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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 90 out of 4,799

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VAERS ID: 1415357 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-17
Onset:2021-06-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough
SMQs:, Anaphylactic reaction (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: Asthma, Recently pregnant
Allergies: PROTON PUMP INHIBITORS/OMEPRAZOLE 10 MG., MEPERIDINE RELATED/MEPERIDINE HCL
Diagnostic Lab Data:
CDC Split Type:

Write-up: Cough, Dry non productive, lasts throughout the day, has been constant since 2 days after vaccine


VAERS ID: 1415365 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-16
Onset:2021-06-19
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009021A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Rash, Rash pustular
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: men''s multi vitamin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: developed rash on my right side one inch above my waste line and is about one inch in size; rash contains individual pustules.


VAERS ID: 1415401 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Periorbital swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (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: Zyprexa, Trazodone, Risperidone
Current Illness: Swelling on legs
Preexisting Conditions: Arthritis, PTSD, hypertension
Allergies: Motrin
Diagnostic Lab Data: None performed.
CDC Split Type:

Write-up: Client reported puffy eyes that did not resolve after the 3rd day after vaccine administered on 06/18/21


VAERS ID: 1415409 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-16
Onset:2021-06-19
   Days after vaccination:3
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: Private       Purchased by: ?
Symptoms: Blood creatine phosphokinase MB increased, Echocardiogram normal, Electrocardiogram abnormal, Myocardial necrosis marker, Myocarditis, Troponin T increased
SMQs:, Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Multiple cardiac enzymes - troponin T and CK-MB from 6/19/2021 thru 6/21/2021 Elevation in both enzymes Abnormal EKG Normal echocardiogram
CDC Split Type:

Write-up: Myocarditis


VAERS ID: 1415411 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   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 ER8727 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Monoplegia, Pain in extremity, X-ray
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: junelle
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: xrays taken at the er on 6/20 . Was given hydocodene 5mg
CDC Split Type:

Write-up: lost all function of left arm . Severe pain continually .


VAERS ID: 1415420 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-06-11
Onset:2021-06-19
   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 EW01818 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Extra dose administered, Fatigue, Feeling abnormal, Tremor, Wrong product administered
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Medication errors (narrow), Hypoglycaemia (broad)

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

Write-up: Patient came in to get Shingles vaccine(Shingrix ) but was given a 3rd dose of COVID-19 vaccine. He was initially given his 2 dose series in February 2021. It was the Pfizer vaccine initially also. After the third dose he experienced: extreme tiredness, shaking, fogginess, and anxiety.


VAERS ID: 1415429 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022M20A / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (broad)

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

Write-up: The patient reported that he has never received a COVID-19 vaccine before so he was administered Pfizer on 06/19/21, however it was documented in the electronic record that he received Moderna on 01/27/21 and 02/24/21


VAERS ID: 1415467 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-17
Onset:2021-06-19
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diabetic coma, Interchange of vaccine products
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Medication errors (broad)

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

Write-up: Patient got 1st dose Moderna at store (number) and 2nd dose Pfizer at store (number). I have no part in this incident. Vaccine was administered by an agency Nurse. Patient told my clerk, she did not feel well after second dose and went to her Drs office. She said she was in a diabetic coma and she does not have diabetes. She also said to my clerk shes not saying this is related to the vaccine.


VAERS ID: 1415490 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Nausea, Peripheral swelling, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: heart problems, headaches/migraines, depression, seizures, thyroid disease, arrhythmias, anxiety, panic attacks, vapes
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: nausea, dizziness and hives, swelling in arms and feet. Saturday felt little dizzy and yesterday had hives with swelling. Bouts of nausea increasing. Patient called Telehealth for further management and instructed to Follow up at the urgent care or ER for unperson evaluation and management.


VAERS ID: 1415496 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001CZ1A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Oral herpes, Vaccination complication
SMQs:, Oropharyngeal infections (narrow), Opportunistic infections (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: IBS symptoms after 1st Moderna shot
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID arm, cold sores


VAERS ID: 1415511 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Aortic aneurysm, Arteriogram coronary abnormal, Bronchostenosis, Cardiac murmur, Chest X-ray abnormal, Condition aggravated, Echocardiogram abnormal, Electrocardiogram abnormal, Fatigue, Heart rate abnormal, Mediastinal mass, Palpitations, Pericardial effusion, Sinus tachycardia, Troponin
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: 6/19/21: EKG: heart rate 122, sinus tachycardia; troponin: 0.03 ng/mL; chest x-ray: Masslike enlargement of the AP window and adjacent left mediastinum likely reflects thoracic aortic aneurysm or other mediastinal mass. CT angiogram of thoracic aorta: 1. Large soft tissue anterior mediastinal mass, 2. small pericardial effusion and 3. Mass effect with severe narrowing of the proximal left mainstem bronchus which measures 2 mm in patent diameter
CDC Split Type:

Write-up: COVID-19 Vaccine EUA (unknown manufacturer) Patient presented to the emergency department on 6/19/2021 for palpitations after heart rate alert from smartwatch while eating dinner. Associated with fatigue. Mother notes a first episode of similar character 1 month ago lasting one day, without any history of syncope. On physical exam: murmur at right sternal boarder noted. POCUS: pericardial effusion without d sign or tamponade physiology identified. No takotsubo morphology of L ventricle. Final diagnosis of mediastinal mass, pericardial effusion, and sinus tachycardia. Patient transferred to another facility.


VAERS ID: 1415692 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-17
Onset:2021-06-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: chest pain


VAERS ID: 1415696 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-14
Onset:2021-06-19
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Lymphadenopathy, 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: moderna #1 hive to injection site
Other Medications: fish oil, mvi
Current Illness: none
Preexisting Conditions: none
Allergies: NKA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: rash, mild lymph adenopathy


VAERS ID: 1415970 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-19
Onset:2021-06-19
   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 RA / SYR

Administered by: Private       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:
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Full body itching


VAERS ID: 1416001 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: 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: N/A
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: no adverse event(s) noted.


VAERS ID: 1416174 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen 800 mg vitamin c 1000mg d3 2000iu super b complex calcium 1200mg letrozole 2.5mg magnesium 250mguu
Current Illness: Had carpal tunnel surgery and 2 trigger finger release surgery on June 10, 2021
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: On June 19, 2021 at 8:00pm the left side of my chest and my left arm began shaking for about 1 minute. Then it would stop for about 2 to 3 minutes and start all over again. This lasted for approximately 1 hour.. I went and laid down when this happened and did not get back up till Sunday morning.


VAERS ID: 1416175 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-18
Onset:2021-06-19
   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 ZW0181 / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Left ventricular dysfunction, Myocarditis, Troponin increased
SMQs:, Cardiac failure (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Chest pain, myocarditis, decreased LV function


VAERS ID: 1416196 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Diarrhoea, Fatigue, Headache, Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ELETRIPTAN, Topamax
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Injection site reactions: pain, tenderness, swelling (hardness), and redness General side effects: fatigue, headache, muscle pain, joint pain, chills, nausea and diarrhea, and fever


VAERS ID: 1416452 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-06-18
Onset:2021-06-19
   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 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood creatine phosphokinase MB increased, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Myocarditis diagnosis


VAERS ID: 1416776 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-19
Onset:2021-06-19
   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 - / UNK LA / IM

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

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

Write-up: Pt. with some SOB, headache, stomachache, nausea , decrease appetite 5 hrs after receiving 2nd Covid-19 Vaccine (Pfizer). Epi (111000)She improved after giving 0.3 mg and giving Prednisone . She was sent home on tab Prednisone 20 mg bid x 3 days


VAERS ID: 1416439 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-06-19
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Pain
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: USJNJFOC20210642462

Write-up: ACHES; CHILLS; TIREDNESS; DULL HEADACHE; This spontaneous report received from a patient concerned a 36 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821286 expiry: UNKNOWN) dose was not reported, administered on 18-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 19-JUN-2021, the subject experienced aches. On 19-JUN-2021, the subject experienced chills. On 19-JUN-2021, the subject experienced tiredness. On 19-JUN-2021, the subject experienced dull headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the tiredness, dull headache, chills and aches was not reported. This report was non-serious. This case, from the same reporter is linked to 20210643041.


VAERS ID: 1416445 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-06-19
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Pain
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: Abstains from alcohol; Non-smoker; Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210642946

Write-up: BODY ACHES; HEADACHE; This spontaneous report received from a patient concerned a 53 year old male. The patient''s weight was 285 pounds, and height was 72 inches. The patient''s concurrent conditions included penicillin allergy, abstains from alcohol, and non smoker.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A, and expiry: UNKNOWN) dose was not reported, administered on 18-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 19-JUN-2021, the subject experienced body aches. On 19-JUN-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body aches on 20-JUN-2021, and had not recovered from headache. This report was non-serious.


VAERS ID: 1416447 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-06-19
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Feeling of body temperature change, Muscle tightness, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210642966

Write-up: SENSATION OF COLD AND HOT AT THE SAME TIME; SHAKING BREASTS; BODY HURTS FROM MUSCLE TENSION; SHIVERING IN LEGS; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported and batch number: 1808982 expiry: UNKNOWN) dose was not reported, administered on 19-JUN-2021 17:30 for prophylactic vaccination. No concomitant medications were reported. On 19-JUN-2021, the subject experienced sensation of cold and hot at the same time. On 19-JUN-2021, the subject experienced shaking breasts. On 19-JUN-2021, the subject experienced body hurts from muscle tension. On 19-JUN-2021, the subject experienced shivering in legs. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from shivering in legs, and the outcome of sensation of cold and hot at the same time, shaking breasts and body hurts from muscle tension was not reported. This report was non-serious.


VAERS ID: 1416466 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-11
Onset:2021-06-19
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / SYR

Administered by: Pharmacy       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? 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: Hives rash on arms, thighs , and legs


VAERS ID: 1416469 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-06-15
Onset:2021-06-19
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram normal, Troponin increased
SMQs:, Myocardial infarction (narrow), 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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Elevated troponin levels with normal EKG
CDC Split Type:

Write-up: Chest pain


VAERS ID: 1416767 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Bone pain, Chills, Diarrhoea, Eye irritation, Eye pruritus, Genital pain, Headache, Hot flush, Insomnia, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: blood pressure meds, cholesterol med, anxiety med, allergy meds, vitamin D, magnesium, Requip, and baby asprin
Current Illness: None
Preexisting Conditions: Asthma
Allergies: mushrooms, chicken, chocolate, cats, and dogs.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: headache, itchy/burning eyes, muscle aches, bone pain, cold chills/hot flashes, insomnia, diarrhea, pain in testicals, and nausea


VAERS ID: 1416823 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: North Dakota  
Vaccinated:2021-06-19
Onset:2021-06-19
   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 EW0153 / 1 LA / IM

Administered by: Pharmacy       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: 1416827 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-06-19
Onset:2021-06-19
   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 EW0187 / 2 LA / IM

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

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

Write-up: Dizzy, nauseated, felt hot. Brought to med screening via wheelchair for evaluation by medics. BP=114/76 Pulse=50 Left in stable condition at 17:13 p.m. Recorded by RN Medic


VAERS ID: 1416863 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 - / IM

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

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

Write-up: Child is too young for vaccine. Accidentally given. Mom thought the vaccine was Pfizer


VAERS ID: 1416897 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cough, Dizziness, Dry throat
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: HA with first Moderna series
Other Medications: None
Current Illness: None, Post 2 months delivery
Preexisting Conditions: NONE
Allergies: NKA
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Received vaccine almost 1:10PM, went to post observation. 5 min past, begin to cough and go out to lobby. Followed out and returned to observation area. C/o dizziness and dry throat and continue to cough. Placed on stretcher. V/S taken: 143/93 HR88 No SOB noted on C/O. Monitored patient until 2:30PM. Escorted to car with family. No distress . Instructions given per RN.


VAERS ID: 1416908 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-01
Onset:2021-06-19
   Days after vaccination:110
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Cough, Respiratory tract congestion
SMQs:, Anaphylactic reaction (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: Amlodopine 5mg Lexapro 5mg Protonix 10mg Vitamin c Vitamin d Calcium citrate Multi vitamin
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: Tequin, all sulfa medications
Diagnostic Lab Data:
CDC Split Type:

Write-up: Upper respiratory and chest congestion and coughing


VAERS ID: 1417173 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 RA / IM

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

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

Write-up: PATIENT RECEIVED 2ND DOSE PFIZER 6 DAYS EARLY.


VAERS ID: 1417212 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-12
Onset:2021-06-19
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050CZ1A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site rash
SMQs:, Hypersensitivity (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: Vitamin D
Current Illness: H. Pylori bacteria infection. Last dose of antibiotic regime was May 14, 2021
Preexisting Conditions:
Allergies: Pineapple
Diagnostic Lab Data:
CDC Split Type:

Write-up: Round rash at injection site exactly 7 days from the first dose.


VAERS ID: 1417312 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Feeling abnormal, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: NONE KNOWN
Preexisting Conditions: NONE
Allergies: UNKNOWN
Diagnostic Lab Data: NONE YET. PHARMACIST HAS ADVISED PATIENT''S MOTHER TO SCHEDULE A VISIT WITH HIS PHYSICIAN FOR A PHYSICAL EXAM.
CDC Split Type:

Write-up: PATIENT''S MOTHER DESCRIBES THAT THE PATIENT DEVELOPED A FEVER WITH HIS 2ND PFIZER DOSE WITHIN 24 HOURS OF RECEIVING. WITHIN 24 HOURS, HE ALSO DEVELOPED CHEST PAINS SPECIFICALLY WHEN BREATHING (INHALING). THE CHEST PAIN HAS GRADUALLY GOTTEN A LITTLE BETTER BUT THE PATIENT STILL DESCRIBES HIS BREATHING AS ''UNUSUAL'' AND ''DOESN''T FEEL LIKE IT USUALLY DOSE''. PATIENT''S MOTHER TOOK HIS PULSE AND REPORTS A PULSE RATE OF 60 WHICH IS LOW FOR THE PATIENT. TODAY IS DAY 4 AFTER VACCINATION AND PATIENT STILL REPORTS NOT FEELING EXACTLY RIGHT.


VAERS ID: 1417314 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-17
Onset:2021-06-19
   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 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Folliculitis, Papilloma viral infection, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (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: Singulair daily Dymista daily Pro-Air as needed
Current Illness: seasonal allergic rhinitis--treated asthma--stable
Preexisting Conditions: asthma allergic rhinitis
Allergies: N/A
Diagnostic Lab Data: Office visit on 6-21-22. On 6-22-21, discussed with parent and will treat as it folliculitis with Benzoyl Peroxide Wash twice a day
CDC Split Type:

Write-up: Patient received COVID vaccine on 6-17-21 and HPV on 6-18-21. On 6-19-21 he developed a diffuse folliculitis type eruption on trunk and extremities. It is not itchy or reddened.


VAERS ID: 1417580 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Aspartate aminotransferase increased, C-reactive protein increased, Chest pain, Dyspnoea, Echocardiogram abnormal, Ejection fraction decreased, Platelet count decreased, Red blood cell sedimentation rate increased, Troponin increased
SMQs:, Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Platelet count 128 AST 88 ESR 31 CRP 3.7 trop 1.05 ECHO with EF 50%
CDC Split Type:

Write-up: Patient developed chest pain and shortness of breath a day after vaccine Admitted to the hospital, troponin were elevated, Echo showed mildly reduced EF treated with colchicine and NSAIDs


VAERS ID: 1417608 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 LA / IM

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

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

Write-up: 6/21/22 8:30pm patient reported excruciating arm and neck pain, and headache since 6/20. This started day after vaccination but worsened on 6/20.He can''t sit up to due to the pain. Feels better standing or lying down. He has been taking Tylenol and motrin, but not much relief. I advised him to ice the injection site as well as to call the doctor the next day. His arm is better today, he can sit up. Headache is still the same. He said he will call the doctor.


VAERS ID: 1417652 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Fatigue, Headache, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cabergoline, Famotidine, Ester-c, d3, Lisinopril, Chlorthalidone, Loratadine, Metformin, Levothyroxine, zinc, Echinacea
Current Illness:
Preexisting Conditions: Asthma, hypo thyrodid
Allergies: Erythromycin levifloxin, rose hips
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Joint pain, headaches, exhausted, chest constriction, sweats, treatment aleve, & excedrin & SLEEP


VAERS ID: 1417735 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood creatine phosphokinase increased, Chest discomfort, Electrocardiogram ST segment elevation, Pericarditis, Pyrexia, Troponin
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: ck 2100, trop 2200, ekg mild st elevation consistent with pericarditis
CDC Split Type:

Write-up: fever, mild chest discomfort


VAERS ID: 1417771 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-19
Onset:2021-06-19
   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 EW0180 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D 50,000 units; Levalbuterol HFA inhaler; Bupropion XL 150mg
Current Illness: none noted
Preexisting Conditions: None noted
Allergies: Hydrocodone; Sulfa antibiotics; lily flower; tetracycline, codeine, clindamycin
Diagnostic Lab Data: None noted
CDC Split Type:

Write-up: Right side facial numbness, right wrist & ankle numbness and tingling and weak.


VAERS ID: 1417984 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: No side effects until third day. Then migraines, tiredness, dizziness, nausea.


VAERS ID: 1418032 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-19
Onset:2021-06-19
   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 ER8735 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Feeling hot, 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? 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 received the 1st dose of the COVID vaccine (Pfizer Lot # ER8735 expiration date 07/05/2021) at 1738. At 1800, the client walked up to the EMT desk and asked EMT, "can you take my blood pressure." EMT asked the client if she was feeling alright. The client stated, "I feel some tingling in my finger tips and I''m a little hot and sweaty." PHN responded at 1801 and helped EMT escort her to the zero gravity chair. The client denied any shortness of breath, difficulty breathing, or nausea. Vital signs were taken at 1802 (blood pressure 142/84, heart rate 62, oxygen 96%). PHN offered the client Benadryl at 1805, which she refused. Client has no medical history, no allergies and is not taking any medications. Vital signs taken at 1812 (132/84, heart rate 59, oxygen 97%). At 1812, client stated, "the tingling is gone. Maybe I was nervous. My friend passed out and vomited when she got her vaccine." Vital signs taken at 1822 (blood pressure 130/80, heart rate 52, oxygen 97%). EMT asked the client if this heart rate was normal for her, which the client replied, "yes." Vital signs taken at 1830 (blood pressure 122/72, heart rate 51, oxygen 97%). PHN advised client to follow up with primary care provider and an allergist, and provided education on when to seek emergency services. At 1832, client stated, "I feel fine now," and left the facility unassisted with a steady gait at 1832.


VAERS ID: 1418087 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cough, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), 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? 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: Strawberries, Bees, Tentnes Shot
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Next morning 6/19/21 patient notices hives all over body, and itchy. Patient has been taking antihistamine with some positive results. Today (6/22/2021) patient states the hives are the worse, especially on her stomach, and they look like chicken pox she said. Also has a little cough.


VAERS ID: 1418112 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-06-15
Onset:2021-06-19
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Diarrhoea, Headache, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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: Associate reports on 6/19 she started to experience a cough, congestion, runny nose, sore throat, headache, 102.1 fever, and diarrhea. Currently, 6/22/21, associate still has a cough and congestion,


VAERS ID: 1418626 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   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 / 1 - / -

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

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

Write-up: Pharmacist did not add the diluent to the vaccine and drew up 0.5 ml and administered to patient on 06/19/2021. I found out the mistake 06/22/2021 and called the patient in question and they claimed to not experience any adverse events since receiving the vaccine.


VAERS ID: 1418629 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   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 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pharmacist did not add the diluent to the vaccine and drew up 0.5 ml and administered to patient. I found out the mistake 06/22/2021 and called the patient in question and they claimed to not experience any adverse events since receiving the vaccine.


VAERS ID: 1419212 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: troponin elevated (14.4ng/mL)
CDC Split Type:

Write-up: chest pain. myocarditis. elevated troponin


VAERS ID: 1419216 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Chills, Gait inability, Headache, Hyperventilation, Pain, Palpitations, Pyrexia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (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: None
Allergies: Peanut allergy
Diagnostic Lab Data: None as of yet but I want to have heart tests run. I?m fearful damage may have been done to his heart from the vaccine.
CDC Split Type:

Write-up: Approx 12 hours after second dose of Pfizer COVID vaccine, my son experienced severe chills (teeth chattering so bad he couldn?t talk) , heart palpitations, said his heart hurt so bad he was crying, rapid uncontrollable breathing, fever, headache (said his head felt like it was going to pop), aches and pains to the point he couldn?t walk.


VAERS ID: 1419219 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest discomfort, Headache, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

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

Write-up: Headache, chest tightness and discomfort, elevated heart rate (resting heart rate bpm in the high 90s as measured by a home pulse oximeter). Resolved the following day, resting heart rate back to low 80s.


VAERS ID: 1419227 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-17
Onset:2021-06-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Cough, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe cough, chest pain, rapid heart rate.


VAERS ID: 1419230 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Vaccination site swelling
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: Sertraline, famotadine, and buspirone
Current Illness: N/A
Preexisting Conditions: Anxiety, obesity, contact dermatitis
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Redness, swelling, and itchiness surrounding area of the vaccination shot roughly an hour or so after injection (continuing as of the present time, 11:41 PM 6/22/2021)


VAERS ID: 1419232 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-19
Onset:2021-06-19
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

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

Write-up: Shingles diagnosis 4 weeks after receiving the second shot.


VAERS ID: 1419760 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-06-19
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210643041

Write-up: DULL ACHES AND PAINS IN LEGS; TIREDNESS; This spontaneous report received from a consumer concerned a 46 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821286, and batch number: 1821286 expiry: UNKNOWN) dose was not reported, administered on 18-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 19-JUN-2021, the subject experienced dull aches and pains in legs. On 19-JUN-2021, the subject experienced tiredness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the tiredness and dull aches and pains in legs was not reported. This report was non-serious. This case, from the same reporter is linked to 20210642462.


VAERS ID: 1419771 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-19
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210644869

Write-up: FEVER; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 18-JUN-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 19-JUN-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of fever was not reported. This report was non-serious.


VAERS ID: 1419978 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Lymphadenopathy, Pain in extremity, Rhinorrhoea
SMQs:, Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 3-36 hours after shot: sore arm; 20-36 hours after shot: slight headache; 30-48 hours after shot: swollen lymph nodes & nasal drainage


VAERS ID: 1420253 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820096 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain
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: Creatine, protein powder
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: N/a
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Shoulder pain in deltoid, rotator cuff, and rear lat


VAERS ID: 1420283 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

Administered by: School       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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: None
Preexisting Conditions: none
Allergies: seasonal allergic rhinitis.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Vaccine #1 5/27/21. Vaccine #2 6/17/21. On 6/19/21, he was working at a climbing wall and his shoulders were sore. He rubbed them and noticed 2 small lumps in the supraclavicular area. He presented today for evaluation. A quick pubmed search revealed case reports of same (but not many) . I wanted to report this. https://pubmed.ncbi.nlm.nih.gov/33685772/ Supraclavicular lymphadenopathy is rare in children and young adults.


VAERS ID: 1420529 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Breast mass, Breast tenderness, Chest pain, Dyspnoea, Fatigue, Headache, Lymphadenopathy, Muscle disorder, Myalgia, Peripheral swelling, Pyrexia, Thyroid disorder, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine Befylate 2.5mg
Current Illness: no
Preexisting Conditions: Asthma
Allergies: no
Diagnostic Lab Data: no
CDC Split Type:

Write-up: While still in the pharmacy right after the vaccine she started wheezing. Next morning had a low grade temp, left arm was swollen and lymph nodes in left arm pit was swollen, left breast has a tender lump, terrible headaches and extremely tired. When trying to exercise she is having serve chest pain. Joint pains in shoulder and neck, muscles has pain and is making a popping sound. Right thyroid is swollen and is getting short of breathe.


VAERS ID: 1420614 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chills, Headache, Injection site mass, Lymphadenopathy, Pain, Peripheral swelling, Pruritus, Pyrexia, Rash erythematous, Tremor
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad)

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

Write-up: Fever, body ache, headache, back ache, joint pain, chills, shakes, painful lump under arm pit, lump at injection sight, swollen arm, red rash, generalized itching around arm, itching over entire body, red spots spreaded


VAERS ID: 1420650 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-09
Onset:2021-06-19
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Peripheral swelling, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Loestrin multivitamin Iron gummy vitamin Fluticasone Albuterol
Current Illness: fibroid uterus asthma
Preexisting Conditions: asthma iron deficiency anemia fibroid uterus abnormal uterine bleeding
Allergies: nsaids doxycycline Macrobid shellfish Symbicort tolmetin allegra menopur
Diagnostic Lab Data: venous duplex 6/22/21
CDC Split Type:

Write-up: patient with new LLE peroneal DVT 2 weeks post vaccine. Left leg swelling


VAERS ID: 1420731 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-12
Onset:2021-06-19
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Headache, Oligomenorrhoea, Pruritus, Vaccination site mass, Vaccination site reaction, Vaccination site warmth
SMQs:, Anaphylactic reaction (broad), Fertility disorders (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headaches, Period lasted longer than 12 days normally only 4. Huge softball size red lump appeared a week later on vaccination arm/hot and itchy


VAERS ID: 1420778 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-15
Onset:2021-06-19
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood bilirubin increased, Blood ethanol, Blood fibrinogen increased, Blood sodium decreased, C-reactive protein increased, Computerised tomogram abdomen abnormal, Culture urine positive, Diarrhoea, Discoloured vomit, Echocardiogram abnormal, Enterocolitis, Fibrin D dimer, Haemoglobin decreased, Hypotension, Immunoglobulin therapy, Intensive care, N-terminal prohormone brain natriuretic peptide increased, Pericardial effusion, Platelet count decreased, Pyrexia, Red blood cells urine positive, Right ventricular systolic pressure increased, SARS-CoV-2 antibody test positive, SARS-CoV-2 test negative, Serum ferritin increased, Streptococcus test negative, Tricuspid valve incompetence, Urine analysis abnormal, Urine cannabinoids increased, Vomiting, White blood cell count decreased, White blood cells urine positive
SMQs:, Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (narrow), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Biliary system related investigations, signs and symptoms (narrow), Pulmonary hypertension (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Ischaemic colitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: None reported
Preexisting Conditions: Depression, anxiety
Allergies: None reported
Diagnostic Lab Data: 6/21/21 ECHO: normal biventricular size and systolic function (LFEF 62%), mild tricuspid regurgitation estimating mildly elevated RV pressure (30-40% systemic), mild flow accelration across normal appearing trileaflet aortic valve and borderline small aortic root and sinotubular junction, normal ascending aorta, no pericardial effusion, normal right, left main, and LAD coronary artery diameter z-score, and mild outpouching in the left main coronary artery that may represent an early appearance of an aneurysm 6/22/21 ECHO: normal biventricular size and systolic function, mild tricuspid regurgitation estimating RV systolic pressure of 30mmHg, left main coronary artery appears slightly prominent but measures within normal limits. LMCA measurement is similar to previous, normal measurement of the proximal RCA and LAD, and trivial pericardial effusion CRP (mg/dL (date)): 18.8 (6/20), 22.5 (6/22), 8.2 (6/23) WBC (x10(3)/mcL (date)): 7.29 (6/20), 5.55 (6/22), 4.35 (6/22) Hgb (gm/dL (date)): 11.1 (6/20), 9.6 (6/22), 9.8 (6/23) Plt (x10(3)/mcL (date)): 143 (6/20), 137 (6/22), 166 (6/23) ALC (x10(3)/mcL (date)): 0.05 (6/20); 0.45 (6/22); 0.92 (6/23) Na (mmol/L): 133 (6/20) CRP (mg/dL (date)): 18.8 (6/20); 22.5 (6/22); 8.2 (6/23) Bilirubin total (mg/dL (date): 2.5 (6/20); 2.1 (6/22) AST/ALT (unit/L (date)): 143/98 (6/20); 40/50 (6/22) NTpro BNP = 309 (6/20) D-dimer = 0.98 (6/20) Fibrinogen = 408 (6/20) Ferritin = 183 (6/21) Cannabinoids Urine = 74 ng/mL (6/20) SARS CoV2 Antibody = IgG positive; IgM negative (6/21)
CDC Split Type:

Write-up: 6/19/21 patient awoke with non-bloody, bright green emesis and abdominal pain. She endorses several episodes of nonbloody diarrhea with continued abdominal pain. She endorses starting her menstrual period 3 days ago. Mom endorses fever at this time, T-max 102.9. Presented to an urgent care for further evaluation where they obtained a rapid strep test and COVID-19 swab that were both negative. 6/21/21 she presented to an ED for continued and worsening symptoms. She received a dose of antibiotics and saline boluses during transfer to another hospital. In route, she became hypotensive with minimal response to fluid resuscitation. She required vasopressors to maintain blood pressure. A CT of the abdomen showed nonspecific findings for enterocolitis. A urinalysis had 5-15 RBCs and 51-100 WBCs. She was started on antibiotics. She required ICU admission initially, but improved and became hemodynamically stable after about 16 hours in the PICU. Her urine culture grew 3 different organisms with low colony counts so antibiotics were discontinued on 6/22/21. An ECHO demonstrated normal biventricular size and systolic function (LFEF 62%), mild tricuspid regurgitation estimating mildly elevated RV pressure (30-40% systemic), mild flow accelration across normal appearing trileaflet aortic valve and borderline small aortic root and sinotubular junction, normal ascending aorta, no pericardial effusion, normal right, left main, and LAD coronary artery diameter z-score, and mild outpouching in the left main coronary artery that may represent an early appearance of an aneurysm. A repeat ECHO the following day revealed normal biventricular size and systolic function, mild tricuspid regurgitation estimating RV systolic pressure of 30mmHg, left main coronary artery appears slightly prominent but measures within normal limits. LMCA measurement is similar to previous, normal measurement of the proximal RCA and LAD, and trivial pericardial effusion. The patient also had an elevated CRP of 18.8 mg/dL, fibrinogen of 408 mg/dL, d-dimer of 0.98, and nt-pro BNP of 309. SARS CoV2 IgG was positive and IgM was negative. She received IVIG 100 gm on 6/23/21 and was started on rivaroxaban. CRP decreased to 8.2 mg/dL on 6/23/21.


VAERS ID: 1421065 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Decreased appetite, Discomfort, Injected limb mobility decreased, Injection site erythema, Injection site pain, Injection site swelling, Nausea, Pain in extremity, Product preparation error, Product reconstitution quality issue
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: : Voltaren 1% gel AAA QID; Cymbalta 30 mg, 1 QD; Norvasc 5 mg, 1 QD; methadone 5 mg, 1 QD; Lantus Solostar U-100 insulin, 14 units QHS; lisinopril/HCTZ 20-12.5 mg, 2 QD; hydroxyzine HCl 25 mg, 1-2 TID PRN; Lyrica 300 mg, 1 BID; ibup
Current Illness: Follow up for chronic problems on 6/18/21
Preexisting Conditions: Chronic Hepatitis C, chronic pain syndrome, essential hypertension, ADHD ? the inattentive type, lower back pain, menopausal symptoms, anxiety.
Allergies: Acetaminophen, prednisone, penicillins
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Received concentrated dose from a vial that was not diluted. 06/23/21 @ 9:59 I called patient to follow-up on Friday?s incident (6/18). She said that Saturday she couldn?t move her left arm because it was so uncomfortable, also had a hard time sleeping. Also, her appetite was greatly reduced and was nauseated. She tried taking ibuprofen taking it only once and it did not do anything for the discomfort; nor did the methadone. Sunday, could start using arm though it still hurt. Today she can move her arm without hurting, there is some swelling, redness at the injection site with tenderness but improved. Appetite is improving though not back to normal. To call if gets worse or has concerns.


VAERS ID: 1421070 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-15
Onset:2021-06-19
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: post-covid myocarditis with troponin leak


VAERS ID: 1421086 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 1 RA / IM

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

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

Write-up: Patient received Moderna COVID Vaccine Lot 028A21A Exp 04/28/2021, no adverse event reported, this was given past expiration listed on manufacture website.


VAERS ID: 1421137 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-04
Onset:2021-06-19
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Borrelia test, Facial paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: None. Healthy.
Allergies: None.
Diagnostic Lab Data: 06/21 - office visit. Checked Lyme titers (pending). Started on Prednisone 60 mg daily x 7 days.
CDC Split Type:

Write-up: Patient came into office at health clinic on 06/21 with complaints of left sided facial paralysis that started 48 hours prior (06/19). Confirmed diagnosis of Bell''s palsy. Started on Prednisone. Only significant history was COVID-19 vaccination a few weeks prior (06/04). He had some malaise and low grade fevers for several days after vaccination but then felt fine leading up to 06/19. Unclear if any correlation but felt should be reported given there were cases of Bell''s palsy in the clinical trials for mRNA vaccines. Currently given Prednisone dosing for 7 days delaying 2nd vaccine. Rescheduled from this Saturday to 3 weeks later.


VAERS ID: 1421340 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Musculoskeletal stiffness, 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), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: Syncope-- about 10 sec after administration, patient became tonic that lasted approximately 5 seconds, then passed out for approximately 20-30 seconds Immediately, EMS was alerted and responded in approximately 8 minutes. Patient''s blood pressure was monitored and then patient declined to be transported to the hospital


VAERS ID: 1421420 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

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

Write-up: Severe chills, body aches


VAERS ID: 1421439 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-21
Onset:2021-06-19
   Days after vaccination:149
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 390896 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Pain in extremity, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: As of 06/19/2021, I was admitted to the hospital with severe pains in lower right leg and chest pains. Prognosis is blood clots in lungs and legs. I was administered heparin and now have to take eliquis daily!
Allergies: None
Diagnostic Lab Data: 06/19/2021
CDC Split Type:

Write-up: Noted on previous page


VAERS ID: 1421834 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Decreased appetite, Diarrhoea, Nausea
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pristiq, Xarelto, Levothyroxine, Remicade, Melatonin
Current Illness: N/A
Preexisting Conditions: Crohn''s Disease, Stage 3 Chronic Kidney Disease, Hypthroidism, Hypercoagulation, Atopic Dermatitis, Kidney Stones, Salivary Gland Stones, Chronic Fatigue, Depression, Anxiety
Allergies: Amoxicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Diarrhea starting approximately 10 hours after administration and continuing up to time of this report. Treatment with OTC Loperamide provided only moderate relief for short periods of time.. Followed normal hydration recommendations to prevent dehydration. Nausea and stomach cramping started approximately 24 hours after administration and continue up to time of this report. Treatment of stomach cramping with Dicyclomine prescribed by GI for previous issues due to Crohn''s Disease provided only moderate relief. Nausea untreated. Combination of symptoms led to anorexia and I am only able to tolerate small amounts of foods such as broth. GI doctor was contacted on 6/23/2021 and informed of symptoms with the objective of being prescribed stronger medications to control them. As of this report I have not received notification of any medications prescribed and awaiting me at pharmacy.


VAERS ID: 1422300 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Patient is not 18 years of age and she received the Moderna vaccine which is intended for ages 18 and up. No signs, symptoms, or side effects. Vaccine was given on 06.19.21 and father notified us on 06.23.21


VAERS ID: 1422794 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood test normal, Ear pain, Fatigue, Fluid replacement, Gait disturbance, Haemoglobin normal, Headache, Hypersomnia, Photophobia, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (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:
Current Illness: None
Preexisting Conditions: Hereditary Spastic Paraplegia or HSP 4
Allergies: None
Diagnostic Lab Data: Blood panel taken on Tuesday June 23rd in Emergency & it was normal. Hemoglobin levels were 13.4. Given IV hydration electrolyte fluids while in ED.
CDC Split Type:

Write-up: Next day on Saturday; developed fatigue & extreme tiredness. Slept most of the day. Did eat two meals with a slight headache. Sunday headaches worsened with ear aches, fatigue & slept all day. Gave Patient Tylenol, pushed fluids to tolerance & used cold compress towels on his head for his headaches. Monday symptoms persisted & taken to his primary MD & was given medication (Tylenol) & was instructed to administer Ibuprofen if symptoms of headache continue. Prior to MD visit he fainted & vomited attempting to use the toilet. Unable to tolerate any light from the house with sensitivity to his vision. Encouraged to hydrate with GatorAid & fluids with meals to tolerance. Was instructed to take patient to Emergency if symptoms persist till Tuesday to obtain IV hydration. Tuesday late afternoon 4:30 pm, took patient to Emergency & was assessed for blood work which was normal & given IV hydration while there. Wednesday- symptoms subsiding with no further headaches & is now able to walk by himself with improving strength. He ate 3 meals today & hydrating most of the day. Sitting up more & trying to improve his strength & endurance. Less sensitive to light.


VAERS ID: 1422829 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-22
Onset:2021-06-19
   Days after vaccination:58
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Dizziness, Fatigue, Feeling abnormal, Heart rate increased, Limb discomfort, Vertigo
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Vestibular disorders (narrow), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Increased Heart rate, discomfort in left forearm for short periods of time, Fatigue, Anxiety, light headedness / clouded mind, sometimes vertigo like symptoms for a briefs period


VAERS ID: 1423396 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Chest pain, Deep vein thrombosis, Dyspnoea, Fatigue, Fibrin D dimer increased, Pulmonary embolism, Pyrexia
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: R-CHOP chemo on 6/2/2021
Current Illness: Non-Hodgkin Lymphoma
Preexisting Conditions: Only lymphoma
Allergies:
Diagnostic Lab Data: Confirmed extensive PE 6/21/2022 (by CTPA; d-dimer over 2000). Right femoral DVT confirmed 6/23/2021.
CDC Split Type:

Write-up: Fatigue, fever, shortness of breath, left sided chest pain. Major pulmonary embolism and right femora vein DVT. Required emergency admission morning of 6/21/2021, EKOS treatment with TPA, 3 night hospital stay so far.


VAERS ID: 1423405 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 RA / IM

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

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

Write-up: Pfizer covid vaccine was held in freezer past beyond use date, and administered. expired 6/15, given 6/19


VAERS ID: 1423416 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

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

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

Write-up: Pfizer covid vaccine was held in freezer past beyond use date, and administered. expired 6/15, given 6/19


VAERS ID: 1423421 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

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

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

Write-up: Pfizer covid vaccine was held in freezer past beyond use date, and administered. expired 6/15, given 6/19


VAERS ID: 1423426 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

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

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

Write-up: Pfizer covid vaccine was held in freezer past beyond use date, and administered. expired 6/15, given 6/19


VAERS ID: 1423578 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-04
Onset:2021-06-19
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Intermenstrual bleeding, Menstrual disorder, Pregnancy test
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: Junel fe 1/20 (birth control) Sumatriptan
Current Illness: None
Preexisting Conditions: None
Allergies: Shell fish
Diagnostic Lab Data:
CDC Split Type:

Write-up: 19 days after my 2nd vaccine my period came 7 days earlier. I?ve been spotting blood for the past 7 days. This is not like my normal period, i have not had my normal flow since i began to bleed and my period is always on time and usually only last a maximum of 4 day. Im currently on birth control and have not missed any pills. I?ve been on the pill for 5 months and i also took a pregnancy test.


VAERS ID: 1423628 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0394214 / UNK LA / IM

Administered by: Private       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? 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: N/A
Allergies: N/A
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: SWELLINGAT INJECTION SITE, ITCHY, REDNESS. ICE HYDROCORTISONE CREAM


VAERS ID: 1423720 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 3 RA / IM

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

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

Write-up: Patient received dose #2 of Pfizer vaccine on 6/8/2021 and was notified by email that vial was left in freezer past recommended time frame. Medication expired beyond its freezer allowable date. Email recommended patient get re-vaccinated with dose again. Physicians re-administered dose on 6/19/2021 as recommended. No adverse reactions identified on site.


VAERS ID: 1423838 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Hypoacusis, Loss of consciousness, Visual impairment
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), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PATIENT IS CURRENTLY ON ANXIETY MEDICATION BUT I AM NOT SURE IF SHE TOOK ANY THE MORNING OF VACCINATION.
Current Illness: NO
Preexisting Conditions: ANXIETY
Allergies: NO
Diagnostic Lab Data: NO
CDC Split Type:

Write-up: PATIENT WAS ASKED TO WAIT AT THE WAITING AREA FOR 15 MINS AFTER RECEIVING THE VACCINE. IN FEW MINUTES SHE SLOWLY WALKED UP TOWARDS MY WORKSTATION AND I QUICKLY RAN OUT AND GRABBED HER BECAUSE I COULD TELL SOMETHING WAS WRONG. A CUSTOMER STANDING BY GRABBED A CHAIR FOR HER AND WE HAD HER SIT DOWN. THEN SHE TOLD ME SHE GOT UP TO GET WATER AND SHE PASSED OUT. I TOLD HER ITS BETTER THAT SHE LAYS DOWN ON THE FLOOR TO PREVENT ANY FURTHER INJURIES AND I HELPED HER TO LAY DOWN. SHE WAS SWEATING AND SHE STATED THAT HAD TROUBLE WITH HER VISION AND HEARING. PARAMEDICS WERE IMMEDIATELY NOTIFIED. MEANWHILE SHE STATED SHE WAS ANXIOUS TO GET THE SHOT AND SHE DIDN''T HAVE BREAKFAST. SO WE GAVE HER WATER, ORANGE JUICE AND CRACKERS. BY THE TIME THE PARAMEDICS ARRIVED SHE STATED HER VISION AND HEARING IS BACK TO NORMAL. PATIENT ALSO WAS FEELING BETTER. PARAMEDICS CHECKED HER BLOOD PRESSURE AND ASKED IF SHE TAKES ANY MEDICATION AND SHE SAID SHE TAKES A ANXIETY MEDICATION AND I AM NOT SURE IF SHE TOOK ANY THAT MORNING. SHE WAS ASKED IF SHE WANTED TO GO THE HOSPITAL AND SHE SAID NO BECAUSE EVERYTHING WAS BACK TO NORMAL. PATIENT WALKED OUT OF THE PHARMACY FEELING BETTER.


VAERS ID: 1423875 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 came in for 2nd dose of Pfizer. She instantly had an increase in heartrate. We had her recline back in the chair in our observation room, checked her BP, Pulse ox, both of which were in normal range.. I gave her a bottle of water and had her try and relax. We covered her with a blanket. After 30 minutes she said she was still not 100% and we had her call a friend to drive her home. The friend could not come, so I had her rest for another 30 minutes. She felt better after staying with us for an hour and a half and she left. She was steady on her feet and reported that she was not dizzy and felt fine.


VAERS ID: 1424023 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia
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: lisinpril 2.5, multi vitiman, baby aspirin
Current Illness: None
Preexisting Conditions: arthritis, atrial fibrillation
Allergies: benadryl, cymbalta, compazine, shellfish
Diagnostic Lab Data: Visited doctor
CDC Split Type:

Write-up: Numbness on left side of face


VAERS ID: 1424134 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Chest discomfort, Dysphagia, Dyspnoea, Joint swelling, Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: inhaler Benadryl steroid
Current Illness: no
Preexisting Conditions: Asthma
Allergies: Flu Shot Advil and Tylenol
Diagnostic Lab Data: Her primary Doctor prescribed her steroids and increased her med in the inhaler 06/21/2021
CDC Split Type:

Write-up: patient report that after the shot she couldn''t swallow, her neck was swollen , and she was short of breathe, chest felt heavy, swelling on left knee


VAERS ID: 1424221 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-07
Onset:2021-06-19
   Days after vaccination:73
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol 2.5 mg /3 mL (0.083 %) nebulizer solution(Expired) albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler aspirin tablet baclofen (LIORESAL) 20 mg tablet bisacodyL (DULCOLAX, BISACODYL,) 10 mg suppository blood sugar diagnost
Current Illness:
Preexisting Conditions: Non-Hospital Disc degeneration, lumbar Esophagitis, reflux Hormone replacement therapy (HRT) LADA (latent autoimmune diabetes mellitus in adults) (CMS/HCC) Lumbar spondylosis Nonspecific vaginitis Non-toxic multinodular goiter OCD (obsessive compulsive disorder) Sacroiliitis (CMS/HCC) Severe vertigo Uncontrolled type 1 diabetes mellitus with hyperglycemia (CMS/HCC) Controlled substance agreement signed Chronic non-seasonal allergic rhinitis Depressed bipolar I disorder (CMS/HCC) Hypersomnia Sensorineural hearing loss, bilateral Spinal stenosis of lumbar region Dehydration After cataract not obscuring vision Pure hypercholesterolemia Vertigo Hypomagnesemia Menopausal and female climacteric states Cerebral infarction due to occlusion of right carotid artery (CMS/HCC) Migraine without aura Left hemiparesis (CMS/HCC) At risk for venous thromboembolism (VTE) Muscle spasticity Unable to care for self Encounter for psychiatric assessment BRBPR (bright red blood per rectum) Rectal bleed
Allergies: AtorvastatinMyalgia / Muscle Pain Sulfa (Sulfonamide Antibiotics)Hives / Urticaria Sulfamethoxazole-trimethoprimHives / Urticaria Mold Other Byetta [Exenatide]Other (document details in comments) Cat DanderSneezing FluvoxamineOther (document details in comments) Invokana [Canagliflozin]Other (document details in comments) MetforminOther (document details in comments) OxycodoneItching
Diagnostic Lab Data: 06/19/21 0813 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 06/19/21 0621 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: #Asymptomatic COVID-19 Infection -Patient has been COVID-19 positive since 12/2020 but denies any fever/chills, cough, shortness of breath, and does not require any oxygen supplementation


VAERS ID: 1424343 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-30
Onset:2021-06-19
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, pravastatin, 1000 vitaminD3, multivitamin
Current Illness: 2 day stomach virus 06/02/2021
Preexisting Conditions: Graves disease
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Diagnosed with Right sided Bell?s Palsy Adverse effect of COVID-19 vaccine


VAERS ID: 1424368 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-17
Onset:2021-06-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstruation irregular
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:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: change in mensural cycle. early onset of period followed by another period after 14 days characterized by longer length then usual.


VAERS ID: 1424396 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Impaired driving ability
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

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

Write-up: patient was light headed had to sit down. came close to fainting. unable to drive.


VAERS ID: 1424446 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-06
Onset:2021-06-19
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / IM

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

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

Write-up: bell''s palsy left. started 6/19/21 prednisone


VAERS ID: 1424450 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Headache, Pain, Pyrexia, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FLUOXETINE, KLONOPIN
Current Illness: NONE
Preexisting Conditions: ANXIETY, DEPRESSION
Allergies: REGLAN
Diagnostic Lab Data: RAPID COVID TEST WAS PERFORMED WITH NEGATIVE RESULT AT TIME OF VISIT 6/24/21
CDC Split Type:

Write-up: PT WOKE UP OM 6/19/21 WITH 102.6 DEGREE FEVER. FEVER LASTED FOR ABOUT 2-3 DAYS. PT ALSO REPORTS SOB, HA, BODY ACHES. PT TOOK TYLENOL AND IBUPROFEN PRIOR TO BEING SEEN IN CLINIC 6/24/21. SHE WAS GIVEN 30 MG OF TORODOL IM AT THIS VISIT.


VAERS ID: 1424613 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Gait disturbance, Nervousness
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (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:
Preexisting Conditions: asthma
Allergies: aspirin biaxin
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt reported light headed shaking feels "drunk" headache stumbling


VAERS ID: 1424837 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH I-WO 180 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Decreased appetite, Discomfort, Dizziness, Dyspnoea, Fatigue, Genital pain, Headache, Insomnia, Muscle spasms, Myalgia, Nasal congestion, Nausea, Neck pain, Pain in extremity, Pain in jaw, Pharyngeal hypoaesthesia, Pyrexia, Tinnitus, Visual impairment, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (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), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Ibuprofen
Diagnostic Lab Data: 06/19/2021 ? Chest numbness ? Trouble breathing ? Sore jaw ? Chills, trembling (no temp taken) ? Exhaustion ? Trouble sleeping 06/20/2021 ? Nausea ? Chest numbness ? Sore neck ? Lack of appetite ? Exhaustion ? Trouble sleeping 06/21/2021 ? Nausea ? Fever ? Exhaustion ? Congestion ? Lack of appetite ? Sore neck ? Trouble sleeping ? General discomfort ? Acute pain in hands 06/22/2021 ? General discomfort ? Trouble sleeping ? Cough ? Exhaustion ? Lack of appetite ? Sore muscles ? Fever (100.1) ? Nausea ? Acute pain in hands 06/23/2021 ? Dizziness, ringing ears, seeing black ? Headache ? Sore on labia ? Chills, sore muscles, muscles spasms ? Fever (highest one in morning, 101.5) ? Vomiting ? Nausea ? Exhaustion ? General discomfort ? Numbness in front of throat (congestion?)
CDC Split Type:

Write-up: None stated.


VAERS ID: 1424857 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-12
Onset:2021-06-19
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO181 / 2 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Fatigue, 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)

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: na
Current Illness: na
Preexisting Conditions: na
Allergies: seasonal hayfever
Diagnostic Lab Data: na
CDC Split Type:

Write-up: Exactly one week after the 2nd shot, patient was at a track meet and suddenly had a sharp pain in his chest. It hurt when he inhaled, and he didn''t compete. He has never experienced this kind of chest pain before. We thought it was an allergic reaction (hayfever?) because it seemed harder to breathe, so we gave him a benadryl and later went home. He was tired and took a long nap. Later he felt better. But it was scary. I think he underreported how he felt, to not alarm us parents. He admits this now. There''s not logical cause other than the vaccine ( no new foods, medications, experiences). However, he didn''t have any other notable side effects from the 1st or 2nd dose, except tiredness and arm soreness the first days.


VAERS ID: 1424861 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Dizziness, Dyspnoea, Injection site reaction, Muscle tightness, Nausea, Rash, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: After receiving the shot on my upper left arm near the shoulder, I had a severe allergic reaction. After 2 hours, a painful rash formed around the injection site and the other parts of the upper arm. I still have markings left from the rash. After 4 hours I was feeling nauseous and dizzy to the point I decided to just lay down and rest. I woke up from the nap as the symptoms worsen and threw up multiple times. About 11 hours after the injection, I was having trouble with breathing and it gradually worsened. I tried breathing by doing heavy breathing for two hours. As I felt like dying from suffocation, my partner decided to call 911 and also called the emergency room nearby to speak to the nurse. We are informed that this is a serious reaction and I needed to be treated ASAP. I took an antihistamine as recommended by a paramedic and the emergency room nurse. I was able to breathe normally after 30 minutes. The day after, I couldn''t breathe in deep since my lung felt as it was bruised from heavy breathing. As of now, I still have some marks from the rash, and muscle tension/sore on my left armpit.


VAERS ID: 1424871 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-25
Onset:2021-06-19
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 LA / UN

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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: Gabepintin, pravastatin, clonaphen
Current Illness: None
Preexisting Conditions: Tinnitus
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Deep vein thrombosis


VAERS ID: 1425048 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Facial paralysis, Magnetic resonance imaging head abnormal
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: took appointment for MRI IACS (Brain MRI) Diagnosis: Facial paralysis on left side
CDC Split Type:

Write-up: Facial Paralysis on LEFT side of face


VAERS ID: 1425203 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-01
Onset:2021-06-19
   Days after vaccination:49
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Escitalopram, hyzaar, metformin
Current Illness: None
Preexisting Conditions: High blood pressure. Type 2 diabetes
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Ringing in left ear. Ongoing and high pitched for 3-4 straight days


VAERS ID: 1425265 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-17
Onset:2021-06-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Pain, Vaginal haemorrhage
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: Naproxen sodium, excedrin, acetaminophen
Current Illness:
Preexisting Conditions: obesity
Allergies: macadamia nuts
Diagnostic Lab Data: None at this time. I have contacted a gyno to speak with on this matter. My appointment is July 6th.
CDC Split Type:

Write-up: Approx 4AM 6/19/21 is when I noticed I was experiencing vaginal bleeding beyond what I had ever experienced before. I was not due for a menstrual cycle. Between 4AM and 10AM I went through 3 overnight sanitary pads. Over the course of the rest of the day I went through 8 regular pads, soaking them through with blood. I contemplated going to the ER. The blood was excessive and bright red, freely flowing and passing clots larger than a dollar coin. The bleeding finally slowed around 36hr after it began. I used ibuprofen beginning the evening of 6/19/21 to help stop the bleeding. The bleeding finally stopped entirely the evening of 6/21/21. The most unique part is that there was little to no pain, even before I began to take the ibuprofen.


VAERS ID: 1425823 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-06-19
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Deafness transitory, Disorientation, Dizziness, Dysgeusia, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210645469

Write-up: THROWING UP; UNCONTROLLABLE SHAKES FROM HEAD TO TOE FEET WERE EXTREMELY COLD; FELT DISORIENTED; FELT LIKE GOING TO PASS OUT; SEVERE CHILLS; SHORT TERM HEARING LOSS; METALLIC TASTE; This spontaneous report received from a patient concerned a patient of unspecified age and sex and of unknown race and ethnicity. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported, expiry: UNKNOWN) dose was not reported, 1 total administered on 19-JUN-2021 14:30 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 19-JUN-2021, within an hour after vaccination the patient had symptoms of short term hearing loss and a metallic taste. After that all was good no signs or symptoms from vaccine, the patient went to bed at 23:00. On 20-JUN-2021, at 1:05 the patient woke up with severe chills and uncontrollable shakes from head to toe feet were extremely cold. The patient was used to stay at -21 temperatures and currently living at place which was rarely ever cold. The patient went outside to warm up roughly for 10 minutes, later felt very disorientated and felt like going to pass out by 1:23 was throwing up two times. Shortly after expelling vomit the patient felt much better. All symptoms seemed to last around an hour or less. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from short term hearing loss, and metallic taste on 19-JUN-2021, and throwing up, uncontrollable shakes from head to toe feet were extremely cold, felt disoriented, felt like going to pass out, and severe chills on 20-JUN-2021. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0:20210645469-covid-19 vaccine ad26.cov2.s-Short term hearing loss.This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


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