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From the 7/16/2021 release of VAERS data:

Found 479,813 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 85 out of 4,799

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VAERS ID: 1413475 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Skin warm, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: DIZZINESS, HOT, BURRY VISION. PATIENT WAS GIVEN COLD WATER AND A SMALL PIECE CANDY


VAERS ID: 1413496 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-15
Onset:2021-06-20
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Nausea, Pain, Pyrexia, Renal pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: told her mother to take her to er
CDC Split Type:

Write-up: fever,nausea,aches and pains, kidney pain


VAERS ID: 1413500 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Altered state of consciousness, Dizziness, Fall, Feeling hot, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Patient received vaccine and 10 minutes into waiting period, he began to slouch in chair and he dropped his belongings. We got to him quickly and held him up while it appeared he was fainting. We lowered him to the ground and called 911 and his father that was in store . He complained of being very hot and dizzy. He began to recover fairly quickly, he drank some water and stayed on floor. His dad arrived and the 911 call was cancelled due to his improving awareness. He stayed in the lobby for 20-30 minutes. He felt much better and left with his dad in good physical condition.


VAERS ID: 1413505 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-14
Onset:2021-06-20
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 2 RA / IM

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

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

Write-up: PATIENT GIVEN SECOND VACCINE 21 DAYS AFTER FIRST VACCINE


VAERS ID: 1413506 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia
SMQs:, Taste and smell disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient stated not taking anything
Current Illness: none
Preexisting Conditions: none
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated he could (taste) vaccine. Had patient wait awhile, said he was ok and was leaving. Counseled patient t go to emergency room if uncomfortable and had any other side effects.


VAERS ID: 1413507 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Hyperhidrosis, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Few minutes after getting the shot, Mom knocked on the Pharmacy door. The child was on the floor and the Dad''s hand was supporting his head. Patient was totally alert and spoke perfectly fine. He demonstrated and said that he has some tingling in his hand and something in his stomach. Child slightly diaphoretic. We called 911- vitals normal and "everything checking up good" paramedics left. When leaving patient said he is feeling anxious, nothing else.


VAERS ID: 1413508 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-01-04
Onset:2021-06-20
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Work       Purchased by: ?
Symptoms: Echocardiogram, Exposure during pregnancy, Premature delivery
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine
Current Illness: Back pain associated with pregnancy
Preexisting Conditions: Hypothyroidism
Allergies: No
Diagnostic Lab Data: Echo 6/13/21
CDC Split Type:

Write-up: Twin pregnancy, due date 7/4/2021. Twin B born on date diagnosed with moderate sized mid muscular VSD at birth


VAERS ID: 1413511 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: One (1) hive on right cheek, approx. 1.5 cm in diameter


VAERS ID: 1413513 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dry mouth, Dyspnoea, Hypertension, Muscle tightness
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Dehydration (broad)

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

Write-up: dry mouth , shiver and difficulty breathing and tightness in arms complained (05.10 pm)by patient within 15 minutes of administration( 450pm) . Patient was laid down on floor with raised legs and cold packs applied to face and hands. Bp monitored and benadryl given ( 5.15 pm) . patient was still breathing . BP was high. next 10 minutes patient was feeling better. was seated with elevated legs. Drank water and Ems was called . Bp was at 178/112 pulse 83 Per EMS possibly syncope or initial reaction to the shot.


VAERS ID: 1413518 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Taste disorder
SMQs:, Taste and smell disorders (narrow)

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

Write-up: Patient stated could (taste) vaccine. I had patient wait awhile, but stated he was leaving after about 15 minutes. I counseled patient that if he was uncomfortable, or has any other side effects, to go to emergency room.


VAERS ID: 1413522 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

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

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

Write-up: Patient and patient''s father both lied and said patient''s birthday was early 2009 when the correct DOB is late 2009 in order to get patient the covid vaccination. When I discovered this and called the patient''s father after they left (having received the vaccination) he confirmed patient''s DOB is late 2009 and she is still 11 y/o. I told the patient''s father she is not to receive the second dose until she turns 12 y/o per control recommendations.


VAERS ID: 1413524 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Erythema, 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Client came in for 2nd COVID vaccine of Moderna. Client had a medical consult in the previous week and was told to come back at a later time. Client medical consult resulted in an approval for 2nd COVID vaccine of Moderna. Client received 2nd COVID vaccine of Moderna (Lot# 026C21A, expiration 07/11/21) at 1319. Client completed 20 minutes in the observation waiting area when reported to EMT, EMT, and EMT about itchiness on the left clavicle area and right forearm at 1338. PHN and PHN responded to this event at 1339. At 1339, vital signs are blood pressure 132/82, heart rate 113, oxygen saturation 99%. Client reports no medical history, no medication, and no known allergies. PHN assessed left clavicle and right forearm. Skin is warm to touch and is red. Client is scratching arm and left clavicle. PHN offered Client Benadryl 50mg by mouth and explained that the client will become tired and fatigued if taken. Client denied Benadryl 50mg by mouth. Client reason for denying Benadryl is because client is taking the bus home. Client denies shortness of breath, lightheaded, chest pain, dizziness, and vomiting. Client was offered water and gold fish snacks. Client accepted water and denied the snacks. Client continues to scratch and almost breaks skin PHN offers Benadryl to client, and Client denies. PHN offered to call emergency services for further evaluation and client accepted. At 1350, emergency services was called and arrived at 1353. At 1353, vital signs are blood pressure 132/88, heart rate 107, oxygen saturation 97%. Emergency services evaluated Client and offered their services. Client denied services and left against medical advise from emergency services at 1359. Emergency services left facility at 1400. PHN gave Client education about common adverse effects of COVID vaccine and ED precautions. In addition, Client was given Scripps urgent care information. Client reports no new symptoms, but continues to feel itchy in the right forearm. PHN and PHN advised Client to follow up with primary care provider. At 1425, vital signs are blood pressure 138/86, heart rate 103, oxygen saturation 98%. Client reports itchiness has spread to left forearm, left clavicle, and both knees. PHN offered Benadryl and emergency services again for further evaluation, and Client denied. At 1427, Client stood up with no complaints and left facility with a steady gait.


VAERS ID: 1413525 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / 1 AR / IM

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

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

Write-up: Patient felt dizzy. when she lowered her head she felt slightly better, but then felt dizzy again and fainted for ca 30 sec. then regained conciousness. We let he lie down. She felt better after a while, but when she sat up she felt dizzy again and lied down again. We called 911 and EMT came to check. They left withou reporting back to me. The patient left at the same time


VAERS ID: 1413528 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-16
Onset:2021-06-20
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

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

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

Write-up: PATIENT RECEIVED PFIZER COVID 19 VACCINE ON WEDNESDAY 06/16/2021 AND EXPERIENCED RASH. MOM REPORTED THE ADVERSE EVENT TO PHARMACY STAFF ON SUNDAY, 06/20/2021. THE PATIENT WAS GIVEN BENADRYL TABLET BY THE PATIENT''S MOM AND WENT HOME.


VAERS ID: 1413533 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-24
Onset:2021-06-20
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Antibody test abnormal, Antinuclear antibody increased, Autoimmune disorder, Biopsy liver abnormal, Blood test, Chills, Cholangitis, Confusional state, Fatigue, Feeling abnormal, Hyperhidrosis, Hypersomnia, Impaired work ability, Liver scan, Loss of personal independence in daily activities, Pain, Paraesthesia, Primary biliary cholangitis, Pyrexia, Renal impairment, Ultrasound scan
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (narrow), Dementia (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Infectious biliary disorders (narrow), Biliary tract disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Vasculitis (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cymbalta- Estring Estradiol creme
Current Illness: n/a
Preexisting Conditions: Chronic anxiety
Allergies: none
Diagnostic Lab Data: I have had blood tests throughout March, April, May, and June 2021. ABNL of ANA, AMA, RNA in tests in April and June 2021 I had liver fibroscan, ultrasound, and liver biopsy in May 2021.
CDC Split Type:

Write-up: I got my second vaccine on 2-24. For 2 days after the vaccine, I experienced chills, a high fever (102), sweats, and overall body aches. By 2-28, I was feeling tired but no symptoms. By March 3, I started to experience severe exhaustion again, plus unusual brain fog, and paresthesia. I went to ER and was checked for stroke. Given MRI and blood tests. Some energy returned by 3-6. On 3-9, severe fatigue returned along with increased cognitive confusion. I was unable to function as I was sleeping up to 15 hours a day 3 or 4 x''s a week. I had to stop working. I was referred to a rheumatologist in March and started getting blood tests. Blood tests show high titers of AMA, ANA,RNAl.Doc suspected AI disease and begin elimination testing. In May 2021, I had a liver fibroscan, ultra sound, and biopsy. Biopsy showed bile duct inflammation. In early June 2021, a gastroenterologist, gave Dx of Primary Biliary Cholangitis. Rx Eursodiol. (Rheumotologist had Rx Hydroxychlorquine before PCB Dx but I never started that.) I have been taking Ursodiol for 2 weeks. Still battling fatigue but it is lessening. I still get fatigued if I do simple adult activities like grocery shop, do light house cleaning, go out for simple dinner.


VAERS ID: 1413534 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Skin swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Puffy red circle about 1.5 inch diameter


VAERS ID: 1413539 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye irritation, Joint contracture, Photophobia
SMQs:, Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Arthritis (broad)

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

Write-up: PATIENT DESCRIBED HANDS FEELING LOCKED IN POSITIONS, EYE SENSITIVITY DESCRIBED AS BRIGHTNESS AND FEELING WARM. IT HAPPENED A FEW MINUTES AFTER SITTING ON CHAIR. HE SAID HE FELT BETTER AND WENT AWAY ON ITS OWN BUT THOUGHT HE SHOULD LET THE PHARMACIST KNOW. HE SAID HAD NOT EATEN YET EITHER. HE DID NOT WANT TO WAIT ANY LONGER AT PHARMACY UPON RECOMMENDATION AND WOULD LET PHARMACY KNOW IF ANYTHING ELSE HAPPENS AND/OR WILL GET IMMEDIATE CARE IF NECESSARY.


VAERS ID: 1413542 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Discomfort, Dizziness, Injection site hypoaesthesia, Muscle tightness, Paraesthesia, Somnolence
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Client received 2nd COVID vaccine of Pfizer (Lot# EW0186 expiration 07/12/21) at 1358. Client is being observed in vaccination room with PHN. At 1406, Client reports lightheaded, numbness at the injection site (left arm) and tingling in the left fingertips to PHN. Client reports a history of anxiety, no medications, and has an allergy to tofu/soy. Client was placed onto the zero-gravity chair. At 1412, RN obtains vital signs which are blood pressure 140/82, heart rate 92, oxygen saturation 97%. At 1416, lightheaded is improving, but numbness and tingling is still present. RN assisted in translation. PHN and RN educated Client about common adverse effects on the COVID vaccine and ED precautions. Client was offered and accepted both water and snacks. At 1421, vital signs are blood pressure 152/80, heart rate 82, oxygen saturation 95%. Client denies headache, shortness of breath, chest pain, lightheaded is improving, numbness and tingling of the arm and fingertips are the same, and reports "feeling heavy" and feels "a little sleepy." PHN offered to call emergency services for further evaluation and Client accepted. At 1426, vital signs are blood pressure 132/82, heart rate 86, oxygen saturation 96%. At 1427, emergency services was called by PHN and arrived at 1435. Emergency services arrived and assessed Client. Client denied transfer to hospital for further assessment and reports tiredness is improving. At 1442, Client goes against medical advice from the emergency services. RN waits with Client as client calls for a ride to pick her up. At 1447, Client reports "feeling better''" while eating Pringles and drinking water. Client states "muscle tightness in the body coming from the back". PHN advises Client to follow up with primary care provider. At 1454, client states feeling "nothing serious" and only tiredness. RN is with Client for observation. At 1540, client is walked to the bathroom with RN. Client denies dizziness, shortness of breath, chest pain, lightheaded, and pain at injection site. At 1546, Client''s father arrived. Client stood up with no complaints and with a steady gait. RN and Ancillary accompanied Client to car.


VAERS ID: 1413545 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-28
Onset:2021-06-20
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: none
Preexisting Conditions: none
Allergies: ibuprofen - mild allergy
Diagnostic Lab Data: temperature checked - 98.5 F
CDC Split Type:

Write-up: chest pain and shortness of breath, lasting about one hour no treatment other than rest


VAERS ID: 1413550 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-06-18
Onset:2021-06-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine, cefdinir
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shortness of breath, some heart palpitations


VAERS ID: 1413553 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Headache, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Rigors Total body joint aches chills fever headache arm pain


VAERS ID: 1413585 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-01
Onset:2021-06-20
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Generic Zyrtec for seasonal allergies, L-lysine vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None; only pet dander, dust and unknown seasonal plants.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Petechiae - a few on my abdomen, one small dot on my upper leg, one on my throat and many small dots across both biceps. I have young children whom I lift - that may have caused them to show on my arms. I recognize these as the same kinds of marks that appeared when I had dengue hemorrhagic fever in 2018.


VAERS ID: 1413590 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Mass, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Large red circle, swollen. Tender lump


VAERS ID: 1413611 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

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

Write-up: patient is a 17yo male who experienced a syncopal event approximately 10 minutes after receiving his first dose of the Pfizer covid-19 vaccine. while sitting in the observation area with his mother, patient began to feel light headed and nauseous. patient was assisted to yoga mat on ground with lower extremities elevated. Per pt and mother, patient has a significant history of anxiety, and also becoming light headed and nauseated, in association with medical procedures, specifically when involving needles. patient''s mother also reports patient has "passed out" previously when he experienced a hypoglycemic episode. Patient reports only having eaten a cookie and a slice of bread for the entire day. Upon initial assessment, no acute distress noted, AOx4, verbal, able to make needs know, and answers questions appropriately. Respiration even and unlabored, lung sound clear to auscultation. after approx <1 minute, noted progressive decreased level of consciousness, patient was minimally responsive for <15 seconds. Noted patient with significant diaphoresis, patient skin and lips were slightly pale & intact. Respiration remained even and unlabored, lung sound clear to auscultation. no sx/sx of allergic reaction. patient''s mother Denied any significant past medical history, or allergies. Patient was assessed while laying on yoga mat on ground with bilateral lower extremities elevated, in observation area. Physical examination and past medical history obtained simultaneously. Initial vital signs @ 1845 95/32 hr 49 O2sat 99% rr17. Patient started to regain consciousness after <15 seconds, with progressive alertness. After approx 1 minute patient was AOx4, verbal and able to make needs known. Patient was provided with a gatorade drink, and encouraged to finish entire drink. Continued to observe patient for an additional 30 minutes. No acute distress noted throughout that time. Respiration remained even and unlabored, lung sound clear to auscultation. denies dizziness, light headedness or other symptoms. Skin warm, dry and color appropriate for ethnicity. V/S@ 1853 111/51 hr 90 O2sat 99% rr18 , AOx4, no acute distress noted. @ 1900 Patient reported ?feeling better?, denied lightheadedness or nausea. V/S @ 1900 128/66 hr 92 O2sat 99% rr 18. Instructed patient''s mother not to leave patient unattended for remainder of day, and encouraged oral hydration. Instructed to call 911 if experiencing return of initial symptoms, difficulty breathing or loss of consciousness. Educated patient and his mother on sx/sx of allergic reactions, and anaphylaxis. Encouraged patient to follow up with his PCP. patient and his mother expressed understanding of all instructions and education. V/S @ 1930 135/72 hr 83 O2sat 98% rr18, no acute distress noted, patient denied any symptoms at that time. Patient left home with mother @ 1930.


VAERS ID: 1413619 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Disturbance in attention, Dry mouth, Dyspnoea, Fatigue, Headache, Hyperhidrosis, Impaired work ability, Myalgia, Oropharyngeal pain, Pyrexia, Sensitive skin, Skin warm, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Fever Sweating Pain in muscles Pain in joints Skin feels hot and sensitive Dry mouth Headache Extreme Fatigue Tremors Inability to concentrate Shortness of breath Sore throat Impaired ability to work


VAERS ID: 1413794 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hypotension, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Hypotension-Medium, Additional Details: Within 5 minutes of received 2nd dose of Pfizer Covid-19 vaccine, patient became very dizzy and fainted. We layed her down and elevated her feet and she immediately regained consciousness. The patient was assessed by paramedics and they did not transport her to the emergency room and instructed her to drink lots of water over the next 24 hours.


VAERS ID: 1413799 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (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), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Mild


VAERS ID: 1413801 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Flushing, Hyperhidrosis, Hypotension, Lethargy
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Hypotension-Medium


VAERS ID: 1413804 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Flushing, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Flushed / Sweating-Mild, Additional Details: Pt was a little shaking before the vaccination. Confirmed with pt that he had no problem with 1st vaccination of covid. Right after the vacciation of 2nd shot, pt told me he was feeling dizzy, sweating, and warm. He told me actually he is afraid of needles so he is not feeling nervse. Stay in the vaccination room wit hpt for about 5 to 10 min. pt felt better after 5 to 10 min. Have pt stay for additional 15min after, he stated he was totally fine now and thanks for my help.


VAERS ID: 1413810 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hypotension, Loss of consciousness, Syncope, Tachycardia
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Medium, Systemic: Hypotension-Mild, Systemic: Tachycardia-Mild, Additional Details: EVENT OCCURED WITHIN 5 MINUTES OF ADMINISTRATION. DURATION OF LOSS OF CONCIOUSNESS LESS THAN 10-15 SECONDS. PULSE PRESENT AT WRIST IMMEDIATELY FOLLOWING REGAIN OF CONCIOUSNESS. PER PATIENT AND CAREGIVER, PATIENT HAS HISTORY OF SYNCOPE WITH IMMUNIZATION/BLOOD DRAWS. PATIENT ABLE TO WALK OUT OF BUILDING FOLLOWING 30 MINUTES OF OBSERVATION INCLUDING ELEVATION OF FEET, EVALUATION OF BP/PULSE (104/60 MMHG/87 BPM), AND INGESTION OF WATER AND CRACKERS.


VAERS ID: 1413812 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Arthralgia, Hyperventilation, Movement disorder, Nausea, Pain, Paraesthesia, Skin discolouration, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Body Aches Generalized-Medium, Systemic: Hyperventilation-Medium, Systemic: Joint Pain-Medium, Systemic: Nausea-Medium, Systemic: Shakiness-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: Pt began to display symptoms related to anxiety that progressed to hyperventilation/nausea/full on body aches/ pt states she was then unable to move her arms/legs/hands due to body aches. Pt reported that her body was aching and that she was feeling nauseated. Pt''s fingers were turning blue due to intense clenching. Paramedics/Ambulance called for so pt can be further evaluated.


VAERS ID: 1413815 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Malaise, Pallor, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (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), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Medium, Additional Details: Patient had vaccination, waited 15 min and apparently felt faint, no problems noted by pharmacy staff, patient picked up vaccination card, asked if feeling ok by pharmacy staff. Apparently patient got in car and got worse. Mother called and came to get pt in parking lot. Came inside to tell pharmacy staff. Pharmacist went to car. Patient "not feeling great" but coherent, pail. Pharmacist asked about breathing and any itching and patient denied.


VAERS ID: 1413832 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-06-12
Onset:2021-06-20
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0137 / 2 AR / SYR

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

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

Write-up: Rash all over both feet


VAERS ID: 1413845 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-22
Onset:2021-06-20
   Days after vaccination:90
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Dialysis, SARS-CoV-2 test positive
SMQs:, Acute renal failure (narrow), Chronic kidney 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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol, allopurinol, apixaban, cinacalcet, Santyl ointment, Epogen, ergocalciferol, Flonase, folic acid, gabapentin, insulin glargine, lanthanum, lidocaine patch, multivitamin w/iron, Bactroban, oxycodone/acetaminophen, polyethylene glyc
Current Illness: N/A
Preexisting Conditions: Anemia, Type 2 diabetes, end-stage renal disease on dialysis, gout, hyperlipidemia, hypertension, mitral insufficiency, obesity, obstructive sleep apnea, atrial fibrillation, chronic leg/heel ulcers
Allergies: None
Diagnostic Lab Data: SARS-COV-2 PCR testing positive 6/20/2021
CDC Split Type:

Write-up: Patient was admitted to the hospital from a skilled nursing facility with asymptomatic COVID-19 on 6/20/2021, subsequent to receipt of a full series of COVID-19 vaccines


VAERS ID: 1413847 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Woke up in the middle of the night with a fever around 101 Fahrenheit. Also had chills, severe headache, lack of energy, and no appetite. Condition significantly improved over the next 24 hours without seeing a doctor or taking any medication.


VAERS ID: 1413925 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache
SMQs:

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

Write-up: Patient stated that the next day after receiving 2nd dose of Moderna vaccine, he had a terrible headache that is still going on, and sever fatigue.


VAERS ID: 1414139 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-18
Onset:2021-06-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dysmenorrhoea, Polymenorrhoea
SMQs:

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

Write-up: Menstrual cycle started 2 weeks early, lots of bad cramps


VAERS ID: 1414215 (history)  
Form: Version 2.0  
Age: 97.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-01-26
Onset:2021-06-20
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / UNK LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Hospice care, No adverse event
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol 37.5 MG Aspirin 81 mg Sodium Chloride 1GM Tab Latanoprost 0.005% SOL one drop to both eyes Brimonidine tartrate 0.2% SOL one drop to both eyes Levothyroxine sodium 88 mcg tablet Potassium chloride 10 MEQ CER Hyoscyamine sulf
Current Illness: Age-related physical debility 2019 -nCov acute respiratory disease (last year)/recovered Hypothyroidism Muscle weakness (generalized) Resident was on hospice care
Preexisting Conditions: Dementia/Alzheimer''s disease Cataract Dysphagia Abnormalities of gait and mobility Bronchitis, not specified as acute or chronic Age-related osteoporosis without current pathological fracture Essential hypertension Chronic atrial fibrillation Heart Failure
Allergies: Acyclovir Celebrex Flagyl Lisinopril Morphine Motrin Niacin Penicillin Questran
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: No adverse events noted Resident was on hospice care


VAERS ID: 1414266 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: sickness


VAERS ID: 1414301 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Hypersensitivity, Pruritus, Swelling face, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Allergies: Amoxicillin
Diagnostic Lab Data: NA
CDC Split Type: Na

Write-up: Allegric Reaction: -Hives -itchy hands and feel -swelling of the face


VAERS ID: 1414394 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-18
Onset:2021-06-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 2 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Blood culture, Blood urine present, Full blood count normal, Hemiparesis, Laboratory test, Limb discomfort, Metabolic function test, Mobility decreased, Movement disorder, Urine analysis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin 81, Metoprolol 25mg, Oxycodone 5 mg, QUEtiapine Fumarate Tablet 25 MG, Miralax, Lyrica 100mg, Lidocaine Patch 5%,Mometasone Furoate Aerosol 200 MCG/ACT, melatonin 5mg, Famotidine Tablet 20 MG, Cyclobenzaprine HCl Tablet 5 MG, Albute
Current Illness: DISPLACED COMMINUTED FRACTURE OF SHAFT OF LEFT TIBIA, SUBSEQUENT ENCOUNTER FOR CLOSED FRACTURE WITH ROUTINE HEALING,CHRONIC VIRAL HEPATITIS C, Anemia, COPD, Hyperlipidemia,Bell''s Palsy, Hypertension,GERD, ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITHOUT ANGINA PECTORIS
Preexisting Conditions: DISPLACED COMMINUTED FRACTURE OF SHAFT OF LEFT TIBIA, SUBSEQUENT ENCOUNTER FOR CLOSED FRACTURE WITH ROUTINE HEALING,CHRONIC VIRAL HEPATITIS C, Anemia, COPD, Hyperlipidemia,Bell''s Palsy, Hypertension,GERD, ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITHOUT ANGINA PECTORIS
Allergies: Atorvastatin, Penicillin, traZODone
Diagnostic Lab Data: On 6/19/21, CBC with auto Differential / Complete Metabolic Profile with eGFR were completed. Results were WNL.
CDC Split Type:

Write-up: On 6/18/2021 resident had received 2 nd dose of Moderna vaccination. 6/19/2021- no adverse reactions noted. None reported. On 6/20/21 resident around noon, reported to the floor nurse that he was unable to move right extremities both hand and leg. Resident refused to go to the hospital for further evaluation. Today, 6/21/2021 resident reported to this nurse that he still has no mobility to his right side. Resident had 2nd COVID vaccination (Moderna) on 6/18/2021 on his left deltoid. Mini neuro check completed. Resident''s mental status is intact. Facial symmetry noted. When instructed to move right arm, resident was not able to pick up arm, unable to perform active ROM. Sensation is intact. Resident is able to discriminate pain, sensory stimulation is intact. Resident was asked to pick up and move right leg, resident was unable to perform the action. Sensation to RLE is intact. Resident was advised that he needs further evaluation but declined to go to the hospital. Resident stated his wife was made aware during visit yesterday and his wife had asked him to go to the hospital but he refused to go. Provider was made aware of findings. Provider advised for him to be sent out to ER for further evaluation however resident refused to go. Resident''s urine output in his urinal was also noted to be dark colored, blood-tinged. Provider made aware of labs on 6/19/21 which were WNL.Orders obtained for blood culture, and UA with C&S. Resident is in agreement with lab orders. Orders were implemented and collected STAT. Lab results are pending as of writing.


VAERS ID: 1414398 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nothing was given by pharmacist
Current Illness: No illnessess
Preexisting Conditions: No health conditions
Allergies: No allergies
Diagnostic Lab Data: No medical test performed at pharmacy
CDC Split Type:

Write-up: Patient stood up after vaccination and asked for water. The Pharmacist was getting water and he passed out. She went over with emergency kit and helped patient off the floor. He had a pulse and was breathing the entire time. She did not have to administer any medications. She called 911 and paramedics were here within minutes. He told the pharmacist after the shot that he passes out with shots , even though he put no on the form. Patient was fine and denied to go to hospital.


VAERS ID: 1414439 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Headache, Nausea, Pain, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Nausea, headache, fatigue, body aches, fever 102.7, and rash around arm.


VAERS ID: 1414482 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-06-18
Onset:2021-06-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Chest discomfort, Electrocardiogram abnormal, Palpitations, Ventricular extrasystoles
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Ventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Hypokalaemia (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: Albuterol 90mcg
Current Illness:
Preexisting Conditions: Asthma
Allergies: Penicillin
Diagnostic Lab Data: EKG shows atrial fibrillation with PVCs.
CDC Split Type:

Write-up: Developed atrial fibrillation two days after vaccine - heart pounding and some chest discomfort.. Presented to ED the following day and was admitted and cardiologist consulted.


VAERS ID: 1414495 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Entresto, metropolol, allicin, coq10, baby aspirin
Current Illness: NA
Preexisting Conditions: High BP
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue, chills


VAERS ID: 1414505 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217WAG5760 / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flecainide 50mg x twice a day Nexium 24HR
Current Illness: None
Preexisting Conditions: Tooth Pain after root canal which not yet resolved
Allergies: None
Diagnostic Lab Data: na
CDC Split Type:

Write-up: 15 min after the shot, I filled tingling (pins and needles) on my eye, then it happened random everywhere , from Face, head, hands back, legs, both sides of the body, it is 27 hours after the shot and still happening.


VAERS ID: 1414560 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site nodule, Injection site pruritus, Nodule, Pain, Skin warm
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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

Write-up: I expected the body aches. But now my arm at the injection site had a 2in knot and is warm to touch and itchy. The knot is extremely painful and staying active and working out the arm did not help.


VAERS ID: 1414565 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect product formulation 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: Sore arm
Other Medications: No information provided.
Current Illness: No Information provided.
Preexisting Conditions: No information provided.
Allergies: No information provided.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Inadvertently administered Pfizer vaccine as the second dose, patient received Moderna vaccine for the first dose.


VAERS ID: 1414577 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Ear pain, Lymphadenopathy, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm pain, chest pain, shortness of breath, earache, headache, and swollen nodes.


VAERS ID: 1414579 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

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

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

Write-up: Patient was given Vaccine one week early. First Vaccination was on June 06, 2021. Second Vaccination Was given June 20, 2021.


VAERS ID: 1414584 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

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

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

Write-up: Patient was given Vaccine one week early. First Vaccination was on June 06, 2021. Second Vaccination Was given June 20, 2021.


VAERS ID: 1414616 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

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

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

Write-up: Patient was given vaccine one week early. First Vaccine was administered: 06/06/2021. Second Vaccine was administered: 06/20/2021


VAERS ID: 1414620 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-18
Onset:2021-06-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

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

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

Write-up: swelling in axilla


VAERS ID: 1414629 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

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

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

Write-up: Patient was given vaccine one week early. First Vaccine was administered: 06/06/2021. Second Vaccine was administered: 06/20/2021


VAERS ID: 1414639 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-06-17
Onset:2021-06-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Advil
Current Illness:
Preexisting Conditions: ADHD, asthma, heartburn
Allergies: Bactrim, Biaxin, Versed, gluten, turkey, cats
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Red spots across shoulders (petechiae)


VAERS ID: 1414653 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse 20mg cap Mirtazapine 3.75 mg
Current Illness:
Preexisting Conditions: ADHD GAD Vocal Chord Dysfunction
Allergies: Septra
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever 101.1 Chills with shaking


VAERS ID: 1414658 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Fatigue, Musculoskeletal stiffness, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MULTI VITAMINS, EXCEDERIN
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: SIDE EFFECTS TO IMITRIX AND PREDNISONE AND SOME ANTI-INFLAMATORIES
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Fever, muscle/joint pain, stiffness and weakness. Tiredness


VAERS ID: 1414660 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gait disturbance, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad)

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

Write-up: swelling in left leg and left arm (side of body where vaccine administered) . patient states having difficulty walking due to swelling in his leg


VAERS ID: 1414696 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine 20 MG Cap Fluoxetine 10 MG Cap Trazaodone 25 MG
Current Illness:
Preexisting Conditions: GAD Depression
Allergies: Septra
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever 101.3 lasting full day (treated with Motrin after vomiting) Projectile Vomiting 3 separate times - 5:15am, 7:30am, 9:15am (Fluoxetine was skipped this morning due to vomiting) Chills


VAERS ID: 1414715 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gait disturbance, Pain, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Patient stated the day that he received vaccine his body was sore. Patient stated that on 6/2121 his foot was swollen up to the point that he could not walk on it. whole left leg under knee is in pain.


VAERS ID: 1415011 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-07
Onset:2021-06-20
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / ID

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

Write-up: Patient broke out in hives head to toe and this we exactly 2 weeks from her second covid vaccine


VAERS ID: 1415015 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-18
Onset:2021-06-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Lymphadenopathy
SMQs:, Arthritis (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: hypo thyroidism
Allergies: codeine, cephalexins
Diagnostic Lab Data: none
CDC Split Type:

Write-up: i have swelling in cervical lymph node of the neck area and pain in right shoulder


VAERS ID: 1415036 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-18
Onset:2021-06-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207 A21A / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Laboratory test normal, Palpitations
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Prior allergic response to vaccines
Diagnostic Lab Data: Tested at emergency room 6/21/2021 - tests within normal values.
CDC Split Type:

Write-up: Chest tightness, dizziness, heart pounding


VAERS ID: 1415053 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate increased, Hypertension, Pruritus
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Hypersensitivity (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? Yes
Hospitalized? No
Previous Vaccinations: patient reports just a mild dizziness after the first dose of Moderna vaccine, no other symptoms
Other Medications: no record of medication dispensed recently under patient''s profile in our pharmacy
Current Illness: patient did not report any illness at the time of vaccination
Preexisting Conditions: no reported by patient or under patient''s profile
Allergies: no allergies reported by the patient
Diagnostic Lab Data: Patient was taken to the hospital emergency. We don''t have any medical tests and laboratory results available to report now.
CDC Split Type:

Write-up: The patient came to receive her second dose of Moderna vaccine on 6/20/21. No allergy reported on the consent form. Patient reported mild dizziness after first dose of Moderna vaccine with no other adverse effect symptoms. I also went over the possible side effects of Covid vaccine again with patient and informed the patient that side effects after second dose may be more intense than the ones she experienced after her first dose. After confirming patient has no questions regarding the Covid vaccine, the vaccine was given at around 12:30pm. Patient sat in front of the pharmacy for a while before going back to work. About 3pm, she came back to report itchy skin and fast heartbeat. We checked her blood pressure immediately. It''s very high (175/111). I called 911 and informed management of code white situation in pharmacy. The 911 agent instructed me not to give any medication (including Epipen) to the patient because she is still conscious and has high blood pressure, and it''s better to wait for ambulance to come in this situation so medical staff can evaluate and ask her questions to assess her condition. The ambulance was here in less than 5 min and took her to hospital after confirming her high blood pressure. (I stayed with the patient until the medical staff arrived). The patient''s son and daughter also arrived and went to the hospital with the patient.


VAERS ID: 1415106 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-17
Onset:2021-06-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / UNK LA / IM

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

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

Write-up: ITCHING, REDNESS, AND SWELLING APPROXIMATELY 1 INCH BELOW INJECTION SITE


VAERS ID: 1415118 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Eye movement disorder, Hyperhidrosis, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: Ten minutes after administration patient became sweaty, nausea, light headed. I had patient elevate his legs. i got cold compresses for his face and some water to drink. He then said he felt like he had to vomit, which he did into our wastebasket. He sat back and his eyes rolled back. I felt he was going to pass out. I had a pharmacy technician call 911 and stayed with the patient until EMS arrived. Patient was checked out and released to go home. I spoke to patient today and he said he was fine after a few hours.


VAERS ID: 1415157 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-11
Onset:2021-06-20
   Days after vaccination:129
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: AMOXICILLIN
Diagnostic Lab Data:
CDC Split Type:

Write-up: TESTED COVID POSITIVE ON 06/20/2021


VAERS ID: 1415250 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Disturbance in attention, Headache, Injection site erythema, Injection site induration, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (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: paroxetine, naproxen
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: swelling, redness, and firmness at the injection site, headaches, loss of appetite, fever, difficulty concentrating


VAERS ID: 1415371 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-11
Onset:2021-06-20
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Deafness, Dizziness, Formication, Head discomfort, Photophobia, Tinnitus
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad)

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

Write-up: Yesterday evening I experienced three episodes of hearing loss/ringing in my left ear. The longest episode lasted for probably about a minute (which is way longer than I''ve ever experienced before). After the hearing loss, I noticed my eyes became a little more sensitive to light and I felt dizzy and a pressure/tickle sensation in my head which then became more focused towards the back of my left eyeball and a little of the back of my left upper arm & left wrist (very strange). No pain or numbness. I wouldn''t describe it as tingle as it was more of tickle. Hearing has not gone out again since last night but I have some constant ringing/tinnitus and still feel tickle sensation in my left arm and behind left eye. I couldn?t find much about the tickle online but came across a user who had COVID who literally described a ?ticklish pressure? in their ear, so I know I can?t be the only one to have noticed this!!!


VAERS ID: 1415375 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Lymph node pain, Lymphadenopathy
SMQs:, 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: I experienced what is known as "Covid Arm" 1 week after receiving my first Moderna Covid Vaccine at the injection spot (my left
Other Medications: Sertraline 50 mg. 1 tablet per day Sprintec Birth Control Pill Plexus Bio Cleanse 2 tablets per day Plexus Pro Bio 5 1 tablet before bed
Current Illness: N/A
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None so far
CDC Split Type:

Write-up: Swollen and very tender lymph nodes on left side of the neck. Still dealing with this adverse event.


VAERS ID: 1415421 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-01
Onset:2021-06-20
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acne cystic, Condition aggravated, Heavy menstrual bleeding, Menstruation delayed
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu vaccine petechia and severe chills once in my life. No problems with it before or after that one incident.
Other Medications: Gabapentin 300mg hs fiorcet prn atarax prn buspar 15mg bid cymbalta 30mg bid Flovent 220mcg bid albuterol prn multivitamin qd
Current Illness: Asthma anxiety depression menorrhaghia
Preexisting Conditions: Asthma anxiety depression menorrhaghia
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Much worse menorrhaghia this month. I?m passing ping pong ball size clots, going through super plus tampon and an overnight pad hourly to every two hours. Cycle was delayed by two weeks and had cystic acne with it which is unusual.


VAERS ID: 1415448 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 202A21A / 1 LA / IM

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

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

Write-up: Guest reports severe headache s/p 10 minutes after being vaccinated. No treatment indicated per EMT''s - increased observation. Declined water/ juice. Guest was assessed and released to home by EMT''s


VAERS ID: 1415482 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I took 2 Tylenol as instructed by the pharmacist.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: High fever, headache, chills and arm pain.


VAERS ID: 1415483 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-21
Onset:2021-06-20
   Days after vaccination:60
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea, Intermenstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: On June 20, 2021, I developed menstrual cramping and light spotting. Have been menopausal for eight (8) years with no history or diagnosis of disease or gynecological issue. Did on-line research and found that post-menopausal bleeding is an identified side effect of COVID 19 vaccination. Symptoms have persisted for 24 hours as of the time of this submission.


VAERS ID: 1415514 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-06-12
Onset:2021-06-20
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Crying, Dyspnoea, Headache, Myocarditis, Sneezing
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Myocarditis, trouble breathing; 2 days ago I had headache, I sneezed a lot, short sneezes, and my eyes were crying unitentionally.


VAERS ID: 1415683 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-02
Onset:2021-06-20
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Intermenstrual bleeding, Postmenopausal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (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: 25 MG Hydrochlorothiazide 10 MG Lisinopril
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: PFIZER BTECH EW0173 I am 53 years old. I have not had a menstrual cycle for more than one year and six months. I received first dose of the vaccine on June 2, 2021. Yesterday morning (June 20) at approximately 7:00 am I had terrible lower back pain. I had light spotting at first. Today on June 21 I am experiencing moderate amounts of bleeding. I am confident that this is the result of this vaccination.


VAERS ID: 1415693 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Fatigue, Headache, Hyperacusis, Hypoaesthesia, Injection site pain, Photophobia, Pyrexia, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (narrow), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lisinopril 20 mg, crestor 40 mg, levothyroxine 50 mcg
Current Illness: Type II diabetes, HBP, hypothyroid
Preexisting Conditions: Same as above plus multiple skin cancers (melanoma 1, squamous 100+, basel 100+)
Allergies: none
Diagnostic Lab Data: None at this time
CDC Split Type:

Write-up: headache, sensitivity to light and sound, light headed, joint pain (arms, legs and back), frostbite sensation on hands and feet, numbness on left hand, fever, tiredness, and injection site pain. Advil did not help. Rest until 29 hours after injection before able to function again. Headache, joint pain and injection site pain continue at least through second day.


VAERS ID: 1415737 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Headache, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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, body aches, muscle pain, headache, fatigue, diarrhea


VAERS ID: 1415945 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Fatigue, Hot flush
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

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

Write-up: dizziness and hot flash x 20 minutes on 6/20/21. fatigue on 6/21/21. no treatment other than fluids and rest.


VAERS ID: 1415986 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, Headache, Inflammation, Injection site pain, Pain, Piriformis syndrome
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Piriformis syndrome was made much worse after both shots. Pain from the injury increased by 80% after both shots. After first dose this inflammation lasted 6 days. I am into my 2nd day of bad inflammation from the 2nd shot I had pain to the injection site and a slight headache, but the inflammation was the worst part.


VAERS ID: 1415989 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 LA / SYR

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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prednisone 5mg Folic acid Digestive enzymes
Current Illness: Idiopathic subglottic stenosis
Preexisting Conditions: Idiopathic subglottic stenosis
Allergies: Penicillin and sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itchy arm


VAERS ID: 1416193 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-18
Onset:2021-06-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye pain, Feeling abnormal, Stress, Vision blurred, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Suboxone, escitalipram, quentiapine
Current Illness:
Preexisting Conditions:
Allergies: Bee sting
Diagnostic Lab Data: None yet. I am going to see my dr and go from there
CDC Split Type:

Write-up: After getting the shot the day of i felt ok but I had gone to bed the next day and woke up around 1:30am and i could not see at all. It felt like a liquid and something sharp was poured into my eyes I rubbed them but it didn''t help i washed them out with water after running into everything getting to the sink. Spent a good half hour to hour freaking out rinsing and on text to talk with my mom asking what to do. After a while I was able to see a little bit of the kitchen light and I just decided to go to bed and hope its better in the morning. I woke up and my eyes hurt horribly but I am able to see a small amount with a ton of blurriness but I could see so I figure it will get better. I still am having a crazy hard time seeing everything is still really blurry. I have two toddler boys and an infant I am starting to stress out that its not coming back so I am making an appointment with my dr. My sister told me to report it to the cdc so I am.


VAERS ID: 1416331 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Hypoaesthesia, Injection site hypoaesthesia
SMQs:, Severe cutaneous adverse reactions (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin 350 mg. Venlafaxine OTC. B-12. Biotin. D-3 Furosemide Atorvastatin Ranexa Levothyfoxin
Current Illness: Problems with control of my blood pressure.
Preexisting Conditions: Heart disease under control
Allergies: None known at this time
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Nasal blisters both nostrils. Numbness in left hand from injection site thru little finger. Still numb on 06/21/2021


VAERS ID: 1416334 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Supraclavicular adenopathy - 5-6 palpable nodes. Still present $g24 hours later.


VAERS ID: 1416443 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:2021-06-20
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Injection site pain, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: USJNJFOC20210642613

Write-up: ITCHY RED SPOTS IN BOTH HANDS; PAINFUL INJECTION SITE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine (route of admin not reported, batch number: Unk) dose was not reported, administered on 18-JUN-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 20-JUN-2021, the subject experienced itchy red spots in both hands. On 20-JUN-2021, the subject experienced painful injection site. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from painful injection site, and itchy red spots in both hands. This report was non-serious.


VAERS ID: 1416481 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

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

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

Write-up: Sore eyes, body chills, fever, headache after first dose lasting more than two days, sore body, dizzy, nausea


VAERS ID: 1416739 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure increased, Condition aggravated, Headache, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lorsartan 25 mg Eutirox 50 mg
Current Illness:
Preexisting Conditions: High hypertension; Hypothyroidism; Gastritis
Allergies: None known
Diagnostic Lab Data: No
CDC Split Type:

Write-up: Within 3 minutes after the pfizer vaccine was given, my heartbeat became very accelerated for a few minutes, my blood pressure went up to 143-99. The effect of my heart passed and I went home, and another episode happened where I felt the acceleration softer, that was about 1.5 hours after having the vaccine. The blood pressure remained high all day reaching 173-104. The next day it happened but I started having a headache and today, which is the third day, I only have a little headache for now. I am blood type ab +


VAERS ID: 1416766 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-06-18
Onset:2021-06-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Mouth swelling, Swelling face, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Mild


VAERS ID: 1416768 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Delaware  
Vaccinated:2021-06-16
Onset:2021-06-20
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Dyspnoea, Dyspnoea exertional, Electrocardiogram abnormal, Fibrin D dimer increased, Peripheral swelling, Pulmonary embolism, Syncope, Troponin
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage laboratory terms (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Chest CT Scan (21Jun2021) D-Dimer (20Jun2021) Troponin (20Jun2021) EKG (20Jun2021)
CDC Split Type:

Write-up: 32yo M, presents to clinic after episode of syncope, and on presentation to clinic c/o SOB/DOE SpO2: 88-90%, left calf swelling, EKG showing S1Q3T3 signs and symptoms concerning for PE. Pt denies any prior history of blood clots and no risk factors on initial presentation. Pt reports only thing new has been receiving Moderna COVID-19 vaccine on 16 Jun 2021. He was transferred immediately via ambulance to hospital for high level of care, where PE was confirmed w/ Chest CT, and also noted to have markedly elevated D-dimer and cardiac enzymes. Pt was then reportedly transferred to hospital for definitive tx.


VAERS ID: 1416976 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-06
Onset:2021-06-20
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: Pt received Janssen J&J COVID-19 vaccine on 4/6/2021. Pt presented to triage on 6/20/2021 (area to be initially assessed and then admitted to L&D) in active labor and almost immediately delivered. She was admitted for recovery and tested for COVID via NP PCR as part of routine admission. Test resulted positive for COVID-19, pt asymptomatic. Baby was delivered early, no weight listed for baby. Pt was at 38w5d as dated by LMP.


VAERS ID: 1417000 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-06-19
Onset:2021-06-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Dyspnoea, Hyperhidrosis, Malaise, Pyrexia, Sleep disorder, Vaccination site haemorrhage, Vaccination site pain
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Patient reports bleeding heavily from vaccination site. He went to bed that night and awoke at 3am unable to breathe temporarily. He was clammy/sweaty and awake for 2 hours. On Sunday, 6/20 he ran a fever of 102 degree F, had an extremely sore vaccination arm, and felt a general malaise.


VAERS ID: 1417068 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient reports injection site pain and redness at injection site. Also complains of nausea and vomiting 1 day after receiving 2nd dose of vaccine. Asymptomatic with 1st dose. Symptoms resolved on day 2 after receiving vaccine.


VAERS ID: 1417082 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-18
Onset:2021-06-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electric shock sensation, Injection site reaction, Muscle twitching, Myoclonus
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (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: myoclonus- muscle twitching in the entire arm that was vaccinated. patient states it feels electrical as muscles twitch at rest and was arm is being used


VAERS ID: 1417085 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-14
Onset:2021-06-20
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test normal, Chills, Computerised tomogram normal, Dizziness, Electrocardiogram normal, Fatigue, Fear, Hypoaesthesia, Menstruation normal, Mobility decreased, Muscle spasms, Paraesthesia, Vertigo
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamins
Current Illness: Severe stomach bug with fever and vomiting 2 weeks prior to second shot of moderna.
Preexisting Conditions: Chronic Dry Eye
Allergies: Sensitive to Prednisone. Rash from amoxicillin when 5yrs old; family history of penicillin allergy (and so I have never been given penicillin).
Diagnostic Lab Data: EKG, CAT scan of brain, blood tests; all of which came back normal.
CDC Split Type:

Write-up: Day after I experienced fever, chills, fatigue. The next day, I got my period. Then, 6 days after the 2nd shot I experienced severe dizziness, vertigo, almost fainting several times, tingling in hands and arms, tingling on both sides of face and ears, some tingling in legs (shin area). Followed by cramping in hands, inability to move hands or feel with hands for about 15 minutes (I have never experienced this before). I went to the hospital to get an IV and felt better 30 minutes later.


VAERS ID: 1417183 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Cold sweat, Feeding disorder, Headache, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

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

Write-up: Caller stated that she had extreme chills, cold sweats, body aches, headaches, and was really weak. Caller stated that she was vomiting every 20 - 30 minutes. The only thing she could keep down was Sprite. Was not able to eat for 2 days.


VAERS ID: 1417189 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Pharyngeal hypoaesthesia
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)

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

Write-up: Numbness of throat. Evaluated by EMS-Cleared


VAERS ID: 1417255 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-18
Onset:2021-06-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: POTS / Dysautonomia (since I was 15 years old).
Allergies: Demerol, Sulfa drugs, and Ciproflaxin.
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Arm, bicep to elbow is swollen and shooting pain to my wrist. Also throbbing pain in my armpit.


VAERS ID: 1417265 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-23
Onset:2021-06-20
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Oligomenorrhoea
SMQs:, Fertility disorders (broad)

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

Write-up: extended days on cycle with first and second vaccine


VAERS ID: 1417288 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-01
Onset:2021-06-20
   Days after vaccination:80
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

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

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

Write-up: Diagnosed with Bell''s Palsy in June 2021. 2 months after receiving the second vaccination of Moderna COVID-19 vaccine.


VAERS ID: 1417346 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-20
Onset:2021-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004021A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Chills, Fatigue, Headache, Injection site pain, Lymphadenopathy, Myalgia, Nausea, Pain, Pain in extremity, Peripheral swelling, Pyrexia, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (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: OTC Probiotics, vitamin D, Benzonatate, Citalopram, Albuterol
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Percocet
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Tiredness, sleepy, nausea, soreness in arm of sight, chills, fever, headaches, under arm pit started hurting and throbbing, lymph node of left leg is swollen and hurting, body aches, muscles ache, pain in color bone on the left side


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