 56 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: 206A21A, and expiry: 21-SEP-2021) dose was not reported, administered on 29-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 29-SEP-2021, the patient experienced administration of an expired vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of administration of an expired vaccine was not reported. This report was non-serious. This case, from the same reporter is linked to 20210959581, 20210959351, 20210958321, 20210958348, 20210958371, 20210958425, 20210958518, 20210958525, 20210958566, 20210958806, 20210958977, 20210958993 and 20210959909.


VAERS ID: 1755738 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-09-29
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Ear pain, Nasal congestion, Oropharyngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Test Date: 20210929; Test Name: Body temperature; Result Unstructured Data: 100.8 F; Test Date: 20210929; Test Name: Body temperature; Result Unstructured Data: 103.6 F
CDC Split Type: USJNJFOC20210959969

Write-up: STUFFED NOSE; SORE THROAT; LEFT EAR ACHE; FEVER OF 103.6 F; This spontaneous report received from a parent concerned an 18 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, intramuscular, batch number: Unknown) dose was not reported, administered on 29-SEP-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 29-SEP-2021, the patient experienced stuffed nose. On 29-SEP-2021, the patient experienced sore throat. On 29-SEP-2021, the patient experienced left ear ache. On 29-SEP-2021, the patient experienced fever of 103.6 f. Laboratory data included: Body temperature (NR: not provided) 103.6 F, 100.8 F. Treatment medications included: dextromethorphan hydrobromide/doxylamine succinate/ephedrine sulfate/ethanol/paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from fever of 103.6 f, and had not recovered from stuffed nose, sore throat, and left ear ache. This report was non-serious.


VAERS ID: 1756475 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 80777-0273-15 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chest pain, Chills, Fatigue, Headache, Insomnia, Lymphadenopathy, Myalgia, Pain, Productive cough, Pulmonary congestion, Pyrexia, Visual impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

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

Write-up: Swollen lymph nodes, severe headache, body aches, muscle and joint pain, severe cough with mucus and chest pain when coughing, chest congestion, fever, trouble sleeping, vision changes, chills, weak and tired


VAERS ID: 1756558 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F47485 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Chills, Headache, Nausea, Oropharyngeal pain, Pain, Pain in extremity, Pyrexia, Rhinorrhoea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 1st vac Pfizer. 9/1/21. Similar reactions.
Other Medications: No prescription drugs. But multi-Vitamin supplements.
Current Illness: Contracted the COVID virus four weeks prior to my second shot.
Preexisting Conditions: None.
Allergies: Sensitive to antibiotics.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Low grade fever, chills, headache , body aches, nausea, sore throat. Runny nose, left arm pain. Abdominal pain.


VAERS ID: 1756712 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Burning sensation, Chills, Confusional state, Decreased appetite, Headache, Mobility decreased, Nausea, Oropharyngeal pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Paxil, Ativan, Wellbutrin, Neurontin, Ambien, Relafen, Rosuvastatin, Topamax, Nexin, Aspirin 81, Biotin, Vit B12, Vit D, Vit E, Multivitamins
Current Illness: Arthritis, Fibromyalgia, fatty liver, sleep apnea, lumbar and cervical affected, migraines
Preexisting Conditions: Arthritis, Fibromyalgia, fatty liver, sleep apnea, lumbar and cervical affected, migraines
Allergies: Crustacean, Lactose, Gluten, Medication-Percocet
Diagnostic Lab Data:
CDC Split Type:

Write-up: Symptoms: fever, left armpit pain, sore throat, headache, joint pain, chills, burning when urinating, nausea. Two days in bed. Total rest. Day 3 (today) I feel better. Still slight armpit pain, inappetent, confused. I understand that by the nature of the new variants the dose is stronger. I just wanted to be part of the documentation. Thanks


VAERS ID: 1756723 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chest pain, Dyspnoea, Laboratory test, Myocarditis, Pain, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: No access to the test or laboratory results performed in the hospital.
CDC Split Type:

Write-up: Myocarditis. Chest pain started at 5am, approximately 19 hours after vaccination. Patient''s symptoms mimicked those of a hear attack. Patient taken to the hospital on Thursday morning after shortness of breath developed. Pain was radiating down his arm and to his back. Patient was admitted on Thursday after being at the ER.


VAERS ID: 1756746 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Nausea, Syncope, Unresponsive to stimuli, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Nausea-Mild, Systemic: Vomiting-Mild, Additional Details: Patient reported she had been fasting and was afraid of needles. She fainted briefly, then several minutes later vomited. Her bp and pulse were good. She stayed 45 minutes extra time, then told us she was feeling better and left.


VAERS ID: 1756753 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Hypoaesthesia, Injection site pain, Injection site swelling, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: Headache - lasted 2 days Severe Nausea- lasted ~6hours Muscle/joint pain - lasted ~1 day Fatigue - lasted 3 days Arm sore & swollen at injection site - still there it''s been 4 days Face numbness lasted 5 minutes ~14 hours after injection


VAERS ID: 1756758 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF 2587 / UNK LA / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Feeling cold, Heart rate increased, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Valsartan 80 Bayer low dose 8 Meta mucil 3-1 fiber B Complex D3 Fish oil Centrum silver Nopalea and inflammatory
Current Illness: None
Preexisting Conditions: Chronic pain
Allergies: Lisinopril Gabapentin Sulfur
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme coldness, uncontrollable shivering ,nausea, heart beating rapidly, leg and arm movements painful. Lasting until early morning next day . Prayed alot, drink hot.lemon tea. After chills subsides, ate yogurt , drink hot tea.


VAERS ID: 1756777 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 061E21A / 2 LA / IM

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

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

Write-up: Systemic: numbness-Medium, Systemic: Numbness (specify: facial area, extremities)-Medium


VAERS ID: 1756804 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Lymphadenopathy, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Covid Shot #2
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling of several lymph nodes in underarm on left with pain. Had shot Tuesday at 12:55pm - woke up from the under arm pain at 3:30am. Put myself on a regiment of Advil and Tylenol with the use of ice on swelling for 3 days. Pain has subsided, but swelling still exist. Underarm is swollen to the point where I cannot carry my arm down naturally along my body.


VAERS ID: 1756829 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Lymphadenopathy, Pain, Pyrexia, Rash, Rash pruritic, Skin warm
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

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

Write-up: Patient reports on 9/30/2021 having fever, body aches, and fatigue. Later in the day, she noticed a growing rash starting from the left arm where she was vaccinated all the way across the chest to the right arm. She reports that the rash is hot to touch, painful and itchy. She also reported a swollen lymph node in her left arm pit. She was unable to see her physician and did not want to go to the ER for treatment.


VAERS ID: 1756864 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Electrocardiogram ST segment abnormal, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fluoxetine 40 mg Bupropion 150 mg
Current Illness:
Preexisting Conditions: Had confirmed Covid 19 in Dec 2020
Allergies: None
Diagnostic Lab Data: Troponin (peak) 0.85 10/2/2021 @ 1011
CDC Split Type:

Write-up: Developed chest pain and shortness of breath, especially with exertion. Had elevated troponin and ST segment abnormalities on EKG.


VAERS ID: 1756891 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure increased, Blood test, Dizziness, Electrocardiogram, Heart rate increased, Malaise, Muscular weakness, Nausea, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Chronic reactivated EBV, chronic all over pain, migraines, vestibular migraines.
Allergies: latex, erythromycin, codeine, clonazepam
Diagnostic Lab Data: Blood work, ECG, BP and pulse observation in ER, nausea medication, saline drip. I will seek primary care follow up and cardiology follow up.
CDC Split Type:

Write-up: 15 minutes post shot, started feeling light headed, dizzy, weak legs. EMTs on sight took BP and pulse. 196/147 and 169 pulse. Normal BP and pulse is 105/65 and 74 pulse. 30 minutes after shot, BP at 157/83 and pulse at 110, also nausea started and still shaky, light headed, dizzy. At 45 minutes after shot, decision made to transport me to hospital because BP/pulse not coming further down, and nausea getting worse. At ER, given saline IV, Zophran for nausea (which is now over a 10 on 1-10 scale), blood work and ECG tests. Zophran did not touch escalating nausea, so a second med was added. 1st dose of that did not help, second dose of second me 5 hours after shot finally got nausea to a 6 (1-10 scale) which was way more tolerable. BP and pulse still not lower than 140/84. Was sent home after 5 hours in ER (6 hours after shot). 3 days later still nauseous, light headed, not feeling ''right'' or good, not going anywhere, just resting, hydrating, eating. Prior to shot I was well hydrated and had eaten regularly that day and was feeling well.


VAERS ID: 1756898 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F2587 / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Fatigue, Nausea, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Hives, facial swelling, nausea and fatigue OTC benedryl, zyrtec and pepcd, as well as tylenol for headache


VAERS ID: 1756914 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 1 LA / SYR

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

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

Write-up: Severe swelling under left armpit since injection date with fever(100) and very fatigue.


VAERS ID: 1756924 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Hyperacusis, Injection site erythema, Injection site swelling, Injection site warmth, Neurological symptom, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: I began feeling light-headed within an hour of receiving the injection. About 2 hours later, my arm began to ache. By midnight, I had a headache, my arm was swollen, feverish and red at the injection site. I seemed to be experiencing some central nervous system difficulties similar to how I feel when I take antihistamines (which I rarely take because of the side effects I experience) or albuterol. My reaction time slowed and voices and loud noises jarred me. That feeling has persisted for the past 3, almost 4 days even though it is diminishing. This may not be life-threatening, but it has been somewhat debilitating.


VAERS ID: 1756936 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Facial pain, Feeling of body temperature change, Headache, Injection site pain, Pain, Pyrexia, Toothache
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, Women''s Multi-vitamin,
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The patient experienced arm soreness at the injection site for 2 days. She developed a fever, chills, body aches and hot and cold flashes around 2am on 9/29/2021 and she is still experiencing these symptoms 3 days later on 10/01/2021. The fever is low-grade and is staying around 99 -100 degree range, but it has never gone away. The patient states her normal temperature is usually around 97.6 -97.8. The patient is also experiencing headaches consistent with having a fever. She had face and teeth pain on 9/29/21, but it lasted one day and went away.


VAERS ID: 1756938 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC 3182 / 2 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 2 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Glipside - 1 10mg 3pm
Current Illness: None
Preexisting Conditions: Diabetes, high cholesterol, quadruple bypass surgery 11/2019, Chronic Lyme,
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 2nd Pfizer shot on 09/29/2021 about 3:25pm. About 11:40pm right arm began itching in and around shot area and a knot developed. Within 30 minutes all of upper right arm breaking out in hives, itching constantly, and swelling. As of 10/02/2021 still having all the above symptons.symptoms. Also got Flu shot at same date and time of 09/08/2021, 3pm that I got 1st vaccine.


VAERS ID: 1756967 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 308A / 3 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D.Desvenlafaxine, Finasteride,Rosuvastatin Biotin, Tylenol
Current Illness:
Preexisting Conditions:
Allergies: Levaquin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Only a very sore arm.


VAERS ID: 1757044 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-26
Onset:2021-09-29
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injection site pain, Pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (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: Postnatal vitamins
Current Illness: No
Preexisting Conditions: No
Allergies: Keflex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme injection site pain, days after vaccine, radiating to shoulder and down forearm


VAERS ID: 1757051 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-01
Onset:2021-09-29
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: I have experienced severe arm pain, fever, dizziness, fatigue, and muscle pains all over my body.


VAERS ID: 1757060 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-12
Onset:2021-09-29
   Days after vaccination:109
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cold sweat, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Hypoglycaemia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: IPC was informed that patient tested positive for COVID-19, specimen collected 10/1/21 (Thermofisher) at facility. HCP works as a(n) Receiving Clerk in the Receiving Department. HCP was vaccinated on 5/21/21 and 6/12/21 (Pfizer). Last day of work was 9/29/21 0730 - 1600. HCP reported that symptoms began on 9/29/21 with cold sweats and congestion. Symptoms persisted with additional loss of taste and smell on 10/2/21 HCP denies fever, chills, body aches, runny nose, sore throat, headache, fatigue, cough, dyspnea, difficulty breathing, chest pain, nausea, vomiting, abdominal pain, or diarrhea. HCP denies contact with confirmed COVID positive in the community, staff, patients, or sick individuals. He states there is no direct patient contact just with staff who also wear eye protection and face mask. HCP denies participation in high-risk activities (eg. gathers, parties, nightclubs/bars, or weddings). He states he does not interact with coworkers outside of the work environment. At work, HCP does report consistent surgical mask and eye protection. HCP does not recall being in contact with any COVID+ patients or staff. HCP mostly eats alone outside but occasionally eats in the breakroom with another coworker. HCP lives with two other roommates, one of which works in the same department, while the other works for facility. Both are asymptomatic and are fully vaccinated. HCP did not feel comfortable disclosing the names of the individuals.


VAERS ID: 1757074 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (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: Vitamins Calcium, magnesium, and zinc Vitamin b12 1000 mcg Vitamin d 2000 IU Viviscal hair vitamin Prescriptions *Oxybutynin 10mg *Amlodipine besylate 5 mg *Baclofen 10 mg 3x *Lamotrigine 50mg *Gabapentin 300mg 3x Ocrevus - multiple scler
Current Illness:
Preexisting Conditions: Multiple sclerosis IBS
Allergies: Codeine Sulfa Penicillin Milk Environmental allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rapid heart rate


VAERS ID: 1757094 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-16
Onset:2021-09-29
   Days after vaccination:44
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arterial stenosis, Computerised tomogram head, Computerised tomogram head abnormal, Coronary artery thrombosis, Craniocerebral injury, Disorientation, Dizziness, Gait disturbance, Headache, Heart rate decreased, Scan with contrast abnormal, Tension, Vertebral artery occlusion, Visual impairment, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Max living womens multivitamin, vitamin d 2000 units, vyvanse 50mg, ecitalpram 10mg, enalapril 5mg
Current Illness: Positive covid 19 delta strand 10 days prior to vaccine
Preexisting Conditions: High blood pressure, hypoglycemia
Allergies: Penicillin, keflex, sumatriptan
Diagnostic Lab Data: 09/29/2021 CT W/Contrast Findings 1. Irregularity and narrowing of the distal right vertebral artery V3 segment extending to the V4 segment which appears subtotally opacified with contrast. In the setting of recent traumatic injury, a dissection would be a consideration. Blunt cerebrovascular injury (BCVI - Biffle Scale: Grade: Grade I Luminal irregularity or dissection with <25% luminal narrowing. Alternative consideration would include a developmentally small vessel with dominant caliber of the left intradural vertebral artery, though the degree of luminal irregularity would suggest against this. 2. Otherwise, patent cervical and intracranial arterial vasculature without additional evidence of vascular trauma.
CDC Split Type:

Write-up: Feeling of Dizziness and Disoriented. Woke up with the severe urge to vomit. When trying to get to the bathroom I could not walk or see clearly. And heart rate dropped in high 40s as well as blood sugar dropped in 50s. I had previously went in to hospital for headaches and tension due to a minor electric bike accident and a CT w/o contrast came back normal on 9/25/2021 the on 9/29/2021 a CT with contrast was done so damage to right distal artery. These symptoms may have been from minor electric bike incident but not 100% sure. Prescribed meclizine, lipitor, and aspirin


VAERS ID: 1757097 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Blood test normal, Computerised tomogram normal, Dizziness, Feeling abnormal, Gait disturbance, Magnetic resonance imaging normal, Neurological examination normal, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Hypoglycaemia (broad)

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

Write-up: The day after I received the vaccine around 6pm I suddenly felt strange. I stood up and began to walk and started stumbling and felt dizzy. Everything around me was spinning and wouldn?t stop. Even if I sat down or laid down everything was spinning. The constant spinning caused me to vomit. This continued to happen for 24 hours and on 9/30/2021 I went to an urgent care. The urgent care instructed me to go to the hospital. The hospital did bloodwork, an mri, and a cat scan, along with several neurological tests. Everything was normal. By the next day the spinning had stopped and after some sleep I was able to feel normal again. On 10/1/2021 around 9pm I started feel strange again. The spinning was not as intense, but present. I have never had symptoms of vertigo my entire life until reviving the Covid vaccine. I?m not sure if I am going to continue to experience these symptoms, I am very nervous to get the second dose.


VAERS ID: 1757108 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Mild


VAERS ID: 1757176 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-09
Onset:2021-09-29
   Days after vaccination:204
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Fatigue, Nasal congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Epinephrine; Ergocalciferol; Cyanocobalamin
Current Illness: none
Preexisting Conditions: Iron and vitamin D deficiency; osteopenia; bilateral cataracts
Allergies: none listed
Diagnostic Lab Data:
CDC Split Type:

Write-up: Symptoms started on Wed, 9/29 with a stuffy nose. She felt exhausted on Mon and lost sense of taste and smell today. Has developed cough today, tested positive on 10/1/21


VAERS ID: 1757198 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pyrexia, Skin warm, Swelling, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? Yes
Hospitalized? No
Previous Vaccinations: Shingrix
Other Medications: lisinopril, lansoprazole, fish oil, vitamin D
Current Illness: none
Preexisting Conditions: chronic lymphocytic leukemia,
Allergies: seasonal allergies, peanuts
Diagnostic Lab Data: Visit to urgent care clinic on 10/1/2021. The doctor noted a number of factors to suggest this is an adverse reaction and not cellulitis.
CDC Split Type:

Write-up: redness, swelling, hot to the touch, fever


VAERS ID: 1757233 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Myalgia, Nausea, Oropharyngeal pain, Peripheral swelling, Pyrexia, Rhinorrhoea, SARS-CoV-2 test negative, Vision blurred, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No did not take any supplements.
Current Illness: I had no illnesses at the time of vaccination and up to one month prior.
Preexisting Conditions: Allergy based asthma
Allergies: On certain types of antibiotics but not often. I have allergies to mold and dust
Diagnostic Lab Data: I went to be tested to day on October 3rd, 2021 . The rapid testing has shown i had no covid nor flu A or B. I could not able to be seen by my doctor because she is on vacation this week. And honestly i strongly believed that all my symptoms will disappear by Saturday morning. It was my believe but it did not happened.
CDC Split Type:

Write-up: After 1.30 minutes after i got my first dose of the Prizer vaccine. I have experienced sore throat, light fever, muscle ache, and blurt vision, the left arm was a little bit swollen. The next day I have experienced the same symptoms and additionally felt nauseas and threw up several time . Today is the day number 5: I still experiences fever, running nose, sore throat, and cough. I have to report to work tomorrow and i feel so sick.


VAERS ID: 1757263 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NOT A COVID SHO / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Allergic: Itch Generalized-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Systemic: Allergic: Rash Generalized-Medium, Additional Details: This was a reaction to FLUAD not covid it would not let me leave that area blank


VAERS ID: 1757320 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Feeling abnormal, Gait disturbance, Headache, Hyperhidrosis, Hypotension, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad), 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: Amlodipine, Atenolol, Losartan, Estring ,AREDS 2 vitamins , Rinocort nasal spray, Mg glycinate, VitD ,
Current Illness: Well, status quo, NO recent symptoms of URI etc
Preexisting Conditions: Hypertension, +ANA, underlying but quiescent connective tissue disease, nasal allergies,
Allergies: Quinolones, Cipro
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme shaking chills making it difficult to walk or function, profuse sweating, severe nausea , weak - all of above lasted 5 hours. Then headache, marked fatigue for 3 days, with episodes of weakness & "brain fog", lower than usual blood pressure despite being well hydrated (114/68 vs WNL 126/84 typical) I had ONLY mild headache and fatigue after 1st and 2nd doses of Moderns COVID vaccine


VAERS ID: 1757365 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-01
Onset:2021-09-29
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Cardiac telemetry, Electrocardiogram, Fatigue, Malaise, Nasopharyngitis, Tinnitus, Vertigo
SMQs:, Hearing impairment (narrow), Vestibular 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Valtrex 1 GM daily Multivitamin
Current Illness: None
Preexisting Conditions: HSV 2 Hyperlipidemia Grover?s Disease
Allergies: Demerol Morphine Tetracycline Clindamycin Acetaminophen
Diagnostic Lab Data: Bloodwork EKG Telemetry IV insertion
CDC Split Type:

Write-up: Vaccinated 9/25/21 Malaise & fatigue within 24 hours Mild cold symptoms 3 days later Ringing in left ear within 5 days later Vertigo treatment at ER 8 days later


VAERS ID: 1757376 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Fatigue, Feeling hot, Headache, Injection site pain, Injection site rash, Pain, Rash, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec Zoloft Singular Doxycycline Benadryl Vitamin D3 Vitamin B12 Vitamin C Zinc
Current Illness: None
Preexisting Conditions: Rosacea Anxiety Allergies Asthma Acne
Allergies: Penicillin Kelflex Levaquin Bactrian Demerol Avocado Pecans Walnuts Melons Cats Dogs Cocoa butter Fragrances Pollens
Diagnostic Lab Data: Bloodwork 9/29/21 normal
CDC Split Type:

Write-up: Fatigue, body aches, headache, injection site pain (day 2) Rash around injection site, warm, itchy, painful (day 3) Rash grew larger (day 4) Rash began to go away (days 5-6) Rash returned bigger and itchy (day 7)


VAERS ID: 1757450 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Headache, Hypoaesthesia, Influenza like illness, Pruritus, Pyrexia, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: n/a
Preexisting Conditions: Multiple Sclerosis (just diagnosed February 2021)
Allergies: Penicillin
Diagnostic Lab Data: N/A.
CDC Split Type:

Write-up: I immediately got itchy throat and itching under skin, then chest tightness started. That same night 9/29/21 I had a 101 fever. On 10/1/21, I had a severe headache, flu like symptoms and my hands and feet went numb. As of today 10/3/21, I still have the numbness in my hands and feet.


VAERS ID: 1757518 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2088 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Computerised tomogram head, Computerised tomogram thorax, Electrocardiogram, Loss of consciousness, Nausea
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), 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: Benazepril 40 mg 1 Tab, PM Xarelto 20 mg 1 Tab, PM Pravastatin Sodium 40 mg 1 Tab, PM Metoprolol succ 25 mg 1 Tab, PM Chlorthalidone 25 mg 1 Tab, AM Multi-vitamin 1 Tab, AM Vitamin C 500 mg 1 Tab, PM Calcium+D3 600 mg 1 Tab, PM Tamsulosin
Current Illness: Hypertension Overweight High BP Controlled Afib
Preexisting Conditions: Hypertension Overweight High BP Afib
Allergies: Penicillin
Diagnostic Lab Data: I am not sure but: EKG, BP, Temp, OX level, CT of head, CT of chest area. Not sure what drugs were administered
CDC Split Type:

Write-up: The morning after the shot I went to the bathroom, took my AM meds and took my BP which was low 103/66 pulse 95. I felt a major push to throw up and so I turned to the commode. As I started to put my head down, I passed out. A short time later (minutes) I was trying to stand up but was too weak so I called my wife to assist. We called 911 and within minutes I was off to the hospital.


VAERS ID: 1757526 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Arthralgia, Asthenia, Burning sensation, Chills, Decreased appetite, Dizziness, Dry skin, Dry throat, Epistaxis, Fatigue, Feeling hot, Incontinence, Injection site swelling, Mobility decreased, Myalgia, Pyrexia, Sleep disorder, Throat irritation
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu Shot
Other Medications: citalopram hbr 10 mg citalopram hbr 20 mg lisinopril-hctz 20-25 mg levothyroxine 25 mgc atorvastatin 80 mg aleve
Current Illness: none
Preexisting Conditions: high blood pressure but been control by medication fatigue and dizziness since having covid in March
Allergies: lactose
Diagnostic Lab Data: None
CDC Split Type:

Write-up: He did not have any of these symptoms except the ones describe in the previous regarding covid 19 that is still in effect since March 2021 Wednesday September 29, 2021 dizziness and light headed Thursday September 30, 2021 feeling hot and dry about 10 a.m., dryness and irritation in back of throat, burning in sinuses, weakness and fatigue, 2:00 or 3:00 p.m. went to bed with chills and dryness and fever symptoms. 4:00 or 5:00 could not roll or move from one side or another, pain in joints, swelling in shot area. Loss of bladder control and unable to get out of bed and unable to move out of position. Couldn''t reach for the phone to call for help or device to message reporter to let her know. Lack of taste. When wife came home around 7 p.m. I found him propped up on the bed not able to talk and his mouth of slanted. I went and got him water and he took it and drank some. I tried to call Health Department but no answer. I was going to call the ER but could not find a phone number and by the time the internet came back up he could talk and was able to get out of bed. His feet was hot and his body was hot but when I check his temperature it was only 97.7. Friday, October 1, 2021: All day weakness, dizziness, loss of appetite, lost of taste, muscle and joint ache, difficult sleeping (he does wear a cpap machine and has never had a previous problems since having the machine) Saturday, October 2, 2021 showing improvement most of Saturday until late afternoon where chills, muscle and joint pain, weakness, and dizziness occurred again. In the evening again started having raspy throat and sinuses. He had a nose bleed where he never had that problem before. He could not sleep more than one hour at a time. Sunday, October 3, 2021: He called into work. He is showing more improvement from last night but still has raspy throat and sinuses. He is planning on going back to work tomorrow and we will be calling the dr to report this and asking about second shot. His taste is still off.


VAERS ID: 1757560 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-23
Onset:2021-09-29
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram, Blood test, Chest X-ray, Computerised tomogram, Hypoaesthesia, Magnetic resonance imaging, Paraesthesia, SARS-CoV-2 test, Transient ischaemic attack
SMQs:, Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Guillain-Barre syndrome (broad), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid 150mg Daily vitamins
Current Illness: None
Preexisting Conditions: Hypothyroidism.
Allergies: Penicillin, NSAID''s, Gluten
Diagnostic Lab Data: MRI, MRA, CT scan, full panel blood work up, chest x-ray and covid rapid test. Test indicated that it was a TIA in the thalamus region.
CDC Split Type:

Write-up: I am a teacher and was in class teaching on September 29, when I began having numbness and tingling on the my right side of my face and my entire right arm. the numbness lasted for 4 -5 minutes. It subsided for about 8-10 minutes after which I experienced a second, stronger numbness sensation. This event lasted about 5 - 7 minutes. Believing it might be a stroke I went to the school nurse. I was then transported to the local hospital ER for evaluation. The symptoms indicated it might be a stroke so I was rushed in and was given a CT scan, MRI and MRA.


VAERS ID: 1757636 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-25
Onset:2021-09-29
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram thorax abnormal, Echocardiogram, Pulmonary embolism, Sinus tachycardia
SMQs:, Supraventricular tachyarrhythmias (narrow), Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cymbalta, Norgestimate
Current Illness: None
Preexisting Conditions: Anxiety
Allergies: Latex, shellfish
Diagnostic Lab Data: Blood work, CT scan, echocardiogram
CDC Split Type:

Write-up: Developed three pulmonary embolisms and sinus tachycardia


VAERS ID: 1757643 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injection site mass, Lymphadenopathy, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Venlaphaxine 225 mg, Zyrtec 3 tablets, iron supplement, birth control pill
Current Illness: N/A
Preexisting Conditions: Obesity, allergies,
Allergies: Sulfa drugs, environmental
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lump in arm, rash that is growing , swelling of lymph nodes under arm pit, elbow pain, rash happened right away and is continuing to grow


VAERS ID: 1757925 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-12
Onset:2021-09-29
   Days after vaccination:229
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Bacteraemia, Biopsy prostate abnormal, Dysuria, Escherichia infection, Pollakiuria, Pyrexia, SARS-CoV-2 test positive, Urinary tract infection
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Prostate malignant tumours (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Sepsis (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin (HALFPRIN) 81 MG tablet chlorthalidone (HYGROTON) 25 MG tablet Cyanocobalamin (VITAMIN B 12 PO) Glucosamine-Chondroitin (GLUCOSAMINE CHONDR COMPLEX) 500-400 MG capsule lisinopril (PRINIVIL) 5 MG tablet Misc Natural Products (TURMERI
Current Illness: None known
Preexisting Conditions: Generalized OA Seizure (HCC) Syncope Gastroesophageal reflux disease with esophagitis Essential hypertension History of total left hip arthroplasty Mild depression (HCC)
Allergies: Fluoroquinolones (tendonitis), davrocet (rash), sulfa (weakness)
Diagnostic Lab Data: COVID-19 test positive on 9/29/2021.
CDC Split Type:

Write-up: Patient presented to hospital on 9/29/2021 for frequent urination and burning with urination. He was found to have a fever. He was recently in the emergency room on 9/11/2021 and from 9/12/2021 to 9/15/2021 for E. coli urinary tract infection and bacteremia following a biopsy of the prostate. He remained asymptomatic for COVID-19 during admission.


VAERS ID: 1758378 (history)  
Form: Version 2.0  
Age: 96.0  
Sex: Male  
Location: Missouri  
Vaccinated:0000-00-00
Onset:2021-09-29
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211000576

Write-up: EXPIRED VACCINE ADMINISTERED; This spontaneous report received from a health care professional concerned a 96 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: 042A21A expiry: 19-SEP-2021) dose was not reported, administered on 29-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 29-SEP-2021, the patient experienced expired vaccine administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of expired vaccine administered was not reported. This report was non-serious.


VAERS ID: 1758595 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Diverticulum gastric, Gastritis, Impaired work ability, Ovarian cyst
SMQs:, Gastrointestinal nonspecific inflammation (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: None
Current Illness: COVID, I tried to wait 90 days to be vaccinated and my job denied my request to wait. I was forced to get the vaccine early.
Preexisting Conditions: Hashimotos
Allergies: None
Diagnostic Lab Data: CT scan and blood work
CDC Split Type:

Write-up: Symptoms still persisting today, missed two days of work. Diagnosed Gastritis, gastric diverticulum and multiple ovarian cysts. Treated with Maalox, morphine and zofran.


VAERS ID: 1758598 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Constipation, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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

Write-up: Pt. states that after receiving the 1st dose of Phizer 09/29/2021, started experiencing symptoms within 10hrs of pain across the abdomen, shortness of breath, and constipation. No noted Primary visit, symptoms have subsided other than Constipation.


VAERS ID: 1758606 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 2 - / IM

Administered by: Military       Purchased by: ?
Symptoms: Effusion, Joint effusion, Joint swelling, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: area of painless swelling/effusion to posterior wrists/hands b/l started the day after receiving 2nd covid-19 vaccine


VAERS ID: 1758608 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 3 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Body temperature increased, Chills, Headache, Heart rate increased, Hyperhidrosis, Nausea, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: receiving the annual flu vaccine and the Prevnar pneumonia vaccine at the same time
Other Medications: No prescriptions. No herbal remedies. 81 mg aspirin daily. Multi-vitamin/mineral, vitamin C, calcium, cranberry, L-lysine, Move Free.
Current Illness: None
Preexisting Conditions: Sjogren''s Syndrome. Osteoarthritis.
Allergies: No known allergies. Sensitive to cardiac stimulants.
Diagnostic Lab Data: N/A. If the leg pain does not resolve by the morning of 10/05/2021, I''m thinking of visiting the local hospital ED.
CDC Split Type:

Write-up: Seven hours post vaccine: severe pain in both hands, strong headache, nausea, strong body aches, chills, elevated heart rate, temperature 1 to 1.4 degrees above my normal. During the night, several episodes of copious sweating. On 10/01/2021, hand pain was quite reduced, nausea was gone. On 10/02/2021, hand pain, headache, body aches resolved. But chills, sweats, and elevated heart rate continued. By 3 p.m. on 10/02/2021, deep pain in Right lower leg. Heart rate normalized sometime overnight. On 10/03/2021, still experiencing Right lower leg pain and throbbing. And still having chills and sweats during the night.


VAERS ID: 1758684 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-02
Onset:2021-09-29
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Anxiety, Bacteraemia, Blood culture, Blood lactic acid, C-reactive protein, Culture urine, Diabetic neuropathy, Differential white blood cell count, Feeling hot, Full blood count, Hyperhidrosis, Hyponatraemia, Inflammation, Influenza A virus test, Influenza B virus test, Laboratory test, Leukocytosis, Metabolic function test, Musculoskeletal pain, Nodule, Nucleic acid test, Pain, Perineal abscess, Pyrexia, Respiratory syncytial virus test, SARS-CoV-2 test, Sepsis, Sinus tachycardia, Swelling, Type 1 diabetes mellitus, Wound
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Gastrointestinal perforation (narrow), Accidents and injuries (broad), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: while in ED: Lab Tests Completed C-REACTIVE PROTEIN (INFLAMMATION) COMPREHENSIVE METABOLIC PANEL LAB ONLY-COMPLETE BLOOD COUNT WITH DIFFERENTIAL LACTIC ACID SARS-COV-2, INFLUENZA A+B, AND/OR RSV NUCLEIC ACID TESTING PANEL URINE DIP, REFLEX TO MICROSCOPIC, REFLEX TO CULTURE Unknown Icon Lab Tests in Progress CULTURE, BLOOD
CDC Split Type:

Write-up: 54yr old male who presents ambulatory with spouse to ED with complaints of left lower buttocks sore. Patient noticed this lump this last Wednesday, and since then it has continued to grow in size. Patient was seen in urgent care yesterday, where they prescribed him with antibiotics. Patient has had a total of three doses. Patient rates pain 8/10. Patient''s spouse stated he had a fever yesterday, but it has subsided at this time. Patient is diaphoretic and hot upon arrival. Patient has taken tylenol last at 1100 today. Perineal abscess Acute This was a fairly deep abscess cavity (~10 cm) that did track up next to the rectum. We felt that some of this might represent sepsis, ForDIAGNOSIS 1. Fever, unspecified 2. Sinus tachycardia 3. Leukocytosis, unspecified type 4. AKI (acute kidney injury) 5. Hyponatremia 6. Perineal abscess Principal Problem: Sepsis Active Problems: Type 1 diabetes mellitus with complications Diabetic polyneuropathy associated with type 1 diabetes mellitus Anxiety Perineal abscess Plan: 1) Sepsis/ Bacteremia suspected - IV Zosyn 2) Perineal abscess - S/p I&D. Wound care with packing 3) Type 1 DM - Continue home Insulin pump. Add accuchecks 4) AKI - IV fluids. Follow ED then hospitalized for 2 days


VAERS ID: 1758723 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Amnesia, Blood test normal, Chest X-ray normal, Confusional state, Electrocardiogram normal, Electroencephalogram normal, Magnetic resonance imaging head normal, Magnetic resonance imaging spinal normal, Urine analysis normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: gabapentin 100 mg prn, losartan potassium 50 mg, od, montelukast,10 mg. od, sertraline 25 mg. od,, meloxacam 7.5 mg. od, hydrochlorothiazide 12.5 mg. od, tramadol 50mg od aleve pm
Current Illness:
Preexisting Conditions: asthma
Allergies: none
Diagnostic Lab Data: As I don''t have any memory of the first day in the hospital, I''m relying on my husband''s recall. Blood work, urinalysis, chest x-rays, EKG, EEG, MRI of the brain and spine.. No issues were found; my bp, temp, and oxygen were always good.
CDC Split Type:

Write-up: Confusion, beginning the afternoon following the injection. My mind became a complete and total blank, including not knowing my own name. On 9/30/2031 I was hospitalized for 3 days.


VAERS ID: 1758817 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-02
Onset:2021-09-29
   Days after vaccination:211
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267, EN6202 / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19 pneumonia, Cough, Hypoxia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: COPD, CAD, hypertension, Type 2 diabetes
Allergies: No Known Allergies
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Hypoxia with COVID pneumonia, could not receive monoclonal antibody infusion due to being hypoxic, weakness, dry cough.


VAERS ID: 1758846 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1758919 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-09-29
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076CA1A / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Asthenia, Dizziness, Feeling cold, Myalgia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu shot, 15-20 years ago
Other Medications: insulin losthartin
Current Illness:
Preexisting Conditions: type 1 diabetic asthma enemia
Allergies: iodine shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: 12 hours after vax she woke up frezzing cold and shaking, was dizzy, upset stomach, says she has all covid symptoms, muscle pain, weakness


VAERS ID: 1758937 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-02-25
Onset:2021-09-29
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Vaccine breakthrough infection
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Breakthrough COVID-19 case. Pt contracted covid after receiving both doses of the vaccine.


VAERS ID: 1758952 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-05
Onset:2021-09-29
   Days after vaccination:236
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / UNK - / -

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

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

Write-up: Vaccine breakthrough. COVID + 9/29. Symptomatic inpatient admit 10/3/21


VAERS ID: 1758969 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Injection site pain, Pain in jaw, Sinus disorder, Tooth disorder
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Osteonecrosis (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: Doxycycline; B3; probiotic; fish oil; calcium
Current Illness: Sinus infection
Preexisting Conditions: Celiac Disease; Eye Conditions; Asthma; Hernia; Dry Eye
Allergies: Amoxicillin; chicken feathers; bird feathers; sensitivity to dairy; nickel; anti-stings; muscle pain; medications
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I went to the pharmacy and I received the booster vaccine. I was the third one to get the shot that day. That evening I had to put ice on the injection shot due to being sore. After that it was kind of sore, it was tender. On Wednesday, I was feeling dizzy. I was taking Sudafed. I figured out that during this time period I was dealing with problems with my sinuses and teeth. I started the prescription on the afternoon on 09/24/2021, I also stopped the Sudafed. My jaw started to hurt again. I called my doctor and they advised that I need to come in to see him. The day before yesterday I woke up and I was dizzy. I took medication for dizziness. That helped with the dizziness. The next day was a little less. This morning was I have had very little. I have used Sudafed my whole adult life.


VAERS ID: 1758970 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2020-12-23
Onset:2021-09-29
   Days after vaccination:280
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 2 RA / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 1758985 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Dyspnoea, Flushing, Hyperhidrosis, Hypotension, Tachycardia, Visual impairment
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Chills-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Medium, Systemic: Tachycardia-Medium, Systemic: Visual Changes/Disturbances-Medium, Systemic: Weakness-Medium, Additional Details: bp was 104/60, pt reported bp to normally be slightly high. started within 5 min of administration, ~5:20pm


VAERS ID: 1758986 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-10
Onset:2021-09-29
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute myocardial infarction, COVID-19, Cough, Diarrhoea, Dyspnoea, Nasal congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Pseudomembranous colitis (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt has diabetes and hypertension. Pt went for evaluation of a 3-day history of shortness of breath, cough, and nasal congestion, as well as some diarrhea. Pt was found to be COVID positive. Pt was transferred due to NSTEMI.


VAERS ID: 1759062 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Dizziness, Headache, Injection site pain, Lymphadenopathy, Myalgia, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Claritin-D Prilosec Vitamins B, C & D Calcium
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: none
CDC Split Type:

Write-up: First day: pain at injections site Second day: Fever, severe joint/muscle ache, headache Third day and continuing: significant swelling in lymph nodes of collarbone area Fifth day: light-headeness, pulling-ache down inside of left arm, some chest pain.


VAERS ID: 1759081 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Fatigue, Muscle aches and low grade fever


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https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=71&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No

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