National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 10/15/2021 release of VAERS data:

Found 800,916 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 92 out of 8,010

Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191   next


VAERS ID: 1765520 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-06
Onset:2021-09-27
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 1 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN0150 / 2 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, 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: Felt sick after flu vaccine in 2020
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I developed and was diagnosed with shingles (diagnosed by a healthcare provider, I believe to be an NP, at Urgent Care)


VAERS ID: 1765537 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-17
Onset:2021-09-27
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 - / -

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

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

Write-up: Patient was hospitalized for Covid 19


VAERS ID: 1765725 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Chest discomfort, Contusion, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Chest pressure almost constant since vaccine. Also sore arm and bruising started 1 week after.


VAERS ID: 1766136 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-02-16
Onset:2021-09-27
   Days after vaccination:223
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Cough, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen-hydrocodone 325mg-5mg q6hrs albuterol 90mcg q4hr alfuzosin 10mg daily aspirin 325mg daily atorvastatin daily buspirone 10mg TID diclofenac topical BID docusate 100mg BID fluticasone nasal daily furosemide 20mg daily glipizid
Current Illness: none documented
Preexisting Conditions: diabetes mellitus, hypertension, asthma
Allergies: amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient contracted COVID after being fully vaccinated cough and congested


VAERS ID: 1766167 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Headache, Muscle spasms, Myalgia, Neck pain, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline 175mg
Current Illness:
Preexisting Conditions: PCOS, Depression
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Experienced headache within 30 minutes of vaccination. Within 3 hours, started experiencing sharp pain and cramping in muscles and in joints, especially in the neck. Then experienced burning sensations and tingling in limbs.


VAERS ID: 1766869 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-09-27
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211009632

Write-up: EXPIRED VACCINE ADMINISTERED; This spontaneous report received from a health care professional concerned multiple patients. No past medical history or concurrent conditions were reported. The patient''s received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204A21A, and expiry: 21-SEP-2021) dose was not reported, administered on 27-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 27-SEP-2021, the patient experienced expired vaccine administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of expired vaccine administered was not reported. This report was non-serious. This case, from the same reporter is linked to 20211009653, 20211006668, 20211006798 and 20211006371.


VAERS ID: 1766915 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 2 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, Product temperature excursion issue
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CELECOXIB; ESTRADIOL; FOLIC ACID; HYDROXYCHLOROQUINE; AMITRIPTYLINE; IPRATROPIUM; METHOTREXATE; OMEPRAZOLE; PHENTERMINE; MIRALAX; PROMETRIUM [PROGESTERONE]
Current Illness: Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: 2nd dose of Moderna given after expriation of 9/25/201 per health system.; patient''s 2nd had undergone a temperature excursion; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (2nd dose of Moderna given after expriation of 9/25/201 per health system.) and PRODUCT TEMPERATURE EXCURSION ISSUE (patient''s 2nd had undergone a temperature excursion) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 038B21A) for COVID-19 vaccination. Concurrent medical conditions included Penicillin allergy. Concomitant products included CELECOXIB, ESTRADIOL, FOLIC ACID, HYDROXYCHLOROQUINE, AMITRIPTYLINE, IPRATROPIUM, METHOTREXATE, OMEPRAZOLE, PHENTERMINE, MACROGOL 3350 (MIRALAX) and PROGESTERONE (PROMETRIUM [PROGESTERONE]) for an unknown indication. On 27-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (2nd dose of Moderna given after expriation of 9/25/201 per health system.) and PRODUCT TEMPERATURE EXCURSION ISSUE (patient''s 2nd had undergone a temperature excursion). At the time of the report, EXPIRED PRODUCT ADMINISTERED (2nd dose of Moderna given after expriation of 9/25/201 per health system.) outcome was unknown and PRODUCT TEMPERATURE EXCURSION ISSUE (patient''s 2nd had undergone a temperature excursion) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment medications were reported. dose 1 start date 30-08-2021 and route intramuscular right deltoid batch number 038b21A Most recent FOLLOW-UP information incorporated above includes: On 30-Sep-2021: Significant follow up received Dose 1 details added in I narrative , concomitant medications, event and Allergy added.


VAERS ID: 1766921 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-08-27
Onset:2021-09-27
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 1 LA / OT

Administered by: Unknown       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Expired vaccine used; Product storage error; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Expired vaccine used) and PRODUCT STORAGE ERROR (Product storage error) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 038B21A and 038B21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Expired vaccine used) and PRODUCT STORAGE ERROR (Product storage error). On 27-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Expired vaccine used) and PRODUCT STORAGE ERROR (Product storage error) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication was reported by the reporter. No treatment was reported by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 30-Sep-2021: Follow-up received Non-significant.


VAERS ID: 1766936 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-20
Onset:2021-09-27
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018B21A / 2 LA / OT

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

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

Write-up: patient was administered an expired dose of Moderna vaccine; second dose received on day 40; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 28-Sep-2021 and was forwarded to Moderna on 28-Sep-2021. This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (patient was administered an expired dose of Moderna vaccine) and INCORRECT DOSE ADMINISTERED (second dose received on day 40) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 018B21A and 021B21A) for COVID-19 vaccination. No Medical History information was reported. On 20-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (patient was administered an expired dose of Moderna vaccine) and INCORRECT DOSE ADMINISTERED (second dose received on day 40). On 27-Sep-2021, EXPIRED PRODUCT ADMINISTERED (patient was administered an expired dose of Moderna vaccine) and INCORRECT DOSE ADMINISTERED (second dose received on day 40) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route), the reporter did not provide any causality assessments. There are no treatment or concomitant medications. There is no previous history given Most recent FOLLOW-UP information incorporated above includes: On 28-Sep-2021: fallow up received contains New event updated


VAERS ID: 1766942 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-01-22
Onset:2021-09-27
   Days after vaccination:248
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site lymphadenopathy
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: USMODERNATX, INC.MOD20213

Write-up: Swollen lymph node under the armpit of the same arm of the shot; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE LYMPHADENOPATHY (Swollen lymph node under the armpit of the same arm of the shot) in a 46-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 058E21A, 023M20A and 029L20A) for COVID-19 vaccination. No Medical History information was reported. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 25-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 27-Sep-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced VACCINATION SITE LYMPHADENOPATHY (Swollen lymph node under the armpit of the same arm of the shot). At the time of the report, VACCINATION SITE LYMPHADENOPATHY (Swollen lymph node under the armpit of the same arm of the shot) outcome was unknown. Patient received third dose due to underlying issues. Patient spoke with doctor and he advised to give it two weeks. Concomitant medications were not provided. Treatment information was not provided. This case was linked to MOD-2021-334583, MOD-2021-334629 (Patient Link).


VAERS ID: 1766980 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:2021-02-13
Onset:2021-09-27
   Days after vaccination:226
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

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

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

Write-up: Sore left arm after 3rd shot; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Sore left arm after 3rd shot) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 13-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 27-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Sep-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced PAIN IN EXTREMITY (Sore left arm after 3rd shot). On 28-Sep-2021, PAIN IN EXTREMITY (Sore left arm after 3rd shot) had resolved. No concomitant were medications reported. No treatment were medications reported. This case was linked to MOD21-148294 (Patient Link).


VAERS ID: 1766994 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Maternal exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)

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

Write-up: Patient is pregnant and got the first dose of the Moderna vaccine; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of MATERNAL EXPOSURE DURING PREGNANCY in a 36-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 046C21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. The patient''s last menstrual period was on an unknown date and the estimated date of delivery was 12-Apr-2022. On 27-Sep-2021, the patient experienced MATERNAL EXPOSURE DURING PREGNANCY. On 27-Sep-2021, MATERNAL EXPOSURE DURING PREGNANCY had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. ? No treatment information was provided.; Sender''s Comments: This report concerns a 36 year old female subject with no relevant medical history, who experienced the unexpected event of vaccine exposure during pregnancy. The patient received the first dose of vaccine at unknown weeks of gestation. The benefit-risk relationship of Spikevax is not affected by this report.


VAERS ID: 1767001 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-25
Onset:2021-09-27
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A1 / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

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

Write-up: dizzy / light dizziness / light headed; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (dizzy / light dizziness / light headed) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 021B21A1) for COVID-19 vaccination. Concomitant products included LISINOPRIL for Blood pressure high. On 25-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Sep-2021, the patient experienced DIZZINESS (dizzy / light dizziness / light headed). At the time of the report, DIZZINESS (dizzy / light dizziness / light headed) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment medication was provided.


VAERS ID: 1767006 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-30
Onset:2021-09-27
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046A21A / 1 LA / OT

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

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

Write-up: Expired Dose; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Expired Dose) in a 73-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 031B21A and 046A21A) for COVID-19 vaccination. No Medical History information was reported. On 30-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 27-Sep-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXPIRED PRODUCT ADMINISTERED (Expired Dose). On 27-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Expired Dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Treatment information was not provided Concomitant medication were not provided.


VAERS ID: 1767010 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-24
Onset:2021-09-27
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039D21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Pain in extremity
SMQs:, Retroperitoneal fibrosis (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: HUMALOG; LEVOTHYROXINE
Current Illness: Type 1 diabetes mellitus
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: back pain; sore arm; This spontaneous case was reported by a consumer and describes the occurrence of BACK PAIN (back pain) and PAIN IN EXTREMITY (sore arm) in a 20-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039d21a) for COVID-19 vaccination. Concurrent medical conditions included Type 1 diabetes mellitus. Concomitant products included INSULIN LISPRO (HUMALOG) for an unknown indication, LEVOTHYROXINE. On 24-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Sep-2021, the patient experienced BACK PAIN (back pain) and PAIN IN EXTREMITY (sore arm). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency and IBUPROFEN (ADVIL [IBUPROFEN]) for Adverse event, at an unspecified dose and frequency. At the time of the report, BACK PAIN (back pain) and PAIN IN EXTREMITY (sore arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment heating pad was taken.


VAERS ID: 1767020 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-20
Onset:2021-09-27
   Days after vaccination:69
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 LA / OT

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

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

Write-up: Expired dose/Had vaccine that expired; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Expired dose/Had vaccine that expired) in a 57-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036C21A) for COVID-19 vaccination. No Medical History information was reported. On 20-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Expired dose/Had vaccine that expired). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Expired dose/Had vaccine that expired) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Concomitant and Treatment medication were reported.


VAERS ID: 1767027 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 031B21A / 1 RA / OT

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

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

Write-up: Expired dose; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Expired dose) in a 52-year-old male patient who received mRNA-1273 (batch no. 031B21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Sep-2021, the patient received first dose of mRNA-1273 (unknown route) 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Expired dose). On 27-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Expired dose) had resolved. For mRNA-1273 (Unknown), the reporter did not provide any causality assessments. No Treatment medications were provided No Concomitant medications were provided No prior temperature excursions for the patient


VAERS ID: 1767336 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-26
Onset:2021-09-27
   Days after vaccination:213
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043L20A / 2 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Acquired diaphragmatic eventration, Angiogram pulmonary abnormal, Atelectasis, Barium swallow, Biopsy skin normal, Blood culture negative, Bone lesion, Bronchial secretion retention, Bronchoscopy abnormal, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Condition aggravated, Cough, Dyspnoea, Hiatus hernia, Hyperhidrosis, Hypoxia, Infection, Lung consolidation, Lung opacity, Pleural effusion, Pneumonia, Pneumonia aspiration, Pulmonary hypertension, Pulmonary oedema, SARS-CoV-2 test negative, Scan with contrast abnormal, X-ray
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (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? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet amLODIPine (NORVASC) 10 MG tablet Calcium Carb-Cholecalciferol (CALCIUM-VITAMIN D) 600-400 MG-UNIT TABS cholecalciferol (VITAMIN D) 50 MCG (2000 UT) capsule diclofenac sodium (VOLTAREN) 1 % gel doxycycl
Current Illness: Chronic respiratory failure with hypoxia and hypercapnia (HCC) Infection of prosthetic hip joint, subsequent encounter
Preexisting Conditions: Hospital Moderate protein-calorie malnutrition (HCC) Advanced care planning/counseling discussion Acute on chronic respiratory failure with hypoxia and hypercapnia (HCC) Multiple comorbid conditions Non-Hospital Essential hypertension Age-related osteoporosis with current pathological fracture with routine healing DJD (degenerative joint disease) Juvenile rheumatoid arthritis (HCC) History of nontraumatic rupture of cerebral aneurysm Intracranial bleed (HCC) Chronic Prosthetic hip infection-right, MSSA Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting right dominant side (HCC) Closed fracture of lateral condyle of distal femur with delayed healing-right Diaphragm dysfunction Chronic respiratory failure with hypoxia and hypercapnia (HCC) Dysphagia Physical deconditioning Macrocytic anemia Gastroesophageal reflux disease without esophagitis Obesity with alveolar hypoventilation and body mass index (BMI) of 40 or greater (HCC) Respiratory acidosis Weakness Cancer related pain Pneumonia of right lung due to infectious organism, unspecified part of lung
Allergies: Latex- systemic swelling Levofloxacin- Seizure Penicillin G- Itching
Diagnostic Lab Data: Procedure Component Value Ref Range Date/Time DR CHEST SINGLE VIEW [340443919] Resulted: 09/12/21 0921 Order Status: Completed Updated: 09/12/21 0923 Narrative: EXAMINATION: Single View Chest EXAM DATE: 9/12/2021 6:39 AM TECHNIQUE: Single view chest INDICATION: follow-up for resolution of suspected mucus plugging s/p bronchoscopy 9/10 COMPARISON: 8/29/2021 chest radiograph, CT thorax dated 9/10/2021 ENCOUNTER: Not applicable _________________________ FINDINGS: See impression _________________________ Impression: 1. The right mainstem bronchus now appears centrally lucent, likely reflecting at least partial resolution of prior mucous plugging. There is persistent right basilar airspace opacity and effusion, increased from 8/29/2010 radiograph, and this likely reflects residual underlying atelectasis/consolidation throughout the right middle and basilar lung fields with known adjacent small effusion. These findings are superimposed upon chronic elevation of the right hemidiaphragm. 2. Increased hazy opacity in the left mid lung is probably secondary to summation artifact of overlying soft tissue folds though additional areas of worsening atelectasis would be difficult to exclude. Recommend attention at follow-up. 3. No pneumothorax. 4. Enteric contrast is seen within the hepatic flexure. FL VIDEO SWALLOW FUNCTION WITH ORAL CONTRAST [340279497] Resulted: 09/11/21 1108 Order Status: Completed Updated: 09/11/21 1108 Narrative: This imaging study has been auto finalized, please refer to the performing providers procedure note for details. CT ANGIO THORAX WITH IV CONTRAST [340186525] Resulted: 09/10/21 0209 Order Status: Completed Updated: 09/10/21 0211 Narrative: EXAMINATION: CT Angiography of the Thorax EXAM DATE: 9/10/2021 1:29 AM TECHNIQUE: Standard protocol CT angiogram images were obtained through the chest following the administration of intravenous contrast. Coronal and sagittal MIP 3-D reformations were performed. CONTRAST: The amount and type of contrast are recorded in the medical record. QPP DOCUMENTATION: At least one of the following dose reduction techniques was utilized: Iterative reconstruction, and/or Automatic Exposure Control, and/or mA/kV adjustment based on body size. INDICATION: copd on 4L, increased O2 requirements, diaphoretic, possible lung ca. COMPARISON: 8/2/2020 CT thorax ENCOUNTER: Not applicable ____________________ FINDINGS: Base of Neck & Axillae: There is no lymph node enlargement. Mediastinum & Hila: There is no mediastinal or hilar lymph node enlargement. Small hiatal hernia. Cardiovascular: The heart has a normal size. There is no pericardial effusion. The thoracic aorta appears normal in caliber. Pulmonary Arteries: The main pulmonary artery measures up to approximately 40 mm. Lungs & Airways: Imaging was performed in expiration. Redemonstration of the severely elevated right hemidiaphragm with associated atelectasis. There is interval near-complete volume loss of the right upper lobe and complete volume loss of the right middle and right lower lobe. Nodular consolidation and patchy groundglass attenuation is visualized within the remaining aerated portion of the right upper lobe. Mild patchy perihilar groundglass attenuation is present at the left lung and there is similar peripheral nodular consolidation at the left lower lobe anterobasilar segment, image #151 series 5. Similar 6 mm solid nodule left upper lobe anterior segment medially. There is complete opacification of the right mainstem bronchus and bronchus intermedius as well as the right upper and right lower lobe airways. Pleural Space: Small right and trace left pleural effusion. Upper Abdomen: Included portions of the upper abdomen are unremarkable. Chest Wall & Musculoskeletal: Similar destructive changes involving the right humeral head and severe bilateral glenohumeral joint degenerative changes. ____________________ Impression: 1. No evidence of pulmonary embolus. 2. Interval near-complete volume loss of the right lung with complete opacification of the right mainstem bronchus, bronchus intermedius, and the right upper as well as right lower lobe airways. Nodular consolidation and patchy groundglass attenuation is visualized within the remaining aerated portion of the right upper lobe which may be related to pneumonia. Persistent nodular consolidation at the left lower lobe as well as somewhat patchy perihilar opacity on the left may be related to infection and/or pulmonary edema. Small right and trace left pleural effusions are also present. 3. Enlarged main pulmonary artery measuring up to approximately 40 mm can be seen with pulmonary hypertension. Procedure Component Value Ref Range Date/Time Peripheral Blood Culture [340186523] Collected: 09/10/21 0025 Order Status: Completed Specimen: Blood, Venous Updated: 09/15/21 0201 Cult Blood Peripheral No bacteria or yeast isolated Peripheral Blood Culture [340186522] Collected: 09/09/21 2349 Order Status: Completed Specimen: Blood, Venous Updated: 09/15/21 0201 Cult Blood Peripheral No bacteria or yeast isolated COVID-19 PCR [340443945] (Normal) Collected: 09/13/21 1417 Order Status: Completed Specimen: Swabbed Collection from Nasopharynx Updated: 09/13/21 1619 COVID-19 PCR Not Detected Not Detected Comment: COVID-19 (SARS-CoV-2) RT-PCR test is negative. This test can only determine infection status at the time of specimen collection. If asymptomatic at the time of testing, it is important to be retested following exposure to someone with COVID-19 if not wearing personal protective equipment or following the development of COVID-19 symptoms. Negative results should not be used as the sole basis for patient management decisions and should be combined with clinical observations, patient history, and epidemiological information. This test has received Emergency Use Authorization (EUA) by the FDA, but performance has not been evaluated for asymptomatic patients. Testing was performed using a nucleic acid amplification method. The specimen source may have been changed from the original order per patient situation or symptoms. COVID-19 PCR [340186524] (Normal) Collected: 09/10/21 0026 Order Status: Completed Specimen: Swabbed Collection from Nasopharynx Updated: 09/10/21 0135 COVID-19 PCR Not Detected Not Detected Comment: COVID-19 (SARS-CoV-2) RT-PCR test is negative. This test can only determine infection status at the time of specimen collection. If asymptomatic at the time of testing, it is important to be retested following exposure to someone with COVID-19 if not wearing personal protective equipment or following the development of COVID-19 symptoms. Negative results should not be used as the sole basis for patient management decisions and should be combined with clinical observations, patient history, and epidemiological information. This test has received Emergency Use Authorization (EUA) by the FDA, but performance has not been evaluated for asymptomatic patients. Testing was performed using a nucleic acid amplification method. The specimen source may have been changed from the original order per patient situation or symptoms.
CDC Split Type:

Write-up: Patient is an 80 year old female with a past medical history of chronic respiratory failure with hypoxia, restrictive lung disease due to paralyzed right hemidiaphragm (baseline 2 L oxygen), previous CVA with left-sided weakness, chronic MSSA infection of right THA on suppressive antibiotics, hypertension, and recent admission for possible aspiration pneumonia as well as new soft tissue/lytic bone lesion concerning for metastatic disease (biopsy inconclusive) who presented from her subacute rehab facility with increasing oxygen requirements as well as a cough with concern for pneumonia. On arrival to the ER, patient was saturating normally on her baseline O2 requirement, but did briefly become hypoxic requiring non-rebreather. CTA thorax was completed and showed no evidence of pulmonary embolus, but did note interval near complete volume loss of the right lung with complete opacification of the right mainstem bronchus, bronchus intermedius, and right upper and lower airways. Remaining aerated portions of the lungs showed findings consistent with infection or pulmonary edema and trace/small effusions present bilaterally. Patient was started on broad-spectrum antibiotics to cover for hospital-acquired, aspiration, and post-obstructive pneumonia. This included doxycycline, flagyl, and cefepime. Infectious disease and pulmonology consulted. Aggressive airway clearance regimen was initiated due to suspected mucus plugging. Bronchoscopy was performed on 9/10 which was notable for thick secretions and mucus obstructing the right mainstem bronchus. Secretions were suctioned and continued bronchopulmonary hygiene recommended. Chest X-ray performed on 9/12 to re-evaluate which demonstrated at least partial resolution of prior mucous plugging. Residual atelectasis/consolidation throughout the right middle and basilar lung fields was also noted. SLP also saw patient due to concern for aspiration risk and performed a videofluoroscopy swallow study. It was recommended she have supervision to ensure she eats and drinks at a slow rate to minimize aspiration risk. PT/OT saw patient with recommendations to return to sub-acute rehab facility. Patient''s shortness of breath and cough significantly improved to the point she was felt stable for discharge back to her facility to complete her course of antibiotics for pneumonia.


VAERS ID: 1767605 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Unknown  
Location: Massachusetts  
Vaccinated:2021-03-04
Onset:2021-09-27
   Days after vaccination:207
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: PCR test; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101286971

Write-up: Lack of efficacy. Fully vaccinated for COVID19 with symptoms and confirmed positive PCR test result on 9/27/21.; Lack of efficacy. Fully vaccinated for COVID19 with symptoms and confirmed positive PCR test result on 9/27/21.; This is a spontaneous report from a contactable Pfizer colleague (Nurse) reported for a patient. A 46-year-old patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot Number: EL3247), dose 2 via an intramuscular route of administration, administered in Arm Left on 04Mar2021 (at the age of 46-year-old) as DOSE 2, SINGLE and dose 1 via an intramuscular route of administration, administered in Arm Left on 11Feb2021 (Lot Number: EL3247), (at the age of 46-year-old) as DOSE 1, SINGLE for COVID-19 immunisation. It was unknown prior to vaccination, the patient diagnosed with COVID-19. The patient medical history and concomitant medications were not reported. It was unknown if the patient received any other vaccines within 4 weeks prior to the COVID vaccine. On 27Sep2021, the patient experienced COVID19. The reported stated that Lack of efficacy, fully vaccinated for COVID19 with symptoms and confirmed positive PCR test result on 27Sep2021. Since the vaccination, the patient had been tested for COVID-19. The patient underwent lab tests and procedures, which included PCR test: Positive on 27Sep2021, Nasal Swab. It was unknown if the patient received treatment for the events. The patient outcome of the event was unknown at the time of this report. No follow-up attempts are possible. No further information is expected. ; Sender''s Comments: Based on known drug safety profile, there is reasonable possibility of causal association between the events vaccination failure and covid-19 and the suspect drug BNT162B2.


VAERS ID: 1767767 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 1 - / OT

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

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

Write-up: Patient received expired dose of the Moderna vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) in a 52-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine). On 27-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication details was reported. No treatment medication details was reported. This case was linked to US-MODERNATX, INC.-MOD-2021-337484 (E2B Linked Report).; Sender''s Comments: US-MODERNATX, INC.-MOD-2021-337484:Master case (same reporter)


VAERS ID: 1767973 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Muscle spasms, Neuralgia, Pain, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (narrow), Dystonia (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: B-12 shots every 2 weeks; Vitamin D
Current Illness: I had a cold virus and upper respiratory infection at the beginning of September.
Preexisting Conditions: I have a anemia.
Allergies: I have a slight reaction to latex
Diagnostic Lab Data: No medical test ordered
CDC Split Type: vsafe

Write-up: 09/27/2021- body ache. 09/29/2021- Itching, swelling of the eyes, nerve pain in hand, feet and leg, muscle spasm, whelps on legs, hand and patches of bumps that comes and disappears. 09/29/2021-virtual doctors visit-advised to come in. 09/29/2021- went in to see primary care doctor and referred to an allergist. 10/4/2021-Allergist prescribed Methylprednisolone and fexofenadine. 10/6/2021- Primary care doctor prescribed gabapentin for nerve pain- referred to Neurologist.


VAERS ID: 1768089 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-01
Onset:2021-09-27
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lotrimin
Current Illness: None
Preexisting Conditions: Type 2 diabetes
Allergies: None
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Rash on my neck, arm, chest, genital area, hip area


VAERS ID: 1768127 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-17
Onset:2021-09-27
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I only take iron
Current Illness: None
Preexisting Conditions: Anemic
Allergies: None
Diagnostic Lab Data: On September 27, 2021 I started to have rash that was red and swelling on my left arm. I called health clinic and I explained to them the symptoms and I went in the same day on September 27, 2021. When I arrived they checked my vitals. No fever and my blood pressure was fine. The doctor examined my left arm where the rash was located. The urgent care Dr. prescribed me some pills but I forgot the name of the pills. The urgent care doctor contacted my PCP about my symptoms and on October My PCP prescribed me ointment Diclofenac for the rash.
CDC Split Type: vsafe

Write-up: On September 27, 2021 I started to have rash that was red and swelling on my left arm. I called health clinic and I explained to them the symptoms and I went in the same day on September 27, 2021. When I arrived they checked my vitals. No fever and my blood pressure was fine. The doctor examined my left arm where the rash was located. The urgent care Dr. prescribed me some pills but I forgot the name of the pills. The urgent care doctor contacted my PCP about my symptoms and on October My PCP prescribed me ointment Diclofenac for the rash.


VAERS ID: 1768240 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-03-02
Onset:2021-09-27
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 2 LA / IM

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

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

Write-up: Patient had a positive COVID PCR test on 9/27/2021 after receiving both COVID vaccine doses


VAERS ID: 1768380 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-09-25
Onset:2021-09-27
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH SC3183 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test, Pancreatitis acute, Scan with contrast, Sleep disorder
SMQs:, Acute pancreatitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Losartan; Cymbalta; Flomax; Xanax XR.
Current Illness: COVID-19 one month prior.
Preexisting Conditions: High blood pressure; Anxiety.
Allergies: Phenobarbital.
Diagnostic Lab Data: CT scan with contrast; Ultrasound of the liver, pancreas, gallbladder, and kidneys; Blood work.
CDC Split Type: vsafe

Write-up: A couple days later, I started feeling stomach pain. It went away. 6 days after the initial shot, I woke up in excruciating pain. I went to the ER. They performed all kinds of tests while at the ER. I was diagnosed acute pancreatitis. I should still be at the hospital, but we had a death in the family so I came home. I was in the hospital for 2 days.


VAERS ID: 1768482 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 3 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin d, crestor, spironolactone valsartan
Current Illness: history of covid19. hypertension, osteoporosis, coronary artery disease, hyperlipidemia, prediabetes, vitamin d deficiency
Preexisting Conditions: history of covid19. hypertension, osteoporosis, coronary artery disease, hyperlipidemia, prediabetes, vitamin d deficiency
Allergies: codeine, oxycodone, sulfa, amlodipine, dilauded, ibuprofen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache for 6 days lightheaded/dizzy


VAERS ID: 1768490 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 3 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin, ergocalciferol, levothyroxine, rosuvastatin, tadalafil
Current Illness:
Preexisting Conditions: hypothyroidism, COPD, coronary artery disease, hyperlipidemia, osteopenia, prediabetes, history of covid 19 infection
Allergies: nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache for 6 days


VAERS ID: 1768493 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA OL16C21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Condition aggravated, Crohn's disease, Dyspnoea, Fatigue, Headache, Pain, Palpitations, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal premalignant disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Entyvio, vitamin D, Folic, multi vitamin
Current Illness:
Preexisting Conditions: Chrohns Disease
Allergies: Bee & seasonal
Diagnostic Lab Data: 10/11 seen my primary for chest pains, headaches, feeling out of breath.
CDC Split Type:

Write-up: Severe headaches, constant heart racing & feeling out of breath almost panic feeling, vomiting night of vaccine, body aches, very tired still, blood work affected along with my crohns.


VAERS ID: 1768530 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Dehydration, Gait inability, Migraine, Muscular weakness, Myalgia, Pyrexia, Tachycardia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

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

Write-up: very high fever, tachycardia (HR 140), tachypnea, extreme muscle pain and weakness (unable to walk), dehydration, severe migraine, abdominal pain - symptoms took 3 days to improve.


VAERS ID: 1768547 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 301558 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chills, Fatigue, Feeling abnormal, Injection site pain, Myalgia, Oropharyngeal pain, Pain, Paranasal sinus discomfort, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Site: Pain at Injection Site-Medium, Systemic: Body Aches Generalized-Medium, Systemic: Chills-Medium, Systemic: Fever-Medium, Systemic: Joint Pain-Medium, Additional Details: pt had muscle aches,chills,fever,sore throat, sinus pressure in face up to 2 days after vax took ibuprofn and sudafed. pt continues to experience "not feeling herself", neck/back pain, muscle soreness and moderate fatigue


VAERS ID: 1768598 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051E21A / 2 LA / IM

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

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Felt like she was going to faint-Medium, Systemic: Nausea-Medium


VAERS ID: 1768803 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-23
Onset:2021-09-27
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, COVID-19, Cough, Fatigue, Headache, Myalgia, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test positive, Sinus congestion
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Venlafaxine Rx
Current Illness: None
Preexisting Conditions: Obesity
Allergies: None
Diagnostic Lab Data: Covid test 10/1- positive result 10/2
CDC Split Type:

Write-up: Intense headache, sore throat, sinus congestion, runny nose, cough, intense fatigue (slept 17 hours one day), muscle and joint pain


VAERS ID: 1768804 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra dose 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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: none known
Diagnostic Lab Data: none known
CDC Split Type:

Write-up: Client received a dose of Janssen COVID19 vaccine on 03/16/2021. Patient received a 2nd dose of Janssen COVID19 vaccine on 09/27/2021. Client completed vaccine consent questionnaire and marked "no" to the question as to whether he had received a COVID19 vaccine previously.


VAERS ID: 1769077 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-25
Onset:2021-09-27
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Hypoaesthesia, Muscle twitching, Pain in extremity, Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: Muscle twitching, tingling, itching all over, numbness and pain to fingers, toes


VAERS ID: 1769079 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-26
Onset:2021-09-27
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Migraine
SMQs:

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

Write-up: The worst miagrain in the world for 5 days... started almost 24 hrs later none of my medication that typically works for a normal miagrains worked. I capped out on dosage


VAERS ID: 1769267 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-21
Onset:2021-09-27
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: Left pinky and left ring finger numbness/tingly.


VAERS ID: 1769278 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30125BA / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVSIN, KLONOPIN, IMIPRAMINE, SUCRALFATE, HYDROCHLOROTHIAZIDE, FOLIC ACID, ATORVASTATIN,
Current Illness: NONE
Preexisting Conditions: HYPERTENSION, HYPERLIPIDEMIA
Allergies: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: PATIENT RECEIVED A PFIZER VACCINE AS BOOSTER WHEN HER FIRST TWO DOSES WERE MODERNA. PATIENT DID NOT HAVE ANY SIDE EFFECTS AT ALL THAT SHE REPORTED AND NO ADVERSE EFFECTS, JUST WRONG VACCINE ADMINISTERED.


VAERS ID: 1769292 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-24
Onset:2021-09-27
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lisinopril
Current Illness: tinea pedis, vertigo
Preexisting Conditions: depression, spinal stenosis, HTN, dementia, chronic pain
Allergies: TMP-SMX
Diagnostic Lab Data: Seen at primary care colleague''s office; discussed vascular ultrasound but not completed.
CDC Split Type:

Write-up: Late local reaction with swelling, erythema, and pain around L wrist; also some swelling by deltoid; these symptoms began 3 days after vaccination and continued for 1 week


VAERS ID: 1770388 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Rhode Island  
Vaccinated:0000-00-00
Onset:2021-09-27
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Expired product administered, Myalgia, Pain in extremity, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Medication errors (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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211009169

Write-up: FAINTING UPON RECEIPT; EXPIRED VACCINE ADMINISTERED; PERSISTENT CHEST PAIN; LEG PAIN; MUSCLE ACHES; This spontaneous report received from a patient concerned an adult male of unspecified age, race and ethnic origin 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: 203A21A expiry: 21-SEP-2021) dose was not reported, 1 Total administered on 27-SEP-2021 in left arm for prophylactic vaccination. No concomitant medications were reported. On 27-SEP-2021, the patient was administered expired vaccine and experienced fainting upon receipt. About 3-4 days later on an unspecified date the patient complained of persistent chest pain and leg pain described as muscle aches. The action taken with Covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the expired vaccine administered, fainting upon receipt, persistent chest pain, leg pain and muscle aches was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20211009169-Covid-19 vaccine ad26.cov2.s- fainting upon receipt. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s). 20211009169-Covid-19 vaccine ad26.cov2.s-expired vaccine administered. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1770410 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Colorado  
Vaccinated:0000-00-00
Onset:2021-09-27
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211011801

Write-up: EXPIRED DOSE OF THE VACCINE ADMINISTERED; This spontaneous report received from a health care professional concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 201A21A expiry: 21-SEP-2021) dose was not reported, administered on 27-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 27-SEP-2021, the patient experienced expired dose of the vaccine administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of expired dose of the vaccine administered was not reported. This report was non-serious. This case, from the same reporter is linked to 20211012114, 20211012141, 20211012209 and 20211012383.


VAERS ID: 1770415 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Colorado  
Vaccinated:0000-00-00
Onset:2021-09-27
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Expired product administered, Fatigue, Headache
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: USJNJFOC20211012114

Write-up: FELT FATIGUE; HEADACHE; EXPIRED DOSES OF THE VACCINE WERE ADMINISTERED; This spontaneous report received from a health care professional concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: 21-SEP-2021) dose was not reported, administered on 27-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 27-SEP-2021, the patient experienced expired doses of the vaccine were administered. On 28-SEP-2021, the patient experienced felt fatigue, and headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the expired doses of the vaccine were administered, felt fatigue and headache was not reported. This report was non-serious. This case, from the same reporter is linked to 20211011801, 20211012141, 20211012383 and 20211012209. This report was associated with product quality complaint: 90000196311.


VAERS ID: 1770436 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 1 RA / OT

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

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

Write-up: 17 year old received vaccine; This spontaneous case was reported by an other health care professional and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (17 year old received vaccine) in a 17-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014F21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Sep-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (17 year old received vaccine). On 27-Sep-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (17 year old received vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications was reported. No treatment drug details was reported. Most recent FOLLOW-UP information incorporated above includes: On 01-Oct-2021: follow up received contains Non significant information.


VAERS ID: 1770487 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 1 - / OT

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

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

Write-up: Patient received expired dose of the Moderna vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) in a 44-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine). On 27-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medications were not reported. Treatment medications were not applicable This case was linked to US-MODERNATX, INC.-MOD-2021-338616, US-MODERNATX, INC.-MOD-2021-338611, US-MODERNATX, INC.-MOD-2021-344166 (E2B Linked Report). This case was linked to MOD-2021-338604 (Patient Link).; Sender''s Comments: US-MODERNATX, INC.-MOD-2021-344166:MOD21-148785 US-MODERNATX, INC.-MOD-2021-338611:Master case (same reporter) US-MODERNATX, INC.-MOD-2021-338616:Master case (same reporter)


VAERS ID: 1770504 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Feeling hot, Gait disturbance, Headache, Pyrexia, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: He started shaking.; He was walking crunched down by his back./He would walk really slow.; He had headaches.; He had chills.; He had fever around 104.; At midnight on same day, he was feeling hot.; This spontaneous case was reported by a consumer and describes the occurrence of FEELING HOT (At midnight on same day, he was feeling hot.), TREMOR (He started shaking.), GAIT DISTURBANCE (He was walking crunched down by his back./He would walk really slow.), HEADACHE (He had headaches.) and CHILLS (He had chills.) in a 38-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 048F21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 27-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced FEELING HOT (At midnight on same day, he was feeling hot.). On an unknown date, the patient experienced TREMOR (He started shaking.), GAIT DISTURBANCE (He was walking crunched down by his back./He would walk really slow.), HEADACHE (He had headaches.), CHILLS (He had chills.) and PYREXIA (He had fever around 104.). The patient was treated with IBUPROFEN at a dose of 1 dosage form. At the time of the report, FEELING HOT (At midnight on same day, he was feeling hot.), TREMOR (He started shaking.), GAIT DISTURBANCE (He was walking crunched down by his back./He would walk really slow.), HEADACHE (He had headaches.), CHILLS (He had chills.) and PYREXIA (He had fever around 104.) outcome was unknown. Patient wants to know if there is any excuse note that can be provided to his work from moderna for not showing up to work and also wants to know if he should go to doctor if he has fever again. No concomitant medication was reported.


VAERS ID: 1770511 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / UNK - / OT

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

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

Write-up: Patient received vaccine beyond 30 days; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received vaccine beyond 30 days) in a 37-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received vaccine beyond 30 days). On 27-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Patient received vaccine beyond 30 days) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant drug information was provided. no treatment information was provided. The vials were in refrigerator for over 30 days. This case was linked to MOD-2021-338604 (Patient Link).


VAERS ID: 1770517 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / 2 - / OT

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

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

Write-up: We vaccinated 20 people with vaccine that was out of date since last Friday; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (We vaccinated 20 people with vaccine that was out of date since last Friday) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 032B21A and 032B21A) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (We vaccinated 20 people with vaccine that was out of date since last Friday). On 29-Sep-2021, EXPIRED PRODUCT ADMINISTERED (We vaccinated 20 people with vaccine that was out of date since last Friday) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were not reported. The 20 patients were vaccinated with the Moderna COVID-19 vaccine that expired on 24-Sep-2021. The vaccinations were administered over 3 days, starting on 27-Sep-2021 and ending on 29-Sep-2021 to all the patients. No treatment medications were not provided.


VAERS ID: 1770526 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 2 - / OT

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

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

Write-up: Patient received expired dose of the Moderna vaccine/ The vials were in refrigerator for over 30 days; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine/ The vials were in refrigerator for over 30 days) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine/ The vials were in refrigerator for over 30 days). On 27-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine/ The vials were in refrigerator for over 30 days) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications or treatment details were reported. This case was linked to MOD-2021-338604 (Patient Link).


VAERS ID: 1770530 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 3 - / OT

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

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

Write-up: Patient received expired dose of the Moderna vaccine/ The vials were in refrigerator for over 30 days; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine/ The vials were in refrigerator for over 30 days) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine/ The vials were in refrigerator for over 30 days). On 27-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine/ The vials were in refrigerator for over 30 days) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. The treatment information was not provided. This case was linked to MOD-2021-337484, MOD-2021-337912, MOD-2021-338264, MOD-2021-338266, MOD-2021-338267, MOD-2021-338271, MOD-2021-338277, MOD-2021-338292, MOD-2021-338347, MOD-2021-338355, MOD-2021-338366, MOD-2021-338372, MOD-2021-338375, MOD-2021-338417, MOD-2021-338458, MOD-2021-338530, MOD-2021-338534, MOD-2021-338564, MOD-2021-338578, MOD-2021-338581, MOD-2021-338604, MOD-2021-338607, MOD-2021-338817, MOD-2021-338604 (Patient Link).


VAERS ID: 1770531 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 1 - / OT

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

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

Write-up: Patient received expired dose of the Moderna vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) in a 21-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine). On 27-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications reported. No treatment reported. This case was linked to MOD-2021-338604 (Patient Link).


VAERS ID: 1770540 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / UNK - / OT

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

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

Write-up: Patient received expired dose of the Moderna vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine). On 27-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No Concomitant medications were provided No treatment medications were provided. This case was linked to MOD-2021-338604, MOD-2021-338616 (Patient Link).


VAERS ID: 1771094 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 2 - / OT

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

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

Write-up: Patient received expired dose of the Moderna vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) in a 46-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. No treatment information was provided. This case was linked to MOD-2021-338604 (Patient Link).


VAERS ID: 1771099 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 1 - / OT

Administered by: Unknown       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Patient received expired dose of the Moderna vaccine; vials were in refrigerator for over 30 days; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) and PRODUCT STORAGE ERROR (vials were in refrigerator for over 30 days) in a 27-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) and PRODUCT STORAGE ERROR (vials were in refrigerator for over 30 days). On 27-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) and PRODUCT STORAGE ERROR (vials were in refrigerator for over 30 days) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medications was not provided by the reporter Treatment information was not provided A part-time Pharmacist called 30SEP2021 to report that expired doses of the Moderna vaccine was administered to 25 patients. This was patient''s 1st dose. The vials were in refrigerator for over 30 days. Lot number(s) 037F21A, Expiration date: 01FEB2022~ Number of doses/vials - 27SEP2021 1 vials of 14 doses, 29SEP2021, 1 vial, 11 doses Date the vial was initially stored in the refrigerator: 24AUG2021 Date(s) of administration of vaccine, 27SEP2021 and 29SEP2021 Did the vial undergo any temperature excursions? No If yes, go to "temperature excursion" section and ask list of questions - N/A This case was linked to MOD-2021-338604 (Patient Link).


VAERS ID: 1771101 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 2 - / OT

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

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

Write-up: Patient received expired dose of the Moderna vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) in a 32-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine). On 27-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication was provided by reporter. No treatment information was provided by reporter.


VAERS ID: 1771105 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 2 - / OT

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

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

Write-up: Patient received expired dose of the Moderna vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) in a 30-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine). On 27-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant product was reported. No treatment was reported. This case was linked to MOD-2021-338604 (Patient Link).


VAERS ID: 1771106 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 3 - / OT

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

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

Write-up: Patient received expired dose of the Moderna vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) in a 58-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine). On 27-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. It was reported that vial did not undergo any temperature excursions. On 24-Aug-2021, vaccine was stored in refrigerator. Concomitant product use was not provided by the reporter. Treatment information was not provided. This case was linked to MOD-2021-338604 (Patient Link).


VAERS ID: 1771107 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 1 - / OT

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

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

Write-up: Patient received expired dose of the Moderna vaccine/ The vials were in refrigerator for over 30 days; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine/ The vials were in refrigerator for over 30 days) in a 20-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine/ The vials were in refrigerator for over 30 days). On 27-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine/ The vials were in refrigerator for over 30 days) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. On 24-Aug-2021, the vial was initially stored in the refrigerator. The vial did not undergo any temperature excursions. No concomitant medications were provided by the reporter. No treatment information was provided by the reporter. This case was linked to US-MODERNATX, INC.-MOD-2021-337484 (E2B Linked Report). Sender''s Comments: US-MODERNATX, INC.-MOD-2021-337484:Master case (same reporter)


VAERS ID: 1771396 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 30145BA / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: Patient arrived to receive their 3rd Pfizer COVID vaccine but was given a dose of the Moderna COVID vaccine.


VAERS ID: 1771415 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145814 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flecainide Diltiazem Vitamin d Calcium Biotin Multivitamin
Current Illness: None
Preexisting Conditions: Arrhythmia (PVCs)
Allergies: Anesthetics
Diagnostic Lab Data: No tests
CDC Split Type:

Write-up: Severe itching and not just at the injection site the itching was particularly bad in hands and feet but arms and legs as well. I scratch so hard I tore open skin. I was seen in urgent care on 929 and had oral dexamethasone and I also had another 10 mg of oral prednisone on 9-28-2021 (30 mg daily for three days was prescribed but the OT hing had improved somewhat and I didn?t want to rusk additional side effects from prednisone) and I started on Zyrtec twice a day for a week and triamcinolone cream. The itching is getting better.


VAERS ID: 1771460 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Erythema, Fatigue, Gait disturbance, Headache, Pain, Pyrexia, Rash, Skin warm
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Patient told me that Monday night, of the same day she received the vaccination, she had a very bad headache. By Wednesday, 9/30/21, she had "an incredible rash" which included the top of her head being red and hot. She experienced fatigue and weakness for a few days. She could not lift things as usual or walk without effort. I told the patient to take Tylenol as needed for any pain or fever that is persisting. Benadryl was recommended for the rash. She said she had taken Benadryl when she first noticed it. I told her to continue if needed but if the rash gets worse to see a doctor. Keeping hydrated with water, ex. Smart Water, was recommended, also.


VAERS ID: 1771487 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 061E21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose 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: unknown
Current Illness: unknown
Preexisting Conditions: none
Allergies: unknown
Diagnostic Lab Data: none
CDC Split Type:

Write-up: patient received 3rd dose of Moderna on 9/27/21 - dose #1 was given 3/25/2021 - dose #2 was given 04/20/2021 - patient is not immune compromised so did not qualify for an additional dose


VAERS ID: 1771565 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chronic inflammatory response syndrome, Condition aggravated, Discomfort, Dizziness, Fatigue, Feeling abnormal, Headache, Injected limb mobility decreased, Loss of personal independence in daily activities, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pfizer 2nd Dose, VAERS report submitted
Other Medications: Synthroid; Liothyronine; Vitamin D-3; Advil
Current Illness: My symptoms from my CIRS had come back.
Preexisting Conditions: CIRS chronic inflammatory response syndrome.
Allergies: Dilaudid; Soft shell crab; Salmon; Bee stings (new after the 2nd dose Pfizer).
Diagnostic Lab Data: No
CDC Split Type: vsafe

Write-up: 09/27/2021- The evening of the vaccination, the arm that the vaccination site was on started to hurt, by dinner I could barely lift my arm. I had to have my husband help me lift my shirt. I felt like my shoulder was broken. I felt I needed to be in a sling. It was very extreme. I started getting small fever, extremely exhausted, uncomfortable. I was down for the count for at least 36 hours. I was not able to do my normal routines for 36 hours. For the past 2 weeks, the last 3 afternoons, I have felt extreme fatigue I have been dizzy, I have brain fog, headaches, certain things set me off like a strong smell, decomposing leaves, anything that has set me off before. I felt like my CIRS was under control prior to the vaccine, after the vaccine. I felt like I went backwards. Even in my own store, a general store, has caused me problems. I have to wear a mask and can only be in there for a short period of time. I took an older medication-WelChol 625 mg, I took 1 today, I was on prior, because it helps get rid of toxins. I saw a message therapist, she recommended her chiropractor to me.


VAERS ID: 1771969 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-15
Onset:2021-09-27
   Days after vaccination:165
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, SARS-CoV-2 test positive, Sickle cell anaemia with crisis
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL EXTRA STRENGTH) 500 MG tablet amitriptyline (ELAVIL) 50 MG tablet aspirin (HALFPRIN) 81 MG tablet cholecalciferol (VITAMIN D-3) 50000 UNIT capsule fentaNYL (DURAGESIC) 100 MCG/HR patch folic acid 1 MG tablet HYDROmorp
Current Illness: None known
Preexisting Conditions: Depression Adnexal mass Hypokalemia Sickle cell anemia with crisis (HCC) Hemoglobin S-C disease (HCC) Uncomplicated opioid dependence (HCC) Pulmonary embolism without acute cor pulmonale (HCC) Dehydration Chronic pain syndrome Nausea and vomiting Abnormal uterine bleeding (AUB) Vaso-occlusive sickle cell crisis (HCC) Acute dehydration Abdominal pain with vomiting Sickle cell crisis (HCC) Intractable pain Vaso-occlusive pain due to sickle cell disease (HCC) Sickle cell pain crisis (HCC) Sickle cell anemia with pain (HCC)
Allergies: Morphine (hives)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to emergency department on 10/1/2021 with worsening shortness of breath. She was found to COVID-19 positive at an outlying facility on 9/27/2021. She was admitted for further management of COVID-19 infection and sickle cell crisis. She was discharged home on 10/7/2021.


VAERS ID: 1772232 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-28
Onset:2021-09-27
   Days after vaccination:242
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

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

Write-up: Breakthrough COVID


VAERS ID: 1773498 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 2 - / OT

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

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

Write-up: Patient received vaccine beyond 30 days on the fridge; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received vaccine beyond 30 days on the fridge) in a 43-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received vaccine beyond 30 days on the fridge). On 27-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Patient received vaccine beyond 30 days on the fridge) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication were reported. No treatment medication were reported. This case was linked to MOD-2021-338604 (Patient Link).


VAERS ID: 1773502 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 2 - / OT

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

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

Write-up: Patient received expired dose of the Moderna vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) in a 28-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine). On 27-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Patient received expired dose of the Moderna vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant concomitant medications were reported. No treatment information was provided. This case was linked to MOD-2021-338604 (Patient Link).


VAERS ID: 1773522 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cellulitis, Depressed mood, Pruritus, SARS-CoV-2 antibody test, Vaccination complication, Vaccination site erythema, Vaccination site induration, Vaccination site rash, Vaccination site swelling, Vaccination site warmth
SMQs:, Anaphylactic reaction (broad), Depression (excl suicide and self injury) (narrow), Hypersensitivity (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: METOPROLOL; ELIQUIS; AMBROXOL; XARELTO; VITAMIN C CITRUS; VITAMIN D [COLECALCIFEROL]; VITAMIN D3; VITAMIN B COMPLEX; ALERID
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210926; Test Name: SARS SEMI quantitative total antibodies; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: covid arm, its pretty big , it took all the top of their arm and is starting to go underneath it is 6 inches wide across the top of their arm.; This got her upset; celulitis; there''s no rash anywhere except the arm; After 6 days my arm still has a red swollen a size of a round grapefruit it was very itchy and hot to touch; swollen arm (size of round grapefruit/there was a little swelling; itchy/it''s spreading, it started as a small egg. Also she has itching all over her head, her whole body is itching/Her head itches; hard to touch; red (injection site); This spontaneous case was reported by a nurse and describes the occurrence of CELLULITIS (celulitis) in an 80-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included RIVAROXABAN (XARELTO) for Eye discomfort, METOPROLOL, APIXABAN (ELIQUIS), AMBROXOL, ASCORBIC ACID (VITAMIN C CITRUS), COLECALCIFEROL (VITAMIN D [COLECALCIFEROL]), VITAMIN D3, VITAMIN B COMPLEX and CETIRIZINE HYDROCHLORIDE (ALERID) for an unknown indication. On 27-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Sep-2021, the patient experienced PRURITUS (itchy/it''s spreading, it started as a small egg. Also she has itching all over her head, her whole body is itching/Her head itches), VACCINATION SITE INDURATION (hard to touch), VACCINATION SITE ERYTHEMA (red (injection site)) and VACCINATION SITE SWELLING (swollen arm (size of round grapefruit/there was a little swelling). On 02-Oct-2021, the patient experienced VACCINATION SITE WARMTH (After 6 days my arm still has a red swollen a size of a round grapefruit it was very itchy and hot to touch). On an unknown date, the patient experienced CELLULITIS (celulitis) (seriousness criterion medically significant), VACCINATION COMPLICATION (covid arm, its pretty big , it took all the top of their arm and is starting to go underneath it is 6 inches wide across the top of their arm.), DEPRESSED MOOD (This got her upset) and VACCINATION SITE RASH (there''s no rash anywhere except the arm). The patient was treated with CEPHALEXIN [CEFALEXIN] for Adverse event, at a dose of 500 milligram. At the time of the report, CELLULITIS (celulitis), PRURITUS (itchy/it''s spreading, it started as a small egg. Also she has itching all over her head, her whole body is itching/Her head itches), VACCINATION SITE WARMTH (After 6 days my arm still has a red swollen a size of a round grapefruit it was very itchy and hot to touch), VACCINATION COMPLICATION (covid arm, its pretty big , it took all the top of their arm and is starting to go underneath it is 6 inches wide across the top of their arm.), DEPRESSED MOOD (This got her upset), VACCINATION SITE INDURATION (hard to touch), VACCINATION SITE ERYTHEMA (red (injection site)), VACCINATION SITE RASH (there''s no rash anywhere except the arm) and VACCINATION SITE SWELLING (swollen arm (size of round grapefruit/there was a little swelling) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 26-Sep-2021, SARS-CoV-2 antibody test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medications also include Alcost. Company comment - This case concerns a 80-year-old, female patient with no relevant medical history, who experienced, serious unlisted event of cellulitis, among other non-serious events. The event occurred on an unspecified duration after first dose of Moderna COVID-19 Vaccine. The rechallenge was unknown as the date for first dose was provided. The benefit-risk relationship of Moderna COVID-19 Vaccine is not affected by this report. Most recent FOLLOW-UP information incorporated above includes: On 02-Oct-2021: Significant followup appended, case become serious On 04-Oct-2021: Non-significant follow up added.; Sender''s Comments: This case concerns a 80-year-old, female patient with no relevant medical history, who experienced, serious unlisted event of cellulitis, among other non-serious events. The event occurred on an unspecified duration after first dose of Moderna COVID-19 Vaccine. The rechallenge was unknown as the date for first dose was provided. The benefit-risk relationship of Moderna COVID-19 Vaccine is not affected by this report.


VAERS ID: 1773637 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-03-02
Onset:2021-09-27
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210927; Test Name: PCR; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101290928

Write-up: Fully vaccinated with breakthrough CV19 confirmed positive case. PCR test performed 27Sep, results positive 27Sep2021.; Fully vaccinated with breakthrough CV19 confirmed positive case. PCR test performed 27Sep, results positive 27Sep2021; This is a spontaneous report from a contactable other hcp. A 62-year-old male patient received second dose of bnt162b2 (BNT162B2, PFIZER-BIOTECH COVID-19 VACCINE, Solution for injection, Lot Number: EL3247), Via intramuscular route of administration, administered in left arm on 02Mar2021 (Age at vaccination: 62-years-old) as DOSE 2, SINGLE and first dose via intramuscular route of administration, administered in left arm on 09Feb2021 (Lot Number: EL3247) as DOSE 1, SINGLE for COVID-19 immunization. (Vaccination facility: Workplace clinic). No medical history and no concomitant medications were not reported. Patient was not diagnosed with covid prior to vaccination. It was reported as patient Fully vaccinated with breakthrough CV19 confirmed positive case. PCR test performed 27Sep2021, results positive 27Sep2021. Patient did not receive any treatment for the events. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 27Sep2021 Nasal Swab. Follow-up attempts are completed. No further information is expected.; Sender''s Comments: Based on the information in the case report and a plausible temporal relationship, a possible causal relationship between the events VF and Covid 19 and suspect drug BNT162B2 cannot be excluded.


VAERS ID: 1773640 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diverticulum intestinal, Gastrointestinal haemorrhage, Off label use, Product use issue
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific dysfunction (broad), Ischaemic colitis (broad), Medication errors (broad)

Life Threatening? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101301841

Write-up: gastrointestinal hemorrhage; It was found to be a diverticula; Flu shot, other vaccine same date vaccine date: 27Sep2021; Flu shot, other vaccine same date vaccine date: 27Sep2021; This is a spontaneous report from a contactable consumer (patient). A 67-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), via an unspecified route of administration, administered in the left arm on 27Sep2021 at 11:00 AM (at the age of 67 years old) (Batch/Lot number was not reported) as dose 3 (booster), single for COVID-19 immunisation; and influenza vaccine (INFLUENZA VACCINE), via an unspecified route of administration in the right arm on 27Sep2021 (Batch/Lot number was not reported) at an unknown dose, single for influenza. The patient medical history was not reported. The patient has no known allergies. Concomitant medications included unspecified multiple medications received in two weeks. The patient did not receive other vaccine in four weeks. The patient did not have COVID-19 prior vaccination and had not been tested post-vaccination. The patient previously received first and second dose of BNT162B2 on 30Jan2021 at 10:00 AM and 20Feb2021 at 10:00 AM respectively, both in the left arm for COVID-19 immunisation at the age of 66-years-old. On 27Sep2021 (time of onset was reported as at 08:00 AM and event onset was also reported as 24 hours after Covid booster and flu shot), the patient experienced gastrointestinal hemorrhage and lost large amount of blood and it was found to be a diverticula. It was also reported that the patient received flu shot the same day (27Sep2021) with BNT162B2 vaccine. The patient had to go to emergency room for resuscitation. The patient was hospitalized for three days. The events resulted in doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care. Treatment was received for the events however it was also reported that the bleeding stopped on its own and treatment for "BP". The events gastrointestinal hemorrhage, and diverticula were reported as serious (hospitalization and life threatening). The outcome of the events gastrointestinal hemorrhage and diverticula were recovering. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.


VAERS ID: 1774980 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-26
Onset:2021-09-27
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039D21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cold sweat, Computerised tomogram normal, Decreased appetite, Dizziness, Electrocardiogram normal, Headache, Impaired work ability, Injection site pain, Laboratory test normal, Middle ear effusion, Mobility decreased, Nausea, Pain, Palpitations, Vertigo
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hearing impairment (narrow), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: budesonide inhalant suspension- 0.25mg/2ml , Vitamin C 1000mg , Pataday once daily relief eye allergy itch relief (eye drops as needed ) xoponex inhaler as needed Azelastine nasal drop hcf 0.1%
Current Illness: sinus pressure headache a week prior to vaccination
Preexisting Conditions: Asthma
Allergies: Clarithromycin, zoloft, simbicort, Advair HFA, Morphine
Diagnostic Lab Data: 09/30/21
CDC Split Type:

Write-up: Began with slight headache, chills , injection site soreness. palpitations, light headed and dizzy . Unable to get up from bed that monday morning , very dizzy as if the room was spinning. nausea , lightheaded palpitation that came and went. loss of appetite. Took 2 500 mg Tylenol which helped with the soreness and headache. Tuesday symptoms continued, seemed to be milder through out the day palpitations continued more frequently and felt clammy throughout my body. (no fever what so ever ) . Wednesday morning , woke up feeling well. attempted to work and the dizziness came full force along with nausea. unable to continue to work . I laid down for the rest of the morning . started to feel better . I went to the store with my son and while in the store felt as if I was going ton pass out. when I arrived home , ate and rested . As I was sitting in the recliner, palpitations and dizzy feeling began again and this time lasted longer. I decided to go to the ER at this time. seen at ER where and EKG , labs and CT scan were performed. per provider all results were normal. DX: dizziness, Palpitations, and Middle ear effusion. prescribed Prednisone 50mg tablets 1 by mouth for 7 days, Diphenhydramine 25mg 3 x a day and Meclizine 25 mg


VAERS ID: 1775331 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 2 LA / IM

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

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

Write-up: Dizziness beginning 24 hours after the second injection. This has continued for the past 11 days.


VAERS ID: 1775372 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Differential white blood cell count, Full blood count, Lymphadenopathy, Oedema peripheral, SARS-CoV-2 test
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 1) Testosterone cypionate 200mg/mL, .5cc every 7 days, intramuscular injection 2) Crestor (Rosuvastatin Calcium), 20mg once daily 3) Cimitedine (OTC), 1x daily
Current Illness: None
Preexisting Conditions: 1) Schatzki Ring, severe GERD 2) Occipital lobe stroke, partial loss of peripheral vision in right eye, trauma-induced (2001) 3) Hypercholesterolemia
Allergies: 1) Bactrim (sulfamethoxale-trimethoprim) (severe hives) 2) Povidone-Iodine (skin comes off) 3) Iodized salt / Iodine 4) Adhesives, even hypoallergenic (localized hives, blisters) 5) Shellfish (minor-moderate hives) 6) Wasp venom (moderate hives) 7) Wheatgrass (vomiting, mild hives)
Diagnostic Lab Data: 1) CBC w/ diff 2) Covid PCR Rapid Test 3) Covid PCR lab test
CDC Split Type:

Write-up: Severe lymphatic swelling under both armpits approx the size of a grapefruit; mild lymphatic swelling along collarbone and under jaw


VAERS ID: 1775460 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-24
Onset:2021-09-27
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / 1 RA / IM

Administered by: School       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: Severe, chronic skin itch with numbing and and tingling throughout both arms.


VAERS ID: 1775560 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Hypersensitivity, Paraesthesia oral, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (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: NO
Current Illness: NO
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had experience some tightness in my throat with the first dose. But after taking benadryl the symptom went away within 24hrs. I had the same experience with my second dose in addition to tingling of my lips and tongue. The symtoms started about 30 mins after the vaccine. Just like with my first dose I took some benadryl in the event that I was having an allergic reaction. The feeling of tightness went away the same day. However, the tingling of lips and tongue still persist. I continued to take benadyl for 5 days to see if symtoms would go away, it did not help, tingling still continues.


VAERS ID: 1775562 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-26
Onset:2021-09-27
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Facial paralysis, Mobility decreased, Muscular weakness, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (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: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: On the third day, my left side of my face became paralyzed, although it happened, but I still have involuntary movements and loss of strength in both arms, I still can''t grasp things, I can''t push myself, both arms hurt, half a month has passed since I was vaccinated. and I can''t force myself to get vaccinated this vaccine garbage was fine a few months before I received blood tests from the whole body and it was fine and this garbage has left me badly they are rubbish And so I have to go to work because nobody gives me anything, they are irresponsible, you do the vaccines and you want me to go to the hospital spending my money, they are rubbish


VAERS ID: 1775871 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-26
Onset:2021-09-27
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Chest X-ray abnormal, Echocardiogram abnormal, Laboratory test, Pericardial drainage, Pericarditis, Pleural effusion
SMQs:, Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cardizem, lisinopril, naproxen PRN, omeprazole, maxide
Current Illness:
Preexisting Conditions: Atrial tachycardia, hypertension, coronary artery disease, hyperlipidemia
Allergies: Ampicillin
Diagnostic Lab Data: Admission to hospital October 10. Laboratory work and clinical monitoring. CRP elevation. Chest XR raising concern for large plerual effusion, verified on echocardiogram with pericardiocentesis
CDC Split Type:

Write-up: Pericarditis with pleural effusion


VAERS ID: 1775949 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / UNK - / IM

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

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

Write-up: This spontaneous case reported by a pharmacist, describes the occurrence of administered expired product (received vaccine beyond 30 days) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 vaccine, batch/lot# 037F21A) for COVID-19 immunization. No medical history reported. On Sep 27, 2021, patient received a dose of mRNA-1273 (Moderna COVID-19 vaccine), intramuscular; 1 dosage form. On Sep 27, 2021, patient administered expired product (received vaccine beyond 30 days). At the time of the report, administered expired product (received vaccine beyond 30 days) resolved. The action taken with mRNA-1273 (Moderna COVID-19 vaccine), intramuscular: unknown. The reporter did not provide any causality assessments, concomitant medication or treatment information. This case linked to MOD-2021-338604 (patient link).


VAERS ID: 1776074 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-17
Onset:2021-09-27
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Decreased appetite, Dizziness, Eye pain, Fatigue, Headache, Hyperhidrosis, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lexipro 10mg, ramapril 25mg, fish oil 2000mg, aspirin
Current Illness: shingles
Preexisting Conditions: high blood pressure
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: chills, sweats, headache, eye pain, nausea,dizziness, fatigue, loss of appetite.


VAERS ID: 1776080 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Aura, Blindness, Contusion, Injection site pruritus
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Convulsions (broad), Accidents and injuries (narrow), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins, biotin, multivitamin
Current Illness: Cold(possibly RSV since my son had RSV at the time)
Preexisting Conditions: Slight heart murmur with exercise (no restrictions per physicians)
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Aura type symptoms being seen an hour after vaccine administration (rainbow and geometrical shapes). Appearance in eyes as if I just looked into a bright light(unable to see certain areas of vision, such as half of someone''s face, half a word..etc...). Aura has gone away. Vision loss improved by the next day, but is still there. Arm still feels bruised and aches into shoulder 2 weeks later. Some itching at site on and off.


VAERS ID: 1776292 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: escitalopram 10mg daily
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Penicillin
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient arrived at appointment to receive 3rd Pfizer COVID vaccine and received a dose of the Moderna COVID vaccine. Patient did not experience any symptoms by receiving the incorrect vaccine.


VAERS ID: 1776330 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-17
Onset:2021-09-27
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None as of yet.
CDC Split Type:

Write-up: Symptoms started 2 weeks after receiving the 2nd dose of the vaccine. The symptoms started as heart palpations that occurred at least once a day. The palpations have progressively become more frequent till they were occurring about 30-40 times a day. The palpations seem to occur more often with position changes but can, and do happen at any time. They occur when standing, walking, sitting, or laying.


VAERS ID: 1776447 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA OL16C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest pain, Chills, Dizziness, Fatigue, Headache, Heart rate increased, Pain, Panic reaction, Pyrexia, SARS-CoV-2 test
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID-19 test, blood pressure, heart rate, and blood work.
CDC Split Type:

Write-up: Patient experienced severe headache, fatigue, chills, fever, dizziness, body aches, and chest pains. Patient also experienced high heart rate and panic. Caused patient to seek care with primary care provider.


VAERS ID: 1776453 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30130819 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Headache, Pain, Pain in extremity, Pyrexia, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Covid vaccine #2 02/12/2021 Pfizer EN6201 Age 65
Other Medications: Quinapril Hcl thiazide Jardiance Ozempic Pantoprazole Synthyoid Rosuvastatin Wellbutrin Citalopram Valacylovir Gabapentin Flonase Zyrtec Aspirin Multivitamin
Current Illness: None
Preexisting Conditions: Diabetic Sleep apnea Depression Acid reflux High cholesterol High BP Herpes Hypothyroidism Sciatica Seasonal allergies
Allergies: Clindymycin Peanuts
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Low grade fever, body aches, headache Arm pain, swelling, redness , warm


VAERS ID: 1776483 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-09-27
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Diarrhoea, Dyspnoea, Hypoxia, Pyrexia, Respiratory viral panel, SARS-CoV-2 test positive, Severe acute respiratory syndrome
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: ESRD s/p kidney transplant 07/2020 complicated with thrombotic microangiopathy HTN DMII Hyperlipidemia Gout
Allergies: No known allergies
Diagnostic Lab Data: 09/27/2021 Respiratory Panel = Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) DETECTED
CDC Split Type:

Write-up: 10/01/21 patient presents with shortness of breath, hypoxia. States her oxygen at home was 85% on RA. Pt admitted for 3 days for covid. Pt tested positive for covid. Had booster last week but her grandson was sick last week. Pt tested positive 9/23/21. Reports chronic diarrhea, shortness of breath, cough ,fever. She did not receive decadron or remdesivir.


VAERS ID: 1776951 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-03-31
Onset:2021-09-27
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Chills, Cough, Dyspnoea, Fatigue, Hypoxia, Increased bronchial secretion, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: MHx of a.fib (not on anticoagulation), hx MI (s/p DES to proximal RCA in 2012), HTN, HLD, hx colon cancer s/p resection & chemo, vocal cord paralysis after intubation (s/p trach/PEG in 10/2019),
Allergies:
Diagnostic Lab Data: COVID rapid antigen + 9/27/21
CDC Split Type:

Write-up: 9/27/21: presented to the ER today for further evaluation of dyspnea, cough, and severe fatigue. COVID-19 Pneumonia, Hypoxemia, Sx onset: 9/19 (chills only) - COVID + on: 9/27 - Vaccination status: fully vaccinated - Current sx: dyspnea, chills, fevers (Tmax 39.3 in ER), cough, increased trach secretions - Current O2 requirement: 6L via trach


VAERS ID: 1778837 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-11
Onset:2021-09-27
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH RC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood test, Dyspnoea, Electrocardiogram, Fall, Hypoaesthesia, Limb discomfort, Palpitations, X-ray
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Morning: Losartan 25mg x1 Atorvastatin 10mg x1 Fenofibrate 160mg x1 Fish oil 1000mg x2 Vitamin D 125mcg x1 Mon/wed/fri: B-12 1000mcg x1 B-6 100mg x1 Evening: Gabapentin 100mg x2
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: EKG taken at dr office on 9/27 X-ray taken on 9/28 Blood work done on 9/28
CDC Split Type:

Write-up: At 4am I woke up and could not breath, it felt like my heart had stopped and it took about 30 minutes to catch my breath. When I got out of bed to catch my breath, I had no strength and fell to my knees, and had to crouch over on my couch I think I regained my strength as well as my breath. I couldn?t feel my left arm for about 1hr, but within 12 hours I regained feeling in it, but it still felt funny. I went to my dr that morning, and have scheduled to go to see a cardiologist later this month. I saw my dr again today and she thinks it could be Cardiac Inflammation. I have stopped taking my Gabapentin since the incident occurred, and my dr and I are awaiting to see the cardiologist for further treatment.


VAERS ID: 1778883 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-04-06
Onset:2021-09-27
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Eye pain, Headache, Migraine
SMQs:, 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: l-lysine 1000 mg od; verapamil ER 180 mg bd; Wellbutrin XL 150 mg od; Zyrtec 10 mg od; meloxicam 15 mg od; amlodipine besylate 5 mg od
Current Illness: no
Preexisting Conditions: high blood pressure; fibromuscular dysplasia; sarcoidosis ( in remission )
Allergies: diclofenac; any opioids
Diagnostic Lab Data: no I am going to see the doctor on 10/18/2021 to get a physical.
CDC Split Type: vsafe

Write-up: On 09/27/2021, I woke up and felt like my eyeballs were falling out, intense pain on the right side of my head. It''s ongoing. I still feel it. It''s not a bad headache. I just know I am going to feel it later, like a pounding, that just has not gone away. Doctor called in some medication- Eletriptan HBR 40 mg, and something for me to sleep, as needed, Diazepam 10 mg. I have never had a migraine or headache like this. I normally take a pill and it''s gone. This is a headache that is ongoing, that I have never experienced before. I have tried taking 4 Advils and 2 Tylenols and they do not touch it. It is not a regular headache that I have. Even if this is from the vaccine, I would still get the vaccine.


VAERS ID: 1778992 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-24
Onset:2021-09-27
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Arrhythmia, Blood magnesium decreased, Blood potassium decreased, Cardioversion, Condition aggravated, Deep vein thrombosis, Electrolyte imbalance, Endotracheal intubation, Implantable defibrillator insertion, Pain in extremity, Ventricular tachycardia
SMQs:, Torsade de pointes/QT prolongation (narrow), Angioedema (broad), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Hypokalaemia (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amiodarone 100mg qam, Amlodipine 5mg bid, Vitamin B12 1000mcg qam, fenofibrate 145mg qd, glipizide 2.5mg qam, Toprol XL 150mg q24, omeprazole 40mg qd, sertraline 100mg qd, Janumet 50/1000mg bid-ac, valsartan 160mg qd
Current Illness: None
Preexisting Conditions: Ischemic cardiomyopathy V-tach / V-fib cardiac arrest 7/2017 V-tach 3/2021 s/p VT ablation 5/24/21
Allergies: NKDA
Diagnostic Lab Data: 9/27 single-chamber AICD interrogated - 23 defibrillations in 24 hours 10/4 AICD exchanged to a dual-chamber AICD 10/8 AICD fired 11 times / last 24 hours - attempted to pace / defib out of V-tach but recurred; amiodarone re-bolus; continues on Amiodarone 1mg/min and Lidocaine 1mg/min; Mexiletine 200mg q12; intubated and sedated to minimize catecholamine surge 10/9 new LLE DVTs and B-PEs - heparin drip started 10/11 Alteplase 50mg IV for PE
CDC Split Type:

Write-up: Patient received 1st dose on 9/24/21 and reported a sore arm afterward but then awoke 9/27 to AICD firing and fired multiple times enroute to ED and in the hospital. Found to have multiple electrolyte abnormalities (K 3.1, Mag < 0.5); placed on amiodarone and lidocaine drips, started mexilitine 200mg q12. Single chamber AICD upgraded to dual chamber AICD on 10/4/21. Recurrent VTach on 10/8/21 - multiple AICD defibs - paced out and started again on amiodarone and lidocaine. Continued issue - required intubation and sedation on 10/8 due to on-going runs of Vtach and AICD defibrillations. At the time of this report, remains on Amiodarone at 1mg/min, Lidocaine at 1mg/min, Mexiletine 200mg PO q12h and is still intubated and sedated. Note - hospital course has now been further complicated by new LLE DVT and B-PEs on 10/9. Unclear if also associated with vaccine or a complication of hospitalization / arrhythmia. This has been treated with 50mg IV alteplase and he is currently on a heparin drip.


VAERS ID: 1779147 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-14
Onset:2021-09-27
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest pain, Exposure to SARS-CoV-2, Loss of personal independence in daily activities, Productive cough, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient states productive cough starting yesterday, reports exposure to Covid 2 nights ago from daughter. KEY SYMPTOMS AND ASSESSMENT:9/29/21 Cough congestion and chest pain with coughing. No fever. Positive for COVID on 9/28/21. Pt not using OTC cough medication. Cough drops helping some. Tylenol as needed helps a little. ADLs effected by situation. Cough producitve per pt clear to yellow.


VAERS ID: 1779149 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-01
Onset:2021-09-27
   Days after vaccination:210
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Malaise
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fully vaccinated and admitted to the hospital with signs/symptoms consistent with COVID


VAERS ID: 1779187 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-26
Onset:2021-09-27
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discomfort, Mass
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: no
Current Illness: no
Preexisting Conditions: Migraines
Allergies: no
Diagnostic Lab Data: none
CDC Split Type: vsafe

Write-up: On 09/27/2021 you noticed a lump in my left arm, it was the size of a kiwi. It was very uncomfortable, the lump is still there but it is going down.


VAERS ID: 1779191 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-13
Onset:2021-09-27
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30130BA / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac disorder, Ventricular extrasystoles
SMQs:, Ventricular tachyarrhythmias (narrow), Hypokalaemia (broad)

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

Write-up: Systemic: Cardiac Disorder (diagnosed by MD)-Medium, Systemic: PVC-Medium


VAERS ID: 1779258 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-06
Onset:2021-09-27
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036A21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Hospitalization after a tetanus shot in 1976
Other Medications: Hydrochlorothiazide 25 mg daily Amlodipine Besylate 10 mg daily Armodafinil 150 mg daily Montelukast SOD 10 mg daily Triameterene 50 mg daily Venlafaxine HCL ER 150 mg daily Naproxen 250 mg x 4 daily Tizanaidine HCL 2mg daily Turmeric 3 cap
Current Illness:
Preexisting Conditions: Asthma, Obesity, depression, High blood pressure, mobility issues from a bulging disk in my back, shoulder pain from a disc issue in my neck. I also have edema and know had it in the summer of 2020, and it returned in the fall. I don''t know if that counts.
Allergies: Poison ivy, and old tetanus serum
Diagnostic Lab Data: Blood test 9/28/2021 - no indication of an infection. Ultrasound 9/28/2021 - no blood clot
CDC Split Type:

Write-up: I am pretty sure this isn''t related to the vaccine. On Monday, 9/27/2021, I noticed that my right shin was red. On Tuesday, my lower leg was very swollen and very red. I thought it might be cellulitis. I called to make an appointment with my primary care doctor and was told to go to Urgent Care or the Emergency Room to rule out a blood clot or major infection. I went to Urgent Care. The PA who examined me was very concerned that it had swelled so much overnight and sent me to the emergency room for what he anticipated would need antibiotics. I traveled to the emergency room where I had an ultrasound, and blood test to rule out other issues and was sent home with a prescription for Cephalexin 500 mg, 4x daily. After a few days of elevation and the antibiotic, the swelling went down and the cellulitis went away. On 10/1/2021 I went to my new primary care doctor who replaced my original primary care doctor who retired the day before. He said it was cellulitis but was better and to continue with the treatment until the medication was finished.


VAERS ID: 1779279 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-25
Onset:2021-09-27
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Asthenia, Atrial fibrillation, C-reactive protein increased, Cardiac tamponade, Cardioversion, Chest discomfort, Computerised tomogram thorax abnormal, Cough, Decreased appetite, Dyspnoea, Echocardiogram, Ejection fraction normal, Hypotension, Inferior vena cava dilatation, Mitral valve incompetence, Mobility decreased, Pericardial drainage, Pericardial effusion, Pleural effusion, SARS-CoV-2 test negative, Troponin increased, Ventricular hypertrophy, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Supraventricular tachyarrhythmias (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine 5 mg, atorvastatin 40 mg, folic acid 1 mg, levothyroxine 50 mcg, methotrexate 2.5 mg
Current Illness:
Preexisting Conditions: rheumatoid arthritis, hypertension, hypercholesterolemia, breast cancer, hypothyroidism, COPD
Allergies: NKDA
Diagnostic Lab Data: Troponin 9/29 at 1806, 2123, and 2249: < 0.02 ng/mL, C-reactive protein 9/29 at 1806: 167 mg/L, (see following page) TTE on 9/29 at 2039: o Left ventricle cavity size is normal. Left ventricular systolic function is in the normal range with an ejection fraction in the 55-70% range. o Right ventricle cavity is underfilled. Right ventricular systolic function is normal. o Moderate circumferential pericardial effusion. Small probability of cardiac tamponade. TTE on 9/30 at 1557: o Left ventricle wall thickness is normal. o Moderate circumferential pericardial effusion. TTE on 10/2 at 1549: o Left ventricular systolic function is in the normal range with an ejection fraction of 55-60%. o Small fibrinous circumferential pericardial effusion. o IVC/SVC: Inferior vena cava is dilated. RA pressures is estimated to be 15 mmHg (IVC diameter $g21 mm and decreases <50% during inspiration). TEE on 10/5 at 1205: o Normal LVEF, $g 55%. o Mild to moderate mitral valve regurgitation, o No LA or LAA thrombus. o Left pleural effusion. o 200J DCCV synchronized shock x 1 with return to NSR 60s.
CDC Split Type:

Write-up: Patient received COVID-19 booster vaccine (Pfizer) on 9/25/21. On 9/27 she reported generalized weakness, not getting out of bed or eating for 2 days. On Wednesday 9/29 she went to Urgent Care for a COVID-19 test which was negative and a chest CT was ordered. There were findings of effusion so she was referred to the emergency department. Upon presentation to the emergency department, the patient was hypotensive, experiencing new onset atrial fibrillation, and requiring 2L oxygen. Cardiology was consulted and advised to monitor with telemetry. The following morning 9/30/21 the patient denied chest pain, shortness of breath, palpitations, and dizziness. A pericardiocentesis was completed on 9/30/21. Post-procedure the patient remained hypotensive and complained of mild chest tightness. The following day, the patient reported shortness of breath and a nonproductive cough. The patient was started on colchicine 0.6 mg BID. The patient''s statin was continued. On 10/2/21, metoprolol was added for rate control for atrial fibrillation and patient reported cough and wheezing. On 10/3 the patient was started on Eliquis 5 mg twice daily for stroke prevention and did not complain of cardiac symptoms. The patient had no further cardiac complaints on 10/2 and 10/3/21 awaiting procedures for cardioversion. The patient tolerated the procedure and did not complain of chest pain, shortness of breath, palpitations, cough, or wheezing. On 10/6/2021 the patient was stable for discharge. She was discharged on home medications with the addition of metoprolol tartrate 25 mg twice daily, Eliquis 5 mg twice daily, colchicine 0.6 mg twice daily, and an albuterol inhaler. Her home amlodipine was discontinued. She was instructed to follow up outpatient for further monitoring.


VAERS ID: 1779285 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-27
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test normal, Bone pain, Fatigue
SMQs:, Osteonecrosis (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, Wellburtrin, Lorazapam, Jintelli
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: bloodwork not showing markers for inflamation
CDC Split Type:

Write-up: Fatigue, pain in joints and bones for 2 weeks now.


VAERS ID: 1779367 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-24
Onset:2021-09-27
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Abdominal rigidity, Extra dose administered, Fatigue, Temperature intolerance
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Magnesium, Calcium, B-complex, Cinnamon, Vit. D-3, Vit. E, Turmeric, Ginger
Current Illness: None
Preexisting Conditions: None
Allergies: Latex?
Diagnostic Lab Data:
CDC Split Type:

Write-up: Three days after vaccine Booster, I experienced very severe cramping/spasms in lower abdomen. It felt like my body was trying to eliminate toxins from my system. This lasted approximately 48 hours, gradually subsiding after approximately 10 days. I was also extremely fatigued, and more susceptible than usual to warm temperatures.


VAERS ID: 1779417 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-31
Onset:2021-09-27
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Dyspnoea, Fatigue, Pneumonia, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: Albuterol, Flovent, QVAR, Bevespi, Crestor, amlodipine, pantoprazole, Nucala, itraconazole, tadalifil, testosterone Mucinex, probiotic, ubiquinol, melatonin, calcium, zinc, D3, K2, caprylic acid
Current Illness: None
Preexisting Conditions: Asthma, ABPA (Allergic Broncho-Pulmonary Aspergillosis)
Allergies: None
Diagnostic Lab Data: chest x-ray 9/29/21 - diagnosed small area of pneumonia
CDC Split Type:

Write-up: unexpected pneumonia flare-up - shortness of breath, fever 101+, fatigue


VAERS ID: 1779458 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Pain in extremity
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: bruising occurred shortly after about 4 inches in diameter, still has bruising 2 weeks after; arm still sore after 2 weeks


VAERS ID: 1779584 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-09-27
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010AZ1A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045AZ1A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Muscular weakness, Rash, Rash erythematous, Rash pruritic, Skin burning sensation, Skin warm, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: pantoprazole 40 mg EC tablet propranolol LA 60 MG 24 hr capsule rizatriptan 10 MG tablet topiramate 50 MG tablet lisinopril 40 MG tablet citalopram 20 MG tablet
Current Illness: N/a
Preexisting Conditions: Bicuspid aortic valve Aneurysm of thoracic aorta Gastroesophageal reflux disease Diverticulitis Gastric polyps Anxiety HTN (hypertension) High cholesterol Obesity
Allergies: N/A
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: I have a severe rash on my cheeks and around my eyes that burns and is very itchy. I saw my doctor via a tele-med appointment and she prescribed methylPREDNISolone 4 MG tablets. The rash is clearing up but it is still very red at times. In addition I have a rash on my left ankle similar to a jelly fish sting in that it is around the lower portion of my ankle. It hurts to touch it and is very warm to the touch and is also itchy. I also had trouble using my leg until I was using the steroids were in my body for 2 days.


VAERS ID: 1780615 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-23
Onset:2021-09-27
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 1 LA / SYR
FLU4: INFLUENZA (SEASONAL) (FLULAVAL QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood test, Chest X-ray, Computerised tomogram, Dyspnoea, Electrocardiogram, Heart rate increased, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft, Daily Multi-Vitamin, Biotin, Zyrtec, Vitamin C + Zinc
Current Illness:
Preexisting Conditions: Exercise-induced Asthma
Allergies: N/A
Diagnostic Lab Data: 10/01/21 - EKG, Cat Scan, Chest X-ray, Blood tests
CDC Split Type:

Write-up: Shortness of breath and elevated heart rate started 09/27/21. Increased throughout that week. I visited the ER on 10/01/21 where I was admitted to the hospital for pulmonary embolism in the lower lobe of my left lung. I was discharged from the hospital on 10/04/21 with Lovenox injections and Coumadin.


VAERS ID: 1780797 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-22
Onset:2021-09-27
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Muscle spasms, Polymenorrhoea
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (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: Contacted OB/GYN and Physician''s office, both said this has been experienced by women in their offices and that if bleeding doesn''t stop to come in for testing
CDC Split Type:

Write-up: Starting menstrual cycle 10 days early (10/27); lasted 2 days longer than usual (until 10/3), heavier bleeding, and painful cramps. SECOND period started 10/12; immediately had intense painful cramps and heaviest bleeding I''ve ever experienced


Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=92&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166