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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 91 out of 4,799

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VAERS ID: 1425831 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
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 UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Hypersomnia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (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: USJNJFOC20210648216

Write-up: SLEPT FOR ABOUT 14 HOURS (SPENT MOST OF THE DAY IN BED); CHILLS; FEVER; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 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 slept for about 14 hours (spent most of the day in bed). On 19-JUN-2021, the subject experienced chills. On 19-JUN-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from chills, fever, and slept for about 14 hours (spent most of the day in bed). This report was non-serious.


VAERS ID: 1426118 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-01-12
Onset:2021-06-19
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: COPD, DM2, Obesity
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient positive for covid-19 11/26/2020. Vaccinated 12/22/2020 and 01/12/2021 with pfizer. Patient sent to hosptial on 06/19/2021 and tested positive for covid-19 06/20/2021 with symptoms. .


VAERS ID: 1426499 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Paraesthesia oral, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, sertraline
Current Illness: None
Preexisting Conditions: Hypothyroidism, obesity, migraine, fybromyalgia
Allergies: Shellfish, nifedipine, singulair
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Was monitored for 15 min afterwards. Left facility, tingling on roof of mouth, swollen tongue, shortness of breath. Stopped at nearest emergency room on way home.


VAERS ID: 1426981 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER EW0186 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood alkaline phosphatase normal, Brain natriuretic peptide, Chest discomfort, Chest pain, Dyspnoea, Electrocardiogram normal, Full blood count normal, Troponin normal
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Miralax Norethindrone acetate 10 mg daily Sertraline 75 mg daily Clonidine 0.1 mg nightly Vimpat 200 mg twice daily Vitamin D Vitamin C Baclofen via intrathecal catheter
Current Illness: No
Preexisting Conditions: Quadriplegic cerebral palsy Seizure disorder Osteopenia Constipation Anxiety
Allergies: Trileptal Tape Artane
Diagnostic Lab Data: 6/23: EKG: normal sinus rhythm, normal EKG Troponin: 0 BNP: <10 Cmp: normal except Alk phos 42 (low) Cbc: normal
CDC Split Type:

Write-up: Shortness of breath Chest tightness/pain - thought to be costochondritis


VAERS ID: 1427024 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Migraine, Nasopharyngitis, Pyrexia, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine, Citalopram, Bisoprolol
Current Illness:
Preexisting Conditions: Hypertension, anxiety
Allergies: Seasonal allergies, perfumes, penicillin, tizanidine
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Client initially developed a migraine and fever the evening of vaccination. At 3:30 am the following day the patient began vomiting and had fainted and passed out in the shower. Client is currently, "experiencing light headedness and is fighting off a cold."


VAERS ID: 1427041 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

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

Write-up: Within a few hours of the 2nd injection, pt developed hives on her left arm. Within 24 hours, hives had spread to her arms and neck, and she developed sharply demarcated, erythematous macules in bilateral axillae. She went to Urgent Care the day after vaccination, was diagnosed with pityriasis rosea and prescribed topical and oral steroids, which she did not take. She was seen in a virtual appointment 5 days after the vaccination by myself her PCP, with persistent urticaria, diagnosed with an allergic reaction to the vaccine, encouraged to take the oral prednisone prescribed in Urgent Care to reduce the duration of symptoms.


VAERS ID: 1427305 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Influenza like illness
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Psychiatric disorder NOS
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021741356

Write-up: Feeling like having Flu; This is a spontaneous report from a contactable consumer (patient) from a Pfizer sponsored program. A 50-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection; lot number: EW0178 and expiration date: not reported), via an unspecified route of administration, on 18Jun2021 (at the age of 50-year-old), as DOSE 2, SINGLE for covid-19 immunization. Medical history included ongoing Psychiatric issue but nothing physical. The patient''s concomitant medications included some psychiatric medication. Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection; lot number: EW0177and expiration date: not reported), via an unspecified route of administration, on 28May2021 (at the age of 50-year-old), as DOSE 1, SINGLE for covid-19 immunization and had no reaction. The patient was feeling like having a flu on 19Jun2021. Patient don''t want to report anything or sign up for anything just want to know if it''s okay to take Tylenol. The outcome of the event was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1427411 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Eye movement disorder, Hyperhidrosis, Loss of consciousness, Nausea, Pallor, Urinary incontinence
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Ocular motility disorders (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: None reported
Current Illness: None reported
Preexisting Conditions: None reported
Allergies: None reported
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient stated she started to feel dizzy and nauseated. I gave her a bottle of soda. As I was about to check her blood pressure, she seemed to lose consciousness. Her eyes rolled back in her head, and she seemed to be out of it for a few seconds. She came back to about 10 seconds later. She was pale, sweating, and had urinated on herself. I gave her a cold rag to wipe her face off. We called 911. Kept reminding the patient to take slow, deep breaths. Ambulance came and checked patient out, but she refused to be transported to hospital. I called to check on the patient later that night. She stated she had taken a nap when she got home, but was overall feeling better


VAERS ID: 1427650 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-06-15
Onset:2021-06-19
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram normal, Magnetic resonance imaging heart, Mitral valve incompetence, Mycoplasma test, Pericardial effusion, Pericardial fibrosis, Troponin increased
SMQs:, Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: Troponin Ihs, Mycoplasma IgM
CDC Split Type:

Write-up: 15 Year old patient presenting chest pain 4 days after de 2nd dose of the COVID-19 Vaccine. Patient had to be hospitalize, elevated troponin levels, electrocardiogram with normal functions, mild FR, trace MR, thickened pericardium. Normal function Cardiac MRI. Pericardium effusion.


VAERS ID: 1427842 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA9093 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Amenorrhoea
SMQs:, Fertility disorders (broad)

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

Write-up: Cycle stopped completely.


VAERS ID: 1428034 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthma, Back pain, Chest discomfort, Condition aggravated, Dizziness, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (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: patient had MMR vaccine at the age of 7 years old- shortly after patient experienced juvenile arthritis and could not move for o
Other Medications: thyroid, cholesterol, blood pressure, asthma, mood
Current Illness: asthma
Preexisting Conditions: asthma
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient experienced lower back pain, nausea, dizziness, tightness in chest, asthma symptoms patient went to see the primary doctor and was evaluated


VAERS ID: 1428092 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Hypoaesthesia, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: pt did not seek medical attention until a week later
CDC Split Type:

Write-up: pt states approximately 24 hours after the vaccination he noticed, numbness and tingling of his left arm and a heaviness in his chest. symptoms have improved over the past week. He did not seek medical attention when the symptoms first started.


VAERS ID: 1428237 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure measurement, Pallor, Peripheral coldness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: BLOOD PRESSURE
CDC Split Type:

Write-up: PATIENT CAME WITH HER PARENTS TO DO SECOND DOSE OF COVID 19 (PFIZER) . PATIENT WAS SCREENED ABOUT FIRST DOSE REACTION THE PATIENT INFORMED US IT WAS ONLY ARM PAIN .A FEW MINUTES AFTER 2ND DOSE PATIENT HAD A POSSIBLE SYNCOPE EPISODE . PATEINT WAS CONSULTED TO WAIT AND SIT FOR 15 MINUTES AFTER HER VACCINATION BUT A FEW MINUTES AFTER THE SHOT SHE CLOSED HER EYES AND HER DAD WAS HOLDING HER IN BETWEEN AISLE 18 AND WE PUT HER TO SIT DOWN SHE OPENED HER EYES ALMOST RIGHT AWAY BUT HER FACE/LIPS WERE PALE AND HANDS GOT COLD SHE RECOVERED IN LESS THEN 5 MINUTES AND WAS RESPONDING BY THE TIME THE AMBULANCE CAME PATIENT REMAINED IN THE CHAIR FOR 30 MINS AND THEN LEFT WITH PARENTS. PHARMACIST CALLED SOC AND REPORTED INCIDENT


VAERS ID: 1428251 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Hyperhidrosis, Therapeutic response unexpected, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant 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: Tdap
Other Medications: Synthroid 88 mcg
Current Illness: No illnesses but I was breastfeeding
Preexisting Conditions: Hypothyroidism
Allergies: Cephalosporin
Diagnostic Lab Data:
CDC Split Type:

Write-up: I was sweating profusely and lost 2 pounds over night. I got my thyroid levels checked 3 days later and it was indicated that I no longer needed my thyroid medication for my hypothyroidism.


VAERS ID: 1428268 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site pain, Limb discomfort, Lymphadenopathy, Periorbital swelling, Peripheral swelling, Pyrexia, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: On 6/19 patient had had mild fever, sore arm (as expected at injection site), and general fatigue (as expected). On 6/20 both of his feet were swollen and it felt as if he was walking on marbles. 6/21 feet had gone down and were normal but later in the day lymph nodes in neck were swollen and he developed a lump on the back of his neck. On 6/22 the neck swelling went away but he then developed left hand and lower left arm swelling. On 6/23 the left hand/arm had gone down but the right hand/arm was swollen. On 6/24 patient experienced swelling around the eyes.


VAERS ID: 1429286 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-06-19
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, Product administration error, 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: USJNJFOC20210643467

Write-up: POSSIBLE ADMINISTRATION ERROR; INCORRECT PRODUCT STORAGE; OUT OF SPECIFICATION PRODUCT USE; This spontaneous report received from a physician concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 19-JUN-2021, the subject experienced possible administration error. On 19-JUN-2021, the subject experienced incorrect product storage. On 19-JUN-2021, the subject experienced out of specification product use. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the possible administration error, incorrect product storage and out of specification product use was not reported. This report was non-serious.


VAERS ID: 1429694 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-08
Onset:2021-06-19
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiovascular evaluation, Fatigue, Musculoskeletal stiffness, Pain in extremity
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Cardiac studies 6/19/2021
CDC Split Type:

Write-up: Left arm sore, stiff, and tired it led me to believe I was having a heart attack and had to go the ER the doctor at the time stated I didn''t have a heart attack nor had any visible signs of heart damage


VAERS ID: 1429815 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-12
Onset:2021-06-19
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Myalgia, Pyrexia, Troponin I increased, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: tylenol as needed for fever
Current Illness: None
Preexisting Conditions: None
Allergies: amoxicillin (From AUGMENTIN) (RASHES AND HIVES 06/25/21) clavulanic acid (From AUGMENTIN) (RASHES AND HIVES 06/25/21)
Diagnostic Lab Data: Troponin I elevated to 2.59 (06/25/2021) WBC 16.8 (06/25/2021) will get Cardiac mri and Transthoracic echo
CDC Split Type:

Write-up: Possible myocarditis (came in with high grade fevers one week after getting vaccinated, chest pains and muscle aches, elevated troponin and white blood cell counts)


VAERS ID: 1429945 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / IM

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

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

Write-up: unknown


VAERS ID: 1429958 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / IM

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

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

Write-up: unknown


VAERS ID: 1429962 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / IM

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

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

Write-up: unknown


VAERS ID: 1429965 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / IM

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

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

Write-up: unknown


VAERS ID: 1429968 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / IM

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

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

Write-up: unknown


VAERS ID: 1429972 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / IM

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

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

Write-up: unknown


VAERS ID: 1429977 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / IM

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

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

Write-up: unknown


VAERS ID: 1429979 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / IM

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

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

Write-up: Unknown


VAERS ID: 1429982 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / IM

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

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

Write-up: unknown


VAERS ID: 1429989 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / IM

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

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

Write-up: unknown


VAERS ID: 1429994 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / IM

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

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

Write-up: unknown


VAERS ID: 1429997 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / IM

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

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

Write-up: unknown


VAERS ID: 1430003 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / IM

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

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

Write-up: unknown


VAERS ID: 1430007 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 RA / IM

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

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

Write-up: unknown


VAERS ID: 1430011 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 RA / IM

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

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

Write-up: unknown


VAERS ID: 1430012 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 1 LA / IM

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

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

Write-up: unknown


VAERS ID: 1430038 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-05-24
Onset:2021-06-19
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, C-reactive protein, Differential white blood cell count, Red blood cell sedimentation rate, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hearing impairment (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: ESR, C=Reactive Protein (Inflammation), Blood Count wit Differential
CDC Split Type:

Write-up: On June 19th I felt swelling on the left side of the face, then within few hours left side of the face become paralyzed, at the Emergency Room was diagnosed with Bell''s Palsy.


VAERS ID: 1430377 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW018 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Eructation, Feeling hot, Flatulence, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient states loss of apatite, flatulence, burping, feeling hot and sweating since day after Vaccine


VAERS ID: 1430477 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Herpes zoster, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Red bump appeared on right side of abdomen adjacent to the naval the next day after receiving second covid-19 vaccine. Patient initially assumed it was a bug bite. Red bump grew in size and smaller bumps appeared around the initial bump three days later. Patient made a doctors appointment on sixth day and diagnosed with shingles. Doctor prescribed Famciclovir and Gabapentin TID for seven days. Prescription is still in progress.


VAERS ID: 1430590 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Inappropriate schedule of product administration, Rash, Rash pruritic, Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Medication errors (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports she feels like her hives are related to an allergy to the maternal vaccine. Patient reports she had her first dose in the beginning of June, about 1-1/2 weeks following her dose she experienced an itching rash, and sensation that her throat was closing. She presented to an urgent care who told her she had anaphylaxis, prescribed her an EpiPen and steroids that she states that she takes as needed. After her second dose on 6/19 patient reports she woke up at 1 AM and had similar sensation of throat closing and itching rash. She has been seen at urgent care and her primary care doctor. She presented today due to frequent episodes over the last 24 hours starting at 4 AM this morning. She states she self administered an EpiPen at 4 AM, and then presented to the emergency room here. She left without being seen. She returned this evening due to persistent symptoms. Most troublesome to her is her rash that is itching, is located on her face trunk arms. ED visit, Non-prescription medication, Prescription medication Shortness of breath


VAERS ID: 1430611 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-17
Onset:2021-06-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Fatigue, Hypersensitivity, Mononucleosis heterophile test negative, Pain, Pharyngeal swelling, Pyrexia, Streptococcus test
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Lo lo estrin
Current Illness:
Preexisting Conditions:
Allergies: Clyndamycin
Diagnostic Lab Data: Strep test, mono test (both negative) administered 06/26/2021
CDC Split Type:

Write-up: Fever, swollen eyes, swollen throat, fatigue, body aches , still present almost 2 weeks after vaccine. Allergic reaction (swollen eyes abs throat) occurred 5 days after vaccine


VAERS ID: 1430641 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-11
Onset:2021-06-19
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Menstruation irregular, Rash
SMQs:, Anaphylactic reaction (broad), Fertility 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: On June 19th I developed a tiny rash on my hip and began spotting in between my period, something that never happens. The spotting only lasted one day and although I was concerned, I read that this is common with women who get vaccinated. This past weekend however, on June 26th, I began itching extremely bad near the top of my vagina. I wasn''t sure what it was as it wasn''t occuring anywhere near the opening of my vagina, but closer to the top under the abdomen. The itching began spreading all over my body, from my scalp to the webs of my fingers, my ears and face, toes, everywhere! Bumps that resemble lots of mosquito bites or hives initially began forming on my stomach yesterday, now I have bumps on the back of my neck, my arms, stomach and back and I have an intense, now burning itch all over my body.


VAERS ID: 1430643 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-02-20
Onset:2021-06-19
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Gait disturbance, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metoprolol, atorvastatin, baby asprin, Allegra
Current Illness: high blood presssure, allergies,
Preexisting Conditions: periodic episodes over 20 years (at least one followed reception of a vaccine): change in gait, loss of balance, weakness in legs, unable to complete balance test without falling
Allergies: night shade vegetables, pollen, mold
Diagnostic Lab Data: none scheduled at this time appointment with primary care is scheduled
CDC Split Type:

Write-up: Change in gait, loss of balance, inability to complete balance test (self administered) weakness in legs, exacerbated by: length of time standing, lateness in the day, hot weather


VAERS ID: 1430938 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-13
Onset:2021-06-19
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal distension, Back pain, Dizziness, Headache, Joint swelling, Pelvic pain, Spinal pain, Swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: My first shot was 4/15/2021 and my second shot was 5/13/2021. I experienced the same type of reaction to both shots, but at different stages and extremes. From my first shot on 4/15/2021. I felt fine until 3 weeks later on 5/5/2021 when my back started aching, then at the base of my spine, it felt like fluid was collected at the base and it was extreme pain - I could not sit down or bend over for a week. After a few days it started to get better, but then my knee started swelling and I could not do simple tasks for 2 days. I could not walk down the stairs, but then on 5/12/2021 it seemed to rectify itself. I did tell the nurse about my ailments before my second shot and they said they had not heard of anyone having these symptoms, and said perhaps I should not get the 2nd shot, but I was told that I had to for my job and I just wanted to get it over with. A friend of mine had said she experienced the same back pain, so I thought maybe it was just a vaccine side effect and decided to get the second shot on 5/13/2021. The next day was brutal. I had a headache so bad for 4 days I could not think or do any work or even leave my bed. On the 2nd and 3rd day I was dizzy - the room was spinning like I was drunk and so I stayed in bed, but then on Tuesday, 5/17/2021 I started to feel better and the headache went away. Then I felt fine for several weeks until 6/19/2021. I started to get a backache, then my stomach swelled like I was having period cramps, but it was 2 weeks until my period, so I should not feel this. My uterus felt so swollen and painful. My back started to hurt badly and fluid felt like it was collecting on the base of my spine again. I could not sit down or get up from bed or bend over from the pain. This lasted for 9 days until it slowly alleviated. But one thing that was different in this episode is that a lump suddenly appeared on my inner right thigh. I read an article that the vaccine causes swollen lymph nodes. I assume that is what it is. It showed up on 6/19/2021 and as of today, 6/28/2021 it is still there. I have not seen a doctor because I have no primary care physician at the moment. I am monitoring my thigh lump, it seems to have gone down slightly, but it is still there today (6/28/2021). My back still hurts slightly, but not as bad. I am continuing to monitor my symptoms.


VAERS ID: 1431051 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-10
Onset:2021-06-19
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dry skin, Headache, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: sleep apnea chronic back pain broadline high blood pressure
Allergies:
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I had dry, itchy skin all over. If I touch any area, it will itch and get a rash. If I touch another part, it will do the same. I went to my doctors about it. She told me to try Benadryl. I try over-the-concern medicine cream and aloe. Nothing is helping. The rashes are light, and they do fade away if I do not touch them. It still does itch. I also had a couple of headaches as well.


VAERS ID: 1431208 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0810 / 1 LA / IM

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

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

Write-up: Patient received vaccine after the manufacturer recommended freezer time.


VAERS ID: 1431213 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0810 / 1 LA / 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: Patient received vaccine after the manufacturer recommended freezer time.


VAERS ID: 1431231 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0810 / 1 LA / 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: Patient received vaccine after the manufacturer recommended freezer time.


VAERS ID: 1431236 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0810 / 2 LA / IM

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

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

Write-up: Patient received vaccine after the manufacturer recommended freezer time.


VAERS ID: 1431240 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0810 / 1 LA / IM

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

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

Write-up: Patient received vaccine after the manufacturer recommended freezer time.


VAERS ID: 1431248 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0810 / 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: Patient received vaccine after the manufacturer recommended freezer time.


VAERS ID: 1431253 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0810 / 2 LA / IM

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

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

Write-up: Patient received vaccine after the manufacturer recommended freezer time.


VAERS ID: 1431256 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0810 / 1 LA / IM

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

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

Write-up: Patient received vaccine after the manufacturer recommended freezer time.


VAERS ID: 1431263 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0810 / 2 LA / IM

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

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

Write-up: Patient received vaccine after the manufacturer recommended freezer time.


VAERS ID: 1431269 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0810 / 1 LA / IM

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

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

Write-up: Patient received vaccine after the manufacturer recommended freezer time.


VAERS ID: 1431273 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0810 / 1 LA / 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: Patient received vaccine after the manufacturer recommended freezer time.


VAERS ID: 1431276 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0810 / 1 LA / IM

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

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

Write-up: Patient received vaccine after the manufacturer recommended freezer time.


VAERS ID: 1431280 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0810 / 1 LA / IM

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

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

Write-up: Patient received vaccine after the manufacturer recommended freezer time.


VAERS ID: 1431284 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0810 / 1 RA / 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: Patient received vaccine after the manufacturer recommended freezer time.


VAERS ID: 1431286 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0810 / 2 LA / IM

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

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

Write-up: Patient received vaccine after the manufacturer recommended freezer time.


VAERS ID: 1431290 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0810 / 2 LA / IM

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

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

Write-up: Patient received vaccine after the manufacturer recommended freezer time.


VAERS ID: 1431293 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0810 / 2 LA / IM

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? 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 vaccine after the manufacturer recommended freezer time.


VAERS ID: 1431301 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-17
Onset:2021-06-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chronic obstructive pulmonary disease, Condition aggravated
SMQs:

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

Write-up: Admission for COPD exacerbation


VAERS ID: 1431324 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-17
Onset:2021-06-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / UNK LA / SYR

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

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

Write-up: 06/18/21 Felt very tiered. 06/19/21 Got chills and nauseous, laid down on sofa w thick blanket for 2 hours. After chills my body started developing small itchy hives. Drank allergy pill at 12am cuz the hives were getting worst. 6/20/21 Still with itchy hives all over body, placed baking soda were the itch was to calm it down but no success. 6/23/21 Went to doctor and was prescribed Methylprednisolone 4mg #21, today was my last pill and the itch and hives are uncontrolable. On 6/27/21 started spraying SkinSmart Antimicrobial Eczema Therapy Skin Cleanser Spray which help a little to control the itch but not totally. My body looks like I had a bad burn on all my body folds and some scatter spots with hives and others with vesicles.


VAERS ID: 1431376 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-06-09
Onset:2021-06-19
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Seen in Urgent Care 6/21/2021, treated with Prednisone
CDC Split Type:

Write-up: Hives started 6/19/2021


VAERS ID: 1431449 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 RA / -

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: no
Current Illness: no
Preexisting Conditions: no
Allergies: peanuts
Diagnostic Lab Data: no
CDC Split Type:

Write-up: Patient father report that she has broken out in hives on her arms and legs... it comes and goes...


VAERS ID: 1431983 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear pain, Facial pain, Herpes zoster
SMQs:, Glaucoma (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: Levothyroxine, topimax, musinex, Zyrtec, asmanex, vitamin d, vitamin b12, vitamin c, Xopenex
Current Illness: N/A
Preexisting Conditions: Pseudotumor cerebri, asthma, hypothyroid
Allergies: Sulfa, penicillin, keflex
Diagnostic Lab Data:
CDC Split Type:

Write-up: shingles -outbreak on left side face, in mouth, sinus. Also face and ear pain. Ongoing treatment is antiviral meds and antibiotics. I have been under the care of my General Physician and ophthalmologist.


VAERS ID: 1432941 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-03-31
Onset:2021-06-19
   Days after vaccination:80
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Herpes zoster, Hypoaesthesia, Pain in extremity, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (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: Low dose estrogen
Current Illness: None
Preexisting Conditions: Raynauds
Allergies: None known
Diagnostic Lab Data: Office visit to urgent care where Dr confirmed that I had shingles.
CDC Split Type:

Write-up: Quickly after receiving the second dose I experienced numbness in my right big toe. That went on for at least a couple weeks. Then this month I experienced pain around my upper right leg and hip area and thought initially that it was bursitis or arthritis in my hip. However, a rash then broke out and I was diagnosed Sunday with shingles.I have read extensively that incidence of shingles have increased following the COVID-19 vaccine especially those with autoimmune issues like me where I have Raynauds.


VAERS ID: 1433144 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-03
Onset:2021-06-19
   Days after vaccination:136
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / UNK - / -

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

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

Write-up: I31.9 - Disease of pericardium, unspecified I31.9 - Pericarditis


VAERS ID: 1433157 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-06-12
Onset:2021-06-19
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chills, Decreased appetite, Diarrhoea, Dizziness, Feeling cold, Head discomfort, Headache, Myalgia, Pain, Pyrexia, SARS-CoV-2 test negative, Tinnitus
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Vitamin C
Current Illness: None
Preexisting Conditions: None
Allergies: Only allergies are to wasp and hornet venom.
Diagnostic Lab Data: On Sunday, June 20th, I went to Urgent care to get tested for Covid. I tested negative and they told me it could be a viral infection. It seems too coincidental to be a viral infection so close to my shot. Not to mention, I keep seeing these side effects listed by others who have had the vaccine.
CDC Split Type:

Write-up: Starting exactly one week after the first shot, on Saturday June 19th, I started to feel extremely weak and cold, I checked my temperature. My fever was 101.5. I was having extreme muscle aches and cold chills. On Sunday, June 20th, my fever continued as 101.6 and I started to have joint pains along with the muscle/body pains. I had a major headache and I started to get extreme diarrhea, every 20-30 minutes. When I stood up my head would throb, and my ears would ring, and I would get the ?wa-wa?s? in my ears and I would feel like I was going to pass out. It felt like there was extreme pressure in my skull almost. On June 19th I started taking Tylenol to help reduce my body pain and fever. It was not working so on the 21st I switched to Motrin. My fever continued while taking Motrin, but it did start to go down. I started drinking Gatorade on the 19th and then I switched to Pedialyte on the 21st, Pedialyte seemed to help more. I did not have an appetite and did not eat. The cold chills and fever continued until Wednesday morning, June 23rd. Once my fever broke my body aches started to subside. However, the diarrhea and headache has continued even until currently, June 29th.


VAERS ID: 1433163 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Injection site pain, Rash erythematous, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: The day she got her shot the had lots of pain in the site of the shot, and got a red rash that same afternoon. This past week it looks like a bruise on the left side of her neck all the way across to the right side. It also is going down the back of her neck looks dark in color.


VAERS ID: 1433228 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / UNK RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Conjunctival haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Conjunctival disorders (narrow)

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

Write-up: Moderna COVID-19 Vaccine EUA Hyposphagma(Subconjunctival hemorrhage), left eye, at 11:00 am 19 Jun 21 Can I take a second shot even this symptoms occurred?


VAERS ID: 1433283 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-16
Onset:2021-06-19
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine, CBD Oil
Current Illness: Sinuses
Preexisting Conditions: Missing right facet joint between L5 / S1 vertebrae.
Allergies: PCN, Amoxicillin, Bactrim, Zithromax, Flagyl, Vicodin, Percocet, Darvocet, Hydrocodone, Peanuts, Tree Nuts, Coconut, Lactose
Diagnostic Lab Data:
CDC Split Type:

Write-up: Reactive lymph node on right side by collar bone. Monitoring. Slowly decreasing in size.


VAERS ID: 1433296 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-16
Onset:2021-06-19
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Haematoma, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: injection site pain
Other Medications: Raberpazole Sod DR, Gabapentin, Testosterone, Lisinopril, Amlodipine Besllylate, Detamethsone VA lotion, Betamethsone DA ointment, Hydorcortisone cream, asprin, glucosamine and chondroitin with MSM, Vitamin D-3, Zinc, Garlic Oil, C complex,
Current Illness: none identified
Preexisting Conditions: hypertension, arthritis, psoriasis.
Allergies: non known
Diagnostic Lab Data: none
CDC Split Type:

Write-up: sever hematoma, pain, under arm swelling


VAERS ID: 1433329 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

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

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

Write-up: Patient received the dose after the manufacturer recommended freezer storage duration.


VAERS ID: 1433333 (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: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / 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: Patient received the dose after the manufacturer recommended freezer storage duration.


VAERS ID: 1433338 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

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

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

Write-up: Patient received the dose after the manufacturer recommended freezer storage duration.


VAERS ID: 1433340 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cough, Headache, Hypoaesthesia, Hypoaesthesia oral, Influenza like illness, Musculoskeletal stiffness, Nausea, Pain, Paraesthesia, Paraesthesia oral, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hypertension (does not take medication)
Allergies: Affexor, Albuterol-hives
Diagnostic Lab Data: None
CDC Split Type:

Write-up: One day 1, after vaccine, patient had flu-like symptoms with low grade fever, nausea, headache, body aches x 4 days. Around day 3, symptoms of severe headache with stiff neck and dry cough started along with tingling and numbness of shoulders, arms, hands, lips, legs bilaterally. These symptoms continue today.


VAERS ID: 1433343 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 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: Patient received the dose after the manufacturer recommended freezer storage duration.


VAERS ID: 1433407 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-04-07
Onset:2021-06-19
   Days after vaccination:73
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood culture negative, Blood test abnormal, Burning sensation, Catheterisation cardiac normal, Chest pain, Culture urine negative, Dyspepsia, Echocardiogram, Electrocardiogram normal, Myocarditis, Pericarditis, Troponin increased, Urine analysis normal, Viral test negative
SMQs:, Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Allegra and Nexium
Current Illness: No illness at or before vaccination
Preexisting Conditions: None
Allergies: Eggs. No medication allergies
Diagnostic Lab Data: Heart cath- No blockage found Blood cultures- Negative Blood test for viruses- Negative Urinalysis- Negative Urine Culture- Negative
CDC Split Type:

Write-up: On June 19, 2021 I woke up around 6:00 a.m. having extreme chest pains. I went to the Emergency Room to be treated. They did an EKG, blood work, and an ultrasound of my heart. My EKG was negative for a heart attack, but my blood work was positive because of my Troponins were elevated. They gave me some aspirin and the chest pain went away. I was admitted into the hospital where I stayed until the end of the day on June 21, 2021. On June 20, 2021 they continued to watch my vitals, took tons of blood for blood cultures and for pretty much every virus you can get along with urine samples as well. All of the test for any virus and the blood cultures were negative. The urinalysis and urine culture were negative as well. Once all test came back negative, the cardiologist ordered a Heart cath. The heart cath was performed on June 21, 2021 and there was no blockage in any of my arteries and everything was clear so I was discharged that afternoon from the hospital. I was diagnosed with Myocarditis or Pericarditis. The doctor prescribed me 25MG Captopril to take 3 times daily and 25 MG Metoprolol Tartrate to take 2 times daily. I have only experienced any other affects a few times since being released which was a burning sensation in my check. I spoke with the doctor and they told me it could be indigestion or heart burn.


VAERS ID: 1433415 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthma, Condition aggravated, Cough, Productive cough, Pyrexia, Respiratory tract congestion, Secretion discharge, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: Inhaler (for Asthma)
Current Illness: Asthma
Preexisting Conditions: Asthma
Allergies: N/A
Diagnostic Lab Data: Asthma flared up
CDC Split Type: vsafe

Write-up: Went to go get the vaccine a little after 10am, later that night after 10PM the adverse event began. She started wheezing and coughing sounding very congested, she did take her inhaler that evening. On the following Sunday she was still congested and the coughing wasn''t getting better which lead to taking cough syrup. That Monday she went to work however she was coughing later that night and mucus was coming up. On Tuesday she went to the doctor and was told she was okay and that everything will be fine. Two days later she had a fever running into that Saturday which lead to going to the hospital following speaking to her pediatrician. She was giving antibiotics and Prednisone at the hospital visit.


VAERS ID: 1433726 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-16
Onset:2021-06-19
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abnormal uterine bleeding, Vaginal haemorrhage
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: N93.9 - Abnormal uterine and vaginal bleeding, unspecified


VAERS ID: 1433756 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Blood test, Chills, Hyperhidrosis, Migraine, Myalgia, Scan with contrast normal, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine
Current Illness: no
Preexisting Conditions: Hypo-thyroidism
Allergies: Penicillin; Propylene Glycol
Diagnostic Lab Data: ER - Friday - a week later - Blood tests - didn''t see results ER - CT scan with contrast - came back normal
CDC Split Type: vsafe

Write-up: First night, I had severe chills and sweats off and on throughout the night; including muscle and joint pain that was severe. Fatigue, joint pain and an occasional chill (better then the next day). Monday - Joint pain and occasional chills - those continued for the rest of the week and Wednesday I also had a migraine headache. Friday - severe migraine and vomiting and my doctor sent me to ER. Medication for the Migraine - three different things - one was an IV Benadryl - the others I don''t know. That cleared my symptoms up that same day just a couple hours later. I have been fine every since.


VAERS ID: 1434003 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Eye discharge, Ocular hyperaemia
SMQs:, Anaphylactic reaction (broad), Glaucoma (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: vsafe

Write-up: Around 6-7:30 pm on the 19th of June, my wife told me that my eye was started to turn red. I tried at first to put allergy drops in it. The next morning I had yellow discharge coming from my eye. I went to the doctor on Sunday and they did not know what it was, they ruled out conjunctivitis. They did prescribed me a medication to use. About two days after of using the medication I felt like it was not needed anymore. About a few days after that the redness went away until it was completely gone.


VAERS ID: 1434052 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Electrocardiogram abnormal, Myocardial infarction, Neck pain, Stent placement
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: gabepentan, bytosin 10mg,
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: ekg - heart attack
CDC Split Type:

Write-up: next day chest pressure, lasted days off & on, neck shoulders hurt, stents from heart attack


VAERS ID: 1434702 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-08
Onset:2021-06-19
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033821A / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Computerised tomogram head normal, Hemiparesis, Hemiplegia, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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:
Current Illness:
Preexisting Conditions: UNSPECIFIED ATRIAL FIBRILLATION, DYSPHAGIA FOLLOWING CEREBRAL INFARCTION, OTHER SYMPTOMS AND SIGNS INVOLVING COGNITIVE FUNCTIONS FOLLOWING OTHER CEREBROVASCULAR DISEASE, MUSCLE WEAKNESS (GENERALIZED), ESSENTIAL (PRIMARY) HYPERTENSION, CHRONIC DIASTOLIC (CONGESTIVE) HEART FAILURE, CONTACT WITH AND (SUSPECTED) EXPOSURE TO COVID-19, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, UNSPECIFIED
Allergies:
Diagnostic Lab Data: CT Ordered Results charted on 6/23/2021 CT demonstrates no acute intracranial abnormality.
CDC Split Type:

Write-up: Noted increased weakness on R side compared to L side - appears drowsier than baseline. HEMIPLEGIA, UNSPECIFIED AFFECTING RIGHT DOMINANT SIDE


VAERS ID: 1435092 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fall, Nausea, Posture abnormal, Vomiting
SMQs:, Acute pancreatitis (broad), Dystonia (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none reported by client
Current Illness: none reported by the client.
Preexisting Conditions: none reported by the client.
Allergies: none reported by client.
Diagnostic Lab Data: none at public health clinic
CDC Split Type:

Write-up: On Saturday, April 17, 2021 client received her first dose of Pfizer COVID vaccine (LOT #EW0217 , EXP 7/15/2021) at approximately 2:20 pm. After vaccine was administered, client directed to observation area for 15 minutes. At 2:25pm, RN observed the client leaning forward in chair and noted that client was falling toward floor. Ae, RN responded at 2:25pm with EMT. RN responded at 2:25 pm. RN found client on the floor in prone position. Client stating she needs to vomit. Client prompted to lay on one side with help of RN. Upon assessment, client alert and oriented to self, place, and situation. Client denied allergies. RN offered client Benadryl IM. Client denied stating "it makes me sick". RN gave direction to EMT to call 911. Client admits to history of "vasovagal reactions" after lab blood draw procedures. At vitals were taken: BP: , HR: , RR: O2 sat: %. Vitals at 2:25 pm: BP: 110/70, HR: 58, O2 sat: 98%. Client denied shortness of breath, swelling of throat or tongue, chest pain, difficulty swallowing, palpitations, or dizziness. Nausea and vomiting resolved at 2:26 pm. Vitals at 2:31pm: BP: 114/70, HR: 59, O2 sat: 97%. At approximately 2:34pm, EMS arrived on seen. RN provided report and informed EMS that client denied benadryl. Client transported to ambulance vehicle at 2:42pm. Per EMS, client signed against medical advice and will be taken home by step mother. RN observed client until client was picked up in by step mother. Client was educated by Lead RN on signs and symptoms of adverse reactions and when to go to the ED/call MD. Client was also encouraged to follow up with PCP as soon as possible. Client was able to ambulate with Lead RN to her car unassisted with a steady gait at approximately pm. Client was driven by step mother.


VAERS ID: 1435858 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-06-19
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cough, Headache, Myalgia, Oropharyngeal pain, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210654249

Write-up: COUGH; SORE THROAT; RUNNY NOSE; MUSCLE PAIN; SEVERE HEADACHE; This spontaneous report received from a patient concerned a 38 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, and batch number: 204A21A expiry: UNKNOWN) dose was not reported, administered on 11-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 19-JUN-2021, the subject experienced cough. On 19-JUN-2021, the subject experienced sore throat. On 19-JUN-2021, the subject experienced runny nose. On 19-JUN-2021, the subject experienced muscle pain. On 19-JUN-2021, the subject experienced severe headache. On 20-JUN-2021, treatment medications included: dextromethorphan hydrobromide/doxylamine succinate/ephedrine sulfate/ethanol/paracetamol, fexofenadine, ibuprofen, naproxen, and paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from severe headache, cough, sore throat, runny nose, and muscle pain. This report was non-serious.


VAERS ID: 1435956 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-29
Onset:2021-06-19
   Days after vaccination:82
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Ischaemic stroke, Product dose omission issue
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (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:
Current Illness: Atrial fibrillation; Hyperlipidemia; Hypertension; Type II diabetes mellitus
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: She never received her second dose; Suffered from an acute ischemic stroke; This spontaneous case was reported by an other health care professional and describes the occurrence of ISCHAEMIC STROKE (Suffered from an acute ischemic stroke) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Hypertension, Hyperlipidemia, Type II diabetes mellitus and Atrial fibrillation. On 29-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Jun-2021, the patient experienced ISCHAEMIC STROKE (Suffered from an acute ischemic stroke) (seriousness criterion medically significant). On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (She never received her second dose). At the time of the report, ISCHAEMIC STROKE (Suffered from an acute ischemic stroke) and PRODUCT DOSE OMISSION ISSUE (She never received her second dose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not reported. Treatment information was unknown. This report refers to a case of Product dose omission issue for mRNA-1273, with associated adverse event of Ischemic stroke. Very limited information regarding this event has been provided at this time. However, multiple underlying co-morbidities may remain as confounding factors. Further information has been requested.; Sender''s Comments: This report refers to a case of Product dose omission issue for mRNA-1273, with associated adverse event of Ischaemic stroke.Very limited information regarding this event has been provided at this time. However, multiple underlying co-morbidities may remain as confounding factors.Further information has been requested.


VAERS ID: 1435964 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Nausea, Vaccination site reaction
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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LAMICTAL; KEPPRA [LEVETIRACETAM]; TEGRETOL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Epilepsy; Vertigo (Get really dizzy.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: she was admitted to hospital due to big reaction after getting the first shot; nausea; the dizziness hit her/ woke up at 8pm and dizziness was still there and kept on going; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE REACTION (she was admitted to hospital due to big reaction after getting the first shot) in a 47-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 051C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Epilepsy and Vertigo (Get really dizzy.). Concomitant products included LAMOTRIGINE (LAMICTAL), LEVETIRACETAM (KEPPRA [LEVETIRACETAM]) and CARBAMAZEPINE (TEGRETOL) for an unknown indication. On 19-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Jun-2021, the patient experienced VACCINATION SITE REACTION (she was admitted to hospital due to big reaction after getting the first shot) (seriousness criterion hospitalization) and DIZZINESS (the dizziness hit her/ woke up at 8pm and dizziness was still there and kept on going). On an unknown date, the patient experienced NAUSEA (nausea). The patient was hospitalized on 19-Jun-2021 due to VACCINATION SITE REACTION. At the time of the report, VACCINATION SITE REACTION (she was admitted to hospital due to big reaction after getting the first shot), DIZZINESS (the dizziness hit her/ woke up at 8pm and dizziness was still there and kept on going) and NAUSEA (nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. On 20-Jun-2021 patient went to the hospital and had blood work done but no results were reported. Treatment reported is unknown nausea medication. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1437343 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Cardiac imaging procedure, Carditis, Chest pain, Fatigue, Troponin increased
SMQs:, Myocardial infarction (narrow), 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? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: heart scan blood work 2 times a day
CDC Split Type:

Write-up: My son experienced chest pain and was very tired - Sat 6/19 - I thought normal Sunday 6/20 - seemed normal Monday 6/21 at 11 am severe chest pain. Taken to hospital - was hospitalized with heart inflammation and very high troponin numbers until Thursday 6/24 - numbers were still elevated but he was allowed to go home since the numbers where on the downward trajectory Has a follow up apt 7/2 @ 3 pm.


VAERS ID: 1437507 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Delaware  
Vaccinated:2021-06-09
Onset:2021-06-19
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Chest discomfort
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Tachyarrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: nothing
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: Felt like I had a quick heart attack on 6-19-21. Since then I''ve been having fluttering, and tightness in my chest.


VAERS ID: 1437581 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-15
Onset:2021-06-19
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: na
Current Illness: na
Preexisting Conditions: na
Allergies: penicillin-rashes throughout the body
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Mild numbness on the anterior surface of the right thigh.


VAERS ID: 1437815 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-19
Onset:2021-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Blood test, Chest pain, Coagulation test, Diarrhoea, Headache, Heparin-induced thrombocytopenia test, Hypotension, Nausea, Platelet count decreased, Pleuritic pain, Pyrexia, Resuscitation, Tachycardia, Thrombocytopenia, Transaminases increased, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ibuprofen
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Thrombocytopenia, Transmaminitis, HIT ab negative, No signs of hemolysis or clotting or bleeding.
CDC Split Type:

Write-up: Headache, fever, nausea, vomiting, diarrhea, pleuritic chest pain starting 6 hours after the second dose of vaccine. Patient reported to the hospital 6 days later(6/25/2021), found to be febrile, tachycardic, hypotensive, concerning for septic shock, also had thrombocytopenia, transaminitis, and Acute Kidney injury. Patient resuscitated with IVF, pressors with improvement in blood pressure and renal function. Patient entire workup as of 6/30/2021 has been negative. Patient continues to spike high fevers to 103, and the etiology of this is unclear at this time.


VAERS ID: 1437910 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Impaired work ability
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: Shingrix, age 64, pain so bad needed to take hydrocodone
Other Medications: estradial, progesterone, S-ame, multi vitamin, naltrexone
Current Illness:
Preexisting Conditions: fibromyalgia
Allergies: dairy, gluten
Diagnostic Lab Data:
CDC Split Type:

Write-up: severe exhaustion to the point of not being able to work a full day - have had to come home half way through work day for over a week.


VAERS ID: 1437956 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Erythema, Feeling of despair, Headache, Migraine, Nausea, Pain in extremity, Pyrexia, Vision blurred, Visual impairment
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (narrow), Hypersensitivity (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: I had breast cancer, but they removed them. I recovered.
Allergies: centrum silver vitamins went into anaphylaxis shock
Diagnostic Lab Data: I have an appointment with my doctor this week.
CDC Split Type: vsafe

Write-up: 24 hours after the vaccination, my arm started hurt, the next 2 my arm was red, a diameter of 4 inches, I had nausea, migraine, fever. I had to rotate Motrin and Tylenol every 4 hours. I have recovered from all my symptoms except I still have massive headaches, my vision changed. I noticed something different with my eyes and it was pretty immediate after my vaccination, within 3 days. I had just had a vision check up, prior to the vaccine. Now my vision has changed, I see blurry now and I continually have real bad headaches, migraine type headaches. And I never had headaches before. I have to take Tylenol and Motrin every day for my headaches. It''s caused me anxiety and loss of hope.


VAERS ID: 1437981 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Headache, Hyperhidrosis, Hyperventilation, Hypokinesia, Sensitive skin
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: About 7- hours after injected, woke up in the middle of the night hyperventilating and unable to move. Sweating and sensitive skin all on the body. Headaches that have been constant for the past week and a half and chest pain


VAERS ID: 1438272 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-02
Onset:2021-06-19
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Balance disorder, Blood test, Electric shock sensation, Fatigue, Feeling abnormal, Memory impairment, Urine analysis
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Vestibular 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: adderall
Current Illness: None known
Preexisting Conditions: none known
Allergies: NA
Diagnostic Lab Data: blood and urine
CDC Split Type:

Write-up: electrical type zaps all over body. Memory issues, brain fog, exhaustion, balance off. Not feeling like myself. Hard to complete tasks as before getting dose 2. I did not get this feeling from dose 1, I experienced the first zap about 30 mins after the first dose. This was sharp and direct zap and it was on the tip of my nose. It felt like a current was going through me.


VAERS ID: 1438443 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Feeling cold, Hot flush
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: Sertraline 150mg
Current Illness: None
Preexisting Conditions: None
Allergies: Augmentin and morphine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Hot/cold flashes lasting greater than 10 days


VAERS ID: 1440007 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-06-18
Onset:2021-06-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Illness, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: USPFIZER INC2021741920

Write-up: they both woke up at 4:00 in the morning vomiting and its been 6 hours of non stop throwing up; extremely ill; This is a spontaneous report from a contactable consumer or other non-health care professional (Parent to patient). A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot number and expiration date was not reported), via an unspecified route of administration on 18Jun2021 as dose number unknown, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. On 19Jun2021 04:00 the patient woke up at 4:00 in the morning vomiting and had 6 hours of non stop throwing up and are extremely ill. Primary reporter (parent) just don''t know whom else to call what to do other than going to the emergency room. The outcome of the events was unknown. Follow up needed, further information was requested.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-2021741983 same reporter/drug/event, different patient


VAERS ID: 1440029 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-14
Onset:2021-06-19
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 1 LA / -

Administered by: Military       Purchased by: ?
Symptoms: Chest discomfort, Chills, Cold sweat, Cough, Decreased appetite, Headache, Hot flush, Oropharyngeal pain, Productive cough, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210621; Test Name: Covid; Test Result: Positive
CDC Split Type: USPFIZER INC2021749078

Write-up: did not want to eat; flushed and hot; tested positive for covid; congestion in chest; mucus cough; vomiting and clammy; vomiting and clammy; headache; sore throad; Fever; chills; Chest tightness; coughing profusely; This is a spontaneous report from a contactable consumer or other non hcp. A 21-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), dose 1 via an unspecified route of administration, administered in Arm Left on 14Jun2021 13:35(age at vaccination 21 years) (Batch/Lot Number: EW0151) as DOSE 1, SINGLE for covid-19 immunization. The patient medical history and concomitant medications were not reported. The patient did not receive any other vaccine within 4 weeks prior to covid-19 vaccination. The patient got her first dose of the Pfizer Covid 19 vaccine on 14Jun2021 and is scheduled to get the second dose on 07Jul2021. On 19Jun2021 on Saturday, after they came home from an event the patient experienced coughing profusely, a lot of congestion in her chest, then she started vomiting, she was turning red and clammy and sweating and developing a fever, states initially she treated symptoms with a cold compress, headache, chills and cold sweats. yesterday afternoon she was clammy again and continued to vomit and complaining of chest tightness as well, the patient was flushed and hot and still complaining about sore throat and still had mucus and congestion, the patient was flushed and hot and still complaining about sore throat and still had mucus and congestion. States today they decided to go to the ER, and she tested positive for Covid on 21Jun2021. she did not want to eat on an unspecified date. The patient treated with Advil and Ibuprofen/Motrin. The patient underwent lab tests which included sars-cov-2 test: positive on 21Jun2021. She Wants guidance on getting the second dose. The event outcome is Unknown for tested positive for covid, did not want to eat, flushed and hot and coughing profusely, Not recovered for Chest tightness, congestion in chest, mucus cough, sore throat and headache Recovering for vomiting and clammy, Fever and chills.


VAERS ID: 1440595 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-15
Onset:2021-06-19
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / N/A LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test normal, Cough, Fatigue, Full blood count, Metabolic function test, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test negative, Secretion discharge, Streptococcus test negative
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: three meds for blood pressure: Metoprolol ER- 100 mg; Amlodipine - 5 mg; Cymbalta - 60 mg; Omeprazole OTC; Atorvastatin; Lisinopril - 40 mg; Anastrozole 1 mg; Latanoprost - eye drop; Vitamin (Multi); Eye vitamin - Ared 2; Magnesium; Cal
Current Illness: no
Preexisting Conditions: Have been treated and still for breast cancer - Anastrozole is for keeping it from coming back; High blood pressure; asthma
Allergies: no
Diagnostic Lab Data: COVID test - negative - a week ago today Strep test - that came back negative Bloodwork - and that came back fine - CBC/CMP and they even checked my heart too and that test came back okay, too.
CDC Split Type: vsafe

Write-up: Woke up with a sore throat and cough. Lots of mucous and congestion. Fatigue as well. Sore throat was only for about three days. I still have the cough and the mucous. I went to ER a week ago today. I have been using my albuterol inhaler (I have not had to use that inhaler in months); and received steroids for cough - (Prednisone) and a Z Pac and Tussin Pearls for the cough. I am finally starting to feel a little better. I have a follow up doctor visit tomorrow.


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