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From the 11/12/2021 release of VAERS data:

Found 875,292 cases where Vaccine is COVID19 and Patient Did Not Die

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

This is page 76 out of 8,753

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VAERS ID: 1836641 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-25
Onset:2021-10-28
   Days after vaccination:217
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH LOT# EN6205, #E / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Anticoagulant therapy, Base excess, Basophil percentage decreased, Blood bicarbonate normal, Blood gases, Blood methaemoglobin, Blood pH decreased, COVID-19, Carboxyhaemoglobin normal, Chest X-ray normal, Chest pain, Coagulation test, Cough, Differential white blood cell count, Dyspnoea, Eosinophil percentage decreased, Fibrin D dimer increased, Fraction of inspired oxygen, Full blood count, Haematocrit decreased, Haemoglobin decreased, Lymphocyte count decreased, Lymphocyte percentage decreased, Mean cell haemoglobin concentration decreased, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume normal, Monocyte count normal, Monocyte percentage, Myocardial injury, Neutrophil count increased, Neutrophil percentage increased, Oxygen consumption decreased, PCO2 increased, PO2 decreased, Platelet count normal, Red blood cell count decreased, Red cell distribution width increased, SARS-CoV-2 test positive, Troponin I increased, Venous oxygen saturation decreased, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Lactic acidosis (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: COPD, TAVR
Allergies: no known allergies
Diagnostic Lab Data: Lab Results: Other Chemistry: 30-Oct-21 18:00, Troponin I Troponin I 0.53 [0.00 - 0.03 ng/mL] Telephone notification of critical result was read back and verified with: 10/30/2021 18:55:31. Normal: <= 0.03 ng/mL Indeterminate: 0.04-0.29 ng/mL Suggestive of Myocardial Damage: $g= 0.30 ng/mL 30-Oct-21 21:05, Troponin I Troponin I 0.65 [0.00 - 0.03 ng/mL] Telephone notification of critical result was read back and verified with: 10/30/2021 21:48:17 Normal: <= 0.03 ng/mL Indeterminate: 0.04-0.29 ng/mL Suggestive of Myocardial Damage: $g= 0.30 ng/mL ABG & VBG: 30-Oct-21 17:45, Venous Blood Gas Request *FIO2 32.0 ABG/VBG Comment 3L nasal cannula Coagulation: 30-Oct-21 21:05, D Dimer D Dimer 1357 [0 - 500 ng/mL FCU] This D-Dimer method is FDA approved for exclusion of both deep vein thrombosis (DVT) and pulmonary embolism (PE) at a cut-off value of 500 ng/mL FEU when the clinical probability of DVT or PE is low (e.g. when assessed by Wells or Modified Geneva scores). Additionally the cut-off value for PE exclusion can be age adjusted upwards for patients greater than 50 years old by multiplying the patient''s age by 10 (e.g. 78 y/o patient would have an upper limit of 780 ng/mL FEU). CBC-Differential-Morphology: 30-Oct-21 18:00, CBC White Blood Cell Count 10.5 [4.5 - 11.0 K/cmm] Red Blood Cell Count 3.57 [3.30 - 5.30 M/cmm] Hemoglobin 10.4 [11.0 - 16.2 g/dL] Hematocrit 33.5 [36.0 - 46.0 %] Mean Corpuscular Volume 93.7 [80.0 - 100.0 fl] Mean Corpuscular Hemoglobin 29.1 [26.0 - 34.0 PG] Mean Corpuscular Hemoglobin Concn 31.1 [31.0 - 37.0 %] Red Cell Distribution Width 16.6 [11.5 - 14.5 %] *Platelet Count 179 [140 - 440 K/cmm] Mean Platelet Volume 8.8 [7.4 - 10.4 FL] Automated Neutrophils % 84 [ %] Automated Lymphocytes % 8 [ %] Automated Monocytes % 7 [ %] Automated Eosinophils % 0 [ %] Automated Basophils % 0 [ %] Absolute Neutrophil Count 8.8 [1.0 - 8.0 K/cmm] Absolute Lymphocyte Count 0.9 [1.0 - 5.0 K/cmm] Absolute Monocyte Count 0.7 [0.1 - 0.8 K/cmm] VBGs: 30-Oct-21 17:45, Venous Blood Gas Request pH. 7.330 [7.320 - 7.42] pCO2. 50.5 [41.0 - 51.0 mm Hg] pO2. <30.0 [37.0 - 43.0 mm Hg] O2 Saturation 39.6 [70.0 - 76.0 %] Actual Bicarbonate. 25.9 [ mmol/L] Hemoglobin, Total. 10.5 [11.5 - 15.1 g/dL] *Carboxyhemoglobin Saturation. 1.9 [ %] Oxygen Content. 5.9 [16.0 - 21.5 Vol %] Methemoglobin.. 1.0 [ %] Base Excess. 0.1 [0.0 - 2.0 mmol/L]
CDC Split Type:

Write-up: shortness of breath. Cough and chest twinge-like pain Covid test came back positive. Patient''s chest x-ray showed no evidence of pneumonia. Her troponin was elevated at 0.53 and repeat was elevated at 0.64 and she was started on heparin drip. 150 mg of amiodarone over 10 minutes.


VAERS ID: 1836668 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-28
Onset:2021-10-28
   Days after vaccination:214
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Decreased appetite, Diarrhoea, Dizziness, Dyspnoea, Exposure to SARS-CoV-2, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), 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: PMH/Chronic conditions include HTN, sleep apnea, DM2
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This case meets criteria for vaccine breakthrough review. Known household exposure. SxS include a few days PTA of cough, SOB, poor appetite, diarrhea, lightheadedness.


VAERS ID: 1836677 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-10-25
Onset:2021-10-28
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 320308D / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Decreased appetite, Dehydration, Diarrhoea, Fatigue, Headache, Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Dehydration (narrow), 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: Birth control
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left knee numbness/tingling, dehydration, headache, diarrhea, tiredness, weakness, loss of appetite?symptoms started around 2:30 am on 10/28 didn?t subside until 11/01? knee is still tingling


VAERS ID: 1836680 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blister, Discomfort, Erythema, Immunodeficiency, Pain, Pruritus, Sleep disorder
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Itchy toe woke me at 2 am, ~18 hours after my COVID-19 booster Found one large fluid filled blister in between toes, it popped. The loose remaining torn skin is very thick, indicative of a deep blister Site has remained red, itchy, and sore as it heals, no more blisters noted 5 days later. The blister was so large and itchy/uncomfortable when I found it at 2 am, I am confident it was not there when I went to sleep


VAERS ID: 1836690 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 32030BD / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deep vein thrombosis, Extra dose administered, Pain in extremity, Ultrasound scan
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad), 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: XARELTO 20MG
Current Illness: PREVIOUS BLOOD CLOT IN A SEPERATE AREA OF THE BODY
Preexisting Conditions: BLOOD CLOT
Allergies: NO KNOWN ALLERGIES
Diagnostic Lab Data: ULTRASOUND 11/1/2021
CDC Split Type:

Write-up: PATIENT STARTED TO EXPERIENCE LOWER EXTREMITY LEG PAIN SHORTLY AFTER RECEIVING BOOSTER PFIZER DOSE. HE WENT TO THE ER 5 DAYS POST VACCINE AND WAS DIAGNOSED WITH LOWER LEFT LEFT DVT. PATIENT CONTINUED XARELTO THERAPY 20MG DAILY. PATIENT WAS ALREADY ON XARELTO 20MG DAILY FOR PREVIOUS DVTS (SINCE 2007).


VAERS ID: 1836700 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-03
Onset:2021-10-28
   Days after vaccination:267
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UJ769AC / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Fall
SMQs:, Guillain-Barre syndrome (broad), Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH/Chronic conditions include dementia, s/p mechanical AVR, chronically anticoagulated, hypothyroidism, HTN, HLD, seizures.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This case meets criteria for vaccine breakthrough review.SxS include weakness, fall.


VAERS ID: 1836713 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Concussion, Disturbance in attention, Fall, Feeling abnormal, Head injury, Malaise, Syncope, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: oral contraceptive; propranolol 20mg prn stage fright
Current Illness: none noted
Preexisting Conditions: social anxiety
Allergies: none noted
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Received vaccine on 10/27. The following morning she reported to work (in a lab). was standing when she felt vision go grey and had syncopal event (unwitnessed) striking head on floor. subsequent days reported mild "brain fog", difficulty concentrating when she reported to my office on 10/2 for evaluation. I felt she had a syncopal episode and a mild concussion from the floor strike (she doesn''t recall if she ate that morning, just that she felt "unwell" the morning after the vaccine.


VAERS ID: 1836739 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-20
Onset:2021-10-28
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Buproprion SR 150 mg Daily, Fluoxetine 40 mg Daily, Methadone 5 mg BID, Cholecalciferol 1,000 units Daily, Cyanocobalamin 1,000 mcg Daily, Alendronate 70 mg once weekly.
Current Illness: N/A
Preexisting Conditions: COPD, AKI, Urosepsis, Metabolic Encephalopathy, CVA.
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized 10/28/21 to present (11/2/21)


VAERS ID: 1836764 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 2 RA / IM

Administered by: Private       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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: allopurinol, atorvastatin, carvedilol, furosemide, ProAir, ramelteon, Montelukast, sprinolactone
Current Illness:
Preexisting Conditions: b-cell lymphoma, hyperlipidemia, cardiomyopathy
Allergies: sertraline
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: This dose was given as a booster to a first dose J&J. . 0.5 ml given instead of 0.25ml. Pt fell into category for full dose due to active cancer treatment, but his first dose was J & J not moderna.


VAERS ID: 1836796 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Immunodeficiency, Inappropriate schedule of product administration, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: patient received 3rd dose of Pfizer (booster) vaccine earlier than 6 months. Patient received 1st dose of Pfizer on May 2, 2021 , 2nd dose on May 22, 2021, and third dose October 28, 2021. No adverse reactions occurred during 15 minute observation period.


VAERS ID: 1836806 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-10-25
Onset:2021-10-28
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF290 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear discomfort, Hypoaesthesia, Pain in jaw
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Osteonecrosis (broad), Sexual dysfunction (broad)

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

Write-up: Sore jaw on my right side and numbness on right side of face. And an odd sensation that feels like a vibration and tickling on right temple and right ear.


VAERS ID: 1836808 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-22
Onset:2021-10-28
   Days after vaccination:220
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Dizziness, Dyspnoea, Fatigue
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH/Chronic conditions include A fib, CHF, cancer hx, dementia, DM2, h/o stroke, HTN, hyperthyroidism.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This case meets criteria for vaccine breakthrough review. SxS include generalized weakness, fatigue, SOB, dizziness.


VAERS ID: 1836827 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-10-25
Onset:2021-10-28
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025LZ0A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 43L2UA / 2 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA O58E21A / 3 - / -

Administered by: Private       Purchased by: ?
Symptoms: Joint stabilisation, Pain, X-ray
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: JOINT PAIN, FATIGUE
Other Medications: LEVOTHYROXIN 100 MG. ESCITalopram 10 mg. Bupropion 150mg. Losartin 12.5 carvidevol zinc 30 mg. Grape seed 100 mg. D3 25mcg
Current Illness: None
Preexisting Conditions: PMR. In remission
Allergies: Codein penicillin Erothymicine
Diagnostic Lab Data: Physical and x-ray
CDC Split Type:

Write-up: Pain, immobility in left knee.


VAERS ID: 1836871 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New York  
Vaccinated:2021-10-26
Onset:2021-10-28
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Headache
SMQs:, Retroperitoneal fibrosis (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: Lower back pain approximately 2 days after injection. Intense on the first day of onset, which gradually dulled over time. On day 7, the pain is still there. Headache on one side of head on day 7. Worried about cerebral venous thrombosis.


VAERS ID: 1836915 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest X-ray, Differential white blood cell count, Dyspnoea, Electrocardiogram, Full blood count, Immunodeficiency, Metabolic function test, Myocardial necrosis marker, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nexium Synthroid
Current Illness:
Preexisting Conditions: Obesity
Allergies: Sulfa drugs
Diagnostic Lab Data: EKG 11/1/2021 Chest x-ray 11/1/2021 Cardiac enzymes 11/1/2021 CBCD 11/1/2021 BMP 11/1/2021
CDC Split Type:

Write-up: Began to feel heart palpitations intermittently about an hour after administration of vaccine. Shortness of breath upon exertion on and off the next day and for several days after leading to ED visit on day 4. Still having intermittent shortness of breath.


VAERS ID: 1836928 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855191 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Heart rate increased, Nightmare, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Bad dreams, slight fever, chest pain and increased heart rate.


VAERS ID: 1836941 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 071F21A / 3 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Extra dose administered, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), 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: Decades ago I fainted after a tetanus vacination.
Other Medications: Amlodipine, benazepril, amitriptyline, multivitamin, vitamin D, fiber
Current Illness: No infections, but see item 12
Preexisting Conditions: osteoarthritis, microscopic colitis, interstitial cystitis/painful bladder syndrome
Allergies: lots of antibiotics, including penicillin, sulfa drugs, tetracycline & others. No known food allergies
Diagnostic Lab Data: none yet as of this date (11/02/2021)
CDC Split Type:

Write-up: Note that this was my booster shot. I am still having MUCH more hip and knee joint pain than normal with my arthritis on the 6th day after my shot.. Additionally, I am having muscle pain in my leg. I did not have these side effects after the first two shots.


VAERS ID: 1836945 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Arthralgia, Chills, Fatigue, Injection site pain, Mobility decreased, Myalgia, Nausea, Pain, Pruritus, Pyrexia, Rash, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-Vitamin
Current Illness: None
Preexisting Conditions: Diagnosed w/ Myocardial Bridge in 2016. Symptoms have been nearly silent (not there) for 2 yrs.
Allergies: Sulfa antibiotic allergy
Diagnostic Lab Data: I went to urgent care who visually observed the rash/hives and looked at the pictures I provided. The doctor prescribed Prednisone to relieve the itching and pain. The rash/hives are still present 6 days post vaccine but are less so given the prednisone treatment. It is STILL itchy.
CDC Split Type:

Write-up: I received the Pfizer Covid vaccine at 2:30 PM on Wednesday, Oct 27. For the first 24-28 hours, I mainly had only a sore arm at injection site and mild fatigue. Then the side effects all started to hit. By Friday morning, I had severe fatigue, muscle aches on full body, major joint pain ( I could not type and my knees and ankles just ached horribly - and I truly have a high pain tolerance). I could not sit at my desk more than 15 minutes w/o having to move to alleviate pain. I was nauseous and had an upset stomach. I had fever and chills. I developed a full body rash and hives. It was the worst on my legs but was all over, including my face.


VAERS ID: 1836986 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Decreased appetite, Nausea, Pain in extremity
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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: heart disease
Allergies: procyclin
Diagnostic Lab Data: N/A
CDC Split Type: vsafe

Write-up: My arm started hurting. Then my top part of my stomach started hurting. I also had nausea and not feeling like I want to eat. These has gone on since October 28th. I went to my PCP about this. There was no test or diagnosis with this visit. They did referrer my to Health Center.


VAERS ID: 1837049 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051F21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Chest discomfort, Dyspnoea, Electrocardiogram normal, Inappropriate schedule of product administration, Laboratory test normal, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PRN Lorazepam, Intra-articular corticosteroid injections periodically. History of being on levothyroxine.
Current Illness: Patient has a flu shot prior to the Covid Vaccine. Also had a cortisone intra-articular vaccine on 10/25/2021
Preexisting Conditions: No history of long standing health conditions Joint issues and possibly hypothyroidism
Allergies: No Known Drug Allergies
Diagnostic Lab Data: ER performed an EKG, CXR, and Labs. Everything came back negative and inclusive. They then prescribed her a prn albuterol inhaler. MD in ER did not think it was related to the shot and felt should go away in time. Patient has a follow-up appointment with PCP on 11/8/2021
CDC Split Type:

Write-up: On 10/28 - Patient was walking to work from her car and became short of breath. Patient then felt heart palpitations throughout the day. The SOB, chest tightness, and palpitations happened all weekend according to the patient. Patient then went to the ER on the morning of 11/1/2021.


VAERS ID: 1837099 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Inappropriate schedule of product administration, Pain
SMQs:, Medication errors (narrow)

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

Write-up: Employee came to vaccine clinic on 10/28 for his COVID BOOSTER. He did not have his covid card with him but attested that it had been 6 mo since 3nd shot. Pfizer booster was given at that time. When put into system it was noted that he was 2 weeks early from needing the booster. PH contacted their director. What symptoms were reported? (check all that apply) Chills~Fatigue (Feeling Very Tired)~Muscle or Body Aches


VAERS ID: 1837189 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: NKDA
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: NONE. PATIENT RECEIVED EXPIRED MODERNA WITHOUT ADVERSE REACTIONS. MODERNA EXPIRED ON 10/13/2021 AND GIVEN ON 10/28/2021


VAERS ID: 1837228 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-18
Onset:2021-10-28
   Days after vaccination:224
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin Adult Low Dose 81 MG Tablet Delayed Release 1 tablet Orally Once a day Fish Oil 1000 MG Capsule 1 capsule Orally Myfortic 180 MG Tablet Delayed Release 3 tablets Orally Twice a day Sensipar 30 MG Tablet 1 tablet after a mea
Current Illness: none
Preexisting Conditions: HTN. renal insufficiency - hereditary nephritis (medullary cystic disease), s/p renal transplant and now followed by U of M. Asthma- triggered by allergies only. Allergies. Creatinine (2.8) in the past- normalized with kidney transplant--Creatinine 1.13 in 4/2016 per Patient. CMV- the kidney she received was postive for this, her bloodwork has been negative. Lung nodule- x3, right upper and middle lobe.
Allergies: penicillin; sulfa; morphine, cell cept, lipitor
Diagnostic Lab Data:
CDC Split Type:

Write-up: onset of a headache and myalgias. On day 3 she didn''t document a fever with highest temp of 102. she was still running a temperature this morning. She has tenderness and sinus congestion/ nasal congestion over the maxillary sinuses with production of some mucus..starting 1 0/28/21


VAERS ID: 1837441 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Blister, Condition aggravated, Oedema peripheral, Pruritus, Rash papular, Urticaria
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline, lunesta, Wellbutrin
Current Illness: Poison Ivy
Preexisting Conditions: depression
Allergies: Sodium Pentathol
Diagnostic Lab Data: none
CDC Split Type:

Write-up: On Oct. 27, noticed a few small blisters on right hand after potentially coming in contact with poison ivy. Later that morning, received the Covid booster. Did not have any reactions with the first 2. Later in day, blisters developing rapidly over hand and forearm. oral Bendaryl and Bendaryl topical applied with only slowing reaction. Continued with oatmeal baths, cortisone cream, and oral Bendaryl but blisters and hives on upper arm and shoulder. Provider ordered prednisone 40mg x 5 days. During course of treatment, cont. Benadryl and topicals but rash spread rapidly. On day 5 of prednisone (Nov. 2), rash developed with plaques on entire right arm, right hand and forearm severely edematous, raised rash w/plaques and hives across chest on lower left arm, and small blisters starting on neck and torso. Went back to provider who represcribed prednisone 40mg and referral to dermatology. Rash cont. to spread with increasing edema and extreme itching on Day 6 after vaccine.


VAERS ID: 1837656 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-10-23
Onset:2021-10-28
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Flushing, Gait disturbance, Grip strength decreased, Hypoaesthesia, Limb discomfort
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall 5 mg
Current Illness:
Preexisting Conditions: Multiple sclerosis
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: 6 days (10/28/2021) after receiving my second dose of Pfizer I started to experience numbing sensation in my lower back when ever I looked down or moved my neck. Sensation went around to my torso. Thought I was having an MS attack so my PCP started me on steroids. Next day I woke up to numbness in my hands and finger tips. My face feels flushed and red constantly and my thighs feel as if they are 50 pounds each and I am having trouble walking at my normal speed. Also having issues holding things/ picking up items. I have been relapse free for 3 years now. I know this vaccine sent me into a relapse after all the hard work I did to keep myself stable. The government should be ashamed of themselves for forcing this vaccine on people who like me, who have an autoimmune disease. I was not ready to get this vaccine. It was too soon and now I am loosing feeling in parts of my body! Who Is going to be held responsible since I was forced into getting to keep my job!! This is beyond upsetting!!


VAERS ID: 1837687 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall
SMQs:, Accidents and injuries (narrow)

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

Write-up: He was nervous at presentation. confirmed no active medical histories or current medications, including seizure. Did not report any previous adverse reaction to any vaccinations. Advised to sit down for 15 minutes and rise slowly. Patient was found on the floor, did not contract any injuries. First responders were called for assessment.


VAERS ID: 1839222 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017F21A / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Dysstasia, Fatigue, Flushing, Gait disturbance, Headache, Hyperhidrosis, Hypoaesthesia, Mobility decreased, Muscle discomfort, Muscular weakness, Walking aid user
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (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: Covid Vaccine No 2 - Had some inability to use legs for 4 to 6 hours.
Other Medications: Losartan, HCL, Tamsulosin, Zyrtec, Metformin, ibuprofen, simvastatin
Current Illness: None
Preexisting Conditions: High Blood Pressure; Type 2 diabetes;
Allergies: Celebrex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: After taking a shower preparing to attend a funraiser I began to have a hedache, muscular discomfort in my arms and found that I was unable to raise my body from a prone position to get dressed. I noted that my arms lost any feeling or strength and were not responsive to my efforts to either si up or get to a standing position. The effort was extremely taxing but I had no success in changing my positio fro prone . Even when I would get near to a sitting position my core muscles could not hold me up and I would fall back to a prone position. I was very flushed and sweated profusely soaking my shirt. I was able with an assist from my wife to get into bed and I stayed in bed for the next 24 hours. On Thursday evening I was able to walk with assistance from my wife and adult son to visit the bathroom.. For the next day I needed to use a walker to get around my bedroom and bathroom. By Saturday I could walk without assistance but My right knee and both shoulders were very painful.. The lack of core strength made me feel as if I was paralyzed. I still have greater than normal fatiague and joint pain.


VAERS ID: 1838713 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-10-28
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 212A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Feeling abnormal, Muscle spasms, Pain in extremity, Paraesthesia, Restless legs syndrome, SARS-CoV-2 test
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient had no known drug allergies. The patient had no history of chronic illness.
Allergies:
Diagnostic Lab Data: Test Date: 20200501; Test Name: COVID-19 virus test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20211102980

Write-up: RESTLESS LEGS SYNDROME LIKE FEELING; FEELING THAT I HAVE TO MOVE THE LEGS; CRAMPING OF BOTH LEGS, CALVES AND BEHIND THE KNEES/CRAMPING OF BOTH THIGHS AND HAMSTRINGS; TIGHTNESS OF BOTH CALVES; PINS AND NEEDLES FEELING; This spontaneous report received from a patient concerned a 27 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: no alcohol use, and non smoker, and other pre-existing medical conditions included: The patient had No known drug allergies. The patient had No History of chronic illness. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 212A21A, expiry: UNKNOWN) dose was not reported, administered on 27-OCT-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-MAY-2020, Laboratory data included: COVID-19 virus test (NR: not provided) NEGATIVE. On 28-OCT-2021, the patient experienced restless legs syndrome like feeling. On 28-OCT-2021, the patient experienced feeling that i have to move the legs. On 28-OCT-2021, the patient experienced cramping of both legs, calves and behind the knees/cramping of both thighs and hamstrings. On 28-OCT-2021, the patient experienced tightness of both calves. On 28-OCT-2021, the patient experienced pins and needles feeling. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from pins and needles feeling, restless legs syndrome like feeling, cramping of both legs, calves and behind the knees/cramping of both thighs and hamstrings, tightness of both calves, and feeling that i have to move the legs. This report was non-serious.


VAERS ID: 1838738 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:2021-10-28
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211103992

Write-up: VACCINE ADMINISTERED TO A 17 YEAR OLD MALE; OFF LABEL USE; This spontaneous report received from a health care professional concerned a 17 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 2128A21A expiry: 21-DEC-2021) dose was not reported, administered on 28-OCT-2021 for prophylactic vaccination. No concomitant medications were reported. On 28-OCT-2021, the patient experienced vaccine administered to a 17 year old male. On 28-OCT-2021, the patient experienced off label use. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vaccine administered to a 17 year old male and off label use was not reported. This report was non-serious.


VAERS ID: 1838739 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-10-28
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chest discomfort, Chills, Dizziness, Fatigue, Headache, Heart rate increased, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TOPIRAMATE
Current Illness: Endometriosis
Preexisting Conditions: Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data: Test Date: 20211029; Test Name: Body temperature; Result Unstructured Data: 101F to 102F
CDC Split Type: USJNJFOC20211104054

Write-up: TIGHTNESS IN CHEST; HEART RATE SPIKE; HEADACHES; ACHINESS THROUGHOUT BODY AND BODY HURT; FEVER; DIZZINESS; CHILLS; FELT TIRED AND FATIGUED; This spontaneous report received from a patient concerned a 31 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: endometriosis, and other pre-existing medical conditions included: The patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1822811 expiry: UNKNOWN) dose was not reported, administered on 28-OCT-2021 20:00 for prophylactic vaccination. Concomitant medications included topiramate for drug used for unknown indication. On 28-OCT-2021, the patient experienced felt tired and fatigued. On 29-OCT-2021, the patient experienced achiness throughout body and body hurt. On 29-OCT-2021, the patient experienced dizziness. On 29-OCT-2021, the patient experienced chills. On 29-OCT-2021, the patient experienced fever. Laboratory data included: Body temperature (NR: not provided) 101F to 102F. On 30-OCT-2021, the patient experienced tightness in chest. On 30-OCT-2021, the patient experienced heart rate spike. On 30-OCT-2021, the patient experienced headaches. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from achiness throughout body and body hurt, heart rate spike, dizziness, chills, and felt tired and fatigued, and fever on 30-OCT-2021, and had not recovered from headaches, and tightness in chest. This report was non-serious.


VAERS ID: 1839914 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017F21A / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZOLPIDEM, LANTUS, SYNTHROID, LIVALO, JANUVIA
Current Illness:
Preexisting Conditions: ASTHMA CARDIAC DISORDER DIABETUS MELLITUS
Allergies: LATEX
Diagnostic Lab Data:
CDC Split Type:

Write-up: RED SWOLLEN ARM


VAERS ID: 1840020 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-10-26
Onset:2021-10-28
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral, Arteriogram carotid, Blood magnesium, Blood thyroid stimulating hormone, Chest X-ray, Computerised tomogram head, Differential white blood cell count, Dizziness, Electrocardiogram, Full blood count, Headache, Hypoaesthesia, Metabolic function test, SARS-CoV-2 test, Scan with contrast, Troponin I, Vertigo
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (narrow), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Medication List As of 10/26/2021 9:13 AM Albuterol Sulfate 108 (90 Base) MCG/ACT 2 puffs Inhalation EVERY 4 HOURS PRN amLODIPine Besylate 10 mg Oral DAILY Aspirin 81 mg Oral DAILY Atorvastatin Calcium 10 mg Oral NIGHTLY Lisinopril 10
Current Illness: Type 2 diabetes mellitus without complication, without long-term current use of insulin (HCC) Essential hypertension, benign Encounter for immunization Snoring Daytime somnolence Frequent nocturnal awakening
Preexisting Conditions: Type 2 diabetes mellitus without complication, without long-term current use of insulin (HCC) Essential hypertension, benign Encounter for immunization Snoring Daytime somnolence Frequent nocturnal awakening
Allergies: Jardiance [Empagliflozin] Lipitor [Atorvastatin]
Diagnostic Lab Data: EKG 12-lead 1115 Comprehensive metabolic panel Magnesium TSH CBC and differential Troponin I 1119 CT Head wo contrast - STROKE ALERT ONLY 1135 Sodium Chloride 100 mL Iohexol 100 mL 1142 CT Angiography Head Neck w wo Contrast 1150 XR Chest 2 Views 1153 CoronaVirus SARS CoV-2 Molecular 1250 Stroke end 1306 Magnesium Sulfate 2 g 1333 EKG 12-lead
CDC Split Type:

Write-up: Patient presents for evaluation of left arm and leg numbness since yesterday morning. She states she had a headache yesterday as well but this has resolved. She has ongoing dizziness where she feels like she is spinning.


VAERS ID: 1840110 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-26
Onset:2021-10-28
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Years ago - Shingles vaccine; sometimes flu shots - get a swollen arm and red ness at injection site arm
Other Medications: several vitamins - Vit C; D3; Vit E; Magnesium Estrogen; Thyroid Hormone; Diuretic; Potassium
Current Illness: Sinuses were bothering me - fall allergies
Preexisting Conditions: no
Allergies: Penicillin; Codeine; Mangoes; get an allergic reaction to Wasp sting
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: I had a delayed reaction - started with redness and swelling - shoulder to elbow (left arm); and pain. That started resolving day before yesterday and it''s completely gone now. I contacted my provider and they said to take oral steroids on hand that I have for allergies. This is something that happens to me with a lot of vaccines.


VAERS ID: 1840152 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-02-17
Onset:2021-10-28
   Days after vaccination:253
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Cough, Diarrhoea, Nasal congestion, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins, Amethyst birth control
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: My daughter and another household member were PCR confirmed for COVID-19. I tested positive for COVID-19 by a rapid test, my PCR test was performed on Nov. 2nd; results are pending.
CDC Split Type:

Write-up: Tested positive for COVID-19 by a rapid test; PCR test results are pending. Symptoms include chills, sore throat, mild cough, loose stool, blocked nose, no smell or taste at times.


VAERS ID: 1840157 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Impaired work ability, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Buspirone, Pantoprazole, Lisinopril, multivitamin
Current Illness:
Preexisting Conditions: (PKD) Polycycstic Kidney Disease (CMT) Charcot Maris Tooth Disorder
Allergies: Sulfa
Diagnostic Lab Data: None, only spoke to a doctor over the phone.
CDC Split Type:

Write-up: 12 hours after injection, felt moderate full body fatigue, full body muscle soreness, and joint pain. Missed work 10/28/21, these effects last until 5pm 10/28. Felt fine until about 1pm on 10/30/21, same symptoms, moderate full body fatigue, muscle soreness and joint pain until about 5pm on 10/31/21. Felt fine until about 8pm on 11/1/21, left work early on 11/2/21, called the clinic at 1pm on 11/2/21. Was advised this should still be normal until at least one week after injection. Symptoms lasted until morning of 11/3/21.


VAERS ID: 1840186 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Inappropriate schedule of product administration, Incontinence
SMQs:, Guillain-Barre syndrome (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: Sinus infection.
Preexisting Conditions: Fibromyalgia
Allergies: Penicillin, Sulfa.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received the Fluzone HD on the same day as PFIZER vaccination. Weakness, loss of bladder control.


VAERS ID: 1840224 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Blood test, Diarrhoea, Dizziness, Headache, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi vitamins
Current Illness: N/A
Preexisting Conditions: Rheumatoid Arthritis
Allergies: N/A
Diagnostic Lab Data: Seen at the ER. 2 days after 2nd dose. Blood work.
CDC Split Type:

Write-up: Dizziness/light headed. Headache. Nausea. Diarrhea. Abdominal pain. Body & muscle aches. Weakness.


VAERS ID: 1840255 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Feeling of body temperature change, Headache, Heart rate increased, Pain, Vaccination complication, Vomiting
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? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu shot 21 1993
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Two hours after the shot, I could feel the heart beating fast. I went back the the place I received the shot where they took my blood pressure. It was 209/131 with heart rate of 118 bpm. They sent me to a local urgency care. They said I should go the the Emergency Room at Hospital. They took my blood, which was 191/127 with a heart rate of 116 bpm. I sat in the waiting room for 3 hours before the ER doctor saw me. He took my blood pressure again an it was 169/98 with a heart rate of 101 bpm. He said it appeared that I was having a serve reaction to the vaccine and told to go home and relax. The rest of that night, my heart rate would go up, then slow down a bit. The next day I had a very bad headache, felt hot then chills, stomach cramps, couldn''t keep solid food down, whole body ached. Day 2, all the same symptoms but worse. Day 3, symptoms were worse. Day 4 through Day 6 (today) I can eat very small amounts of solid food.


VAERS ID: 1840281 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER N959G / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Lymphadenopathy, Product preparation error
SMQs:, Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Client reports his lymph nodes in his neck and clavical area swelled after second Pfizer immunization
Other Medications: emgality injection same day
Current Illness:
Preexisting Conditions: Heart arrhythmia, only has one kidney from kidney cancer
Allergies: none
Diagnostic Lab Data: na
CDC Split Type:

Write-up: The Registered Nurse that drew up the Phizer immunization forgot to use the Diluent. He received 0.3ML of straight Phizer. Once the medication error was found the client was contacted. He reported that he had swelling in his lymph nodes in his neck and clavical area but the same thing happened after his second immunization of Phizer. We asked him to notify us if he had any more adverse changes to his health.


VAERS ID: 1840338 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA D17F27A / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: asa, metoprolol succ, losartin, montelukast, claritin, flticasone, ibuprofen, omeprazole, calcium w/ D3, multivitamin, super B complex
Current Illness: none
Preexisting Conditions: allergies, osteoarthritis, HTN
Allergies: bactrim, PPD injections, dogs, cats, grass, trees, mold
Diagnostic Lab Data: none
CDC Split Type:

Write-up: ~24 hrs from injection, developed low grade fever progressing to 102 degrees later that day (30 hrs post injection). Body aches, fatigue, and a very swollen axillary lymph node. Same side as the COVID vaccine.


VAERS ID: 1840343 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arrhythmia, Dizziness, Dyspnoea, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (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: Calcium, magnesium, vitamin c, vitamin b complex, vitamin d3, omeg-3, lecithin, vitamin e; levothyroxine, omeprazole, aspirin
Current Illness: Psoriatic arthritis
Preexisting Conditions: Psoriatic arthritis, fibromyalgia
Allergies: Dairy allergy; Premarin allergy
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Hard heartbeat with persistent arrhythmia. Lightheadedness because of arrhythmia. Trouble getting a deep breath because of arrhythmia.


VAERS ID: 1840409 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939904 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Injection site bruising, Injection site erythema, Injection site induration, Injection site pain, Injection site pruritus, Injection site rash, Injection site swelling
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), 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: Centrum Silver Women 55+ Cranberry concentrate, 50,000 mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Redness, soreness, hard swelling, rash (about 10 cm wide by 4 cm high) with intermittent itching. Applied cold pack (once only). All of the above began Day 1 following the injection; started to subside on Day 4, with only soreness and a yellow bruise at the injection site remaining on Day 5 following the injection (11/03/21).


VAERS ID: 1840421 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-10-25
Onset:2021-10-28
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025021A / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VALSARTAN, ATORVASTATIN,, CALCIUM/MAGNESIUM/ZINC, B12, TUMERIC, IBUPROFEN
Current Illness: NONE
Preexisting Conditions: SJOGREN''S SYNDROME
Allergies: NONE KNOWN
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: WIDESPREAD RASH THAT STARTED AT INJECTION SITE THEN SPREAD TO BOTH ARMS THEN OVER ENTIRE BODY OVER A PERIOD OF 4 DAYS ALONG WITH EXCESSIVE FATIGUE. TOOK IBUPROFEN AND ZYRTEC AND OATMEAL BATHS UNTIL IT RESOLVED ON 11/2/2021.


VAERS ID: 1840449 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 2 RA / IM

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

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

Write-up: Nurse prepared to start vaccinating with Pfizer and did not reconstitute the vaccine before administering second dose vaccine into right arm. Lead nurse caught error right away. Patient stayed in observation area 40 minutes and had no reaction. Supervisor spoke with mother and explained what happened and what to do if symptoms developed.


VAERS ID: 1840543 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 3 UN / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Fall, Heart rate increased, Hypoaesthesia, Unresponsive to stimuli
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (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: similar but much more mild reaction to first 2 doses
Other Medications: none
Current Illness: none
Preexisting Conditions: asthma
Allergies: none
Diagnostic Lab Data: We sent him out via 911
CDC Split Type:

Write-up: Within 1 minute of receiving injection, patient described numbness in all extremities, and became verbally unresponsive. B/P of 200/100, accelerated HR. He was slumping in his chair and unable to respond though he never lost conciousness.


VAERS ID: 1840563 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Lethargy, Pyrexia, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Fever, chills on day off. Next day extreme lethargy to the point of not being able to stay awake for more than an hour. First round of vaccine was Moderna


VAERS ID: 1840578 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-03
Onset:2021-10-28
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Cough, Injection site erythema, Lymph node pain, Lymphadenopathy, Pain
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (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: Mild Asthma
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: I noticed the front of my right neck had a lymph node Lymph node at the right side of my neck next to my trachea slight pain when I coughed or moved my head The vaccine site was red and lasted for 10days


VAERS ID: 1840596 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Fever Missed 1 day of work.


VAERS ID: 1840598 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-10-26
Onset:2021-10-28
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076C21A / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered, Headache, Injection site pain, Lymph node pain, Lymphadenopathy, Myalgia, Pain, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: COVID Vaccines Dose 2 - five days of feeling bad - fever for three days; full body aches - muscular and bone aches for four days
Other Medications: yes - Venlafaxine; Montelukast; Azelastine; Flonase; Zyrtec
Current Illness: Re-current Migraine - about a month prior
Preexisting Conditions: Re-current Migraines; Anxiety; Allergies - I get sinus issues from them
Allergies: mild adhesive tape allergy
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: On the 27th, I had a fever of 100.6; body aches; a headache; my entire arm was sore from neck to hand. I had an ache in the lower back and upper thigh and my calves both sides. I took Tylenol and that brought my fever down and helped with muscle aches and body aches. I had fever again on the 28th in the morning. I woke up with a fever 100.1; my muscle aches were gone; my left arm still hurt (but just from elbow to neck at this time). At 03:30-04:00 pm, I noticed that I had a lymph node between shoulder and neck - in that hollow - it was very sore. If I moved it hurt and even if I didn''t move, it hurt. It was the size of golf ball. I called advice line, they told me that I was still within the range of immediate affects of vaccine but if it wasn''t gone by the following day, I should call the doctor. The 29th, I didn''t have fever or muscle aches. My arm was only sore where I got the injection but it was still extremely painful to the touch. I called back about 02:00 pm that afternoon and spoke to a nurse at about 04:00 pm and then I told her about the lymph node and she recommended I go to Urgent Care to make sure there wasn''t anything else going on. The doctor took a look at it and that symptoms can persist up to a week (I think my symptoms lasted 5 days on the second dose but I hadn''t had a swollen lymph node before). They said it was in the realm of normal still. The pain is gone now; it''s not swollen too much anymore - I can still feel the "bean" on the left side but there''s no pain at and it''s been more than a week.


VAERS ID: 1840619 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-03-29
Onset:2021-10-28
   Days after vaccination:213
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 LA / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine Carvediol Clonidine Hydrochlorothiazide-lisinopril Prilosec Tylenol
Current Illness: Chronic GERD, Chronic sinusitis, Colon polyp, Elevated LFT''s, HTN
Preexisting Conditions: Chronic GERD, Chronic sinusitis, Colon polyp, Elevated LFT''s, HTN
Allergies: No known drug allergies
Diagnostic Lab Data: Ordered Test: SARS-CoV-2 RdRp Resp Ql NAA+probe (Abbott ID NOW Cov2 POC, Molecular) Ordered Test Codes: 94534-5 (LN LOINC)/7914123271 (L LOCAL) Status: Final Accession Number: 2021293005281001 Specimen Source: Nasal Specimen Site: Specimen Collection Date/Time: 2021-10-20 17:16:00.0 Result: * Resulted Test: SARS-CoV-2 RdRp Resp Ql NAA+probe (POC Covid-2 Abbott, Molecular (COVID-19)) Coded Result: Positive (LOCAL) Numeric Result: Units: Text Result: Reference Range From: Negative Reference Range To: Performing Facility Details: Date/Time: 2021-10-20 17:20:25.0 Interpretation: Very abnormal Result Code: 10828004 (SCT/Positive (L LOCAL)
CDC Split Type: 1053891

Write-up: Case completed Covid series in March 2021, then was hospitalized for Covid in October 2021


VAERS ID: 1840653 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / UNK - / -

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: expired vial 10/24 administered on 10/28


VAERS ID: 1840655 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / UNK - / -

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: expired vial 10/24 administered on 10/28


VAERS ID: 1840657 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / UNK - / -

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: expired vial 10/24 administered on 10/28


VAERS ID: 1840661 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Unknown  
Location: Texas  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / UNK - / -

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: expired vial 10/24 administered on 10/28


VAERS ID: 1840666 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Unknown  
Location: Texas  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / UNK - / -

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: expired vial 10/24 administered on 10/28


VAERS ID: 1840670 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / UNK - / -

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: expired vial 10/24 administered on 10/28


VAERS ID: 1840671 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / UNK - / -

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: expired vial 10/24 administered on 10/28


VAERS ID: 1840673 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / UNK - / -

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: expired vial 10/24 administered on 10/28.


VAERS ID: 1840679 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Unknown  
Location: Texas  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / UNK - / -

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: expired vial 10/24 administered on 10/28


VAERS ID: 1840683 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / UNK - / -

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: expired vial 10/24 administered on 10/28


VAERS ID: 1840685 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / UNK - / -

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: expired vial 10/24 administered on 10/28


VAERS ID: 1840688 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / UNK - / -

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: expired vial 10/24 administered on 10/28


VAERS ID: 1840706 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Lymphadenopathy, Myocarditis, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: local swelling of chest wall, lymphadenopathy, and myocarditis


VAERS ID: 1840754 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-10-11
Onset:2021-10-28
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Jardiance 25Mg amLODIPine-benazepril 5-10 mg hydroCHLOROthiazide 12.5 mg Tab Janumet XR 50-500 mg Tm2
Current Illness: Bacteria Vagnosis; yeast infection
Preexisting Conditions: Diabetes; Hypertension
Allergies: Stone fruit
Diagnostic Lab Data:
CDC Split Type:

Write-up: I began to itch all over in the evening of 10/28/21. The morning of 10/29/21, I broke out in hives all over. The hives continued on 10/30/21 and 10/31/21. By 11/1/21 the hives were much worse and covered my entire body from head to toe. I sought treatment at an urgent care facility.


VAERS ID: 1840757 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Hypoaesthesia, Influenza virus test negative, Muscle spasms, Pain, Paraesthesia, Pyrexia, Rash erythematous, SARS-CoV-2 test negative, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: penicillin
Diagnostic Lab Data: Urgent Care COVID test - both were negative and Flu test - negative result
CDC Split Type: vsafe

Write-up: Body aches, chills, fever. I had every symptom that was on the paperwork except did not have diarrhea or nausea. I was fine right after the vaccine. The symptoms didn''t start until 09:00. Then I had numbness and tingling in my opposite arm - my right arm. And then I got a red rash outside of my thighs (both) and then also where my elbows and knees are. The rash on my thighs was almost like shingles - almost like pin needle dots. The one on my elbows and knees was almost like hives/welts but smaller. Neither one of the kinds of rashes itches. I had all the symptoms, including the rashes, until Saturday afternoon. I still have the rash a little on my knees, elbows and thighs. The tingling/numbness on my arm went away. Today, I was getting a cramp in my right leg - it wasn''t even an hour - but it went away. On Saturday, around 03:00 pm I went to Urgent Care. I knew I was having some kind of adverse reaction to vaccine. If I get numbness back in right arm I am to go to ER. I feel better right now but I have had the leg cramping and rash is still a bit visible.


VAERS ID: 1840764 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Bursitis, Injection site pain, Joint stiffness, Movement disorder, Muscle spasms, Pain in extremity, Walking aid user
SMQs:, Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: PATIENT CALLED THE PHAMRACY ON OCTOBER 28 AT AROUND NOON. SHE WAS HAVING SEVER PAIN IN HER LEFT LEG. SPECIFICALLY AROUND HER KNEE. THE PAIN IN THE LEFT KNEE WAS VERY SEVER AND SHE COULD NOT MOVE. THE KNEE WAS STIFF AND BURSED. SHE SAID IT FELT LIKE IT WAS TURNED SIDEWAY WITH TOTAL SPASIM. SHE WAS SCARED OF MOVING BECAUSE SHE THOUGHT HER KNEE WOULD FREEZE AND HURT. HER INJECTION SITE WAS OK, SHE EXPERIANCED THE EXPECTED PAIN AND SORENESS AT THE INJECTION SITE. HER RIGHT KNEE WAS FINE AS WELL AS HER LEFT AND RIGHT ARM. WHE THE SHOT WAS ADMINSTERED THE PATIETN WAS ON CRUCHES UPON ARRIVAL AND APEARED TO HAVE SOME KIND OF LEG PAIN.


VAERS ID: 1840965 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH3219 / 2 LA / IM

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

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

Write-up: Chest pain and stabbing pains left side of chest ongoing for 24 hrs after first shot and ongoing after second shot and current 11/04/21


VAERS ID: 1840971 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mydayis Coumadin Multivitamin Fetzima Fish Oil Busbar Zyrtec
Current Illness: None
Preexisting Conditions: Factor V Leiden Obesity
Allergies: Seasonal Ketek Aimovig Ajovy
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Red Rash covering both arms; persisting for days.


VAERS ID: 1841202 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 4 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Headache, Pain in extremity, Wrong product administered
SMQs:, Dementia (broad), Tendinopathies and ligament disorders (broad), 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: SANCTURA 20MG DAILY
Current Illness: MULTIPLE SCLEROSIS
Preexisting Conditions: MULTIPLE SCLEROSIS
Allergies: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: PATIENT CAME IN TO GET FLU SHOT AND WAS ACCIDENTLY GIVEN PFIZER COVID SHOT AFTER SHE HAD ALREADY RECEIVED 3 MODERNA DOSES. WE INFORMED PATIENT IMMEDIATELY AS WE REALIZED THERE WAS A MISTAKE IMMEDIATELY. FOLLOW UP WITH MD REVEALED THAT SHE SUFFERED HEADACHE, FUZZY HEADED, SORE ARM AND FATIGUE AFTER BEING GIVEN INCORRECT VACCINE.


VAERS ID: 1841401 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-20
Onset:2021-10-28
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SC

Administered by: Work       Purchased by: ?
Symptoms: Condition aggravated, Extra dose administered, Headache, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), 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: Before receving the covid Pfizer vaccine, I rarely had headaches. I started having headaches periodically since the 2nd dose (January 2021). Afer the booster shot (the 3rd dose on 10/20/2021), other than the muscle pain on my left arm, I developed a low grade fever (up to 99.7 F) after 26 hours of the injection. The fever lasted for 5 hrs. Two weeks later, all of sudden I had a headache at aournd noon. The headache persisted overnight. By the time I woke up, I felt nauseated due to the headache. I took two Ibuprofens and the headsche went away.


VAERS ID: 1842118 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-02-24
Onset:2021-10-28
   Days after vaccination:246
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Hypoaesthesia oral, Myalgia, Taste disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: little bit tired in the arm; tongue was numb; glass of water felt peppery/couldn''t taste the candy; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA ORAL (tongue was numb), TASTE DISORDER (glass of water felt peppery/couldn''t taste the candy) and MYALGIA (little bit tired in the arm) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 24-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In March 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 28-Oct-2021 at 5:00 AM, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 28-Oct-2021, the patient experienced HYPOAESTHESIA ORAL (tongue was numb) and TASTE DISORDER (glass of water felt peppery/couldn''t taste the candy). On an unknown date, the patient experienced MYALGIA (little bit tired in the arm). At the time of the report, HYPOAESTHESIA ORAL (tongue was numb), TASTE DISORDER (glass of water felt peppery/couldn''t taste the candy) and MYALGIA (little bit tired in the arm) outcome was unknown. no concomitant and treatment medications are provided by the reporter. After the booster shot, everything was fine right away,Consent denied for Safety to contact HCP.


VAERS ID: 1842221 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Ohio  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling cold, Headache, Immunisation, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101482235

Write-up: Freezing; Horrible body aches; Major headache; Nausea; Administration date 28Oct2021, dose number=3; This is a spontaneous report from a contactable consumer, Pfizer colleague. A non-pregnant female patient of unspecified age received the third dose of BNT162b2 (COMIRNATY; Lot Number: Unknown) via an intramuscular route of administration in the arm on 28Oct2021 as a single dose for COVID-19 immunisation. Prior to the vaccination, the patient was not diagnosed with COVID-19. It was unknown whether the patient received any other vaccines within four weeks prior to the vaccination. It was unknown whether the patient received any concomitant medications. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: Unknown) via an intramuscular route of administration on an unknown date and also received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: Unknown) via an intramuscular route of administration on an unknown date as a single dose for COVID-19 immunisation. On 28Oct2021, the patient had "administration date 28Oct2021, dose number=3". On 29Oct2021, the patient woke up the following day "freezing, had "horrible body aches" and a "major headache." She also had nausea. She took ibuprofen (ADVIL) 800mg went to bed then woke up about an hour later feeling better. The events freezing, horrible body aches, major headache and nausea did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were taken as a result of the events freezing, horrible body aches, major headache and nausea which included treatment with ibuprofen (ADVIL) 800mg. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events freezing, horrible body aches, major headache and nausea was resolved on 29Oct2021. The clinical outcome of the event "administration date 28Oct2021, dose number=3" was unknown at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1842224 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Headache, Immunisation, Vomiting
SMQs:, Acute pancreatitis (broad), 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: SUBOXONE; LYRICA; PRAMIPEXOLE; LAMICTAL; MELOXICAN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COPD; Drug allergy (known allergies: Nausea medications); Fibromyalgia; Post laminectomy syndrome; Restless leg syndrome
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101482363

Write-up: Loose stool; Vomiting; Fatigue; Headache; Booster; This is a spontaneous report from a contactable consumer, the patient. A 51-year-old non-pregnant female patient received third dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FF2590) via an unspecified route of administration in the left arm on 28Oct2021 at 14:00 (at the age of 51-year-old), as a single dose for COVID-19 immunisation. Medical history included chronic obstructive pulmonary disease (COPD), fibromyalgia, restless leg syndrome, post laminectomy syndrome and allergy to nausea medications. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included naloxone hydrochloride/buprenorphine hydrochloride (SUBOXONE), pregabalin (LYRICA), pramipexole (MANUFACTURER UNKNOWN), lamotrigine (LAMICTAL) and meloxicam (MELOXICAN); all for unspecified indication from unknown date and unknown if ongoing and also included influenza vaccine (MANUFACTURER UNKNOWN) via unspecified route of administration in left arm on 15Oct2021 for immunization. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 17Mar2021 at 15:00 (at the age of 50-year-old) and received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EWO170) via an unspecified route of administration in the left arm on 30Apr2021 at 18:00 (at the age of 50-year-old); both as a single dose for COVID-19 immunisation. On 29Oct2021 at 02:30, the patient experienced loose stool, vomiting, fatigue and headache. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events loose stool, vomiting, fatigue and headache were resolving at the time of this report.


VAERS ID: 1842233 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Body temperature, Crying, Depression, Dysphagia, Eye pain, Facial pain, Headache, Immunisation, Insomnia, Muscle tightness, Myalgia, Nausea, Neck pain, Paraesthesia, Pyrexia, Tremor, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (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), Glaucoma (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Depression; Latex allergy (Known allergies: Powder on latex gloves); Narcolepsy
Allergies:
Diagnostic Lab Data: Test Date: 20211029; Test Name: Body temperature; Result Unstructured Data: Test Result:100 degrees; Comments: Time: 12:00, temp is 100 degrees
CDC Split Type: USPFIZER INC202101483128

Write-up: Headache; Nausea; Running a fever / temp is 100 degrees; Severe muscle pain in whole body; Tingling in arms and legs; Neck hurts; Jaw tight; Pain behind eyes; Having trouble keeping food down; Depressed; Crying; Face pain; Shaking; Back pain; Unable to stay asleep; Throwing up; The patient received the third/booster dose of BNT162b2; This is a spontaneous report from a contactable consumer, the patient. A 46-year-old non-pregnant female patient received the third (booster) dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FF2590) via an unspecified route of administration in the right arm on 28Oct2021 at 15:45 (at the age of 46-years-old) as a single dose for COVID-19 immunisation. Medical history included narcolepsy and depression. The patient was allergic to powder on latex gloves. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications were not reported. The patient previously received cefalexin (CEPHALEXIN) and escitalopram oxalate (LEXAPRO) and experienced drug allergy. The patient previously received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot number: EW0172) via an unspecified route of administration in the right arm on 30Apr2021 at 15:30 (at the age of 45-years-old) and also received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot number: EW0162) via an unspecified route of administration in the right arm on 09Apr2021 at 16:30 (at the age of 45-years-old) as a single dose for COVID-19 immunisation. On 29Oct2021 at 12:00, the patient experienced headache, nausea, running a fever, severe muscle pain in whole body, tingling in arms and legs, neck hurts, jaw tight, pain behind eyes, temperature was 100 degrees, having trouble keeping food down, depressed, crying, face pain, shaking, back pain, unable to stay asleep and throwing up. The events did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. On 29Oct2021, the patient underwent body temperature test and the result was 100 degrees (unspecified units). Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events headache, nausea, running a fever, severe muscle pain in whole body, tingling in arms and legs, neck hurts, jaw tight, pain behind eyes, temperature was 100 degrees, having trouble keeping food down, depressed, crying, face pain, shaking, back pain, unable to stay asleep and throwing up were unknown at the time of this report.


VAERS ID: 1842236 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 320398D / 3 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ALLEGRA-D 24 HOUR; VITAMIN D3; NASACORT
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101483261

Write-up: Rash/skin redness, similar to sunburn on neck, chest, back, sides, stomach, and upper legs/groin areas; Rash/skin redness, similar to sunburn on neck, chest, back, sides, stomach, and upper legs/groin areas; Rash/skin redness, similar to sunburn on neck, chest, back, sides, stomach, and upper legs/groin areas.; Some parts are blotchy.; Rash/skin redness, similar to sunburn on neck, chest, back, sides, stomach and upper legs/groin areas. Some parts are blotchy. It is a little warm(3/10).; A third (booster) dose of BNT162b2 was administered; This is a spontaneous report from a contactable consumer, the patient. A 33-year-old male patient received third booster dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: 320398D) via an unspecified route of administration in the left arm on 28Oct2021 at 14:45 (at the age of 33-years-old) as a single dose for COVID-19 immunisation. The patient did not have any medical history. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID-19 vaccine. Concomitant medications included fexofenadine hydrochloride/pseudoephedrine hydrochloride (ALLEGRA-D 24 HOUR), colecalciferol (VITAMIN D3) and triamcinolone acetonide (NASACORT 24 HOUR); all for unknown indications from an unknown date and unknown if ongoing. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot number: UNKNOWN) via an unspecified route of administration in the right arm on 24Mar2021 at 14:00 (at the age of 32-years-old) as a single dose for COVID-19 immunisation and received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot number: UNKNOWN) via an unspecified route of administration in the right arm on 15Apr2021 at 14:30 (at the age of 32-years-old) as a single dose for COVID-19 immunisation. The patient previously received amoxicillin (MANUFACTURER UNKNOWN) on an unknown date for an unknown indication and experienced drug allergy. On 30Oct2021 at 12:30 AM, the patient experienced rash/skin redness which was similar to the sunburn on neck, chest, back, sides, stomach and upper legs/groin areas, some parts were blotchy and it was a little warm (3/10). It was reported that it did not itch and was not painful. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events rash/skin redness, similar to sunburn on neck, chest, back, sides, stomach and upper legs/groin areas, some parts were blotchy and it was a little warm (3/10) was not resolved at the time of this report. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1842242 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 3 LA / OT

Administered by: Work       Purchased by: ?
Symptoms: Axillary pain, Fatigue, Feeling hot, Immunisation, Increased upper airway secretion, Malaise, Pain in extremity
SMQs:, 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: METFORMIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Polycystic ovarian syndrome (PCOS)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101484044

Write-up: Booster induced sore arm the next day. "I" woke up and felt some soreness go down "my" whole arm, like nerve pain but it was not extremely painful.; Armpit it also sore and tender to touch.; Also feeling a little warm; Feel kind of sick; "I" also feel tired; "I" have mucus buildup in "my" throat; Booster dose; This is a spontaneous report from a contactable other healthcare professional, the patient. A 24-year-old non-pregnant female patient received third dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0217) via an intramuscular route of administration in the left arm on 28Oct2021 at 10:45(at the age of 24-years-old) as a single dose for COVID-19 immunisation. The medical history included polycystic ovarian syndrome (PCOS). Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The concomitant medications included metformin (MANUFACTURER UNKNOWN) before booster shot from an unknown date for an unknown indication and unspecified birth control throughout all shots from an unknown date and all were unknown if ongoing. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EL3247) via an intramuscular route of administration on 25Jan2021 (at the age of 23-years-old) and received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EL3247) via an intramuscular route of administration on 15Feb2021 (at the age of 23-year-old) as a single dose for COVID-19 immunisation. The patient also took previously amoxicillin(MANUFACTURER UNKNOWN) on an unknown date and experienced allergy. On 29Oct2021, the next day, the patient experienced booster induced sore arm and woke up and felt some soreness went down whole arm, like nerve pain but it was not extremely painful. The armpit also sore and tender to touch. The patient also felt a little warm, felt kind of sick, felt tired and she noticed she had mucus buildup in her throat. The adverse events did not result in doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care. Therapeutic measures were not taken as a result of reported events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events booster induced sore arm the next day and woke up and felt some soreness went down whole arm, like nerve pain but it was not extremely painful, armpit also sore and tender to touch, also felt a little warm, felt kind of sick, felt tired, mucus buildup in throat were resolving at the time of this report. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1842257 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 3 LA / OT

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Headache, Immunisation, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hashimoto''s thyroiditis (Hashimotos Thyroiditis); Sulfonamide allergy (Known allergy: Sulfa containing medications)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101487822

Write-up: Significant joint pain in entire body (Not Day 0, Day 1-3) Moderate joint pain continues on Day 4; Significant joint pain and stiffness in entire body (Not Day 0, Day 1-3); Headache on day 1; Booster dose; This is a spontaneous report from a contactable healthcare professional, the patient. A 49-year-old non-pregnant female patient received third dose (booster) of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0177) via an intramuscular route of administration in the left arm on 28Oct2021 at 14:30 (at the age of 49-years-old) as a single dose for COVID-19 immunisation. Medical history included Hashimotos thyroiditis and allergy to sulfa containing medications. The patient received unspecified medications within two weeks of vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: ER2613) via an intramuscular route of administration in the left arm on 25Mar2021 (at the age of 48-years-old) and second dose of BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE; Lot number: EW0169) via an intramuscular route of administration in the left arm on 22Apr2021 (at the age of 48-years-old) as a single dose for COVID-19 immunisation. On 29Oct2021, the patient experienced significant joint pain and stiffness in entire body (Not Day 0, Day 1-3), moderate joint pain continued on Day 4 and headache on day 1. The events did not result in doctor or other health care professional office/clinic visit and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events headache and significant joint pain was resolving, while that of the event stiffness in entire body was resolved on 31Oct2021.


VAERS ID: 1842551 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-25
Onset:2021-10-28
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Erythema, Headache, Oral pain, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Weak Pain in chest Rashes and swollen admit On going Headaches Pain in mouth and face Red skin


VAERS ID: 1842643 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dyspnoea, Hypersensitivity, Interchange of vaccine products, Laboratory test normal
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Medication errors (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Chest Tightness / Heaviness / Pain-Severe, Additional Details: This was reported by patient''s wife. She stated pt has difficulty breathing and chest pain after his vaccine. they took him to an urgent care who ran tests and stated patient was "fine". They gave him some type of shot (steroids?) and pt felt better the next day. This was patient''s booster--first vaccine was Janssen.


VAERS ID: 1842649 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033421A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Wrong patient
SMQs:, Medication errors (narrow)

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

Write-up: Error: Wrong patient (documentation in EMR).


VAERS ID: 1842847 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Hallucination, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: hallucinations and arm pain


VAERS ID: 1842920 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-10-26
Onset:2021-10-28
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011F21A / 3 LA / IM

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

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

Write-up: Whole body itching including scalp. Went to dr and was told to take some cortisone cream and if itching persist to return.


VAERS ID: 1842939 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-09-16
Onset:2021-10-28
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Extra dose administered, Haematospermia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Humira Plaqunil
Current Illness: rheumatoid arthritis
Preexisting Conditions: Rheumatoid arthritis, Oates arthrits
Allergies: NKDA
Diagnostic Lab Data: All blood work and urine screens normal. No blood in urine or stools. Bleeding is isolated to prostrated or Vas deferens
CDC Split Type:

Write-up: Blood in Semen. Current. No pain or other syptoms


VAERS ID: 1843088 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered, Fatigue, Product preparation issue
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: metformin ER 500 mg take two tabs 2 times a day Invega 600 mg
Current Illness: None
Preexisting Conditions: Type 2 diabetes Schizophrenia
Allergies: N/A
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The patient was given 0.3 ml of undiluted Pfizer vaccine on 10/27/21. The patient was notified 11/4/21. He reports that he had fatigue the following day on 10/28/21. No other symptoms. Continues to do well now.


VAERS ID: 1843090 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-30
Onset:2021-10-28
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Influenza, Nasal congestion, Pain, Productive cough, SARS-CoV-2 test negative, Sneezing
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Infective pneumonia (broad), Opportunistic infections (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: Trileptal; Warfarin; Prozac; Wellbutrin
Current Illness: no
Preexisting Conditions: Clotting Condition - Protein S Deficiency
Allergies: Tuberculin test (TB Test)
Diagnostic Lab Data: COVID test - quick test -Clinic - negative result
CDC Split Type: vsafe

Write-up: I started noticing normal flu symptoms. Phlegmy throat; coughing and sneezing; congestion in my throat and nose and some body aches. I did not have a fever. COVID test - negative result at Clinic. Road it out with no treatment - the symptoms lasted about a week and a half. All I have now is a stuffy nose. Had the flu vaccine - Had that around October 8 (around that week either prior or a bit after).


VAERS ID: 1843101 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / N/A RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea
SMQs:, Acute pancreatitis (broad), 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: 10mg of Hydrochloride, 40mgs of Atorvastatin, 500mgs of Vitamin C and 25mcg of D3
Current Illness: None.
Preexisting Conditions: High blood pressure and high cholesterol.
Allergies: No.
Diagnostic Lab Data: I did not have any medical or laboratory tests.
CDC Split Type:

Write-up: Stomach ache for over 2 hours; then a bowel movement with some diarrhea 3 times that day. I had a stomach every morning until October 30th accompanied by some diarrhea 2 or 3 a day. I did not eat anything different. I ate what I usually eat. After the 30th, the stomach aches were very mild but, I still have some diarrhea 2 or 3 a day.


VAERS ID: 1843150 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 32030BD / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Muscle spasms
SMQs:, Dystonia (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: Moderna dose 2, fever chills fatigue headache rigors 4/6/21 age 29
Other Medications: None
Current Illness: None
Preexisting Conditions: Major depression and anxiety disorder
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue, headache, muscle spasm lasted about 48 hours


VAERS ID: 1843152 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, 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: we provided the booster shot (0.25ml) 3 weeks too early for the patient. His last dose was 5/18/2021


VAERS ID: 1843159 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-05
Onset:2021-10-28
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042B21A / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Deafness unilateral, Ear discomfort, Headache, Influenza virus test negative, Injection site pain, Paranasal sinus discomfort, Respiratory viral panel, SARS-CoV-2 test negative
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hearing impairment (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: All my current med list - calcium - 600 mg twice a day; Super C - Vit C with multiple vitamins/minerals; Glucosamine 1500 mg once a day; Fexofenadine - once a day - 180 mg; Baby aspirin - 81 mg every day; Metformin ER - 500 mg - take two t
Current Illness: no
Preexisting Conditions: Diabetic; Hypothyroidism; High cholesterol; Asthma - everything has been in pretty good control Was only recently diagnosed with Hypertension - about 1 years ago
Allergies: Sulfa drugs; morphine; Ceftin; have hay fever; pollens (spring and fall)
Diagnostic Lab Data: November 1st - They did respiratory virus panel testing - flu/COVID etc - negative result
CDC Split Type: vsafe

Write-up: I started feeling a lot of pressure in my sinuses and ears on Thursday, 28th, and I took decongestants and Ibuprofen until Monday morning when I went to walk-in Clinic at my doctor''s office. I lost hearing in my right ear on Saturday the 30th. I got amoxicillin for 10 days twice a day to help with my symptoms. It is helping somewhat but my ear still has a lot of pressure in it and I still have no hearing on my right ear. I will go to my doctor on Monday, the 8th, for follow up. I still feel a bit stuffy but not as bad. Notes: I did have COVID in January 2021 before my vaccines - BAM infusion. I had my regular flu shot on October 5th. Symptoms immediately after the vaccine: Had a sore arm; starting the evening of the shot, I had a few chills and headache and I took Tylenol and went to bed and by the next morning, I was better.


VAERS ID: 1843189 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-06-10
Onset:2021-10-28
   Days after vaccination:140
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 RA / 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: Patient swabbed at our offsite testing location and no primary care provider listed. Please contact patient for follow-up questions.
Current Illness: Patient swabbed at our offsite testing location and no primary care provider listed. Please contact patient for follow-up questions.
Preexisting Conditions: Patient swabbed at our offsite testing location and no primary care provider listed. Please contact patient for follow-up questions.
Allergies: Patient swabbed at our offsite testing location and no primary care provider listed. Please contact patient for follow-up questions.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient vaccinated for and then tested positive for COVID-19


VAERS ID: 1843203 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-09-29
Onset:2021-10-28
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0214 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Heart rate abnormal, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 3 Blood Pressure Medications, Statin Valtrex, Aspirin, Prostate Medications
Current Illness: N/A
Preexisting Conditions: Hypertension, Prostate Hyperlipidemia
Allergies: Radiologic Dye
Diagnostic Lab Data: Heart Testing
CDC Split Type: vsafe

Write-up: I have a watch and it indicated that my heart rate was abnormal four weeks after the vaccine. A couple of days later I felt that my heart rate was very high. It was between 100 and 130. I went to the ER after five hours. I was diagnosed with Atrial Fibrillation. I have never had any Atrial Fibrillation before. I went to the Cardiologist. I have been prescribed a blood thinner and a Beta Blocker.


VAERS ID: 1843205 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-20
Onset:2021-10-28
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anticoagulant therapy, Atrial fibrillation, Brain natriuretic peptide increased, COVID-19, COVID-19 pneumonia, Cardiac imaging procedure abnormal, Chest X-ray abnormal, Chest discomfort, Computerised tomogram thorax abnormal, Condition aggravated, Cough, Dyspnoea, Echocardiogram abnormal, Ejection fraction decreased, Fatigue, Haematocrit increased, Haemoglobin increased, Hypoxia, Infection, Lung infiltration, Nausea, Orthopnoea, Platelet count normal, Pulmonary oedema, SARS-CoV-2 test positive, Stress cardiomyopathy, Troponin increased, Vomiting, White blood cell count increased
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Supraventricular tachyarrhythmias (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Other ischaemic heart disease (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet apixaban (ELIQUIS) 5 MG tablet aspirin 81 MG enteric coated tablet atorvastatin (LIPITOR) 40 MG tablet CALCIUM PO Cholecalciferol (VITAMIN D3 PO) furosemide (LASIX) 20 MG tablet levothyroxine (SYNTHROID
Current Illness:
Preexisting Conditions: Circulatory Hypertension Left carotid artery stenosis Splenic artery aneurysm NSTEMI (non-ST elevated myocardial infarction) Atrial fibrillation with RVR (HCC)Endocrine/Metabolic Hypercholesterolemia Hypothyroidism due to acquired atrophy of thyroid
Allergies: Ibu [Nsaids] LovastatinNausea Only, GI Upset Pravastatin
Diagnostic Lab Data: Recent Labs 10/28/21 10/29/21 10/30/21 WBC 21.68* 18.66* 24.17* HGB 16.7* 14.1 13.6 HCT 47.8* 40.2 40.1 PLATELET 293 223 194
CDC Split Type:

Write-up: 75-year-old female presented with nausea, chest tightness, and shortness of breath. Patient did have some mild fatigue and a mild cough 2 weeks prior. After getting her flu shot, about 4 hours later, she developed nausea, vomiting, and chest tightness. This was then followed by progressive shortness of breath with orthopnea. Upon presentation to the emergency department, patient was found to be in atrial fibrillation with RVR which is new for her. She was also hypoxic at 87% on room air. CT angiogram thorax showed no PE but there was bilateral infiltrates, pulmonary edema versus infectious. Her COVID test came back positive. She also had significantly elevated troponin at 683 with an elevated BNP at 4000. Patient has been vaccinated for COVID. Upon discussion with Cardiology, patient was started on a heparin drip and daily aspirin. Patient was started on Decadron and remdesivir for COVID pneumonia. Her presentation was thought to be multifactorial cause by pulmonary edema, AFib with RVR, and COVID pneumonia. Patient was placed on Cardizem drip. Her symptoms and hypoxia quickly resolved after her rate was controlled. An echocardiogram showed a decreased ejection fraction of 40% with hypokinetic distal and apical segments. A cardiac MRI was then done which showed findings consistent with stress-induced cardiomyopathy (apical type). There was no MRI evidence of myocardial infarction or myocarditis. Left ventricular ejection fraction was 48%. Patient was given a dose of Lasix with very good response and urine output. Follow-up chest x-ray the next day showed improvement of her bilateral infiltrates which points more towards resolving pulmonary edema. With improvement of her symptoms, patient was discharged home with plans to have a follow-up echocardiogram in 4 weeks. Patient''s metoprolol dose was increased to 75 mg daily. She was discharged on atorvastatin 40 mg daily, Lasix 20 mg daily, and transition to Eliquis 5 mg twice a day for atrial fibrillation. She will follow-up with cardiology as an outpatient.


VAERS ID: 1843220 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-18
Onset:2021-10-28
   Days after vaccination:252
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 2 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest X-ray, Cough, Dyspnoea, Hypoxia, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Outpatient Medications acetaminophen (TYLENOL) 325 MG tablet aluminum, magnesium & simethicone (MAALOX EX) 400-400-40 MG/5ML atenolol (TENORMIN) 50 MG tablet benzonatate (TESSALON) 100 MG capsule Calcium Carbonate (CALCIUM 600 PO) Cholecalc
Current Illness:
Preexisting Conditions: Respiratory Snoring Circulatory Atrial fibrillation Persistent atrial fibrillation Essential hypertension with goal blood pressure less than 140/90 Heart murmur Chronic heart failure with preserved ejection fraction Venous insufficiency Digestive Gastroesophageal reflux disease without esophagitis Morbid obesity Infectious/Inflammatory Atrophic vaginitis Cellulitis COVID-19 virus pneumonia Nervous Vulvar pruritus Chronic midline low back pain without sciatica Endocrine/Metabolic Hypocarbia Other hyperlipidemia Other Wound of right lower extremity Rosacea Anxiety Age-related osteoporosis without current pathological fracture History of breast cancer Anticoagulated Degenerative arthritis of knee, bilateral Caregiver stress Compression fracture of body of thoracic vertebra Skin ulcer of right lower leg, limited to breakdown of skin Closed compression fracture of body of L1 vertebra Hospital discharge follow-up
Allergies: Ace InhibitorsCough KeflexUnknown
Diagnostic Lab Data: Procedure Component Value Ref Range Date/Time DR CHEST SINGLE VIEW [349535521] Resulted: 10/28/21 1318 Order Status: Completed Updated: 10/28/21 1320 Narrative: EXAMINATION: Single View Chest EXAM DATE: 10/28/2021 12:53 PM TECHNIQUE: Single view chest INDICATION: Cough, congestion, COVID-19 COMPARISON: 9/19/2020. ENCOUNTER: Not applicable _________________________ FINDINGS: Cardiomegaly is unchanged. No focal airspace opacity, pulmonary edema, pneumothorax, or pleural effusion. Postoperative changes in the right chest wall. _________________________ Impression: Unchanged cardiomegaly without acute cardiopulmonary abnormality. Procedure Component Value Ref Range Date/Time COVID-19 PCR - Rapid BL and Regionals [349535529] (Abnormal) Collected: 10/28/21 1252 Order Status: Completed Specimen: Swabbed Collection from Nasopharynx Updated: 10/28/21 1300 COVID-19 PCR Detected Abnormal Not Detected Comment: COVID-19 (SARS-CoV-2) test is positive. Clinical correlation with patient history and other diagnostic information is necessary to determine infection status. This test has received Emergency Use Authorization (EUA) by the FDA, but performance has not been evaluated for asymptomatic patients. Testing was performed using a nucleic acid amplification method. The specimen source may have been changed from the original order per patient situation or symptoms. See http://lab.spectrumhealth.org for additional information. Covid 19 Result Comment See Comment Comment: COVID-19 results reported as "detected" means COVID-19 positive. Positive patients should self-isolate for 10 days or 24 hours after fever resolves and other symptoms are improving, whichever is longer: - Stay home except to get medical care and wear a facemask if you must leave - Separate yourself from other people in your home, known as home isolation - Cover your coughs and sneezes - Wash your hands often - Avoid sharing household items - Clean high-touch surfaces everyday - If you have a medical emergency and need to call 911, notify dispatch personnel that you may have COVID-19 and put on a facemask before emergency medical services arrive. If the result is "inconclusive" or "invalid" and you have not been contacted by a medical professional about your result or if you have questions about COVID-19, your symptoms, or need a return to work/school note, please contact your primary care provider (PCP).
CDC Split Type:

Write-up: a 79 y.o. female who presented on 10/28/2021 with a 4 day complaint of cough, congestion and shortness of breath and found to be COVID-19 positive (confirmed 10/28/2021), CXR was negative for infiltrates. The patient is vaccinated for COVID 19. She was initially hypoxic in the ED requiring 2L NC but has since been weaned to room air. The patient received treatment with 4 days of remdesivir and decadron. Decadron will be continued upon discharge to complete a total of 10 days of therapy. The patient was planning to discharge back there. However given her COVID-19 positive status she will be returning home until her 10-day quarantine period is complete per the facilities guidelines and will follow-up with the patient at her home. Recommend post-hospital follow-up with PCP in 1-week.


VAERS ID: 1843235 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-19
Onset:2021-10-28
   Days after vaccination:192
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Acquired diaphragmatic eventration, Adenovirus test, Angiogram abnormal, Anticoagulant therapy, Aortic arteriosclerosis, Aortic dilatation, Arteriosclerosis, Arteriosclerosis coronary artery, Asthenia, Atelectasis, Atrial fibrillation, Atrial flutter, Bacterial test negative, Bacterial test positive, Blood culture negative, Bordetella test negative, Bronchiolitis, Bronchitis, COVID-19, Cardiac monitoring, Cardiac septal hypertrophy, Cardiac telemetry, Chest X-ray, Chest injury, Chlamydia test negative, Cholelithiasis, Clostridium test, Computerised tomogram abdomen abnormal, Computerised tomogram thorax abnormal, Condition aggravated, Coronavirus test negative, Cough, Culture urine positive, Dyspnoea, Dyspnoea exertional, Echocardiogram, Echocardiogram abnormal, Ejection fraction normal, Enterococcus test positive, Enterovirus test negative, Fall, Fatigue, Hepatic cirrhosis, Hepatic hypertrophy, Hilar lymphadenopathy, Human metapneumovirus test, Human rhinovirus test, Inferior vena cava dilatation, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Left atrial dilatation, Lung opacity, Lymphadenopathy, Lymphadenopathy mediastinal, Mitral valve calcification, Mitral valve stenosis, Mycoplasma test negative, Nodule, Oedema peripheral, Pulmonary granuloma, Pulmonary mass, Pyrexia, Respiratory syncytial virus test negative, Respiratory viral panel, Right ventricular dilatation, SARS-CoV-2 test positive, Scan with contrast abnormal, Splenomegaly, Stool analysis normal, Tricuspid valve incompetence, Vascular device user, Viral test
SMQs:, Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Angioedema (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Gallbladder related disorders (narrow), Gallstone related disorders (narrow), Pulmonary hypertension (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Other ischaemic heart disease (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amoxicillin (AMOXIL) 500 MG capsule apixaban starter pack (ELIQUIS) 5 MG TBPK tablet benazepril-hydrochlorothiazide (LOTENSIN HCT) 20-25 MG per tablet benzocaine-menthol (CEPACOL) 15-3.6 MG LOZG benzonatate (TESSALON) 100 MG capsule gabapen
Current Illness:
Preexisting Conditions: Respiratory COPD (chronic obstructive pulmonary disease) Circulatory Hypertension associated with diabetes Peripheral arterial disease Digestive Squamous cell carcinoma of anal canal Primary liver hepatocellular carcinoma Malignant neoplasm of overlapping sites of rectum, anus and anal canal Colon cancer Infectious/Inflammatory Gout of right knee COVID-19 virus infection Acute cystitis Hematologic Anemia, blood loss Platelets decreased Nervous Bilateral leg weakness Chemotherapy-induced peripheral neuropathy Genitourinary Right renal mass - right 20 mm Endocrine/Metabolic Type 2 diabetes mellitus without complication, without long-term current use of insulin Hypothyroidism due to medication Other Primary osteoarthritis of knees, bilateral Former Smoker Left adrenal mass- indeterminate Bilateral lower extremity edema Generalized weakness
Allergies: No Known Allergies
Diagnostic Lab Data: Procedure Component Value Ref Range Date/Time CV Patch Monitor w/hookup- 14day Resulted: 10/31/21 1231 Order Status: Sent Updated: 10/31/21 1311 DR CHEST SINGLE VIEW Resulted: 10/30/21 0324 Order Status: Completed Updated: 10/30/21 0326 Narrative: EXAMINATION: Single View Chest EXAM DATE: 10/30/2021 2:05 AM TECHNIQUE: Single view chest INDICATION: fever w/u COMPARISON: Chest CT 10/29/2021 ENCOUNTER: Not applicable _________________________ FINDINGS: Normal heart size. Calcified aorta. Right-sided port in good position. Elevated right hemidiaphragm. Prior right shoulder surgery. Old right clavicle fracture. The lungs are fairly well-inflated without consolidation. No effusion or pneumothorax. There are multiple granulomas. _________________________ Impression: No acute airspace process. CV Echo Complete With Contrast Collected: 10/29/21 0925 Order Status: Completed Updated: 10/29/21 1131 Narrative: LIMITED ECHOCARDIOGRAPHY REPORT Name: (PRIVACY) Study Date: 10/29/2021 Patient Location: Emergency Department DOB: (PRIVACY) Patient Class: Inpatient Gender: Male Ordering Physician: (PRIVACY) Age: 79 yrs Height: 180 cm Weight: 101 kg Resting HR: 111 BSA: 2.2 m2 Resting BP: 121/76 mmHg Reason For Study: Atrial fibrillation/flutter (AF), Dyspnea on exertion (DOE), atrial fibrillation/flutter, New onset A-fib History/Symptoms: hypertension, diabetes, COPD, history of smoking, Peripheral arterial disease, COVID 19 (10/21) Electronically signed by: MD on 10/29/2021 11:31 AM Interpretation Summary Limited TTE: Upper septal hypertrophy (sigmoid septum), normal variant. Left ventricular systolic function is normal. The left ventricular ejection fraction is 65%. No regional wall motion abnormalities noted. The right ventricle is mildly dilated. The right ventricular systolic function is normal. There is moderate mitral annular calcification. No mitral valve stenosis. Left atrium is at least moderately dilated by visual estimation. There is no comparison study available. STUDY PERFORMED/QUALITY: AORTIC VALVE: A two-dimensional transthoracic The aortic valve is not well echocardiogram with color flow and visualized. There is no aortic valve spectral flow Doppler was performed in stenosis. limited views only. The technical quality of the exam was fair. The MITRAL VALVE: apical views were difficult to obtain There is moderate mitral annular and are suboptimal in quality. Due to calcification. There is no mitral limited acoustic windows, Definity was valve stenosis. administered. LEFT VENTRICLE: TRICUSPID VALVE: The left ventricle is normal in size. There is no tricuspid stenosis. There Upper septal hypertrophy (sigmoid is mild tricuspid regurgitation. The septum), normal variant. Left estimated right ventricular systolic ventricular systolic function is pressure is 27 mmHg. normal. The left ventricular ejection fraction is 65%. The LV ejection fraction was determined utilizing visual estimation. There was insufficient diastolic data to allow for diastolic function assessment. No regional wall motion abnormalities noted. LEFT ATRIUM: Left atrium is at least moderately dilated by visual estimation. The interatrial septum is not well visualized. RIGHT ATRIUM: Right atrial size is normal. RIGHT VENTRICLE: The right ventricle is mildly dilated. The right ventricular systolic function is normal. INFERIOR VENA CAVA: The IVC is dilated ($g2.1 cm) with normal collapse during patient sniff ($g50% collapse). The estimated RA pressure is 8 mm Hg (5-10 mm Hg)). Left Ventricle Tricuspid Valve IVSd: 1.1 cm TR max vel: 2.22 m/sec LVPWd: 1.1 cm TR max PG: 20.0 mmHg LVIDd: 5.9 cm LVIDs: 4.0 cm ______________________________________________________________________________ Great Vessels IVC diam: 2.2 cm Reference Table: Normal Mild ModerateSevere Men LVEF $g 52% 41-51% 30-40% <30% Women LVEF $g 54% 41-53% 30-40% <30% Men LVIDd 4.2-5.8 5.9-6.3 6.4-6.8 $g6.8 Women LVIDd 3.8-5.2 5.3-5.6 5.7-6.1 $g6.1 LA Volume (ml/m^2) < 34 35-41 42-48 $g48 ______________________________________________________________________________ Electronically signed by: MD on 10/29/2021 11:31 AM All sources of data reside in the Cardiology EJECTION FRACTION ECHO Collected: 10/29/21 0925 Order Status: Completed Updated: 10/29/21 1131 EJECTION FRACTION ECHO 65 % CT ANGIO THORAX WITH IV CONTRAST Resulted: 10/29/21 0146 Order Status: Completed Updated: 10/29/21 0148 Narrative: EXAMINATION: CT Angiography of the Thorax EXAM DATE: 10/29/2021 12:07 AM TECHNIQUE: Standard protocol CT angiogram images were obtained through the chest following the administration of intravenous contrast. Coronal and sagittal MIP 3-D reformations were performed. CONTRAST: The amount and type of contrast are recorded in the medical record. QPP DOCUMENTATION: At least one of the following dose reduction techniques was utilized: Iterative reconstruction, and/or Automatic Exposure Control, and/or mA/kV adjustment based on body size. INDICATION: Chest trauma, mod-severe. History of colon and hepatocellular cancer. COMPARISON: Chest, abdomen and pelvis CT 6/25/2021 ENCOUNTER: Not applicable ____________________ FINDINGS: Base of Neck & Axillae: Similar appearance to mildly prominent bilateral axillary nodes without interval suspicious change. Mediastinum & Hila: Similar appearance to slightly prominent and mildly enlarged multicompartmental nodes. No mediastinal hematoma or frank mass. No pneumomediastinum. The esophagus is within normal limits for technique. Cardiovascular: Heart size and pericardium are within normal limits. Similar minimal to mild coronary artery calcifications. Similar ectasia of the ascending thoracic aorta to approximately 4.5 to 4.6 cm. No dissection or aneurysm. Similar atherosclerotic disease. There is no evidence for right heart strain. Pulmonary Arteries: No pulmonary embolism is present. Lungs & Airways: No evidence of consolidation to suggest lobar pneumonia or contusion. Minimal dependent atelectasis present. There are a few subtle areas of mild bronchocentric groundglass opacity scattered throughout both upper lobes slightly more pronounced on the right than on the left suggestive of process such as minimal respiratory bronchiolitis. No change in the subcentimeter solid nodules of the middle lobe at the fissure and inferolateral left upper lobe pleural-based nodule continuing to measure approximately 9 and 7 mm respectively. No interval suspicious pulmonary nodule. Pleural Space: There are no pleural effusions. There is no pneumothorax. Upper Abdomen: Evaluation of the upper abdomen is limited by early phase enhancement but no interval acute change or suspicious finding within the limits of the exam. Stable cirrhotic appearance of the liver with hypertrophy of the caudate noted. There is similar partially visualized splenomegaly. Cholelithiasis again noted without acute inflammatory change. Similar enlarged gastrohepatic ligament nodes. Chest Wall & Musculoskeletal: Visualized soft tissues are intact without acute or suspicious finding. Bone windows likewise show no acute or suspicious finding. ____________________ Impression: 1. No traumatic appearing finding of the chest noted. 2. No evidence of pulmonary embolus. 3. Minimal groundglass bronchocentric opacities of the upper lobes right greater than left suggest resolving or evolving acute process such as bronchitis or respiratory bronchiolitis. No consolidating pneumonia. 4. Stable appearance to pulmonary nodules. 5. No acute interval change the appearance of the visualized upper abdomen within the limits of the exam. Procedure Component Value Ref Range Date/Time Peripheral Blood Culture Collected: 10/31/21 0854 Order Status: Completed Specimen: Blood, Venous Updated: 11/04/21 1001 Cult Blood Peripheral No Growth 4 Days Central Line Blood Culture (Normal) Collected: 10/30/21 0149 Order Status: Completed Specimen: Blood, Central Line Updated: 11/04/21 0301 Cult Blood Central Line No bacteria or yeast isolated Central Line Blood Culture (Normal) Collected: 10/29/21 0543 Order Status: Completed Specimen: Blood, Central Line Updated: 11/03/21 0702 Cult Blood Central Line No bacteria or yeast isolated Peripheral Blood Culture Collected: 10/29/21 0041 Order Status: Completed Specimen: Blood, Venous Updated: 11/03/21 0300 Cult Blood Peripheral No bacteria or yeast isolated Peripheral Blood Culture Collected: 10/28/21 2234 Order Status: Completed Specimen: Blood, Venous Updated: 11/03/21 0002 Cult Blood Peripheral No bacteria or yeast isolated Urine Culture (Abnormal) Collected: 10/29/21 0046 Order Status: Completed Specimen: Urine, clean catch Updated: 10/31/21 0742 Bacterial culture, urine $g=100,000 CFU/mL Enterococcus faecalis Abnormal Susceptibility Enterococcus faecalis Not Specified Ampicillin Susceptible Levofloxacin Susceptible Nitrofurantoin Susceptible Tetracycline Susceptible Vancomycin Susceptible Linear View Clostridioides difficile Toxin (Normal) Collected: 10/29/21 2312 Order Status: Completed Specimen: Stool from Rectum Updated: 10/30/21 0533 C difficile Toxin Negative Negative Respiratory Pathogens (Abnormal) Collected: 10/28/21 2234 Order Status: Completed Specimen: Swabbed Collection from Nasopharynx Updated: 10/29/21 0614 Adenovirus PCR Film Array Not Detected Not Detected Coronavirus 229E PCR Film Array Not Detected Not Detected Coronavirus HKU1 PCR Film Array Not Detected Not Detected Coronavirus NL63 PCR Film Array Not Detected Not Detected Coronavirus OC43 PCR Film Array Not Detected Not Detected COVID-19 PCR Detected Abnormal Not Detected Comment: COVID-19 (SARS-CoV-2) test is positive. Clinical correlation with patient history and other diagnostic information is necessary to determine infection status. This test has received Emergency Use Authorization (EUA) by the FDA, but performance has not been evaluated for asymptomatic patients. Testing was performed using a nucleic acid amplification method. The specimen source may have been changed from the original order per patient situation or symptoms. See website for additional information. Metapneumovirus PCR Film Array Not Detected Not Detected Rhinovirus-Enterovirus PCR Film Array Not Detected Not Detected Influenza A PCR Film Array Not Detected Not Detected Influenza A H3 PCR Film Array Not Detected Not Detected Influenza A H1 PCR Film Array Not Detected Not Detected Influenza A 2009 H1 PCR Film Array Not Detected Not Detected Influenza B PCR Film Array Not Detected Not Detected Parainfluenza 1 PCR Film Array Not Detected Not Detected Parainfluenza 2 PCR Film Array Not Detected Not Detected Parainfluenza 3 PCR Film Array Not Detected Not Detected Parainfluenza 4 PCR Film Array Not Detected Not Detected Respiratory Syncytial Virus PCR Film Array Not Detected Not Detected Bordetella pertussis PCR Not Detected Not Detected Bordetella parapertussis PCR Not Detected Not Detected Chlamydia pneumoniae PCR Not Detected Not Detected Mycoplasma pneumoniae PCR Not Detected Not Detected COVID-19 PCR (Abnormal) Collected: 10/28/21 2234 Order Status: Completed Specimen: Swabbed Collection from Nasopharynx Updated: 10/28/21 2328 COVID-19 PCR Detected Abnormal Not Detected Comment: COVID-19 (SARS-CoV-2) RT-PCR test is positive. Clinical correlation with patient history and other diagnostic information is necessary to determine infection status. This test has received Emergency Use Authorization (EUA) by the FDA, but performance has not been evaluated for asymptomatic patients. Testing was performed using a nucleic acid amplification method. The specimen source may have been changed from the original order per patient situation or symptoms. See website for additional information. This test was performed at Laboratory. Covid 19 Result Comment See Comment Comment: COVID-19 results reported as "detected" means COVID-19 positive. Positive patients should self-isolate for 10 days or 24 hours after fever resolves and other symptoms are improving, whichever is longer: - Stay home except to get medical care and wear a facemask if you must leave - Separate yourself from other people in your home, known as home isolation - Cover your coughs and sneezes - Wash your hands often - Avoid sharing household items - Clean high-touch surfaces everyday - If you have a medical emergency and need to call 911, notify dispatch personnel that you may have COVID-19 and put on a facemask before emergency medical services arrive. If the result is "inconclusive" or "invalid" and you have not been contacted by a medical professional from medical facility about your result or if you have questions about COVID-19, your symptoms, or need a return to work/school note, please contact your primary care provider (PCP). If you do not have a PCP, visit website.
CDC Split Type:

Write-up: Patient is a 79 y.o. male with a PMH of COPD, HLD, hypothyroidism, HTN, DM, and corectal cancer. Patient presented to the ED for generalized weakness and fatigue x 1-2 days. Stated prior to coming to the ED he had a mechanical fall. + Dry cough that started 1 night PTA. + SOB, mildly worse than his baseline. + Conversational dyspnea; patient stated that is his baseline 2/2 to his COPD. + BLE edema; unchanged from baseline per patient. The patient was admitted for further evaluation and management. He had a positive urine culture for enterococcus. He was initially treated with Rocephin, then Zosyn prior to changing to Amoxicillin 1 g PO TID to complete a 7 day course. The patient was also positive for Covid. He was given dexamethasone in the ED, and Regeneron on 10/29 with subjective improvement in symptoms per patient. Cardiology was consulted for new onset afib. The patient''s metoprolol was increased to 100 mg daily and they recommended a Ziopatch which was placed prior to discharge. He was also started on Lovenox during his admission and changed to Eliquis at time of discharge. Prior to discharge, the CM arranged additional services as the patient will be quarantined through 11/11 and lives alone. The patient was eating and ambulating at the time of discharge. Answered all questions and the patient was comfortable with the discharge plan. Medications as listed below. The patient will follow up with Dr. after his quarantine ends.


VAERS ID: 1843273 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Lymphadenopathy, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Caprylic Acid, Magnesium, Digestive Enzymes, B12, Vitamin D3, Probiospore, and S Boullardi.
Current Illness: None
Preexisting Conditions: None
Allergies: Supha and Dilantin.
Diagnostic Lab Data:
CDC Split Type:

Write-up: 24 hours after receiving the booster shot the lymph node in my left armpit swelled up to the size of a lemon and my arm was extremely sore. This lasted for almost a week before the lymph node started to go down.


VAERS ID: 1843285 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-15
Onset:2021-10-28
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adenovirus test, Angiogram cerebral normal, Arteriogram carotid normal, Bordetella test negative, COVID-19, Chest X-ray normal, Chlamydia test negative, Computerised tomogram head normal, Condition aggravated, Coronavirus test negative, Diffusion-weighted brain MRI normal, Echocardiogram, Echocardiogram abnormal, Ejection fraction normal, Enterovirus test negative, Hemiparesis, Human metapneumovirus test, Human rhinovirus test, Indeterminate investigation result, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Magnetic resonance imaging, Mitral valve incompetence, Mycoplasma test negative, Oropharyngeal pain, Perfusion brain scan normal, Respiratory syncytial virus test negative, Respiratory viral panel, SARS-CoV-2 test positive, Scan with contrast normal, Stress, Tricuspid valve incompetence
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Pulmonary hypertension (narrow), Noninfectious encephalitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin 81 mg chewable tablet atorvastatin (LIPITOR) 40 mg tablet busPIRone (BUSPAR) 15 mg tablet chlorthalidone (HYGROTON) 25 mg tablet cholecalciferol, vitamin D3, 400 unit capsule DULoxetine (CYMBALTA) 60 mg capsule metoprolol tart
Current Illness:
Preexisting Conditions: Nervous Left-sided weakness Aphasia Respiratory Chronic seasonal allergic rhinitis due to pollen OSA (obstructive sleep apnea) Circulatory Benign essential hypertension Hot flash, menopausal PAC (premature atrial contraction) PVC (premature ventricular contraction) Incomplete right bundle branch block (RBBB) Digestive Indeterminate colitis Vitamin D deficiency Regional enterocolitis Ileostomy in place Intestinal malabsorption, unspecified type Genitourinary Postmenopausal atrophic vaginitis Recurrent UTI Vaginal atrophy Kidney cyst, acquired Vaginal discharge Bacterial vaginosis Vulvar abscess Musculoskeletal Kyphosis, acquired Hidradenitis Endocrine/Metabolic Dyslipidemia Hyperglycemia Hypokalemia Hypomagnesemia Hypophosphatemia Hematologic Anemia, unspecified type Other Alkaline phosphatase raised Anxiety Attention-deficit/hyperactivity disorder Insomnia Overweight S/P colectomy Insomnia, unspecified type
Allergies: InfliximabHives / Urticaria, Shortness of breath / Dyspnea, Swelling Oxycodone-acetaminophenHives / Urticaria, Swelling
Diagnostic Lab Data: 10/28/2021 1216 Respiratory virus detection panel Collected: 10/28/21 1216 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result Detected Critical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected Transthoracic echo (TTE) limited Resulted: 10/29/21 1406 Order Status: Completed Updated: 10/29/21 1409 LVIDd 4.00 3.7 - 5.6 cm LVIDs 2.80 2 - 3.8 cm IVSd 1.00 0.6 - 1.1 cm LVPWd 1.10 0.6 - 1.1 cm LADs 2.10 1.9 - 4 cm LVOT diameter 2.00 cm Aortic Root (2.0-3.7) 2.70 cm TR max PG 17.30 mmHg TR max vel 207.70 cm/sec Narrative: FINALIZED REPORT TWO-DIMENSIONAL ECHOCARDIOGRAPHIC FINDINGS LEFT VENTRICLE: Normal LV size and function. EF is estimated at 60 to 65%. No regional wall motion abnormality. RIGHT VENTRICLE: RV function is normal AORTIC VALVE: Opens well MITRAL VALVE: Grossly normal TRICUSPID VALVE: Grossly normal PULMONIC VALVE: Grossly normal LEFT ATRIUM: Normal size RIGHT ATRIUM: Normal size AORTIC ROOT: Normal size PERICARDIUM: No effusion INTERATRIAL SEPTUM: No shunt by color Doppler. Saline contrast bubble study was negative for interatrial shunt IVC: Not well seen AORTIC ARCH: Not seen COLOR AND SPECTRAL DOPPLER: No aortic stenosis. No aortic insufficiency. Mild tricuspid regurgitation. Trace mitral regurgitation. Indeterminate diastolic function. RV systolic pressure estimate is 25 mmHg which is within the range of normal FINAL IMPRESSIONS: Normal LV size and function. EF is estimated at 60 to 65%. No regional wall motion abnormality. RV function is normal. No significant valvular abnormalities. Normal right ventricular systolic pressure estimate. No pericardial effusion. Saline contrast bubble study was negative for interatrial shunt. CT head without contrast - Tomorrow Resulted: 10/29/21 1319 Order Status: Completed Updated: 10/29/21 1320 Narrative: CT HEAD WO CONTRAST IMPRESSION: No acute intracranial abnormality. END OF IMPRESSION: INDICATION: Suspected stroke, COVID-19. TECHNIQUE: Helical CT scanning of the head is performed without IV contrast. Multiplanar reformations created and submitted for review. Dose limiting techniques utilized when possible. COMPARISON: Noncontrast head CT yesterday 10/20/2021 FINDINGS: No acute intracranial hemorrhage. No measurable mass or mass effect. Normal gray-white distinction and CSF spaces. No acute or aggressive osseous abnormality; no acute fluid. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. MRI brain without contrast Resulted: 10/29/21 1247 Order Status: Completed Updated: 10/29/21 1247 Narrative: MRI BRAIN WO CONTRAST IMPRESSION: There is no acute infarct in the brain. END OF IMPRESSION: INDICATION: Stroke, Covid positive. TECHNIQUE: Axial T1, T2, FLAIR sequence, diffusion-weighted imaging, axial gradient echo sequence, sagittal T1-weighted sequences were obtained. FIELD STRENGTH: 1.5 Tesla COMPARISON: CT 10/29/2021 FINDINGS: There is no acute infarct in the brain. No restricted diffusion on the diffusion-weighted imaging. No intracerebral or subdural hemorrhage. No focal dark signal intensity with blooming effect in the brain on the gradient echo sequences. No mass effect or midline shift. No cerebral edema identified. The ventricular system and basal cisterns are normal. Normal flow-voids of the intracranial vascular structures are well preserved. No focal T2 bright white matter signal abnormality both hemispheres, posterior fossa and brainstem. The craniovertebral junction is normal. The sella and corpus callosum are unremarkable. The paranasal sinuses and mastoid air cells show normal aeration. Both orbits and the optic nerves are unremarkable. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view Resulted: 10/28/21 1547 Order Status: Completed Updated: 10/28/21 1547 Narrative: XR CHEST 1 VW PORT IMPRESSION: No acute cardiopulmonary disease. END OF IMPRESSION: INDICATION: shortness of breath COVID+. TECHNIQUE: Single view of the chest COMPARISON: Chest x-ray 9/5/2017 FINDINGS: No evidence for focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is stable in appearance. The thoracic skeleton appears intact. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. CT head without contrast Resulted: 10/28/21 1329 Order Status: Completed Updated: 10/28/21 1329 Narrative: CT HEAD WO CONTRAST IMPRESSION: No acute intracranial abnormality. END OF IMPRESSION: INDICATION: Change in symptoms status post TPA TECHNIQUE: Spiral CT scan through the head from the skull base through the vertex was performed with 5 mm axial reconstructions. Images obtained without contrast. CONTRAST: No contrast was administered. COMPARISON: Same day. FINDINGS: Contrast is identified within the intracranial vasculature. No acute hemorrhage. No acute territorial infarction. Ventricles remain within normal limits and basal cisterns are patent. No extra-axial fluid collections are identified. Paranasal sinuses and mastoid air cells are clear This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. CT angiogram neck with and without contrast Resulted: 10/28/21 1147 Order Status: Completed Updated: 10/28/21 1147 Narrative: CT ANGIOGRAM NECK W WO CONTRAST IMPRESSION: Unremarkable CT angiography neck. No evidence of internal carotid artery stenosis using the NASCET criteria. END OF IMPRESSION: INDICATION: stroke. TECHNIQUE: Enhanced helical CTA scan of the neck was performed with sequential transaxial images before and after iodinated contrast administration. Coronal and sagittal reconstructions were performed. 3D postprocessing images were obtained and stored. CONTRAST: 130mL of IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION administered INTRAVENOUS. COMPARISON: None available. FINDINGS: The partially visualized lung apices are unremarkable. The origins of the great vessels and visualized upper thoracic aortic arch are unremarkable. The common carotid arteries are patent bilaterally. The carotid bulb regions are unremarkable. The internal and external carotid artery origins are patent. The cervical internal carotid arteries are patent. Bilateral cervical segments of the vertebral arteries are patent. The basilar artery is well perfused. The source images show no evidence of dissections. The cervical spine is in anatomic alignment. Note: Any estimation of ICA stenosis is based on data which utilizes the distal internal carotid diameter as the denominator for stenosis measurement. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. CT brain perfusion with and without contrast Resulted: 10/28/21 1144 Order Status: Completed Updated: 10/28/21 1144 Narrative: CT BRAIN PERFUSION W WO CONTRAST IMPRESSION: Unremarkable cerebral perfusion map imaging. END OF IMPRESSION: INDICATION: stroke. TECHNIQUE: Dynamic CT of the brain is performed after administration of iodinated contrast at 4 mL/sec with perfusion map imaging software for determination of cerebral blood flow, blood volume and mean transit time. CONTRAST: 130mL of IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION administered INTRAVENOUS. COMPARISON: None available. FINDINGS: The initial noncontrast enhanced images of the head show no areas of abnormal high or low attenuation throughout the brain parenchyma. The perfusion map images show normal cerebral perfusion in the supra and infratentorial regions. There are no areas of hypoperfusion to suggest ischemia or penumbral area. Blood Flow: Normal Blood Volume: Normal Mean Transit Time: Normal This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. CT angiogram head with and without contrast Resulted: 10/28/21 1144 Order Status: Completed Updated: 10/28/21 1144 Narrative: CT ANGIOGRAM HEAD W WO CONTRAST IMPRESSION: Unremarkable CT angiography of the circle of Willis. END OF IMPRESSION: INDICATION: stroke. TECHNIQUE: Enhanced helical CTA scan of head was performed with sequential transaxial images after iodinated contrast administration including noncontrast images, if performed. Coronal and sagittal reconstructions were performed. 3D postprocessing images were obtained and stored. CONTRAST: 130mL of IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION administered INTRAVENOUS. COMPARISON: None available. FINDINGS: There is no mass-effect or midline shift. There are no intra or extra-axial fluid collections, intraventricular or intraparenchymal hemorrhages. The ventricles and cisterns are normal. The contrast-enhanced images of the head show no abnormal post contrast enhancement. Bilateral intracranial vertebral arteries, basilar artery, and superior cerebellar arteries are unremarkable. The supraclinoid internal carotid arteries, petrous, cavernous and distal intracranial segments of the internal carotid arteries are unremarkable. The A1 and A2 segments of the anterior cerebral arteries are patent. The anterior communicating artery is unremarkable. The middle cerebral arteries and branches are patent distally. The posterior cerebral arteries are unremarkable. There are no aneurysms or significant atherosclerotic disease noted. There are no arteriovenous malformations seen. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. CT head stroke without contrast Resulted: 10/28/21 1140 Order Status: Completed Updated: 10/28/21 1140 Narrative: CT HEAD STROKE WO CONTRAST IMPRESSION: 1. Normal noncontrast brain CT scan. 2. No evidence of acute intracranial hemorrhage or acute cortical-based infarct at this time. END OF IMPRESSION: INDICATION: Stroke TECHNIQUE: Axial images from skull base to vertex of head were obtained. COMPARISON: None available. CONTRAST: No IV contrast was administered. FINDINGS: Ventricles: Normal. Brain parenchyma: Normal. No areas of abnormal high or low attenuation. Midline shift: None. Mass effect: None. Extra-axial collection: None. Calvarium and skull base: Intact. Soft tissues: Normal.
CDC Split Type:

Write-up: ED to Hosp-Admission Discharged 10/28/2021 - 10/30/2021 (2 days) Hospital MD Left-sided weakness Hospital Diagnosis Left-sided weakness Hospital Course 44-year-old female with hypertension, Crohn''s disease, admitted on 10/28/2021 for left arm and leg weakness. Patient had recently received the Covid vaccine on 10/15/21. Noted onset of Covid symptoms including sore throat around 10/25/21. On 10/28/2021, patient noted left arm and leg weakness. Came to the hospital for further evaluation. Symptoms were concerning for stroke and she received TPA. CT angiogram head/neck without stenosis. Follow-up MRI luckily without stroke. Echocardiogram with EF 60 to 65%. No significant wall motion abnormalities. Neurology was consulted. Recommend continuing aspirin 81 mg and atorvastatin 40 mg nightly. Follow-up with neurology as outpatient. Patient does report a prior history of migraines more than 20 years ago. Denied any headache or migraine symptoms with this episode. Does report that she is under some stress, but this would be a diagnosis of exclusion. PT/OT cleared for discharge to home. Does still have some minimal left arm and leg weakness. Have ordered outpatient physical therapy. On discharge, patient is satting well on room air, feels well to go home. Given instructions on COVID care.


VAERS ID: 1843320 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-10-27
Onset:2021-10-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Fatigue, Headache, Lymphadenopathy, Nausea, Pain, Pyrexia, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: First covid-19 vaccine
Other Medications: Levothyroxine 125mcgs once a day; Nexium 20mg once a day; Allegra 180mg once a day.
Current Illness: None
Preexisting Conditions: Hyperthyroid; GERD; Diabetes Type 2.
Allergies: None
Diagnostic Lab Data: Just a COVID-19 test that came back negative on Friday the 29th of October.
CDC Split Type: vsafe

Write-up: I had lymph nodes in my left arm were swollen from the 28th to 31st of October. I had a fever, I didn''t check it on Thursday but I did have it on the 29th and 30th. I had a headache from the 28th the 29th. From the 28th to 30 of Oct, I had aches and nausea on the 29th. I had chest pain and shortness of breath. I also had fatigue. I still have shortness of breath. It mainly occurs when I had to step out of the apt. I had a COVID-19 test done on Friday and it came back negative. I took Tylenol to help with the pain and the complications.


VAERS ID: 1843326 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-10-08
Onset:2021-10-28
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039D21A / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphasia, Computerised tomogram, Condition aggravated, Headache, Idiopathic intracranial hypertension, Lumbar puncture, Papilloedema, Venogram, Vision blurred, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (narrow), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetazolamide ER (Diamox) 1000 mg Metformin ER 1000 mg Sertraline 50 mg Calcium with Vitamin D3 500 mg Fish oil 1000 mg Vitamin B Complex with C Riboflavin 400 mg Vitamin D3 5000 IU Turmeric 500 mg Butterbur/Feverfew 275 mg Vitamin C 1000
Current Illness: None
Preexisting Conditions: Idiopathic intracranial hypertension Polycystic ovarian syndrome Depression Anxiety
Allergies: None
Diagnostic Lab Data: Spinal tap, CT scan, CT venogram with contrast
CDC Split Type:

Write-up: I have idiopathic intracranial hypertension that has been stable since July 2021. I woke up the morning of October 28, 2021 with a massive headache that had been building for a week and half, since around 10/18, and my vision was dark and blurry in my right eye. I also had a moment of aphasia for about 2-3 minutes where I could not speak. I don''t know if this was related to the vaccine or just the normal course of this illness, as I have only been diagnosed with this since May 2021. I had testing done that showed the beginnings of papilledema in my right eye, but normal CSF pressure and nothing new in my CT scans.


VAERS ID: 1843341 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 1st Moderna shot, flu like symptoms
Other Medications: Buspirone HCl (busPIRone HCl) 15 MG Oral Tablet Loratadine 10 MG Oral Tablet Lurasidone HCl (Latuda) 60 MG Oral Tablet Nutritional Supplements (HIV Support) THERAPY PACK Oral Trazodone HCl (traZODone HCl) 100 MG Oral Tablet
Current Illness: HIV Depression Anxiety Insomnia PTSD Schizoaffective disorder
Preexisting Conditions: HIV Depression Anxiety Insomnia PTSD Schizoaffective disorder
Allergies: Penicillins
Diagnostic Lab Data:
CDC Split Type:

Write-up: body rash, hives, itching, burning


VAERS ID: 1843409 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-28
Onset:2021-10-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 LA / IM

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

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

Write-up: Error: Wrong Dose of Vaccine - Too High-


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