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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 72 out of 8,010

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VAERS ID: 1759103 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-13
Onset:2021-09-29
   Days after vaccination:228
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 4 - / -

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

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

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


VAERS ID: 1759104 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Colorado  
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 FF2589 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Pain, Pyrexia, Vertigo
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Body aches, headache, fever 102 started ~16 hours after vaccine and lasted 24 hrs+ then new onset vertigo and dizziness that started couple days after vaccine and lasted ~36-48hrs.


VAERS ID: 1759113 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: North Dakota  
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 FE3592 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BABY ASPIRIN, CHOLESTEROL MEDICATIONS, PRE DIABETIC MED
Current Illness: NO
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data: NO
CDC Split Type:

Write-up: BELL''S PALSY LEFT SIDE OF FACE


VAERS ID: 1759137 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-16
Onset:2021-09-29
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

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

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

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


VAERS ID: 1759186 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Florida  
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 FF2558 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Diarrhoea, Dysgeusia, Headache, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole, Estradiol, Simvastatin, Hydrochlorothiazide, Lisinopril, Levothyroxin, Vit B12, Vit D3, Biotin
Current Illness: None
Preexisting Conditions: Hypothyroid, high blood pressure
Allergies: None Known
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Ongoing: Severe nausea, diarrhea, loss of appetite, aching, headaches, metallic taste in mouth, no temp Ceased: Vomiting after 48 hours


VAERS ID: 1759205 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Indiana  
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 301308A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Hyperhidrosis, Nausea, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: injection site tenderness
Other Medications: levothyroxin, Vit C, vit D, Calcium, Sodium bicarbonate,
Current Illness: none
Preexisting Conditions: Chronic kidney disease, degenerative arthritis bilateral knees, hypothyroid due to total thyroidectomy
Allergies: sulfa drugs
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Received Booster vaccine just 7 months after 2nd vaccine dose. Arm became extremely painful by evening same day. Awoke with sweats and significant arm discomfort/pain with slight nausea but no vomitiing. Next day running fever up to 102 and continued arm pain. Fever continued for 24 hr and began to reduce gradually but 100 for next 24 hr. All fever with chills, sweats resolved after 48 hr. Arm discomfort improved but remains noticeable. Otherwise feel back to normal.


VAERS ID: 1759254 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Indiana  
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 (JANSSEN)) / JANSSEN 1816027 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: COVID-19 positive 9/3/2021
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nauseous, dizziness (within 15 minutes), headache (within 18 hours), chills, body aches, low grade fever, sore arm


VAERS ID: 1759295 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Montana  
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 014F21A / 1 LA / IM

Administered by: Pharmacy       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: Patient received 2 Pfizer vaccines previously but did not disclose that to pharmacy staff and was given one dose of Moderna COVID vaccine


VAERS ID: 1759340 (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: Other       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Headache, Lymphadenopathy, Nausea, Night sweats, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 50mcg
Current Illness: none
Preexisting Conditions: asthma seasonal allergies
Allergies: sulfa
Diagnostic Lab Data: none
CDC Split Type:

Write-up: fatigue, body aches, headache, nausea, decreased appetite, night sweats, swollen lymph node to axillary area on side of injection


VAERS ID: 1759368 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Disorientation, Headache, Irritability, Lethargy, Myalgia, Urinary incontinence
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bystolic, Amlodipine Besylate, Simvastatin. Levothyroxine, Venlafaxine, Xanax, ASA, Cinnamin, Calcium, D3, Multivit, Trandolapine, Folic Acid, Farxiga
Current Illness: N/A
Preexisting Conditions: Thyroid, Hypertension, heart block
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Lethargy, muscle aches, headache, disoriented without memory of incidents, urinary incontinence, agitation, loss of balance. Treated symptoms at home with assistance and reported to pharmacist. By the way, symptoms subsided the next am except for muscle aches.


VAERS ID: 1759369 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-08
Onset:2021-09-29
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 2 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Cough, Fatigue, Feeling abnormal, Headache, Nausea, Oropharyngeal pain, Painful respiration, Pharyngeal swelling, Secretion discharge
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Multi vitamin Probiotics
Current Illness:
Preexisting Conditions:
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: After my second shot on 09/29/2021 I experienced brain fog. The next day I woke up with a sore throat, headache, fatigue, nausea. I experienced these symptoms on 09/30/2021 - 10/01/2021. On 10/02/2021 I still experienced sore throat, headache, fatigue and now a cough. On 10/03/2021 - 10/04/2021 I am still experiencing fatigue, headache, sore throat, cough with green mucus, and throat swollen/ pain with deep breath. I am going to visit the hospital today. I?ve been taking DayQuil which has helped a little.


VAERS ID: 1759431 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-26
Onset:2021-09-29
   Days after vaccination:187
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: 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: Non PCR test was positive (and patient symptomatic)
CDC Split Type:

Write-up: EE tested positive for COVID-19 $g 14 days after vaccination


VAERS ID: 1759446 (history)  
Form: Version 2.0  
Age: 69.0  
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 / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Mobility decreased, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: woke up couldnt move muscles or joints, horrible chills, nausea, fatigue, vomited, headaches


VAERS ID: 1759459 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Illinois  
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 FC3184 / 3 LA / IM

Administered by: Pharmacy       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? 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 HAD 2 MODERNA SHOTS AND WAS GIVEN A PFIZER VACCINE AS A THIRD DOSE


VAERS ID: 1759480 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
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 (JANSSEN)) / JANSSEN 1855809 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Dyspnoea, Electrocardiogram, Heart rate increased, Hypoaesthesia, Pain in extremity, Paraesthesia, Visual impairment
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), 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), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (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: Tylenol
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin, cherries, all fruit, dogs, cats, pollen, mold, dust
Diagnostic Lab Data: EKG and chest x-ray proved normal. Blood work normal. Diagnosed with severe case of paresthesia.
CDC Split Type:

Write-up: Had shortness of breath and accelerated heart 60 minutes after vaccine. The about two hrs later numbness on left side of face, neck shoulder, arm, hand, hip, leg and foot, which got worse as the day wore on. Excruciating pain in left leg and arm for two days, and numbness in left side for two day but numbness in left side of face is still present. Numbness around the left eye is also present and my eye is cloudy and have trouble focusing on reading material and I''ve not had this problem before the vaccine.


VAERS ID: 1759485 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Indiana  
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 FF8839 / 3 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin 20mg, B12 100mcg, Fenofibrate 160mg, Iron 65mg-325mg Ferrous Sulfate, Metformin 1000mg, Olmesartan Medoxomil 20mg, One a day vitamin, Pioglitazone 30mg, Fish oil 1000mg-300mg Omega 3, 81mg low dose aspirin
Current Illness: None
Preexisting Conditions: Diabetes, high blood pressure, high cholesterol, high triglycerides, anemic
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Muscle aches, headaches, soreness at injection site, fatigue, slight fever all lasting about 24 hours


VAERS ID: 1759543 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Alabama  
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 30145BA / 3 LA / IM

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

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

Write-up: localized soreness, pain in shoulder, arm,


VAERS ID: 1759569 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-05-20
Onset:2021-09-29
   Days after vaccination:132
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: No known allergies
Diagnostic Lab Data: Positive COVID-19 PCR test results on 9/29/2021 and 10/1/2021
CDC Split Type:

Write-up: Hospitalization following COVID-19 vaccination


VAERS ID: 1759580 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-29
Onset:2021-09-29
   Days after vaccination:274
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

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

Write-up: PATIENT HAD PFIZER VACCINE 12/29/2020 and 01/19/2021, AND TESTED POSITIVE TO COVID.


VAERS ID: 1759587 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Arkansas  
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: Private       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
SMQs:, Medication errors (narrow)

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

Write-up: Patient received third booster dose intended for 6 months post second dose 34 days after second dose.


VAERS ID: 1759629 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Puerto Rico  
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 FF2588 / 2 LL / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Impaired work ability, Injection site discolouration, Injection site pain, Injection site vesicles, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: blood pressure meds, Vit. C
Current Illness: no
Preexisting Conditions: high blood pressure only
Allergies: none
Diagnostic Lab Data: NO, doctor examined site and prescribed antibiotics 100 mg and topical triple antibiotic cream.
CDC Split Type:

Write-up: REPORTER: The other morning the day after the vaccine I woke up the next morning I had water blisters around the injection site looked and felt burnt, still having symptoms till the elbow, with a burning feeling with blister and a brown burnt looking skin. Went to the doctor today and doctor prescribed me antibiotics. Was not able to work due to the arm pain and the burnt feeling symptoms.


VAERS ID: 1759644 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Michigan  
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 (JANSSEN)) / JANSSEN 204A21A / UNK UN / SYR

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

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

Write-up: pt received expired dose of Janssen vaccine


VAERS ID: 1759649 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Indiana  
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 FD0809 / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache, Pyrexia, Thirst
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Tetanus, age 18
Other Medications: Omeprazole Areds2 Basic daily vitamins
Current Illness: None
Preexisting Conditions: GERD
Allergies: Tetanus serum Ampicillin Cipro
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme fatigue Fever Headache Thirst


VAERS ID: 1759654 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Arthralgia, Dry mouth, Headache, Injection site mass, Injection site pain, Injection site pruritus, Injection site reaction, Injection site warmth, Pyrexia, Respiratory tract congestion, Rhinorrhoea, Taste disorder
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Novolog, Toujeo, Ozempic, spironolactone, losaran, Apri, rosuvastatin, Xyzal, Advil, Tylenol
Current Illness: None
Preexisting Conditions: Type I Diabetes, hypertension, high cholesterol, PCOS, environment allergies
Allergies: Sulfa, ACE Inhibitors
Diagnostic Lab Data:
CDC Split Type:

Write-up: Congestion, runny nose and headache all started within 4 hours. Within 6 hours, I had the most intense joint pain in every joint that lasted 2 days and GI upset that is still ongoing. I''ve had intermittent severe headaches and fever, 3" injection site reaction with fever, itching, pain and 1.5" diameter knot that is still present today, dry mouth for several days. Currently still experiencing GI upset and runny nose. I''ve also had an altered sense of taste since the 1st vaccine on 8/21/21 that I forgot to originally report.


VAERS ID: 1759684 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-03-05
Onset:2021-09-29
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (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: bilat PE .. 6 months after vaccine


VAERS ID: 1759692 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New Mexico  
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 EN6203 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3 OF 308A / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Bone pain, Bronchitis, Chapped lips, Chest pain, Chills, Gait disturbance, Headache, Lip discolouration, Lip swelling, Nausea, Pain, Pain of skin, Paraesthesia oral, Swollen tongue, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Osteonecrosis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Degenerative neck disease. High blood pressure on and off
Allergies: Sulfa: Hives Amoxaclav: Hives Codine, Vicadin: Vomiting Iodine: Swelling Meclazine: Swelling of throat and hands, face Compazine: After a few weeks, swelling of hands, face Welbuturain: Severe hives Amlodipine (calcium blocker): Severe stomach pain, vomiting, severe headaches. NOTE: Says you should not take if allergic to sulfa drugs. Lisinopril (bp Medicine): Hives. On 2/12/2021 tried again and lots of swelling in knees to the point you cannot bend and hurts to bend. NOTE: Says you should not take if allergic to sulfa drugs. Losartan (bp Medicine): Severe dizziness, headache from ears forward, sweats, nausea, increased blurred vision 2 hours after taking it. Doctor removed me off of 100 mg on June 27, 2016 from the side effects after being on it for 2 1/2 months. NOTE: Says you should not take if allergic to sulfa drugs. Hydrochlorothiazide 12.5 mg Shot blood pressure up to 168/118 Metoprolol Succinate ER 25 MG Oral Tablet Extended Release 24 Hour Shortness of breath, swelling under neck, eyes and nose. Started taking this on Jan 6, 2020 ? tablet first week. Made it 2 days caused Shortness breath, face swelling and hard to swallow. NOTE: Says you should not take if allergic to sulfa drugs. Hydralazine: Joint pain in hands, wrists, fingers and legs and hives all over.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 2nd dose had headache, body n bone aches. 3rd dose. After 5 hrs of vaccine bad nausea. At 12:30 am wed morn, bones n skin hurt so bad could hardly walk along with severe chills and headache. Lasted til 10:00 am. Then felt like throat n lungs burning, like bronchitis, tongue feels swollen n tingly with loss of taste. Lips are darker color with tingling and swelling feeling along with sensation of severe chappedness. Wed thru Friday afternoon couldn''t eat due to severe nausea n headache. This is Monday October 4 and my lips, tongue throat and lungs have not changed. I went to doctors office n was told it''s a neurological affect from the Pfizer vaccine but felt he was blowing me off. It was not my regular PCP. He said to take 25mg of benedryl 2x a day for about 4 days and follow up with regular PCP there. Then as I was leaving, I heard him making comments n laughing.


VAERS ID: 1759712 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-07-29
Onset:2021-09-29
   Days after vaccination:62
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None Documented
Current Illness: None documented
Preexisting Conditions: Eustachian tube dysfunction, acid reflux, migraine, nicotine vapor product user
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient contracted COVID after being fully vaccinated


VAERS ID: 1759724 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-14
Onset:2021-09-29
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Dexilant, Atorvastatin, Alopurinol, Valsartan
Current Illness:
Preexisting Conditions: High Blood Pressure, Acid Reflux, High Cholosterol
Allergies: Latex, Iodine, Augmentin, Influenza
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash, itching, burning, went to skin doctor


VAERS ID: 1759727 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Texas  
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 EWO158 / 3 LA / SYR
FLU4: INFLUENZA (SEASONAL) (AFLURIA QUADRIVALENT) / SEQIRUS, INC. - / 1 - / SYR

Administered by: Military       Purchased by: ?
Symptoms: Mobility decreased, Myalgia, Pain in extremity, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin Lisinopril Ezetimibe B12
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Indocin Sulfa Codeine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme pain in muscle of left arm. Could not move arm for 10 hours. Could not sleep because of pain. Took 5 low dose aspirin and two extra strength Tylenol. Pain lessened and could move arm in 12 hours. Was then normally sore for three days after .


VAERS ID: 1759830 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Virginia  
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 061E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Hyperhidrosis, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec 10mg
Current Illness: None
Preexisting Conditions: Seasonal Allergies
Allergies: Patient says she has an allergy to a filler that is used in some medications, but could not recall the name
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bright red rash appeared on over 50% of back on the evening of the day of vaccination, and gradually darkened over the following days. Patient also reported feeling hot/sweating over time.


VAERS ID: 1760291 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-01
Onset:2021-09-29
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Lymphadenopathy, Pain in extremity
SMQs:, 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:
CDC Split Type:

Write-up: Swallow limp mode in neck, headache, sore arm


VAERS ID: 1760461 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-16
Onset:2021-09-29
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram abnormal, Echocardiogram, Magnetic resonance imaging normal, Retinal vascular thrombosis, Ultrasound Doppler, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Eyelid surgery 9/8/21
Preexisting Conditions: Polycythemia vera Primary iridocyclitis open angle glaucoma Obstructive sleep apnea Hyperlipidemia Obesity CKDIII HTN
Allergies: Penicillin
Diagnostic Lab Data: as above; I do not have copy of these records yet
CDC Split Type:

Write-up: Patient developed acute onset of severe blurry vision in R eye on 9/29/21. He reports being diagnosed with "clot" in eye that "dissolved"--was seen by an Ophthalmologist while traveling. He also underwent hospital work up for CVA that was normal (initial CT apparently showed possible areas of concern but MRI was reassuring as per carotid ultrasound and ECHO per patient). No other associated neurologic symptoms. Vision back to baseline on 9/30/21.


VAERS ID: 1761217 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-20
Onset:2021-09-29
   Days after vaccination:252
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9/29/2021 tested antigen positive @ airport
CDC Split Type:

Write-up: patient tested positive for COVID-19 $g 14 days after vaccine series


VAERS ID: 1761226 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-04
Onset:2021-09-29
   Days after vaccination:237
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Exposure during pregnancy, SARS-CoV-2 test positive
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Routine testing in pregnancy tested PCR positive on 9/29/21
CDC Split Type:

Write-up: patient tested positive for COVID-19 $g 14 days after vaccine series. patient is due to deliver on 10/07/2021, and tested positive @ routine 39 week prenatal visit, patient is asymptomatic.


VAERS ID: 1761236 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Pericarditis


VAERS ID: 1761350 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-22
Onset:2021-09-29
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain, Pain in extremity, Peripheral swelling, Pyrexia, Rash, Rash pustular
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin c, coq10, melatonin, prenatal vitamin
Current Illness: none
Preexisting Conditions: vonwillebrands disorder
Allergies: ceftin, seasonal, apples, cherries
Diagnostic Lab Data: none
CDC Split Type:

Write-up: full body rash. pustular. painful on palms and soles of feet used telemedicine dr who prescribed 0 meds. told me to ride it out 10/2- onset of L finger severe swelling, fever and pain. onset random, no precipitating event. used telemedicine again and dr adivsed me to be seen in urgent care. Was seen in urgent care and told to take Allegra 60mg BID other fingers starting to now hurt mildly as well


VAERS ID: 1761403 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK LA / IM

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

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

Write-up: Patient received expired dose of vaccine. Vaccine expired 9/21/2021


VAERS ID: 1761407 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Unknown  
Location: New Hampshire  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK LA / IM

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

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

Write-up: Patient received expired vaccine dose. Vaccine expired 9/21/2021


VAERS ID: 1761424 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Twice had flu-like symptoms after flu vaccine; other times no symptoms from flu vaccine
Other Medications: Metropolol
Current Illness:
Preexisting Conditions: Irritable Bowel Syndrome Leg muscle cramps
Allergies: Furesamide Bee stings Pollen allergies
Diagnostic Lab Data: Reported to physician, no tests or medical visit
CDC Split Type:

Write-up: Vertigo, mild headache, mild nausea. Sudden onset, subsided after 30 minutes. Some remains after several days.


VAERS ID: 1761453 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Ear pain, Feeding disorder, Gait disturbance, Impaired driving ability, Neck pain, Nystagmus, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Ocular motility disorders (narrow), Arthritis (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: Prenatal Vitamins
Current Illness: Was post c section and just delivered my baby 4 weeks ago
Preexisting Conditions: None
Allergies: Iodine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 24 hours after the vaccine vomited continuously could not eat. Received 2 IV bags of fluid along with Zofran and Tornadol. Had right ear Pain and neck pain. Also have vertigo with nystagmus and dizziness that is still present 1 week later. Not able to walk well without feeling off balance. Symptoms are improving slowly. Have a hard time driving.


VAERS ID: 1761498 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040CZ1H / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abnormal dreams, Blood test, Discomfort, Dizziness, Electrocardiogram, Euphoric mood, Feeling abnormal, Headache, Influenza virus test, Magnetic resonance imaging head, Mental impairment, Pain, Paralysis, SARS-CoV-2 test, Slow speech, Speech disorder
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, .23mg
Current Illness: Sinusitis Hashimotos
Preexisting Conditions: thyroid Hashimotos, depression, anxiety
Allergies: Macrodanton, most fruits, avocado, nuts, honey, bananas, seafood
Diagnostic Lab Data: EKG, MRI brain, blood tests, flu/covid tests,
CDC Split Type:

Write-up: Headache, soreness in upper body, cloudy thoughts, lucid dreams, fragmented thoughts, dizzy, drugged feeling, heaviness in whole left side, partial paralysis, impaired speech, impaired thinking, could not talk fast.


VAERS ID: 1761515 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Immediate post-injection reaction, Injection site pain, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, losartan, zofran, folic acid.
Current Illness: Lung cancer.
Preexisting Conditions: Diabetes, hypertension, and hyperlipidemia.
Allergies: Pencillin.
Diagnostic Lab Data: None. My dr. told me not to worry.
CDC Split Type:

Write-up: Severe pain in injection site immediately when vaccine was administered lasting for several minutes. The same evening I woke up with foot and leg pain on my left side. It felt like my leg / foot were on fire and lasted about 30 miutes.


VAERS ID: 1761537 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Dyspnoea, Obstructive airways disorder, Throat irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetazolamide 1000mg 2x
Current Illness: None
Preexisting Conditions: None
Allergies: Augmentin Azithromycin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: After 10 minutes of receiving my 2nd shot I began to feel a tickle sensation in my throat and started to cough. The cough became stronger and harder for me to breath. The lady who gave me the shot took me next door to the urgent care where the doctor told me he could hear the tops of my lungs closing. Within minutes. The Dr told me had I waited any longer I would have had a far worse outcome. They gave me several different types of medications there and it stopped the coughing.


VAERS ID: 1761548 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Extra dose administered, Fatigue, Pain
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: After first dose of Pfizer vaccine, he developed body aches, chills and fatigue lasting about 3 days. No side effects after sec
Other Medications: metoprolol, lisinopril, fenofibrate, atorvastatin, B12 supplement, ameprazole
Current Illness: no
Preexisting Conditions: Had atrial fibrilation until November 2019 when it was treated with a Hybrid Maze ablation which cured the Afib. Has high blood pressure and high cholesterol. Is overweight (5''6" and about 200 pounds). Has long term issues with acid reflux and frequent loose stools and sometimes diarhea. Has psoriasis as a result of one of the maintenance medications listed above.
Allergies: no
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fatigue started a few hours after receiving the booster shot. Overnight, body aches began. Also developed occasional chills lasting a few days. Body aches lasted for four days. Fatigue continues today (six days) after receiving booster.


VAERS ID: 1761561 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Fatigue, Injection site pain, Pain, Pyrexia, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Lisinopril, Lamotrigine, Synthroid, Fenofibrate, Alendronate Sodium, Omepazole, Vitamin B Complex, Multivitamin, L-lysine, Biotin, Aspirin, vitamin D3,
Current Illness: none
Preexisting Conditions: none
Allergies: Gluten and Shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sept 29th 2021 Sore arm after shot was given 11:00 fever and sore to touch or lay on at 9:00 PM and all night Also had a flu shot on same arm same time Sept 30th around noon really tired and achy all over still fever and sore arm to touch. Oct 1st itchy rash, redness, fever and sore until Oct 4th. Tried cortizone-10 one night and Neosporin one night to relieve itch, Tylenol for fever at site of shot. Oct 4th better and Oct 5th almost all gone for rash, and fever is gone.


VAERS ID: 1761593 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Exposure during pregnancy, Uterine contractions during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (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: Vitamins
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I experienced braxton hicks contractions that would not subside, the estimated date of delivery is 12/22/2021.


VAERS ID: 1761600 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-25
Onset:2021-09-29
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002A21A / UNK - / -

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

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

Write-up: Covid positive contact unknown


VAERS ID: 1761651 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Diarrhoea, Fatigue, Headache, Immunodeficiency, Influenza
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: I had severe arm soreness after all Pfizer vaccines
Other Medications: Bacterium; Paxil; metoprolol; Nexium; hydrochlorothiazide; amlodipine; Livatrex; Bentyl; guaifenesin; Asacol; metformin
Current Illness: Hip surgery
Preexisting Conditions: Colon issues; Sinus issues (had 7 prior sinus surgeries)
Allergies: Penicillin; losartan; codeine
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I got extremely tired. I would put my head down and would fall asleep. It took a full day after getting the vaccine to feel this way. It lasted all through the weekend. I started feeling headaches. Then I started to have abdominal problems. I was having really severe diarrhea. That lasted for about a day. It was like I had a little flu episode there. I went in to see my doctor yesterday. I think that maybe I got the booster too soon after my 2nd dose. I had more of a reaction this time. My immune system feels like it is in overdrive.


VAERS ID: 1761673 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Confusional state, Dizziness, Fatigue, Hypertension, Hypotension, Palpitations
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Shot felt weird when injected and felt dizzy. Two days after vaccine I had low blood pressure and very tired. That lasted 2 days. Then my blood pressure became high. I have had dizziness, heart palpitations, confusion and fatigue since then. ER visit with blood pressure of 165/92. Still no answer. Waiting to see cardiologist


VAERS ID: 1761730 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-25
Onset:2021-09-29
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (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: Contrav, Red Yeast Rice, Saw Palmetto Berries, Glucosamine Chondroitin, Vitamin D3, Fish Oil; occassionally Zyrtec
Current Illness: None
Preexisting Conditions: Allergies (dust, grass), Obesity
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue (about one week from injection); red ring almost around the entire circumference of arm approx 2 inches below the injection site


VAERS ID: 1761760 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test normal, Lymphadenopathy, Musculoskeletal stiffness, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (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: Ibuprofen
Current Illness: No
Preexisting Conditions: No
Allergies: Sulfa
Diagnostic Lab Data: Blood work(white blood count was normal)
CDC Split Type: vsafe

Write-up: I had swelling on the left side of my neck at my lymph gland. Also exp swelling on left side face down to my collar bone and neck felt stiff. The doctors stated it would gradually go away may take up to two weeks. I have taking Ibuprofen as needed. I wanted to make a note that had Covid April 2020 and had a antibody test in Dec. 2020 wanted to inform.


VAERS ID: 1761806 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-19
Onset:2021-09-29
   Days after vaccination:253
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9/29/2021 tested PCR positive for Covid-19
CDC Split Type:

Write-up: patient tested positive for COVID-19 $g 14 days after vaccine series


VAERS ID: 1761811 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-28
Onset:2021-09-29
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / UNK - / -

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

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

Write-up: Covid positive contact unknown


VAERS ID: 1761831 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Blood test normal, Computerised tomogram normal, Confusional state, Electrocardiogram normal, Electroencephalogram normal, Heart rate increased, Hyperhidrosis, Impaired driving ability, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tamoxifen, Effexor XR, Multi Vitamin, aspirin
Current Illness: None
Preexisting Conditions: NONE
Allergies: Celery hydrocodone Cefalexin
Diagnostic Lab Data: treatment- sent to ER , Ct scan, ekg, blood work, eeg --- All normal MRI of brain is scheduled Oct. 18, 2021
CDC Split Type:

Write-up: 1. Fever for 6 hrs 2. Confused unaware of my location, unable to identify co-workers, fast heart rate, elevated BP, Tremors in injection arm and right leg , sweating treatment- sent to ER , Ct scan, ekg, blood work, eeg --- All normal MRI of brain is scheduled Oct. 18, 2021 No longer allowed to drive for 6 months.


VAERS ID: 1761841 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-10
Onset:2021-09-29
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

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

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

Write-up: Covid positive contact unknonw


VAERS ID: 1761922 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 212A21A / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 RA / IM

Administered by: Pharmacy       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was asked about duplicate vaccination and confirmed doses. Initial Pfizer Covid vaccine was given where patient experienced extreme fatigue and was directed by doctor to not receive second dose. Patient was instructed by doctor to get Johnson and Johnson vaccination as given by the pharmacy. Patient did not indicate a history of vaccination nor adverse effect per screening questionnaire at time of vaccination. Patient has reported no other adverse effects as of today 10/5/2021


VAERS ID: 1762004 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Patient came to the pharmacy for an additional covid vaccine dose, she did receive Moderna for her first 2 doses earlier in the year. Patient had marked off she was over 65 years old on the attestation form, but Moderna is currently not approved for this population at the moment. The 3rd additional dose of Moderna was administered. Patient is not experiencing any side effects from the third dose.


VAERS ID: 1762034 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-09-27
Onset:2021-09-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Dermatitis, Peripheral swelling, Pruritus, Rash
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (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), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Full body skin rash, dermatitis with blisters and itch. Swollen fingers from the reaction also.


VAERS ID: 1762082 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Back pain, Chest pain, Dyspnoea, Fatigue, Headache, Injection site erythema, Injection site pruritus, Injection site swelling, Lymphadenopathy, Nasopharyngitis, Oedema peripheral, Pain in extremity, Palpitations
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot - similar reaction to the hive. But it occurred within 24 hours of flu vaccination
Other Medications: Synthroid
Current Illness: Na
Preexisting Conditions: Hypothyroidism
Allergies: Amoxicillin, latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Racing heart, trouble catching breath, major fatigue started about 4.5 hours after the shot; the next 2 days had a severe headache and no energy, pain in my arm and in my chest and all the way around to my back (all on the left side - I thought I was having a heart attack at first and then realized the pain was coming and going, like a slow throb; the following 2 days I had what can only be described as a ?head cold? and was extremely fatigued. 3 days after the shot, my arm started hurting very badly and a lymph node under my arm became very enlarged - this made my whole arm hurt. It is still hurting at day 6 after the shot. 5 days after the shot at approximately 4pm, I noticed an itch at the vaccine site on my arm - it welped up and itched and grew in size over night. This morning it was very large in size and red, swollen and itchy.


VAERS ID: 1762112 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-19
Onset:2021-09-29
   Days after vaccination:253
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9/30/21 SARS/COV-2, Positive
CDC Split Type:

Write-up: Breakthrough COVID


VAERS ID: 1762189 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-26
Onset:2021-09-29
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Herpes virus infection, Immune system disorder, Inflammation, Vaccination complication
SMQs:, Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I took my normal medications - Simvastatin and Levothyroxine.
Current Illness: No
Preexisting Conditions: Sleep Apnea
Allergies: Antibiotics
Diagnostic Lab Data: Not applicable
CDC Split Type: vsafe

Write-up: I experienced a herpes outbreak on my left hand (had it for about 13 years). It was an immune system reaction to the vaccine. My PCP confirmed that it was no doubt some inflammation or immune reaction to the vaccine. She prescribed medication to treat the adverse event.


VAERS ID: 1762343 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine, 81 mg aspirin, 10 mg loratidine, 5 mg oxybutinin, calcium carbonate, vitamin D3, polyethylene glycol.
Current Illness: None acutely. Only chronic health conditions.
Preexisting Conditions: 1. Hypothyroidism after Hashimoto''s thyroiditis hyperthyroidism. This is treated. 2. Left body mild muscle weakness from right brain radiation in 2002. 3. History of right frontal lobe glioblastoma in 2002, resected and in 18-year remission. 4. General environmental allergies (rhinitis when outdoors). 5. Urinary bladder stress incontinence, treated. 6. Right knee mild arthritis.
Allergies: Septra/Bactrim (sulfamethoxazole/trimethoprim combination)
Diagnostic Lab Data: None needed or done.
CDC Split Type:

Write-up: Mild injection site muscle soreness with onset 4 hours after dose, spontaneous resolution within 40 hours.


VAERS ID: 1763687 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate increased, Malaise, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan
Current Illness: no known illnesses
Preexisting Conditions: no known health conditions
Allergies: no known allergies
Diagnostic Lab Data: BP: 199/100, 188/89, 190/89 HR: 117bpm O2 sat: 99%
CDC Split Type:

Write-up: Patient initially experienced tachycardia (HR $g110 bpm). She reported that she''s not feeling too well and that her heart is beating so fast. This occurred within the 15 min monitoring period post vaccination. Checked her bp and reading was 199/100. checked it once again after 15 mins and it was at 188/89. 15 mins after paramedics came, her bp was still at 190/89 and HR of 117bpm, O2 sat 99%. Patient was still not feeling too well, although conscious and was able to communicate with me and the paramedics.


VAERS ID: 1763943 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-09-29
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 212A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Ear discomfort, Injection site pain, Nausea, Tinnitus
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VITAMIN D [ERGOCALCIFEROL]; VALACYCLOVIR [VALACICLOVIR]
Current Illness: Abstains from alcohol; Cholesterol (An unspecified cholesterol medications.); Cigarette smoker (Quit a year ago for 6 months, and started over anxiety of getting vaccine. Plans on quitting once side effects go away.); Herpes NOS
Preexisting Conditions: Medical History/Concurrent Conditions: Motion sickness; Comments: The patient had no drug abuse or illicit drug.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211004095

Write-up: PRESSURE IN HER EARS; LOUDER RINGING IN EARS; QUEASY WHEN STANDS UP TOO FAST; REALLY HURT WHEN VACCINE WAS ADMINISTERED; DIZZY; This spontaneous report received from a patient concerned a 63 year old female. The patient''s weight was 178 pounds, and height was 66 inches. The patient''s past medical history included: motion sickness, and concurrent conditions included: herpes, smoker, non alcohol user, and cholesterol, and other pre-existing medical conditions included: The patient had no drug abuse or illicit drug. The patient experienced drug allergy when treated with chlorphenamine maleate/phenylpropanolamine hydrochloride for drug used for unknown indication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 212A21A, and expiry: 21-DEC-2021) dose was not reported, administered on 29-SEP-2021 for prophylactic vaccination. Concomitant medications included valaciclovir for herpes, and ergocalciferol. On 29-SEP-2021, the patient experienced dizzy. On 29-SEP-2021, the patient experienced really hurt when vaccine was administered. On an unspecified date, the patient experienced pressure in her ears, louder ringing in ears, and queasy when stands up too fast. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from dizzy, louder ringing in ears, pressure in her ears, and queasy when stands up too fast, and the outcome of really hurt when vaccine was administered was not reported. This report was non-serious.


VAERS ID: 1764299 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Energy increased, Fatigue, Feeling abnormal, Headache, Impaired driving ability, Nausea, Pain, Sleep disorder, Vaccination site swelling, Vaccination site warmth, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna first 2 vaccines however reactions resolved in 48 hours
Other Medications: .175 Synthroid .5 lexapro every other day Vitamin D supplement once a week
Current Illness: None
Preexisting Conditions: Auto Immune : Thyroid. Hashimotos Lupus
Allergies: No but high sensitivity to all meds. I can not even take Benadryl without experiencing 2 day ?fog?
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Day 1. After 5 hours So tired could not stay awake but felt fine Woke up at 12:30 am burning up, achey, massive headache, swollen vaccination site HOT to touch Day 2. Slept entire day..same as above Day 3. Same symptoms, no fever, WEAK, foggy feeling, dizzy, throbbing headache Day 4. I thought I was feel a bit more energy but then became SO nauseous , vomiting throughout the day and early evening Day 5. Woke up in a burst of energy, worked out?back to myself ?.by 5pm.. fatigue and massive headache returned Day 6/7. More energy (not normal). Foggy head, massive headache, fatigue *I am very active, exercising 6 days a week, eat vegetarian diet, healthy lifestyle. Today has been a week and I am just not feeling myself?not comfortable driving due to a foggy/dizzy/headache feeling that has not subsided. I do not believe that I need doctor or care beyond Advil/Tylenol/hydration but I am not myself. Could be some bug and timing is exact same but I do not believe so. Sill grateful to be vaccinated! I take care of my 86 year old mom and feel safe together with her!


VAERS ID: 1764344 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Coordination abnormal, Dysphagia, Feeling hot, Flushing, Hypoaesthesia, Limb discomfort, No reaction on previous exposure to drug, Sensory loss, Tongue disorder
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (broad), Hypoglycaemia (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: Multivitamin, Orthobiotic, probiotic, fish oil, antacid
Current Illness: N/A
Preexisting Conditions: reflux, migraines - generally well controlled
Allergies: reactions to sulfa based medications - severe stomach pain;
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: I left the pharmacy without waiting the recommended 10 minutes; they had run late and I was taking my son to an appointment; I had my first 2 shots without event and was unconcerned. About 5 minutes after leaving I noticed my tongue felt thick and I was having trouble swallowing; a few minutes later I felt very hot and when looked in the mirror noted I was quite flushed. I drive to the nearest , and checked in with that pharmacist around 3:35 who noted the flush and recommended I wait there until things subsided; she did not feel it was an allergic reaction. Several minutes later my right arm lost some sensation and felt heavier / clumsier. This increased but never to the point of significant dysfunction. I consulted with the pharmacist who indicated Urgent Care or 911 was appropriate. I went to Urgent Care where I waited about 2 hours to be seen. My symptoms had improved by the time the APNP interviewed and assessed me. She also seemed to feel that was not an allergic reaction. She seemed to suggest this might have been an anxious overreaction to getting the booster. The paraesthesia continued until early evening the next day, when I noticed things seemed resolved. This morning; a week later; I woke up and again feel some lack of coordination and slight numbness. It does not appear to be impacting my strength or overall performance. Let me reiterate that I was not at all anxious about getting the booster. The APNP''s opinion of the event was informed from an assessment taking place 2.5 hours after the initial symptomatology, and seemed impacted by a very anxious nurse who admitted being terrified of getting the vaccine. I am reporting this because I do not believe she would consider what happened to be a reportable concern.


VAERS ID: 1764557 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-20
Onset:2021-09-29
   Days after vaccination:252
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9/29/2021 tested positive
CDC Split Type:

Write-up: patient tested positive for COVID-19 $g 14 days after vaccine series


VAERS ID: 1764558 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011F217 / 2 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Anosmia, Chills, Cough, Fatigue, Headache, Nasal congestion, Pyrexia, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Fever (103.3), Chills, loss of smell, headache, nasal congestion, persistent coughing, sneezing and fatigue.


VAERS ID: 1764597 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Adverse reaction, Axillary pain, Chills, Decreased appetite, Dizziness, Feeding disorder, Headache, Mobility decreased, Pain, Pyrexia, Skin tightness, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Anal cancer in 2000. Chemotherapy and radiation. Currently cancer-free. Collapsed left lung (presumed from frequent bouts of bronchitis and pneumonia as a teen/young adult)
Allergies: None
Diagnostic Lab Data: I sent a message to my PCP. His response was that adverse reactions are normal and that I should just wait it out.
CDC Split Type:

Write-up: Injection was received late afternoon Wednesday. Fever, chills, headache, total body aches/pain, stomach upset, dizziness. I spent Thursday lying on the sofa unable to eat (no appetite) or do anything else (couldn''t walk my dog). I texted my neighbor about 6:00 pm (Thursday) for help when it looked like the symptoms were not getting better, as I live alone and do not normally take pain medications so had nothing to treat the pain. He brought me Ibuprofen. I drank water but had no appetite for food. (lost 3 pounds). By Friday I was able to eat a little and leave my post on the sofa. Today is Wednesday, a week after the injection, and my appetite is still very poor and I cannot raise my left arm above my head because the area of the armpit is quite tight and sore.


VAERS ID: 1764605 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Asthenia, Chills, Dizziness, Fatigue, Headache, Hot flush, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: Hot flashes, tired, no energy, sick to stomach, headache, dizzy, nause chills,


VAERS ID: 1764737 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / N/A LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cardiac flutter, Immediate post-injection reaction, Musculoskeletal stiffness, Pain
SMQs:, Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Tachyarrhythmia terms, nonspecific (narrow), Hypersensitivity (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: B2 Vit, Omega 3, Magnesium, Vit D3 +K2
Current Illness: none
Preexisting Conditions: migraines, 2 brain cysts
Allergies: steroids, anaprox, amoxicillen, levaquin, topiramate, augmenti allergies: sulfa drugs, freetext allergy, meloxicam, celebrex, relafen, metals, requip, cleocin HCI, Flagyl, Keflex, levofloxacin, macrobid, oxycodone, omeprazole
Diagnostic Lab Data: none at this time
CDC Split Type:

Write-up: Immediately began feeling a stiffness in my neck and a stinging heart flutter. That''s the best way to describe it. Both were sporadic, meaning not non-stop, however they existed consistently off/on from time of shot until I went to bed at 10pm that night. Today, October 6, 2021 at 0857am I began feeling the stinging heart flutters again. They don''t feel ''severe'' but are most definitely noticeable. I''ve never experienced this sensation before with anything else. FYI


VAERS ID: 1764800 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (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: Lexapro, Ambien, Viagra, Motrin, Flexeril
Current Illness: None
Preexisting Conditions: Depression, Anxiety, Chronic joint pains
Allergies: None
Diagnostic Lab Data: Pending Optometry evaluation
CDC Split Type:

Write-up: Patient reports blurred vision that got much worse after initial injection


VAERS ID: 1764879 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-26
Onset:2021-09-29
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 1 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046A21A / 2 AR / IM

Administered by: Private       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? Yes
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: none
Allergies: n/a
Diagnostic Lab Data: + covid test 9/29/2021
CDC Split Type:

Write-up: Covid 19 break-through case 9/29/2021


VAERS ID: 1764997 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Facial asymmetry, Facial pain, Hypoaesthesia, Neck pain, Pain in jaw
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Osteonecrosis (broad), Arthritis (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data: patient is admitted to the hospital
CDC Split Type:

Write-up: Neck pain, numbness of the face right side, asymmetry on the right side of the face, and face pain and on the mandibula


VAERS ID: 1765108 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-04-05
Onset:2021-09-29
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Ear pain, Feeding disorder, Oropharyngeal pain, SARS-CoV-2 test negative, Vomiting
SMQs:, Acute pancreatitis (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Yes, took my prescribed medications
Current Illness:
Preexisting Conditions: Irritable bowel syndrome
Allergies: Mild asthma
Diagnostic Lab Data: Covid test
CDC Split Type: vsafe

Write-up: I experienced throwing up, extreme sore throat and earache pain, lost of taste and smell and can not eat. I have had two negative Covid tests this week. I am going for a strep test on 10-07-2021 at 10am at a drive through vaccination site. Dr. who I see is just an herbalist.


VAERS ID: 1765165 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-19
Onset:2021-09-29
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: Hospitalization due to Covid


VAERS ID: 1765178 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Joint injury, Limb injury, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Arthritis (broad)

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

Write-up: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-


VAERS ID: 1765261 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Abdominal discomfort, Diarrhoea, Hypersensitivity, Nausea, Pyrexia, Sensation of foreign body, Throat tightness, Tremor, Urticaria, Wheezing
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec Daily Dose and Benadryl 50MG PO taken 45 mins prior to Vaccine Long Team use noted of Hydroxychloroquine and Methotrexate
Current Illness: N/A
Preexisting Conditions: Cardiovascular (Livedo Reticularis, Migraine Headaches, Raynaud''s Disease) Gastrointestinal (Dry Mouth, Oral Ulcer) Immune (History of Sjogren''s Disease) Musculoskeletal (Inflammatory Arthritis)
Allergies: Hepatitis B Vaccine (Anaphylaxis, Angioedema) Amoxicillin (Hives) Ciprofloxacin (Hives) Moxifloxacin (Rash) Sulfa (Rash) Influenza Virus Vaccines (Dizziness, Fatigue, Muscle Weakness)
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Employee called to report Allergic Reaction to J&J Vaccination. Received vaccine on 09/29/2021. Reported that she had immediate onset on involuntary shaking, and stomach upset with watery stools. Reports that due to known history of anaphylaxis to Hepatitis B vaccine along with allergies to multiple other medications, she pre-medicated with both Zyrtec and Benadryl approximately 45 mins prior to vaccine. Employee reports that she was monitored post vaccination and was not treated with any addition medications during this time. Reports that when she got home approximately 1 hour post vaccination she noted feeling as if she had a lump in her throat/throat tightness "like a piece of steak caught in your throat when you''re eating." She reports that she did not seek further care but laid down to rest and several hours later took more Benadryl (4 hours post vaccination) when the throat tightness increased to the point of wheezing. She went on to report that she had a fever $g101 that night and into the next day, along with Diarrhea, Nausea and Hives over body x3 days.


VAERS ID: 1765280 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-15
Onset:2021-09-29
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW8731 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen 325mg q4hr prn for pain albuterol 2.5mg q6hr prn for wheezing albuterol CFC free 90mcg QID prn for wheezing diphenhydramine 25mg prn for allergy symptoms epinephrine 0.3mg prn for anaphylaxis fluticasone-vilanterol 200mcg-25mc
Current Illness: None documented
Preexisting Conditions: Scheurmann''s disease, obesity, history of cervical cancer, asthma, obstructive sleep apnea, gastroesophageal reflux disease, chronic rhinitis.
Allergies: Bee Stings - anaphylaxis
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient contracted COVID-19 after being fully vaccinated fatigue, fever, chills, shortness of breath, congestion


VAERS ID: 1765295 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-10
Onset:2021-09-29
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8930 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Covid19.


VAERS ID: 1765312 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-11
Onset:2021-09-29
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038K20A / 1 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002B21A / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Condition aggravated, Fatigue, Genital herpes, Herpes simplex test positive, Pain, Rheumatoid arthritis
SMQs:, Arthritis (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Enbrel 50mg/ml sureclick Methotrexate 20mg 1x/wk Sertraline 50mg/day Wellbutrin HCL XL 300mg/day Rosuvastatin 10mg/day Folic acid 1mg/day Fluticasone nasal Women?s Multi vitamin 1/day Vitamin C 500mg/day Fish oil 1000mg 1x/day D3 25mcg-1
Current Illness:
Preexisting Conditions: Rheumatoid Arthritis Obesity
Allergies: None
Diagnostic Lab Data: September 30, 2021 at Labcorp. Positive for Herpes simplex virus type-2. Typing was confirmed by monoclonal antibody microscopic immunofluorescence.
CDC Split Type:

Write-up: First ever genital herpes outbreak during Rheumatoid Arthritis flare. Blister on genitals, fatigue and all over body pain in joints RA/muscles. Never had any symptoms of Herpes before. Medical practitioner mentioned that the vaccine could possibly awaken dormant viruses. I am immuno suppressed.


VAERS ID: 1765472 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Abdominal pain upper, Dry mouth, Dysphagia, Dysphonia, Ear discomfort, Eye irritation, Hypersensitivity, Lip swelling, Oropharyngeal discomfort
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pfizer Covid- 19 injection Levaquin 500 mg
Current Illness: no
Preexisting Conditions: no
Allergies: Pfizer Covid- 19 injection Levaquin 500 mg
Diagnostic Lab Data: 09/29/2021
CDC Split Type:

Write-up: allergic reaction, my eyes, ears burn, lips swollen ,stomach hurt and throat felt like I had hair ball , dry mouth , and it became hard to swallow and my voice became horse .


VAERS ID: 1765491 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Echocardiogram abnormal, Ejection fraction decreased, Headache, Troponin I, Troponin increased, Vomiting
SMQs:, Cardiac failure (narrow), Acute pancreatitis (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Troponin IHS- 8,476 (10/1/2021)--- $g18,884 (10/1/2021)--- $g5,988 (10/2/2021) C V echo: o Normal chamber sizes. o Normal left and right ventricular systolic function. o LVEF 58% by biplane method of disks. o Normal left ventricular wall motion. o No significant valvular regurgitation. o Normal left ventricular diastolic function. o Unable to estimate right ventricular systolic pressure due to insufficient tricuspid regurgitation Doppler signal. o No comparison study
CDC Split Type:

Write-up: Patient developed vomiting and headache on 9/29/2021 around 2:30 am which subsided gradually. He developed chest pain On 9/30/2021 at night and therefore went to ED on 10/1/2021 AM. He was transferred to another hospital on 10/1/2021 and patient was admitted to cardiology service for observation. He was discharged on 10/2/2021 as he found to have no chest pain and was stable.


VAERS ID: 1765513 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adenovirus test, Alanine aminotransferase increased, Aspartate aminotransferase increased, Bacterial test negative, Blood culture negative, Chest pain, Culture stool, Culture throat, Cytomegalovirus test negative, Cytomegalovirus test positive, Dizziness, Electrocardiogram PR segment depression, Electrocardiogram ST segment elevation, Enterovirus test negative, Epstein-Barr virus antibody negative, Epstein-Barr virus antibody positive, Fatigue, Full blood count abnormal, HIV antibody negative, HIV antigen negative, Haemoglobin normal, Human herpes virus 6 serology negative, Hypersomnia, Immunoglobulin therapy, Impaired work ability, Metabolic function test, Myocarditis, Parvovirus B19 test negative, Platelet count normal, Pyrexia, Respiratory viral panel, SARS-CoV-2 antibody test, SARS-CoV-2 antibody test positive, Skin warm, Sleep disorder, Troponin increased, Varicella virus test negative, Viral test negative, Vomiting, White blood cell count increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Haematopoietic leukopenia (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Other ischaemic heart disease (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: ADHD, exercise induced asthma, delayed puberty
Allergies: Onions (tongue swelling)
Diagnostic Lab Data: (10/3) COVID-19 IgG by ELISA (Spike Ab) - Positive (10/3) Covid-19 IgG, Qualitative by CIA (Nucleocaspid Ab) - Negative (10/1) Blood culture - No growth (10/3) Enterovirus PCR - Negative (10/3) Enterovirus Stool culture- Pending (10/3) Enterovirus Throat culture - Pending (10/1) Adenovirus, Qualitative PCR - Negative (10/1) HHV 6 PCR - Pending (10/1) Parvovirus B19 Ab (IgG and IgM) - Negative (10/1) EBV Ab Panel - IgG Positive, IgM negative (10/1) CMV IgG screen - Positive, (10/1) CMV IgM screen - Negative (10/3) Varicella Zoster IgM - Negative (10/3) Varicella Zoster IgG - Negative (10/3) Varicella Zoster serology - Negative (10/3) HIV Ag/Ab combo 1/2 screen - Negative (10/1) VRP - Negative (10/1) Troponin 27.33 (10/6) Troponin 1.19 (10/1) CBC with WBC 17.6, Hg 15.4, Platelets 361 (10/1) CMP with AST/ALT 134/39
CDC Split Type:

Write-up: He presented with excessive fatigue, fevers, emesis, and chest pain. He received his second COVID-19 vaccination on 9/29, 3 days prior to ED presentation on 10/1. Per patient, he went to work the same day after receiving his second COVID vaccination. While at work, he became lightheaded and had to leave early. He went home and went to bed. He woke up in the middle of the night and vomited then went back to sleep for the rest of the night. The following day (9/30) he reports excessive fatigue and says he slept all day (~12-13 hours). Per mom, he was also very hot to the touch throughout the day. He then woke up on 10/1 with "really bad" left anterior, non-radiating chest pain in addition to his persistent dizziness, 3-4 episodes of emesis, and not being able to keep anything down - which prompted mom to bring him to the ED. He was transferred and admitted to a local hospital for myocarditis with a troponin of 27.33 and diffuse ST elevation with PR depression on EKG. A complete infectious disease workup was negative for other viral or bacterial causes of myocarditis. He received IVIG on 10/3. He also got tylenol and motrin and one dose of aspirin. His troponin down trended after receiving IVIG and his symptoms resolved. He was discharged on 10/6 with cardiology follow up outpatient.


VAERS ID: 1765544 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-02-27
Onset:2021-09-29
   Days after vaccination:214
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012A21A / 2 UN / IM

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: HTN, COPD, Hypothyroidism
Allergies: Morphine, Amiodarone, Crestor, Librium, Phenergan and Zestril
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was admitted on 10/2/2021 after being fully vaccinated in Feb 2021.


VAERS ID: 1765545 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-17
Onset:2021-09-29
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hypertension, hyperlipidemia,
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was hospitalized for Covid 19


VAERS ID: 1765558 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-15
Onset:2021-09-29
   Days after vaccination:137
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asymptomatic COVID-19
SMQs:, COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: CVA, HTN
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: hospitalization - patient was admitted for non-covid issue. COVID-19 was an incidental finding at discharge to a Rehab facility. Patient is asymptomatic.


VAERS ID: 1765578 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bone swelling, Lymphadenopathy, Swelling, Tenderness
SMQs:, Anaphylactic reaction (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Buspirone, Simvastatin, Blisovi 24 Fe, Flovent HFA
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen left shoulder and collar bone. Swollen lymph node in left collar bone. Hurt to touch and more. Persisted 9/29/21-10/1/2021.


VAERS ID: 1765588 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test abnormal, Fatigue, Pyrexia, Renal impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 2nd dose Pfizer Vaccine/ E-REPORT # 671947
Other Medications: Vitamin D Vitamin B12 Tylenol Rosuvastatin ( 20mg 1xday ) Dexilant ( 60mg 2xday )
Current Illness: NA
Preexisting Conditions: IBS Osteoarthritis Blocked artery LPR
Allergies: Penicillin Erythromycin Sulfa Codeine Wellbutrin Arbutin
Diagnostic Lab Data: Bloodwork
CDC Split Type: vsafe

Write-up: I developed fever and fatigued the following day after I received the vaccine .I had an online appointment with Dr. and he ordered bloodwork at that visit. My kidneys aren''t functioning right I have more bloodwork scheduled for 10/7/21 not sure if its related to vaccine or not.


VAERS ID: 1765633 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 212A21A / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Headache, Heart rate increased, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Dehydration (broad)

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

Write-up: Symptoms are constant headaches ,nausea, heart beating extremely fast.


VAERS ID: 1765649 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cold sweat, Depressed level of consciousness, Dizziness, Hyperhidrosis, Hypoaesthesia, Hypoventilation, Muscular weakness, Pallor, Pulse abnormal, Skin warm, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Hypokalaemia (broad), Sexual dysfunction (broad)

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

Write-up: Approximately 10 minutes after patient received his COVID-19 vaccine while he was sitting in the observation area, he stated he was feeling dizzy and lightheaded. Pt was extremely diaphoretic, pale/grey, weakening extremities and decreased level of consciousness. Patient started to hypoventilate, close eyes and lean over while sitting. Vitals checked: BP 90/62, HR 44 fluctuating as low as 39, pulse ox 97%, pulse thready, skin clammy and diaphoretic. RN used ammonia inhalant to keep patient alert. Patient was transferred to floor. He became more alert and able to speak clearly and aware of surroundings. Color improved but BP stayed between 39-44 with complaints of hands becoming numb. Clinic lead called 911 and EMS arrived approx 10 minutes later. No sign of anaphylaxis per skin assessment. Pt was A & O x 4, skin color improving, less diaphoretic, extremities warm to touch - HR 66, oxygen sates 98%. Transfer and report given to EMS. Epi-pen not given as advised by 911. Patient eventually had resolution of symptoms and was able to ambulate with wife present. No hospital transport. Incident report written up as vasovagal syncope.


VAERS ID: 1765674 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Presyncope
SMQs:, Anticholinergic syndrome (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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 5 minutes after patient was vaccinated with COVID-19 vaccine, he complained of feeling dizzy and lightheaded while still seated at the vaccination station. Patient was moved to floor and assessed. Lungs were clear, A x O x 3, pulse regular and steady. EMS was already present from responding to another emergency so patient was assessed by them. Pulse 80, RR 16. Patient likely had vasovagal reaction as per mother he had similar symptoms when he underwent an MRI in the past. Patient had resolution of symptoms and ambulated out of clinic in stable condition with his parents. No hospital transport.


VAERS ID: 1765707 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Feeding disorder, Hypoaesthesia, Insomnia, Pain, Paraesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: 101.5 Fever, body aches, couldn''t sleep or eat. Felt exactly like having COVID but more intense in a shorter time frame. Also felt numb and tingling in my arms and legs.


VAERS ID: 1765733 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLULAVAL QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS NDC:19515-818-4 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site erythema, Injection site mass, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: At injection site: pain, swelling, redness, itching, lump, warm to touch


VAERS ID: 1765897 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 is experiencing tremors in his hand


VAERS ID: 1765909 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Work       Purchased by: ?
Symptoms: Headache, Pain, Pyrexia, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: negative of covid - Sept 30, 2021
CDC Split Type:

Write-up: Headache, fever, body ache


VAERS ID: 1766141 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-29
Onset:2021-09-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Migraine, Pain, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Extreme vomiting for 5 days, migraine headaches 5 days, arm soreness and body aches.


VAERS ID: 1766848 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-09-29
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211001; Test Name: COVID-19 virus test; Result Unstructured Data: Positive.
CDC Split Type: USJNJFOC20211006541

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a consumer concerned a White and Hispanic or Latino male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029, expiry: 23-AUG-2021) dose was not reported, 1 total, administered on 12-MAR-2021 to right arm for prophylactic vaccination. No concomitant medications were reported. On 29-SEP-2021, patient experienced the headaches, stuffy nose and sneezing. On 29-Sep-2021, patient experienced the Covid-19 symptoms (suspected Covid-19 infection and suspected clinical vaccination failure). On 01-OCT-2021, patient lost sense of taste and smell and decided to get tested for Covid-19. On 01-Oct-2021, patient tested for Covid-19 infection. On 02-OCT-2021 (Reported as Saturday) the test resulted positive for Covid-19. It was reported that, physician was notified and there was no change in lifestyle of patient". On 04-OCT-2021, patient experienced the chest congestion, fatigue and body aches. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from suspected covid-19 infection, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint 90000195816.; Sender''s Comments: V0: 20211006541-COVID-19 VACCINE AD26.COV2.S-Suspected clinical vaccination failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1766850 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-09-29
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 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: USJNJFOC20211006798

Write-up: EXPIRED VACCINE ADMINISTERED; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204A21A, 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 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. This case, from the same reporter is linked to 20211006668 and 20211006371.


VAERS ID: 1767126 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-28
Onset:2021-09-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH DF8448 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Crying, Depression, Feeling abnormal, Feelings of worthlessness, Hyperacusis, Hyperaesthesia, Migraine, Nausea, Photophobia
SMQs:, Acute pancreatitis (broad), Dementia (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (narrow), Hearing impairment (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: Allergic to flu vaccine, swelling, rash
Other Medications: Albuterol Inhaler
Current Illness: None
Preexisting Conditions: Food allergies
Allergies: Multiple food allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Depression - does not want to get out of bed, has been crying frequently, feelings of worthlessness. All very unlike his normal self Migraines: severe light sensitivity, noise sensitivity, touch sensitivity, nausea.


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