National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

From the 1/14/2022 release of VAERS data:

Found 16,905 cases where Vaccine is COVID19 and Symptom is Acute endocarditis or Atypical mycobacterium pericarditis or Autoimmune myocarditis or Bacterial pericarditis or Carditis or Endocarditis or Endocarditis bacterial or Endocarditis enterococcal or Endocarditis noninfective or Endocarditis staphylococcal or Endocarditis viral or Eosinophilic myocarditis or Fungal endocarditis or Giant cell myocarditis or Hypersensitivity myocarditis or Immune-mediated myocarditis or Lupus endocarditis or Lyme carditis or Meningococcal carditis or Myocarditis or Myocarditis bacterial or Myocarditis infectious or Myocarditis post infection or Myocarditis septic or Myopericarditis or Pericarditis or Pericarditis constrictive or Pericarditis infective or Pericarditis lupus or Pericarditis meningococcal or Pericarditis rheumatic or Pericarditis tuberculous or Pleuropericarditis or Purulent pericarditis or Streptococcal endocarditis or Subacute endocarditis or Viral myocarditis or Viral pericarditis

Government Disclaimer on use of this data

Table

   
Event OutcomeCountPercent
Death2191.3%
Permanent Disability7344.34%
Office Visit2,66215.75%
Emergency Doctor/Room3,81822.59%
Hospitalized9,03953.47%
Hospitalized, Prolonged290.17%
Recovered3,04318%
Birth Defect120.07%
Life Threatening1,4628.65%
Not Serious4,16024.61%
TOTAL† 25,178† 148.94%
† Because some cases have multiple vaccinations and symptoms, a single case can account for multiple entries in this table. This is the reason why the Total Count is greater than 16905 (the number of cases found), and the Total Percentage is greater than 100.



Case Details

This is page 1 out of 170

Result pages: 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   next


VAERS ID: 912891 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: California  
Vaccinated:2020-12-19
Onset:2020-12-22
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2020-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dyspnoea, Exercise tolerance decreased, Painful respiration, Pericarditis, Pleuritic pain
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin Ambien as needed
Current Illness: None
Preexisting Conditions: History of kidney stones, low back pain, and Dupytren''s Contracture.
Allergies: None
Diagnostic Lab Data: No definitive proof of pericarditis. Was told to come in for an EKG if my symptoms persisted beyond the next few days. Since I''m improving I''m not planning on any additional testing.
CDC Split Type:

Write-up: Received the COVID-19 vaccine 12/19/2020 and felt great the next few days with zero symptoms. About 3-4 days later I felt some chest discomfort especially when taking a deep breath in. This occurred on both the front side and back side of chest. This continued for the next 5-7 days. Kept experiencing pain with deep breaths and my exercise tolerance was diminished. When I would hike up a small incline I felt I was not getting enough air and was a bit winded. Finally made an e-visit with my healthcare provider on 12/28/2020 after 5-7 days of symptoms. Knowing I work in healthcare my provider asked if my pain felt like, "pleuritic chest pain" and I think that is a spot on description of how it felt. Based on my symptoms he told me the most likely diagnosis is a mild case of pericarditis and prescribed me ibuprofen 400 mg by mouth 3 times daily for a few days. After ~36 hours of ibuprofen I''m feeling 80-90% better but still have some discomfort with deep breaths or exertion.


VAERS ID: 919087 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: California  
Vaccinated:2020-12-23
Onset:2020-12-27
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Antinuclear antibody negative, C-reactive protein increased, Fibrin D dimer increased, Hepatitis C antibody negative, Pericarditis, Red blood cell sedimentation rate normal, Troponin T increased
SMQs:, Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin daily
Current Illness: No illness one month prior to or at time of vaccination
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: 12/29 ANA negative. CRP 7.2 mg/dL. ESR 8 mm/hr. 12/28 Troponin T 67 ng/L. Hep C Ab = Non reactive. D-dimer 319 ng/mL.
CDC Split Type:

Write-up: Acute Pericarditis. Patient was admitted from 12/27-12/28/2020 at hospital by cardiology team who strongly felt the acute pericarditis was due to the Pfizer Vaccine (Dr. was senior cardiologist).


VAERS ID: 919334 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New York  
Vaccinated:2020-12-28
Onset:2021-01-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5703 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Echocardiogram normal, Electrocardiogram normal, Full blood count normal, Metabolic function test normal, Pericarditis, Troponin normal
SMQs:, Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Truvada, Lexapro, Wellbutrin
Current Illness:
Preexisting Conditions: prior COVID-19 infection in March 2020
Allergies: Cefprozil
Diagnostic Lab Data: 1/1/2021 EKG Echo (no effusion, normal cardiac wall motion) Troponin (wnl) CBC (wnl) BMP (wnl)
CDC Split Type:

Write-up: Acute pericarditis


VAERS ID: 923354 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2020-12-23
Onset:2020-12-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2020520292

Write-up: acute pericarditis; This is a spontaneous report from a contactable physician. A male patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot/batch number not reported), via an unspecified route of administration on 23Dec2020 at a single dose for covid-19 immunization. The patient medical history and concomitant medications were not reported. It was unknown if other vaccines were given in four weeks and unknown if patient had Covid prior vaccination. The patient experienced acute pericarditis on 24Dec2020. Clinical course as follows: Doctor colleagues at the institution admitted (at Emergency room/department or urgent care) and treated a patient with acute pericarditis who received his first dose of Pfizer SARS-CoV-2 EUA vaccine on 23Dec2020. The physician (reporter) considered the event as non-serious. The outcome of the event was recovering. Information about batch/lot number has been requested.; Sender''s Comments: The causal relationship between BNT162B2 and the event acute pericarditis cannot be excluded as the information available in this report is limited and does not allow a medically meaningful assessment. This case will be reassessed once additional information becomes available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 925542 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New York  
Vaccinated:2020-12-28
Onset:2021-01-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Echocardiogram normal, Electrocardiogram PR segment depression, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Laboratory test normal, Pericarditis, Troponin normal
SMQs:, Systemic lupus erythematosus (broad), Myocardial infarction (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Cefprozil (Hives)
Diagnostic Lab Data: See "Item 18"
CDC Split Type:

Write-up: On 1/1/21 (4 days post dose 1), patient developed sudden onset substernal chest pain that resolved and recurred the next day on 1/2/21. Patient was seen in the emergency department. VS were reported WNL, EKG with diffuse ST elevations and subtle PR depressions consistent with pericarditis. ECHO did not show evidence of effusion or tamponade. CXR and basic labs were unremarkable including troponin WNL. Patient sent home with colchicine and NSAIDS with plan for outpatient cardiology follow up. Of note, patient had COVID-19 in April 2020 with documented positive antibodies at that time.


VAERS ID: 932325 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-01-05
Onset:2021-01-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Chest discomfort, Chills, Electrocardiogram, Nausea, Pain, Painful respiration, Pericarditis, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Plaquinel, b12, Flonase,
Current Illness: None
Preexisting Conditions: SLE
Allergies: NKDA
Diagnostic Lab Data: 1/9 EkG and chest x-ray, both looked good. They did not have an echo or a CT scanner. Recommended me to go to the ER. I have been taking 600 mg ibuprofen every 6 hours (around the clock) to clear the inflammation and as of this morning 1/10 I am feeling 95% better! I will call my rheumatologist tomorrow when they open to see if he recommends echo/ct to check my heart.
CDC Split Type:

Write-up: 1/5/21 started with fever (up to 101), severe body aches, shaking from being cold even bundled with electric blanket, nausea and vomiting. That lasted through 1/8. On 1/7 I started having trouble with taking a deep breath. Chest would get very tight and hurt when I would take a big breath, bend forward, or lay back. I went to express care and they could not rule out pericarditis. Told me to go to the Emergency Room for further work up to rule out spontaneous PE or pericarditis.


VAERS ID: 935452 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-01-06
Onset:2021-01-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Diarrhoea, Echocardiogram normal, Electrocardiogram T wave abnormal, Myocarditis, Nausea, Platelet count decreased, Pyrexia, Thrombocytopenia, Troponin increased, Vomiting
SMQs:, Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multivitamin daily
Current Illness: no
Preexisting Conditions: no
Allergies: NKDA
Diagnostic Lab Data: Troponin 0.08 and then 2.3 and up to 4 Platelets 85 and then 61.
CDC Split Type:

Write-up: 1/6/21 8pm started with Nasuea, vomiting, diarrhea and fever. 1/7/21 started having intermittent chest pain in the morning. Then in the evening it became constant. Went to ER that evening due to chest pain. EKG showed t wave abnormality. 1st Trop was negative went from 0.08 to 2.3 Had 2 Echo''s done and they were normal. Platelets were 85. Was discharged without chest pain. Troponin on discharge was 0.67 and platelets 61. Was admitted due to Chest pain and troponin. Attending provider diagnosed as myocarditis and thrombocytopenia R/T vaccine.


VAERS ID: 937932 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-01-07
Onset:2021-01-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram ST segment elevation, Myalgia, Myocarditis, Pyrexia, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Patient presented with myalgias, fevers, and chest pain on 1/10/21 and was found to have diffuse ST elevation and elevation troponin. He was evaluated by cardiology and diagnosed with acute myopericarditis. He was treated with NSAIDs and colchicine. He improved with this treatment and was discharged on 1/12/21 with ibuprofen and colchicine and outpatient cardiology follow up.


VAERS ID: 944489 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Virginia  
Vaccinated:2020-12-18
Onset:2020-12-28
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chest discomfort, Chest pain, Chills, Impaired work ability, Myalgia, Pericarditis, Pyrexia, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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: Modafinil 200mg daily
Current Illness: No
Preexisting Conditions: Central sleep apnea
Allergies: Amoxicillin
Diagnostic Lab Data: See above 1/13 dx pericarditis Split S2 PR depressions St elevations
CDC Split Type:

Write-up: Feverish feeling and chills with myalgias and weakness at 4am on 12/18/2020. Took 800mg advil and 1000mg tylenol. Felt perfect by 7 am. Despite this, fearing covid, I did not go to work, was rapid trsted covid negative that day and pcr tested that day retirning negative 2 days later. Days later I began to have vague nagging chest pain with occasional sharp chest pain over my heart. I had what I would describe as chest tightness in addition in which it felt hard for me to expand my chest fully like pressure without being short of breath. This would last at most several minutes and perhaps occurred three or four times over a seven day period. Throughout this. I could exercise with no chest pain no increasing shortness of breath, including a PR on Peloton and two hours of tennis without cardiac symptoms. Yesterday, my smart internist heard a split S2 heart sound as I lay on my left side and held my breath; the EKG showed a depressed PR interval ad some ST elevstions consistent with pericarditis, which I am treating with motrin. I assume this is a viral pericarditis. I had two types of Covid tests during that time period. My second dose of the vaccine was January 8. The feverish feeling occurred before dose 2, as did some of the chest oains and tightness.


VAERS ID: 952497 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Illinois  
Vaccinated:2020-12-19
Onset:2021-01-08
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal distension, Cardiac failure, Cardiomegaly, Cardiomyopathy, Computerised tomogram abdomen abnormal, Computerised tomogram thorax abnormal, Constipation, Cytomegalovirus test, Cytomegalovirus test negative, Dyspnoea, Dyspnoea exertional, Echocardiogram abnormal, Ejection fraction decreased, Epstein-Barr virus antibody negative, Hepatitis viral test negative, Hilar lymphadenopathy, Hypertension, Left ventricular dysfunction, Lymphadenopathy mediastinal, Magnetic resonance imaging heart, Myocarditis, Obesity, Pain in extremity, Pericardial effusion, Pleural effusion, Pulmonary oedema, Respiratory viral panel, Right ventricular ejection fraction decreased, SARS-CoV-2 antibody test negative, SARS-CoV-2 test negative, Sleep apnoea syndrome, Ventricular hypokinesia
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nexium 20mg po daily Duloxetine 60mg po daily Ibuprofen as needed Vitamin D
Current Illness:
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data: Echo with severe diffuse LV hypokinesis 1/12 Hepatitis panel negative, EBV/CMV IgG positive/IgM negative, 1/12 COVID antibody: negative 1/9 RVP negative 1/8 COVID PCR negative RADIOLOGY: MRI cardiac 1/11: 1. There is linear mid myocardial late gadolinium enhancement in the inferoseptal wall of the left ventricle in a nonischemic pattern. This may represent sequela of myocarditis. Findings do not appear to be acute. 2. The left ventricle is dilated with global hypokinesis and significantly reduced LV systolic function. The calculated left ventricular ejection fraction is 25%. There is also diastolic dysfunction. 3. The right systolic function is also reduced with ejection fraction of 30%. 4. There is a moderate-sized pericardial effusion without evidence of pericarditis or constrictive physiology. CT chest 1/8: 1. No evidence of pulmonary embolism. 2. Mild cardiomegaly with small/moderate-sized pericardial effusion that appears mildly increased in size from the earlier abdominal CT. There are findings of mild pulmonary edema which are greatest in the lung bases and are new from the earlier abdominal CT. 3. Small/moderate right and small left pleural effusions which have mildly increased in size from the earlier abdominal CT. 4. Nonspecific mediastinal and right hilar lymphadenopathy CT A/P 1/8: 1. No evidence of acute abdominal/pelvic abnormality. 2. Small/moderate-sized pericardial effusion. 3. Small right and trace left pleural effusions.
CDC Split Type:

Write-up: Patient with PMH of depression and GERD who presented 1/8 with constipation, abdominal discomfort and worsening dyspnea. Symptoms began around 12/29. COVID vaccine 12/19. Previously quite active, marathon runner, gained some weight over last couple years but was still in good enough shape to complete 10K in New Orleans in early February. In late February, had a flu-like illness, as did one of his friends from church. 2020 was hard on him - weight gain, decreased activity, stress, overall deconditioning. No issues apart from sore arm after COVID vaccine 12/19 but then starting getting abdominal fullness/discomfort around 12/29, which steadily worsened, also develop worsening dyspnea on slight exertion. No known sick contacts.. Work-up notable for pericardial effusion, pleural effusions. Echo with severe diffuse LV hypokinesis, concern raised for myocarditis. COVID PCR negative, serology negative. RVP negative. . Concern raised that COVID vaccine may have played a role in myocarditis. He was found to have the following conditions Acute heart failure with reduced EF NYHA FC II, non-ischemic cardiomyopathy. Myocarditis appears subacute per MRI hypertension obesity small pericardial effusion- asysmptomatic no pericarditis suspected obstructive sleep apnea. .Started on the following medications. Continue Carvedilol 12.5mg BID, Farxiga 5mg daily, Digoxin 0.125mg daily, Entresto 97-103mg BID, and Spironolactone 25mg daily. Per MD note. While it remains uncertain, team is doubtful COVID vaccine played a role in his cardiac issues. Given the MRI findings are not acute, more likely that the cardiac insult occurred weeks to months ago - potentially in the setting of the February 2020 illness. Perhaps his "deconditioning" in 2020 was related to worsening cardiac function. Nevertheless, will hold on 2nd COVID vaccine dose given absence of a clear explanation for his myocarditis. conversation with team will continue to determine if candidate for second covid vaccine. If consensus is that myocarditis pre-dated vaccine, might be able to proceed with dose 2 of vaccine.


VAERS ID: 953557 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2020-12-30
Onset:2020-12-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / OT

Administered by: Senior Living       Purchased by: ?
Symptoms: Myocarditis
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (No reported medical history)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Myocarditis; A spontaneous report was received from a physician, concerning a 18-year-old, male patient who received Moderna''s COVID-19 vaccine (mRNA-1273) and experienced myocarditis. The patient''s medical history was not provided. No relevant concomitant medications were reported. On 30 Dec 2020, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (lot number: 037K20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 31 Dec 2020, within 24 hours of vaccine administration, the patient develop symptoms of myocarditis and was admitted to the hospital. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome for the event, myocarditis, was not reported.; Reporter''s Comments: This case concerns an 18-year-old, male, who experienced a serious unexpected event of myocarditis. The event occurred approximately 2 days after first dose of mRNA-1273, Lot# 037K20A administration. No information available regarding medical history and concomitant medications. Very limited information regarding this event has been provided at this time. Based on temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 963213 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-18
Onset:2021-01-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Acute myocardial infarction, Catheterisation cardiac, Chest pain, Electrocardiogram ST segment elevation, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Daily Multivitamin
Current Illness: No
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 1/21/2021: Troponin 4.8 at 10:00. EKG showed inferior and lateral ST elevation
CDC Split Type:

Write-up: Patient had 4 hours of chest pain 3 days after vaccine. EKG showed STEMI. Troponin elevated at 4.8. Patient sent for cardiac catheterization and results pending. At this time suspect myocarditis, but STEMI not yet excluded


VAERS ID: 965715 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-08
Onset:2021-01-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood test, Catheterisation cardiac, Chest pain, Echocardiogram, Electrocardiogram, Magnetic resonance imaging, Myocarditis, Viral cardiomyopathy
SMQs:, Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Breast Cancer 2010
Allergies: None
Diagnostic Lab Data: Blood work, EKG, Echocardiogram, MRI, cardiac catheterization
CDC Split Type:

Write-up: viral cardiomyopathy, myopericarditis, weakness, chest pains


VAERS ID: 966243 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-18
Onset:2021-01-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 2 UN / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Chills, Electrocardiogram normal, Fatigue, Full blood count normal, Hyperhidrosis, Lymphoedema, Metabolic function test, Myalgia, Myocarditis, Nausea, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: penicillin
Diagnostic Lab Data: BP 127/72, HR 88, RR 18, SpO2 98%RA Troponin peaked at 3.02 (1/21) CXR did not have abnormalities (1/21) Other labs including CBC and BMP were unremarkable (1/21) EKG revealed diffuse ST elevations (1/21, 1/22)
CDC Split Type:

Write-up: According to patient, he received the COVID vaccine on 1/18 and endorsed typical vaccine symptoms (myalgias, fatigue, lymphedema on right axillary, sweats and chills). He was taking ibuprofen for prophylactic symptom relief and was able to attend work the following day. The patient stated to still endorses symptoms of the vaccine days after but did not seek medical attention because he thought the symptoms would resolve. The morning of 1/21, patient sustained constant, nonradiating chest pain located along the sternal that was moderate to severe in nature and exacerbated with deep inspiration that lasted 2 hours. Lying on the side provided minimal relief but the pain was still moderate. Nausea also accompanied the pain but the patient denied any vomiting. Patient decided to go to the ED for work-up. Patient had two further episodes of chest pain and EKG revealed diffuse ST elevations. Troponin level peaked at 3.02. He was diagnosed with myopericarditis and started on colchicine, with improvement of chest pain.


VAERS ID: 966794 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-08
Onset:2021-01-19
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J 20-2A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Chest pain, Computerised tomogram normal, Echocardiogram normal, Electrocardiogram normal, Impaired work ability, Laboratory test normal, Magnetic resonance imaging normal, Pain, Pericarditis, Troponin normal
SMQs:, Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Cellulitis in injected arm. Age 50y Pneumonia vaccine given around 2016
Other Medications: Wixela, Sildenafil
Current Illness: None
Preexisting Conditions: Asthma, hypertension
Allergies: None
Diagnostic Lab Data: 1/19/21: CTA w contrast, no aortic dissection Blood work x 2, negative Troponin and inflammatory markers Echo, no pericardial effusion MRI w contrast, no pericardial effusion and normal pericardial thickness EKG, diffuse ST segment elevation more pronounced than baseline ECG done in 2018 which showed early repolarization
CDC Split Type:

Write-up: Severe stabbing chest and back pain radiating to the left axilla. Diagnosed with atypical pericarditis with diffuse ST elevation on EKG but no effusion or pericardial thickening on echo/MRI. Treated with ongoing Colchicine and complete resolution of pain. Spent the night under ER observation. Missed 4 days of work.


VAERS ID: 967286 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-13
Onset:2021-01-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Chest pain, Electrocardiogram PR segment depression, Electrocardiogram PR segment elevation, Electrocardiogram ST segment elevation, Fatigue, Myalgia, Myocarditis, Pyrexia, Red blood cell sedimentation rate increased, Troponin increased, Viral infection
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: dysplipdemia, pre-diabetes, obesity, OSA, s/p COVID infection 8/2/20
Allergies:
Diagnostic Lab Data: Elevated troponin levels and EKG with diffuse slightly upsloping ST elevations and mild PR depressions in precoridal leads and slight PR elevation in Avr. Elevated ESR/CRP.
CDC Split Type:

Write-up: s/p vaccination with 2nd Covid Vaccine dose, developed low grade viral type illness with fevers up to 102 with myalgias, fatigue. Began to recover, teh awoke in the morning of 1/16/20 wtih crushing, substernal chest pain. Presented to the emergency department. Was admitted to he hospital - diagnosed with myopericarditis. Stayed in the hospital one night, and discharged the next day.


VAERS ID: 968687 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-20
Onset:2021-01-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Echocardiogram normal, Electrocardiogram PR segment depression, Electrocardiogram ST segment elevation, Myocarditis, Pericarditis, Troponin increased
SMQs:, Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aripiprazole Buspirone Quetiapine Sertraline
Current Illness: No
Preexisting Conditions: No
Allergies: Lorazepam (hives and hallucinations)
Diagnostic Lab Data: Found to have elevated troponin (peaked at 4.0 ng/mL). ECG showed diffuse PR segment depressions and ST segment elevations consistent with pericarditis. Transthoracic echocardiogram was normal.
CDC Split Type:

Write-up: Acute myopericarditis Chest pain developed 24 hours after vaccine administration. Presented to emergency department 48 hours after vaccine administration. Symptoms resolved after an additional 24 hours (72 hrs after vaccine) with administration of ibuprofen three times daily.


VAERS ID: 969093 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-01-05
Onset:2021-01-08
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Senior Living       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram abnormal, Echocardiogram, Embolism, Endocarditis, Hepatic embolisation, Magnetic resonance imaging brain abnormal, Renal embolism
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Renovascular disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown- please contact pt center for up to date list
Current Illness: DVT R LE, stent x 2 L groin, PNeumonia
Preexisting Conditions: HTN, PVD, COPD, FMS
Allergies: Lisinopril, erythromycin
Diagnostic Lab Data: 1/16/21- ct scan positive 1/18/21- mri confirmed extent of stroke 1/19/21- TEE confirmed endocarditis 1/21/21- mri confirms another stroke 1/23/21- ct scan shows emboli to liver, spleen, kidneys
CDC Split Type:

Write-up: Pt received vaccine and within 72 hrs developed a stroke. Low platelet count. Endocarditis. Emboli to liver, spleen, kidney.


VAERS ID: 969618 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Illinois  
Vaccinated:2020-12-30
Onset:2021-01-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0011JZ0A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (No reported medical history)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Pericarditis; Severe chest pain; A spontaneous report was received from a 56 year-old, female consumer, who was also the patient, who received Moderna''s COVID-19 vaccine (mRNA-1273) and experienced pericarditis and severe chest pain. The patient''s medical history was not provided. Concomitant product use was not provided by the reporter. On 30 Dec 2020, approximately five days prior to the onset of symptoms, the patient received their first of two planned doses of mRNA-1273 (Lot number: 0011JZ0A) intramuscularly for prophylaxis of COVID-19 infection. On 04 Jan 2021, the patient went to the emergency room due to severe chest pain. On 05 Jan 2021, the patient went to see the cardiologist and was diagnosed with pericarditis. Treatment information was not provided. Action taken with mRNA-1273 in response to the events was not provided. The outcome of the events, pericarditis and severe chest pain, was unknown.; Reporter''s Comments: This case concerns a 56 year old, female patient. The patient''s medical history was not provided. The patient experienced a serious, unexpected event of pericarditis and severe chest pain. The event of severe chest pain occurred 5 days and the event of pericarditis occurred after 6 days after first dose of mRNA-1273 (Lot number: 0011JZ0A). Very limited information regarding this event has been provided at this time. Based on temporal association between the use of the mRNA-1273 and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 970198 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-01-12
Onset:2021-01-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chest X-ray, Chest pain, Chills, Computerised tomogram, Dizziness, Dyspnoea, Electrocardiogram abnormal, Myocarditis, Pain
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vyvanse, propranolol, Wellbutrin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Chest Xray on 01/15/2021 CT Scan on 01/15/2021
CDC Split Type:

Write-up: First day I was lightheaded, dizzy, sore all over, weak and had the chills. The second day i had severe chest pain and trouble breathing, I went to the ER and was admitted into the hospital because of this. After an EKG it was found that I had Myocarditis. To treat it they gave me an IV for the pain, then I was prescribed ibuprofen and 2 other meds for the inflammation around my heart.


VAERS ID: 970682 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-07
Onset:2021-01-19
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Pericarditis, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: 01/19/2021 developed chest pain, shortness of breath and fever 100.8. Went to ER and was diagnosed with acute pericarditis


VAERS ID: 971536 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Ohio  
Vaccinated:2020-12-28
Onset:2021-01-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 1 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (If COVID prior vaccination: Yes); Hypertension; Pericarditis; Pre-eclampsia
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021028783

Write-up: 7 days after the vaccine-developed onset of Pericarditis; This is a spontaneous report from a contactable Other HCP reporting for a patient. A 31-year-old female patient received the 1st dose of bnt162b2 (BNT162B2, Lot # EK9231) intramuscular at single dose at left arm on 28Dec2020 13:00 for Covid-19 immunisation, administered at Nursing Home/Senior Living Facility. Medical history included recurrent idiopathic pericarditis, hypertension, pre-eclampsia, Covid-19. No known allergies. Patient was not pregnant. The patient had experienced Covid-19 prior vaccination. The patient''s concomitant medications were not reported. The patient had not received any other vaccines within 4 weeks prior to the BNT162B2 vaccine. The patient developed onset of pericarditis 7 days after the vaccine on 04Jan2021. AE resulted in doctor or other healthcare professional office/clinic visit. Patient received Colchicine and Ibuprofen as treatment. Post vaccination, the patient has not been tested for COVID-19. The outcome of event was not recovered.; Sender''s Comments: Based on the temporal relationship, the association between the event pericarditis with BNT162b2 can not be completely excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 971558 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Kansas  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021053133

Write-up: Pericarditis; This is a spontaneous report from a contactable pharmacist. A patient of unspecified age and gender received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient previously took the first dose of BNT162B2 on an unspecified date for COVID-19 immunization. The pharmacist had an ICU patient that received the COVID vaccine dose 2. On day 3 after the vaccine, the patient was admitted to ICU with pericarditis. It was not a confirmed diagnosis. Outcome of the event was unknown. Information on Lot/Batch number has been requested.; Sender''s Comments: The information provided is limited and doesnot allow a full medical assessment. Considering a temporal relationship, a possible contribution role of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) to the onset of pericarditis cannot be fully excluded. The case will be reassessed should additional information become available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics committees and Investigators, as appropriate.


VAERS ID: 977242 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-01-22
Onset:2021-01-26
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Electrocardiogram ST segment elevation, Hypoaesthesia, Magnetic resonance imaging heart, Myocarditis, Pain in extremity, Troponin increased
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Myocardial infarction (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Patient''s EKG showed diffuse ST elevations, c/w diagnosis Troponin elevated and peaked at 3.4 Cardiac MRI pending
CDC Split Type:

Write-up: Patient developed myopericarditis requiring hospitalization four days after receiving second dose of moderna vaccine. He developed left arm pain and numbness as well as substernal chest pressure. He was admitted.


VAERS ID: 977531 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-22
Onset:2021-01-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood potassium normal, Chest X-ray normal, Chest discomfort, Chest pain, Chills, Echocardiogram abnormal, Electrocardiogram ST segment elevation, Fatigue, Full blood count normal, Headache, Lymphocyte count normal, Myalgia, Palpitations, Pericardial effusion, Pericarditis, Pyrexia, Respiratory viral panel, SARS-CoV-2 test negative, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 1-27-2021: CBC: unremarkable, nml lymphocyte count BMP: unremarkable Trop #1: 11.57 Trop #2: 11.2 Trop #3: 7.2 Trop #4: 6.5 EKG #1: diffuse STE in II, III, aVF, V4-6. Sub-mm STD in V1-3, consistent with pericarditis, no STEMI. EKG #2: diffuse STE in II, III, aVF, V4-6, no STD or other reciprocal changes. EKG #3: mildly improved STE II, III, aVF, V4-V6, and no reciprocal change, consistent with pericarditis, no STEMI EKG #4: Unchanged from #3 CXR: unremarkable Bedside ECHO: trace pericardial effusion, no wall motion abnormalities, nml EF COVID PCR: neg RVP + COVID: neg AM CBC: unremarkable AM BMP: K 3.5, otherwise unremarkable. Rpt Bedside ECHO: trace pericardial effusion (improved from yesterday), nml EF, no wall motion abnormalities.
CDC Split Type:

Write-up: 25yo M with no sig PMHx or FMHx for ACS presents with 4 days of viral symptoms: f/s/c/myalgia/fatigue/HA that progressed to include CP for last 3 days. Classic positional CP, dull pressure, worse lying flat, better leaning forward, feels every heart contraction. Work up consistent with Acute Pericarditis and treated outpatient with Ibuprofen and Colchicine. symptoms worsened and he was evaluated and admitted overnight hospital for observation due to elevated troponin and STE on EKG. Pt stable and discharged next day.


VAERS ID: 977955 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-06
Onset:2021-01-19
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time shortened, C-reactive protein increased, Chest pain, Computerised tomogram thorax normal, Electrocardiogram normal, International normalised ratio normal, Mobility decreased, N-terminal prohormone brain natriuretic peptide, Painful respiration, Pericarditis, Prothrombin time normal, SARS-CoV-2 test negative, Troponin normal, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Famotidine 20 mg BID Potassium Chloride 20 mEq 2 tab daily Calcium 250 mg caps CoQ10 1 tap daily Levothyroxine 50 mcg daily Olmesartan 40 mg daily Amiloride 5 mg daily Amlodipine 10 mg dail Cholecalciferol 5000 unit weekly Cyanovobalmin 500
Current Illness: Broken wrist 12/25
Preexisting Conditions: Premature ventricular contractions Essential (primary) hypertension
Allergies: Lisinopril Sulfa antibiotics
Diagnostic Lab Data: Troponin negative x2 ProBNP 42.4 WBC 11.96 PTT 36.7 PT/INR 11/1 ECG - no significant changes CT Chest - no PE CRP 1.522
CDC Split Type:

Write-up: Pt seen in ED on 1/20 with increasing chest pain - pain in the mid chest, worse with breathing and limited ability to bend over and lay flat.. Troponin negative x2, ProBNP 42.4. Slightly elevated WBC at 11.96 and PTT at 36.7. PT/INR ok at 11 and 1. CT of the chest demonstrates no PE or pericardial effusion. ECG with no significant changes. Pt given ASA 324 mg and Norco 7.25/325 x1 in ED. D/C with Ibuprofen 800 mg TID for pericarditis. Covid test on 1/21 was negative. Pain improved as of 1/26. Per cardiologist review on 1/22 patient with elevated CRP (1.522) suggestive of pericarditis as cause.


VAERS ID: 980243 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-30
Onset:2021-01-13
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Pericarditis, Pleural effusion, Pleuritic pain
SMQs:, Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levothyroxine
Current Illness: Viral illness dec 15 , 2020
Preexisting Conditions: Hypothyroidism
Allergies: Garbanzo beans, Nsaids
Diagnostic Lab Data:
CDC Split Type:

Write-up: Acute pericarditis, left pleural effusion.severe typical pericarditis and pleuritic Chest pain started 1/13 , got worse , went to Er on 1/15/2021 , was admitted to cardiology service and discharged 1/17/2021 and now on colchicine since admission.


VAERS ID: 983111 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-25
Onset:2021-01-28
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-01-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, C-reactive protein increased, Chills, Electrocardiogram T wave inversion, Fatigue, Myalgia, Pericarditis, Pleuritic pain, Pyrexia, Red blood cell sedimentation rate increased, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (broad), Chronic kidney disease (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Hypokalaemia (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Rifampin 600 mg daily; Zoloft 100 mg daily
Current Illness: None
Preexisting Conditions: ADHD, anxiety
Allergies: Buproprion, Codeine, Morphine
Diagnostic Lab Data: EKG 1/28/2021- sinus rhythm with TWI in leads V1-V4 troponin: 0.08, 0.07, 0.06 CRP: 7.6
CDC Split Type:

Write-up: Pericarditis :severe, pleuritic chest pain, with subtle T-wave inversions, mildly elevated troponin, elevated CRP and ESR-- developed symptoms approx 50-54 hours after immunization) Also had 36 total hours of severe arthralgias, myalgias, fatigue, fevers and chills.


VAERS ID: 983362 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-08
Onset:2021-01-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-01-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025220A / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood creatine phosphokinase MB increased, Chest pain, Dyspnoea, Electrocardiogram ST segment depression, Myalgia, Myocarditis, Pyrexia, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Troponin: 3.7 CKMB:$g27 EKG findings with ST segment depression in III, aVF, V4, V5
CDC Split Type:

Write-up: 7 Days after receiving the vaccine, patient developed generalized myalgia, fever, shortness of breath, and chest pain. Patient admitted to our hospital on 21JAN and diagnosed with myocarditis. Difficult to elucidate whether the myocarditis was secondary to Moderna vaccination or other viral etiologies.


VAERS ID: 985024 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-01-23
Onset:2021-01-25
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Chills, Cold sweat, Discomfort, Dyspnoea, Echocardiogram normal, Electrocardiogram normal, Fatigue, Myocarditis, Pain, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG = Normal Troponin = Elevated, but falling over the course of several hours. Echocardiogram = Heart structures and function normal. Cardiologist diagnosed myopericarditis. Full labs and tests available on request.
CDC Split Type:

Write-up: 13 hours after injection: Typical chills, body aches, cold sweats lasting 24 hours. Relief with Acetaminophen and Ibuprofen. On 1/25/21 around 4:00 PM: Following intercourse, shortness of breath and mild chest pain. Unable to go for walk with son and wife due to fatigue and mild chest pain. Discomfort ameliorated with rest. On 1/26/21 around 6:00 AM: Shortness of breath and chest pain in shower with minimal effort. Pulse around 140 BPM. Drove to ER for workup. Transferred to hospital for admission.


VAERS ID: 989100 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-01-12
Onset:2021-01-28
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac stress test abnormal, Chest pain, Computerised tomogram, Dyspnoea, Electrocardiogram abnormal, Fibrin D dimer, Pericarditis, Troponin
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: None
Diagnostic Lab Data: Abnormal EKG, consistent pericarditis Stress test
CDC Split Type:

Write-up: Severe chest pain, difficulty breathing Hospitalized for 24 hours EKG, troponin, ddimer, stress test, CT scan


VAERS ID: 989822 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-01-26
Onset:2021-01-29
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Catheterisation cardiac normal, Chest pain, Echocardiogram normal, Electrocardiogram normal, Fatigue, Headache, Left ventricular dysfunction, Magnetic resonance imaging abnormal, Magnetic resonance imaging heart, Malaise, Myalgia, Myocarditis, Pyrexia, Red blood cell sedimentation rate increased, SARS-CoV-2 test negative, Troponin T increased, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril, atorvastatin, ezetimibe,
Current Illness: None
Preexisting Conditions: none
Allergies: No
Diagnostic Lab Data: hs-cTnI peaked at 6700 CRP 19, ESR 25, normal cath, ECG Markedly abnormal cardiac MRI with clear evidence myocarditis Negative COVID PCR x 2
CDC Split Type:

Write-up: The patient had a very severe side effect profile from the second dose of vaccine: "worst I''ve ever felt" with myalgia, headache, fever and fatigue. This subsided and then on day 3 he developed severe substernal chest pain and came to ER where his hs-cTnI was $g 2000 ng/L and peaked at 6700 ng/L. His ECG, echo and cardiac cath were normal but MRI showed evidence of myocarditis with mild left ventricular dysfunction. He is doing well clinically and we are managing expectantly. This appears to be immune mediated myocarditis from the Moderna vaccine


VAERS ID: 990198 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-09
Onset:2021-01-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025AL20A / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Atrioventricular block first degree, Bundle branch block right, C-reactive protein, Chest pain, Dyspnoea, Electrocardiogram abnormal, Fatigue, Full blood count, Lipids, Metabolic function test, Pericarditis, Red blood cell sedimentation rate
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nexplanon, prenatal vitamin, Lunesta PRN
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: EKG- 14Jan- 1st degree AV block with RBBB EKG- 19Jan- 1st degree AV block- LIPID Panel, BMP 27Jan- Echocardiogram- Mild Pericarditis- ESR, C-reactive, CBC
CDC Split Type:

Write-up: During cardiovascular exercise experienced SOB, Dyspnea, Chest pain, during and for 1-2hrs post cardio exercise. this continued for 2-3 days. with fatigue, sob,. Pt. had EKG performed which showed 1st degree AV block w RBBB. Pt. was then referred to cardiology where she was seen and diagnosed on 27Jan with pericarditis. Pt has since started NSAID therapy with mild symptoms persisting. Pt. will have Cardiology follow-up at 4weeks time.


VAERS ID: 991213 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-01-19
Onset:2021-01-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 - / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Acute myocardial infarction, Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood creatine phosphokinase increased, Electrocardiogram abnormal, Full blood count normal, Pericarditis, Troponin increased, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prozac Adderall (I have since discontinued)
Current Illness: none
Preexisting Conditions: None
Allergies: NONE NKDA
Diagnostic Lab Data: EKG (STEMI) next 3 EKGs NORMAL Troponin- Saturday 0.63, then 1.84 then 1.87 finally 3.3 next day. WBC count normal none out of range CBC normal. CK elevated ALT elevated, AST slight elevation.
CDC Split Type:

Write-up: Heart swelling (pericarditis) , abnormal EKG showing STEMI initially on Saturday approximately 3 days after 2nd vaccine dose administration.


VAERS ID: 992123 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-01-26
Onset:2021-01-30
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram ST-T change, Electrocardiogram ST-T segment elevation, Myalgia, Myocarditis, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dupixent, Albuterol, Zyrtec, Montelukast, Symbicort
Current Illness: None
Preexisting Conditions: Asthma Food allergy
Allergies: Egg, Peanut, Treenut
Diagnostic Lab Data: EKG: 1/30/2021 EKG: shows NSR with ST-T elevation in inferior and lateral leads. .
CDC Split Type:

Write-up: Acute myocarditis with chest pain and elevated troponin with EKG ST segment changes, muscle aches


VAERS ID: 992506 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-01-30
Onset:2021-01-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Acute coronary syndrome, Chest pain, Chills, Echocardiogram, Ejection fraction, Electrocardiogram ST segment elevation, Pain, Pericarditis, Pyrexia, Troponin increased
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: see above, all done on 2/1/2021
CDC Split Type:

Write-up: pt developed fever 102, chills and body aches evening of vaccine. Mon am (2/1/2021) awoke with chest pain. Came to ED for evaluation, diffuse ST elevation in all leads, troponin elevated 4.1, 2nd trop 33. echocardiogram with EF 50% pt currently being worked up for pericarditis, ACS with plans for heart cath in am


VAERS ID: 992836 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-01-27
Onset:2021-01-30
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Catheterisation cardiac normal, Chest discomfort, Chest pain, Echocardiogram abnormal, Ejection fraction normal, HIV test negative, Hepatitis B antibody negative, Hepatitis C antibody negative, Pericardial effusion, Pericardial fibrosis, Pericarditis, Respiratory viral panel, SARS-CoV-2 test negative, Troponin increased
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aderell Truvada
Current Illness: Nil
Preexisting Conditions: Taking PreP ADHD
Allergies: Augmentin Cat Dander
Diagnostic Lab Data: Echo showed normal EF, but thickened pericardium with small effusion Cardiac cath normal HIV 4th gen negative ( PCR pending) Acute hepatis B and C Ab negative ( PCR pending) Respiratory virus panel including COVId-19 negative All other tests for acute pericarditis pending ( coxsackie, echo entero serologies, parvo PCR RPR GC/ Chlamydia)
CDC Split Type:

Write-up: Presented about 60 hours after 2nd moderna vaccine with crushing chest pain and was found to have acute pericarditis and a troponin of 10.


VAERS ID: 993137 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-29
Onset:2021-02-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-02-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042L20A / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Dyspepsia, Dyspnoea, Electrocardiogram ST segment elevation, Full blood count normal, Lipase normal, Metabolic function test normal, Myocarditis, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: N/A
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: Initial EKG not c/w STEMI, but there are STE in II and aVF w/ no reciprocal changes. TWI in aVR, V1, and V2. Normal intervals. Repeat EKG 10 minutes later w/o changes. CBC, CMP, lipase NAD. Trop ~6. CXR NAD. Bedside echo NAD. EKG not c/w STEMI and pt is currently CP free, pt has no RF for ACS--I doubt ACS/AMI. No tearing CP, neuro sx, or other historical/exam features to suggest aortic dissection. PERC neg, low concern for PE. Pt''s high trop and EKG findings could represent myocarditis.
CDC Split Type:

Write-up: pt presents with mid epigastric chest burning x1 hour after breakfast, 21 yo M w/ no known chronic medical conditions, presents w/ 2 hours MEG/central chest burning. Initial a/w mild SOB and LH; by time of my eval, LH/SOB had resolved and CP was 4/10. Pts sx completely resolved w/ GI cocktail. No exertional sx. No recent infectious sx. VS w/o acute abn. Well-appearing, NAD. Normal CV exam; no edema. LCTAB. PT transferred for troponemia.


VAERS ID: 994756 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Michigan  
Vaccinated:2021-01-15
Onset:2021-01-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chest pain, Dyspnoea, Dyspnoea exertional, Headache, Imaging procedure abnormal, Myalgia, Pericarditis
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: My mom who is 75 had an adverse reaction on from the COVID vaccine she took on Jan 15, 2021. She went to bed at night and woke up at 4 AM with a severe headache. She took Aleve and went back to bed. When she woke up at 8:30 AM her headache was very severe and was accompanied with very severe chest pain. I immediately took her to the ER. They did a very thorough work up to check on her heart and Aorta. They managed her severe pain with two doses of morphine followed by two days of Dilaudid. The imaging and symptoms left her with a newly discovered diagnosis of Pericarditis. The medical professions were sure this was a result of the COVID vaccine. They continued to treat her for a few days and sent her home with anti inflammatories to help. She continues to have muscle pain, weakness and shortness of breath when she walks. She is scheduled to take her 2nd dose on February 5th but we are very concerned and hesitant as we don''t want to cause any more damage to her heart. Please have somebody contact us and let us know how to proceed. Thanks.


VAERS ID: 998291 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-01-28
Onset:2021-01-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Pain in extremity, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Copper IUD
Current Illness: None
Preexisting Conditions: Asthma Poly cystic ovary syndrome
Allergies: None
Diagnostic Lab Data: Pericarditis
CDC Split Type:

Write-up: Pericarditis. Burning and stabbing pain in chest, pain shot down into left arm. Lasted days.


VAERS ID: 998532 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-01-21
Onset:2021-01-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Antinuclear antibody negative, Arteriogram coronary normal, Chest pain, Chills, Coxsackie virus test negative, Cytomegalovirus test negative, Electrocardiogram abnormal, Epstein-Barr virus antibody negative, HIV test negative, Hyperhidrosis, Magnetic resonance imaging heart, Malaise, Myocarditis, SARS-CoV-2 test negative, Treponema test negative, Troponin increased
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: OTC collagen supplement Ibuprofen prn
Current Illness: none
Preexisting Conditions: migraines secondary to a TBI in 2016
Allergies: NKDA
Diagnostic Lab Data: High sensitivity troponin: 493.5 -- $g 662.0 -- $g 602.3 on 24 January Coxsackie B serology panel negative on 25 January EBV IgM, Parvovirus IgM and CMV IgM Negative RPR nonreactive on 25 January HIV negative on 26 January ANA negative on 26 January No peripheral eosinophilia Coronary angiogram with no obstructive disease on 24 January SARS-CoV-2 PCR negative on 24 and 25 January Cardiac MRI on 26 January 1. Cardiac MR findings highly suggestive of myocarditis (i.e infectious or perhaps post-vaccine) as evidenced by confluent sub-epicardial hyperenhancement on myocardial delayed enhancement (MDE) imaging in the inferoseptal, inferior, inferolateral, anterolateral and anterior segments of the basal to mid left ventricle.
CDC Split Type:

Write-up: The patient was admitted to the hospital on 24 January with chest pain, elevated troponin, and EKG changes in the setting of a couple days of chills, sweats and malaise after receiving the covid vaccine. Initially there was concern for acute MI and he was taken for a coronary angiogram. The angiogram was clean and showed no obstructive disease. He had a cardiac MRI which showed findings consistent with myocarditis. He was treated with supportive care and eventually was discharged. He was worked up for other causes of myocarditis with none to be found.


VAERS ID: 998774 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-01-15
Onset:2021-01-24
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 1 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone, Body fluid analysis, Brain natriuretic peptide, C-reactive protein, Chest X-ray, Chest discomfort, Chest pain, Chills, Differential white blood cell count, Echocardiogram, Electrocardiogram, Full blood count, Lymphadenopathy, Metabolic function test, Pain, Painful respiration, Pericardial drainage, Pericardial drainage test, Pericardial effusion, Pericarditis, Pyrexia, SARS-CoV-2 test, Troponin, Urine analysis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol 650 mg q 6 hours as needed Aspirin 81 mg daily Clonazepam 1 mg as needed Colchicine 0.6 mg daily Famotidine 20 mg daily as needed Metoprolol tartrate 100 mg every 12 hours Omeprazole 20 mg daily as needed
Current Illness: None
Preexisting Conditions: Hypertension GERD Anxiety Recurrent syncopal episodes in the past New onset atrial fibrillation at time of adverse event
Allergies: No known drug allergies
Diagnostic Lab Data: Cardiac Echocardiogram (1/25/21) Pericardiocentesis (1/25/21) Complete blood count with differential (1/24/21) Complete metabolic panel (1/24/21) Troponin x 2 (1/24/21) B-Type Natriuretic Peptide (1/24/21) Covid Swab (1/24/21) Urinalysis (1/24/21) C reactive protein (1/24/21) Pericardial fluid analysis (1/25/21) Thyroid stimulating hormone (1/25/21) Electrocardiogram (1/24/21) Chest X ray (1/24/21)
CDC Split Type:

Write-up: Pericarditis with pericardial effusion. Treatment: Pericardiocentesis, Colchicine, Aspirin, Ibuprofen, Omeprazole Symptoms began (syncopal episode, retrosternal chest heaviness and aching worse with inspiration, fever, chills, lymphadenopathy for a for 9 days following vaccination) Outcome: Patient discharged home after 3 day hospitalization. Currently feeling better at 1 week follow up.


VAERS ID: 998995 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-01-20
Onset:2021-01-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood cholesterol, C-reactive protein, Chest discomfort, Echocardiogram, Electrocardiogram, Metabolic function test, Pericarditis, Red blood cell sedimentation rate, Troponin I
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cetirizine 10mg tablet Escitalopram oxalate 10mg tablet Fluticasone 50mcg nasal spray Omeprazole 20mg capsule
Current Illness: None
Preexisting Conditions: GERD Allergic rhinitis Anxiety Cerebral palsy
Allergies: NKDA
Diagnostic Lab Data: EKC, ECHO, C-reactive protein, CMP, lipid panel, ESR, troponin I
CDC Split Type:

Write-up: Received the second dose in the series on Wednesday 1/20/21. The following day, he noticed some chest discomfort. He then performed some-what of a self physical and was suspicious of pericarditis. Had an EKG pointing to pericarditis. He then had an ECHO performed at the hospital that confirmed the diagnosis. Was then started on a course of colchicine to treat the pericarditis. It is important to know he contracted COVID earlier in the fall with a confirmed laboratory diagnosis on 11/13/20 which he was fully recovered from. He was never hospitalized for the infection.


VAERS ID: 1000418 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2020-12-15
Onset:2021-01-04
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / UNK LA / SC
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / UNK LA / SC

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Chest X-ray abnormal, Chest X-ray normal, Echocardiogram normal, Pericarditis, Pleural effusion, Pleuritic pain
SMQs:, Systemic lupus erythematosus (broad), Supraventricular tachyarrhythmias (narrow), 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? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Acetaminophen Aspirin Dextromethorphan Shellfish
Diagnostic Lab Data: TEE: Normal 2DEcho: Normal CXR: Left pleural effusion
CDC Split Type:

Write-up: Pleuritic chest pain. Admitted due to acute pericariditis. Course complicated with new onset atrial fibrillation.


VAERS ID: 1000874 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-01-21
Onset:2021-01-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 UN / SYR

Administered by: Public       Purchased by: ?
Symptoms: Cardiac tamponade, Chest discomfort, Condition aggravated, Mechanical ventilation, Pathology test, Pericardial excision, Pericarditis
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Chronic kidney disease (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metoprolol, Lisinopril, Plavix, Pepcid, baby aspirin, daily vitamin, vitamin D
Current Illness: No
Preexisting Conditions: Had a heart attack and stent in Sept 2020. Prior to that, no health issues.
Allergies: No
Diagnostic Lab Data: We are still waiting on final pathology but the Hospitalist recommended we submit this information. Her cardiologist was reviewing if there are similar potential responses to the vaccine as well, but since it is so new had yet to find a similar issue.
CDC Split Type:

Write-up: Pericarditis Tamponade. She went to the hospital with chest discomfort on the 25th and by the evening of the 26th had pericarditis to a degree that required a Pericardial Window emergency procedure. Prior to the vaccine, she was doing great with no issues. She was put on a ventilator and came through the procedure on the 27th. She was moved to rehab on February 1st, which is where she remains as of this submission.


VAERS ID: 1001632 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (No reported medical history)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Myocarditis; A spontaneous report was received from an healthcare professional, regarding a patient who received Moderna''s COVID-19 vaccine (mRNA-1273) and experienced Myocarditis. The patient''s medical history was not provided. No relevant concomitant medications were reported. On an unknown date, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On Unknown date, after receiving the vaccine, the patient experienced Myocarditis. Treatment for the event was not provided. Action taken with the second dose of mRNA-1273 in response to the event was not reported. The outcome for the events, Myocarditis is Unknown.; Reporter''s Comments: This case concerns a patient, who experienced a serious unexpected event of myocarditis. The event occurred on an unspecified date after first dose of mRNA-1273, lot # unknown. Treatment was not reported. Very limited information regarding this event has been provided at this time. Based on the current available information and temporal association between the use of the product and onset of the event a causal relationship cannot be excluded.


VAERS ID: 1002102 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
Vaccinated:2020-12-18
Onset:2021-01-02
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Blood test, C-reactive protein increased, Chest X-ray, Chest pain, Computerised tomogram, Echocardiogram, Electrocardiogram, Fibrin D dimer, Limb discomfort, Pericarditis, Red blood cell sedimentation rate increased, Troponin, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT Blood work BMP chest x-ray Echo troponin EKG D-dimer
CDC Split Type: vsafe

Write-up: The first couple days just some arm discomfort. January 2 I woke up about 3:45AM with chest pain, I thought it was heart burn. It didn''t improve so I ended up going to the Hospital, they did test to rule things out. I had a little bit elevated ESR,CRP and little high white count with a left shift. They did an echo and they found pericarditis. They started me on treatment and by the next day I was pain free.


VAERS ID: 1003486 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Michigan  
Vaccinated:2020-12-30
Onset:2021-01-27
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Angina pectoris, Arteriogram coronary normal, Chest discomfort, Chest pain, Chills, Echocardiogram, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Fatigue, Malaise, Myalgia, Myocardial necrosis marker increased, Myocarditis, Pyrexia, Troponin I increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: She presented to the hospital with acute typical angina approximately 72 hours after receiving her 2nd vaccine dose. The morning following her vaccine she developed fever, chills, generalized malaise, myalgias, and fatigue lasting about 48 hours. The following morning, she was awoken from sleep by a crushing substernal chest pain with associated typical anginal symptoms. Her initial troponin-I was elevated at 7.47 ng/mL and peaked at 19.19 ng/mL. An ECG demonstrated minimal ST elevations followed by an echocardiogram demonstrated preserved systolic function and an ejection fraction of 60-65%. Due to her elevation in cardiac enzymes and persistent angina, coronary angiography was performed revealing no obstructive coronary artery disease. She was diagnosed with suspected myocarditis and treated successfully with anti-inflammatory medication. In follow-up, she had an uncomplicated treatment course with complete resolution of anginal systems and improvement in troponin and inflammatory markers.


VAERS ID: 1017662 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-19
Onset:2021-01-22
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache Pericarditis Narrative: Diagnosed as idiopathic pericarditis.


VAERS ID: 1005180 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-25
Onset:2021-01-29
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Catheterisation cardiac, Chest X-ray, Computerised tomogram, Echocardiogram, Electrocardiogram, Myocarditis, Scan with contrast
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Anxiety
Allergies: Latex
Diagnostic Lab Data: Cardiac catheterization, heart ultrasound, chest x ray, EKG, Cat Scan with IV, bloodwork
CDC Split Type:

Write-up: Diagnosed with myocarditis 4 days after injection. Hospitalized for 1 day.


VAERS ID: 1005747 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2020-12-24
Onset:2021-01-15
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FIRST:EJ1685/SE / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Fatigue, Heart rate increased, Influenza A virus test negative, Influenza B virus test, Myocarditis, Respiratory syncytial virus test negative, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (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: 1000 mg of PO Tylenol and Pepcid 1 tablet before 2nd dose.
Current Illness: no illnesses
Preexisting Conditions: Ezcema mild
Allergies: no allergies
Diagnostic Lab Data: No test or laboratory results ordered, based soley on assessment and symptoms.
CDC Split Type:

Write-up: Starting last Thursday January 28th ,I started to experience shortness of breath at rest. Friday January 29th I was experiencing constant chest tightness/discomfort. Breath started to catch with speaking, fatigue. On Saturday January 30th at work in teh hospital I moved a heavy patient, became short of breath that the patient heard it and inquired about it, and my heart rate went up into the 120s. After a hot shower on January 31st, my heart rate went into the 110s, shortness of breath experienced. Vital signs have all been normal, no fever, normal blood pressure, normal oxygen saturation. My heart rate only increased on Saturday and Sunday and have been fine since. Negative fro Covid on January 29th and Negative for COVID, flu A and B and RSV on Monday February first. Saw to PCP on Wednesday February 3rd and with my symptoms states it is mild myocarditis from the vaccine, to rest and take an NSAID daily for two weeks.


VAERS ID: 1012387 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-01
Onset:2021-02-05
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: C-reactive protein increased, Chest pain, Electrocardiogram abnormal, Inflammatory marker increased, Pain, Pain in jaw, Pericarditis, Red blood cell sedimentation rate increased
SMQs:, Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Osteonecrosis (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prilosec
Current Illness:
Preexisting Conditions: Reflux
Allergies: None
Diagnostic Lab Data: EKG, 05-Feb-2021, Pericarditis; Inflammatory markers CRP and SED RATE elevated.
CDC Split Type:

Write-up: Severe chest pain with radiation to left chest and jaw 5 days after moderna covid vaccine. No heart attack but diagnosed with pericarditis. Will be in treatment for 3 months.


VAERS ID: 1007452 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-25
Onset:2021-01-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Chills, Electrocardiogram abnormal, Fatigue, Myalgia, Myocarditis, Pyrexia, Troponin abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Reported moderate fever, chills, muscle aches, and fatigue for 2 days following dose 2 vaccination. Then, began complaining of chest pain. EKG abnormal and referred to Hospital for evaluation. Found to have elevated troponins and myocarditis. Then discharged home.


VAERS ID: 1008473 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-02
Onset:2021-02-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram abnormal, Chest pain, Chills, Electrocardiogram abnormal, Headache, Musculoskeletal stiffness, Neck pain, Pain, Pericarditis, Troponin increased
SMQs:, Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: All performed on 2-6-21 EKG Blood work (troponin) Echo Currently still in hospital, not sure if recovered yet. Possibility of release tomorrow.
CDC Split Type:

Write-up: Tuesday afternoon began with a headache. Chills followed in the late evening. Body aches by Wednesday morning with continued headache. Neck stiffness and soreness began Thursday evening. Severe chest pains early Saturday morning (3am). Taken to urgent care - EKG showed irregularity and high level of troponin. Transported from there to the hospital. They did angiogram, and diagnosed me with pericarditis. The on call physician believes this was most likely caused by the second dose of the vaccine.


VAERS ID: 1009827 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-04
Onset:2021-02-06
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-02-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038K20A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Catheterisation cardiac, Chest pain, Echocardiogram, Electrocardiogram abnormal, Laboratory test, Magnetic resonance imaging, Pericarditis, Troponin increased, X-ray
SMQs:, Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Concerta , abilify, clonidine
Current Illness: Nasal congestion/ cough three to four weeks prior
Preexisting Conditions: Adhd; mood swings; sleep apnea
Allergies: None
Diagnostic Lab Data: Heart cath, labs. Echo, mri X-ray ekg
CDC Split Type:

Write-up: Chest pain- pericarditis. Elevated troponin. Heart cath. PCU hospital admit. No previous heart hx. Ekg abnormal. Echo, mri.


VAERS ID: 1010639 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-01-15
Onset:2021-01-01
Submitted: 0000-00-00
Entered: 2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Cardiac imaging procedure abnormal, Cardiovascular evaluation, Chest pain, Dyspnoea, Headache, Myalgia, Pericarditis, SARS-CoV-2 test negative, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210116; Test Name: imaging; Result Unstructured Data: Test Result:Pericarditis; Test Date: 20210116; Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC2021063749

Write-up: accompanied with very severe chest pain; Pericarditis; woke up with a severe headache; severe pain; continues to have muscle pain; weakness; shortness of breath when she walks; This is a spontaneous report from a contactable consumer. A 75-year-old female patient received first dose of BNT162B2 (lot number and expiry date not provided), via an unspecified route of administration on 15Jan2021 10:30 at single dose for COVID-19 immunization. There were no medical history. The patient was not pregnant at the time of vaccination. The patient''s concomitant medications were not reported. On 16Jan2021 04:00, she went to bed at night and woke up at 4 AM with a severe headache. She took Aleve and went back to bed. When she woke up at 8:30 AM her headache was very severe and was accompanied with very severe chest pain. She immediately took her to the ER. They did a very thorough work up to check on her heart and Aorta. They managed her severe pain with two doses of morphine followed by two days of Dilaudid. The imaging and symptoms left her with a newly discovered diagnosis of Pericarditis. The medical professions were sure this was a result of the COVID vaccine. They continued to treat her for a few days and sent her home with anti inflammatories to help. She continues to have muscle pain, weakness and shortness of breath when she walks. She is scheduled to take her 2nd dose on February 5th but we are very concerned and hesitant as we don''t want to cause any more damage to her heart. The patient was hospitalized for events ''headache'', ''chest pain;'', ''pericarditis'' and ''pain'' for 4 days. The patient did not receive any other vaccines within four weeks prior to the vaccination and did not received any other medications within 2 weeks of vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has been tested for COVID-19. The patient underwent lab tests and procedures which included imaging: pericarditis on 16Jan2021 and Nasal Swab: negative on 16Jan2021. Therapeutic measures were taken as a result of all the events which included Colchicine and prednisone, morphine and dilaudid. The outcome of the events was recovering. The events "headache", "chest pain", "pericarditis"and "severe pain" were assessed as serious due to hospitalization and disability. The events "myalgia", "asthenia" and "dyspnea" were assessed as serious due to disability. The events (''headache'', ''chest pain;'', ''pericarditis'' and ''pain'') resulted in emergency room visit. Information on the lot/batch number has been requested.


VAERS ID: 1011883 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-21
Onset:2021-01-25
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest pain, Condition aggravated, Echocardiogram, Headache, Myocarditis, Pyrexia, Troponin increased
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cannabidiol
Current Illness: None.
Preexisting Conditions: Previous myopericarditis 5 years prior, pericarditis 7 years prior.
Allergies: None.
Diagnostic Lab Data: Blood work, cardiac echo, chest x ray.
CDC Split Type:

Write-up: I had a fever, headache for two days following the vaccine. Two days after I had chest pain and went to the emergency room. I was admitted with elevated troponin and diagnosed with myopericarditis.


VAERS ID: 1012385 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-09
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pericardial effusion, Viral pericarditis
SMQs:, Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Fever (negative for covid)
Allergies:
Diagnostic Lab Data: Test Date: 20210101; Test Name: Covid; Test Result: Negative
CDC Split Type: USPFIZER INC2021070746

Write-up: fluid on her heart caused by a virus; fluid on her heart caused by a virus; This is a spontaneous report from a contactable consumer (patient). A female patient of an unspecified age received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection) via unspecified route of administration on (lot number and expiry date unknown) at single dose for Covid-19 immunization. Medical history included low fever from 01Jan2021 (negative for covid on 01Jan2021). The patient''s concomitant medications were not reported. On 14Jan2021, the patient was hospitalized for fluid on her heart caused by a virus on unspecified date. The patient was scheduled to take her second dose of the vaccine on Saturday (unspecified date). The patient would like to know if she would be able to get her second dose of the Pfizer Covid vaccine after the side effects she experienced post-vaccination on the first dose. Her family doctor has told her to wait 90 days. She was also scheduled to visit her cardiologist tomorrow. The outcome of the events fluid on her heart caused by a virus was unknown. Follow-up activities are possible, information on the batch number has been requested.


VAERS ID: 1019823 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-02-06
Onset:2021-02-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Chest pain, Electrocardiogram, Insomnia, Pericarditis, X-ray
SMQs:, Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Famotidine, BC Pill, Hair and Nail vitamins
Current Illness: None
Preexisting Conditions: Hashimoto''s thyroiditis, Euthyroid
Allergies: Pineapple
Diagnostic Lab Data: X-ray, EKG, D-Dimer, Troponin, Blood draw, IV with Toradol, Pepcid, GI cocktail and Tylenol
CDC Split Type:

Write-up: Woke up day after with a slight pain in chest. As day progressed pain became much worse and when tried to lay down to sleep could not. Breathing in caused pain as well. She went to ER and was diagnosed with Acute Pericarditis. Was in ER for 4 hours and sent home on oral Ibuprofen 600 mg.


VAERS ID: 1021221 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-01-19
Onset:2021-01-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cardiac arrest, Catheterisation cardiac normal, Fall, Implantable defibrillator insertion, Magnetic resonance imaging, Medical induction of coma, Myocarditis, Resuscitation, Unresponsive to stimuli, Viral cardiomyopathy
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (narrow), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: pantropazole, plavix, cialis, multi-vitamin, vitamin c, b-complex, zinc, glucosimine, pro-biotic, eldeberry,
Current Illness: none
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data: On 1/25/2021 i Had a cadiac catharization that indicated no blockages, or scar tissue. A defibrillator was surgically implanted in my chest on 1/27/21. MRI on 1/27/2021.
CDC Split Type:

Write-up: cardiac arrest. Heart stopped, I fell to the ground, and was administered CPR by Police. I was admitted to hospital unresponsive and induced in a coma for two days. MRI results indicated I had a virus in my heart which caused Myocarditis. On 1/25/2021 i Had a cadiac catharization that indicated no blockages, or scar tissue. A defibrillator was surgically implanted in my chest on 1/27/21. Admitted to hospital 1/20/2021. Released 1/28/2021.


VAERS ID: 1021922 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Kentucky  
Vaccinated:2020-12-29
Onset:2020-12-31
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Catheterisation cardiac normal, Chest pain, Myocarditis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Chest pain; Acute Myocarditis; Fever; A spontaneous report was received from a healthcare professional concerning a 35-year-old male patient who received Moderna''s COVID-19 Vaccine (mRNA-1273) and developed chest pain, myocarditis, and fever. The patient''s medical history included COVID-19 in Oct of 2020. No relevant concomitant medications were reported. On 29 Dec 2020 the patient received their first of two planned doses of mRNA-1273 (lot number or batch number not provided) intramuscularly (in the left arm) for prophylaxis of COVID-19 infection. On an unknown date after receiving vaccine the patient developed a fever and chest pain. On 31 Dec 2020 the patient was admitted to the hospital where a heart catheterization was done-negative results. The patient was diagnosed with myocarditis. He was scheduled to receive his second dose of vaccine on 03 Feb 2021. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not provided. The outcome of the events chest pain, myocarditis, and fever were not reported.; Reporter''s Comments: This case concerns a 35-year-old, male patient with a medical history of COVID-19, who experienced a serious unexpected event of chest pain, myocarditis and an expected event of pyrexia. The events of chest pain and pyrexia occurred on an unspecified date and the event of myocarditis occurred 3 days after the first dose of mRNA-1273. A heart catheterization was done-negative results.Very limited information regarding this event has been provided at this time. Based on temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. Additional information has been requested.


VAERS ID: 1022039 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-14
Onset:2021-01-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Chest discomfort, Dyspepsia, Echocardiogram normal, Pericarditis, Troponin increased
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific dysfunction (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: High cholesterol
Allergies:
Diagnostic Lab Data: Test Date: 20210116; Test Name: CTA; Test Result: Negative ; Test Date: 20210116; Test Name: ECHO; Test Result: Negative ; Test Date: 20210116; Test Name: troponins; Result Unstructured Data: Test Result:elevated
CDC Split Type: USPFIZER INC2021077960

Write-up: Pericarditis after admit and negative ECHO, and CTA; Chest discomfort; initially thought it was heart burn lasted over 15 overs decided to visit ER.; Had elevated troponins was diagnosed with Pericarditis after admit and negative ECHO, and CTA; This is a spontaneous report from a contactable nurse (patient) reported that a 32-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EK9231), via an unspecified route of administration on the left arm on 14Jan2021 15:30 at a single dose for COVID-19 immunization. Medical history included high cholesterol from an unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. The patient previously received influenza vaccine (FLU) on 10Dec2020 for immunization; and received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EK9231) on 24Dec2020 15:30 for Covid-19 immunization. On 16Jan2021 15:30, the patient experienced chest discomfort, initially thought it was heart burn lasted over 15 "overs" decided to visit ER. The patient had elevated troponins, and was diagnosed with Pericarditis after admit and negative ECHO, and CTA. As treatment, patient received IV Toradol. The reported events resulted hospitalization for 1 day. The patient underwent lab tests and procedures which included angiogram (CTA): negative, echocardiogram (ECHO): negative, troponin: elevated; all on 16Jan2021. The outcome of the events was recovering.; Sender''s Comments: Based on the vaccine''s safety profile, the event pericarditis and the associated symptoms are more likely intercurrent condition, unrelated to suspect vaccine BNT162B2 administration. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.


VAERS ID: 1022440 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-23
Onset:2021-02-01
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute myocardial infarction, Chest pain, Death, Dyspnoea, Pericarditis
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-09
   Days after onset: 8
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: HTN, hyperlipidemia, pericarditis (diagnosed in 2014)
Allergies: None
Diagnostic Lab Data: None reported
CDC Split Type:

Write-up: The decedent experienced severe chest pain and dyspnea approximately nine days following the first series of the vaccine. He reported to family members that he was having a "severe reaction" to the vaccine and believed it was acute pericarditis due to the same symptoms he experienced prior. He reported that on 2/1/21 around 0300 hours, the symptoms were the most severe and he was going to seek medical attention, but did not. He waited till the convenient store opened and purchased OTC Tylenol for relief of symptoms. He continued to have dyspnea and chest pain up until 2/9/21, when he called 911 complaining of chest pain and was found to have a STEMI; subsequently died at Hospital in the ER.


VAERS ID: 1023685 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-05
Onset:2021-02-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Military       Purchased by: ?
Symptoms: Abnormal dreams, Angiogram, Angiogram abnormal, C-reactive protein increased, Catheterisation cardiac normal, Chest pain, Chills, Coxsackie virus test, Dyspnoea, Echocardiogram normal, Electrocardiogram normal, Fatigue, Full blood count normal, Headache, Low density lipoprotein increased, Lymphadenopathy, Magnetic resonance imaging heart, Malaise, Metabolic function test normal, Mycoplasma test, Myocarditis, Night sweats, Pericardial effusion, Pleuritic pain, Pyrexia, Respiratory viral panel, SARS-CoV-2 test negative, Troponin increased
SMQs:, Anaphylactic reaction (broad), Dyslipidaemia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: At that time his vitals were stable. Labs significant for elevated troponin of 3.41 (which peaked at 13.00), mildly elevated LDL cholesterol of 109, elevated CRP of 11.7 but otherwise normal cbc and bmp. EKG no clear evidence of STEMI. Had echocardiogram which revealed normal heart function, no evidence of of focal wall abnormalities and no pericardial effusion. CT angiogram was negative for PE, did show trace pericardial effusion and minimally enlarged left axillary lymph node. Troponin was increasing and he underwent a left heart catheterization on 2/9 which did not show any evidence of coronary disease. Underwent cardiac MRI on 2/10 that revealed multifocal subepicardial and mid myocardial delayed enhancement within the lateral, anterolateral and inferolateral walls consistent with myocarditis. He then underwent a Right heart Cath with biopsy on 2/10 whcih did not show any evidence of myocarditis. He was started on IV steroids by cardiology. He initially had a negative covid rapid test on 2/8 and a negative PCR test on 2/10. Also had a negative respiratory viral panel. At the time of this writing he has coxsackie and mycoplasma antibodies pending. He is clinically doing well
CDC Split Type:

Write-up: 39 year old male no known past medical history received his second dose of the moderna vaccine on 2/5. That evening he developed headache, malaise, fatigue, fevers. The symptoms persisted on 2/6 and 2/7 with some improvement in his headache on 2/7. On the evening of 2/7 he developed high fevers to 103, rigors, "vivid dreams" woke up with night sweats. On 2/8 developed pleuritic chest pain and shortness of breath and went to the hospital.


VAERS ID: 1025021 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-22
Onset:2021-02-03
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20-2A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Cardiopulmonary exercise test normal, Chest pain, Echocardiogram, Electrocardiogram abnormal, Electrocardiogram normal, Pericardial effusion, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MVI Probiotic
Current Illness: None
Preexisting Conditions: Exercise induced asthma
Allergies: Cirprofloxacin Milk Gluten
Diagnostic Lab Data: EKG 2/3/21: PR depressions US 2/3/21: Trace pericardial effusion EKG 2/10/21: Normal Exercise Cardiopulmonary Testing: No hypoxemia
CDC Split Type:

Write-up: Pt is a 37y F with previous history of pericarditis diagnosed after an initial COVID infection SEP20 with a second occurrence NOV20. Pt subsequently received her first COVID Vaccine shot on 22JAN21 and reported to medical on 3FEB21 with mild chest pain and an EKG with changes demonstrating pericarditis and a US demonstrating trace effusion. Pt was minimally symptomatic but given her previous episodes was sent to the Role 3 for further evaluation. Her work up on 10FEB21 demonstrated resolution of EKG changes and effusion with normal cardiopulmonary work up. Given her history it has been recommended that she does not receive the second dose of the vaccination.


VAERS ID: 1025489 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-02-06
Onset:2021-02-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cardiomegaly, Chest pain, Chills, Computerised tomogram thorax, Computerised tomogram thorax abnormal, Electrocardiogram normal, Malaise, N-terminal prohormone brain natriuretic peptide increased, Pain, Pain in extremity, Pericardial effusion, Pleuritic pain, Pyrexia, SARS-CoV-2 test negative, Troponin normal, Vena cava embolism, Viral pericarditis, White blood cell count normal
SMQs:, Cardiac failure (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Carvedilol, Humalog, Iron tablets, levothyroxine, metformin, omeprazole, pravastatin, Toujeo, valsartan/HCTZ
Current Illness:
Preexisting Conditions: hypertension, hyperlipidemia, DM2
Allergies: Levemir, sitagliptin
Diagnostic Lab Data: COVID test: negative WBC: 5.2 Troponin <0.3 proBNP 2310 ECG: NSR, no acute ischemic changes CTA: no PE, with cardiomegaly and mild pericardial effusion, distention of IVC
CDC Split Type:

Write-up: Patient received 1st dose of vaccine on 2/6/21. That afternoon, developed malaise and fever/chills over the next few days. On the evening on 2/9/21, began to have left-sided chest pain (severe, pleuritic, radiating to left arm) leading her to seek medical care. Was determined to have viral pericarditis and admitted to the hospital for several days


VAERS ID: 1027010 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-01-22
Onset:2021-01-30
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Adenovirus test, Angiogram pulmonary abnormal, Antinuclear antibody negative, Blood culture negative, Brain natriuretic peptide decreased, Brain natriuretic peptide increased, C-reactive protein increased, COVID-19, Cardiac failure acute, Cardiogenic shock, Catheterisation cardiac, Coxsackie virus test positive, Cytomegalovirus test negative, Echocardiogram, Echovirus test negative, Ejection fraction decreased, Epstein-Barr virus antibody positive, Fibrin D dimer, Human herpes virus 6 serology negative, Hypotension, Influenza virus test negative, Intra-aortic balloon placement, Left atrial dilatation, Left ventricular dysfunction, Left ventricular hypertrophy, Lung consolidation, Magnetic resonance imaging heart, Mediastinitis, Mitral valve incompetence, Mycoplasma test negative, Myocarditis, Parvovirus B19 test negative, Pericardial effusion, Pericarditis, Pleural effusion, Pneumonia, Pneumonitis, Polymerase chain reaction, Pulmonary mass, Pyrexia, Rash morbilliform, Right atrial dilatation, SARS-CoV-2 test positive, Sarcoidosis, Tricuspid valve incompetence, Troponin
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, arterial (narrow), Pulmonary hypertension (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Eosinophilic pneumonia (narrow), Chronic kidney disease (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zinc, Vitamin C, and Vitamin D3
Current Illness: COVID-19, 12/30/21
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: 1/31/21 - Flu Ag negative 2/2/21: - Mycoplasma IgM negative - EBV Ab panel consistent with prior infection 2/4/21: - Blood cultures negative - CRP $g 320 mg/dL - D-dimer 3.53 - Troponin 7.05 - BNP 3, 583 2/5/21: - SARS CoV2 Ab: positive - Transthoracic Echo: Interpretation Summary o The left ventricular systolic function is decreased (35 - 40%). o There is mild concentric left ventricular hypertrophy present. o Left ventricular global hypokinesis. o Indeterminate left ventricular diastolic function. o The right ventricular systolic function is normal. o The left atrium is mildly dilated. o The right atrium is mildly dilated. o Mild mitral valve regurgitation. o Mild tricuspid valve regurgitation. o Procedure performed with the patient in a supine position. 2/5/21 CTA Chest: IMPRESSION: 1. No evidence of acute pulmonary embolus through the segmental level. 2. Multifocal nodular airspace disease of the right upper lobe and right middle lobe is suspicious for pneumonitis. More masslike appears of consolidation in the lower lobes left greater than right may also be secondary to pneumonitis although other etiologies possible including aspiration. Radiographic follow-up to resolution recommended. 3. Small pleural effusions. 4. Nonspecific mediastinal edema. This may be result of vascular congestion but inflammatory change (i.e. mediastinitis) is not excluded on the basis of imaging appearance and clinical correlation is recommended. 5. Nonspecific solitary pericardial adenopathy visualized. This is of uncertain etiology or significance. 2/6/21 ANA, CMV PCR, Adenovirus PCR, Echovirus AB panel, Parvovirus PCR, HHV6 PCR negative; Coxsackie Ab panel weakly positive for multiple strains 2/6/21 Left heart cath: Conclusion 1-PRESENTATION WITH CARDIOGENIC SHOCK 2-PAP 59/29, PW 30, LVEDP 25-28 3-NORMAL CORONARY ARTERIOGRAM 4-SUCCESSFUL PLACEMENT OF IABP 2/11/21 Cardiac MRI: o Normal left ventricular chamber size and systolic function, LV EF 67%. Focal point of subepicardial delayed enhancement in the basal inferolateral segment. Differential diagnosis inlcudes subacute myocarditis or sarcoidosis. o Normal right ventricular chamber size and systolic function. o No significant valvular abnormality. o No evidence of hypertrophic cardiomyopathy or prior myocardial infarction. o Small circumferential pericardial effusion.
CDC Split Type:

Write-up: Pt received vaccine on 1/22/21. On 1/31/21 he presented to urgent care with fever and morbiliform rash. He tested negative for the flu and was given empiric oseltamivir. He had persistent fever and was given doxycycline and ceftriaxone by urgent care on 2/2. On 2/4 at urgent care he was noted to be hypotensive and referred to ER. He had findings of cardiogenic shock and intra-aortic balloon pump was placed. He was treated for acute heart failure with improvement in symptoms. He was also treated for pneumonia with piperacillin/tazobactam as well as amoxicillin / clavulanic acid. He was discharged with resolved fever, resolved rash, and improvement in EF based on cardiac MRI. Workup for other viral causes of myocarditis was negative.


VAERS ID: 1029788 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-05
Onset:2021-02-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042L20A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Angina pectoris, Blood test, Chest X-ray, Chest discomfort, Chills, Echocardiogram, Electrocardiogram, Fatigue, Headache, Inflammation, Influenza virus test, Palpitations, Pericarditis, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Toprol XL / Tapazole / Multivitamin / Omega 3 Fish Oil
Current Illness: None
Preexisting Conditions: Grave''s Disease / Vitiligo
Allergies: Codeine / Erethromycin
Diagnostic Lab Data: EKG, heart/chest x-ray, bloodwork, echo, oxygen levels, covid19 test, flu tests. All done 2/12/21
CDC Split Type:

Write-up: Day 1: headache and chills, no fever. Day 2: fatigue and chills, no fever Day 3-4 : fatigue and chills, no fever Day 5: Strong heart palpitations, chills and fatigue . Day 6-7 Heart pain, palpitations, chills and fatigue/ Had to rest constantly. Began taking ibuprofen to calm the inflammation. Day 8: Heart pain, pressure & palpitations worsening, fatigue. Primary and Cardiologist recommended going to ER. Diagnosed with mild pericarditis. Day 9-10: Home on bedrest taking ibuprofen 3x day with continued heart palpitations, pain, chils and fatigue.


VAERS ID: 1030018 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2020-12-29
Onset:2021-01-26
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Myocarditis, Pain in extremity
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: DUPIXENT; SINGULAIR; SYMBICORT; ZYRTEC [CETIRIZINE HYDROCHLORIDE]; ALBUTEROL [SALBUTAMOL]; Epi-pen
Current Illness: Allergy to nuts (Tree nuts); Asthma; Egg allergy; Peanut allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Myocarditis; Acute onset of chest pain; Soreness of the arm; A spontaneous report was received from a physician concerning a 20-year-old, male patient, who received Moderna''s COVID-19 vaccine (mRNA-1273) and experienced soreness of the arm, acute onset of chest pain, and myocarditis. The patient''s medical history, as provided by the reporter, included asthma, and allergy to egg, peanut and tree nuts. Concomitant medications reported included dupilumab, montelukast, budesonide / formoterol, cetirizine, albuterol and epinephrine. On 29 Dec 2020, the patient received their first of two planned doses of mRNA-1273 (Lot number: 025J20A) intramuscularly for prophylaxis of COVID-19 infection. On 26 Jan 2021, prior to the onset of events, the patient received their second of two planned doses of mRNA-1273 (Lot number: 028L20A) intramuscularly in the left deltoid for prophylaxis of COVID-19 infection. On 26 Jan 2021, after receiving the second dose of the vaccine, the patient reported soreness of the arm for 3 to 4 days. On 30 Jan 2021, the patient presented to the hospital with acute onset of left sided chest pain. The physician reported that the patient developed myocarditis. Consent for Safety to follow up was received. Treatment for the events, as reported, included patient''s concomitant medications of dupilumab, montelukast, budesonide / formoterol, cetirizine and albuterol. No additional treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The event, soreness of the arm, was resolved on unknown date. The event acute onset of chest pain and myocarditis was not resolved at the time of this report.; Reporter''s Comments: This case concerns a 20 year old male with medical history of multiple allergies, who was hospitalized with serious unexpected events of chest pain and myocarditis and a non-serious unexpected event of pain in extremity. The chest pain and myocarditis occurred 33 days after first dose and 4 days after last dose of mRNA-1273. Based on the current available information and temporal association between the use of mRNA-1273 and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1030019 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-01-20
Onset:2021-01-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Atrial fibrillation, Bedridden, Body temperature increased, Decreased appetite, Feeling abnormal, Oxygen saturation decreased, Pericarditis, Pyrexia, Troponin
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Dementia (broad), Acute central respiratory depression (broad), Chronic kidney disease (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: PENTASA; METFORMIN; ZOLOFT; ATORVASTATIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (No reported medical history)
Allergies:
Diagnostic Lab Data: Test Date: 20210126; Test Name: Temperature; Result Unstructured Data: High; Test Date: 20210126; Test Name: SatO2 low; Result Unstructured Data: Low
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: feeling much worse; Bloodwork with elevated parameters (troponins); Couldn''t take food; Couldn''t get up from bed; Fever (101�F); Atrial fibrillation; Pericarditis; A spontaneous report was received from a non-healthcare professional concerning a 67-year-old, female patient who developed a fever of 101 degrees Fahrenheit, feeling much worse, couldn''t take food, couldn''t get up from bed, bloodwork with elevated troponin, pericarditis, and atrial fibrillation. The patient''s medical history was not provided. Concomitant products known to have been used by the patient, within two weeks prior to the event, included Pentasa, metformin, insulin, Zoloft and atorvastatin. The patient received their first of two planned doses of mRNA-1273 (lot number 028L20A) on 20 Jan 2021 in the right arm for prophylaxis of COVID-19 infection. The patient developed a fever on 25 Jan 2021, and it got up to 101 degrees Fahrenheit on 26 Jan 2021. On 26 Jan 2021 she felt must worse, couldn''t take food, and couldn''t get up from bed. On 27 Jan 2021, she was taken to the emergency room where her oxygen saturation was low, but the fever was gone. She was placed on oxygen, and blood work had elevated troponin. The patient was diagnosed with pericarditis and she was kept overnight. On 28 Jan 2021 she had atrial fibrillation and the medical team couldn''t convert her chemically. She was stabilized on 30 Jan 2021 and she was feeling much better. Treatments of these events included oxygen and ibuprofen. The events, fever of 101 degrees Fahrenheit, feeling much worse, couldn''t take food, couldn''t get up from bed, bloodwork with elevated troponin, pericarditis, and atrial fibrillation were considered Recovering.; Reporter''s Comments: This case concerns a 67 year old female who experienced serious unexpected events of feeling abnormal, decreased appetite, bedridden, elevated troponin, pericarditis, and atrial fibrillation, and a serious expected event of fever. The events began 6 days after first dose of mRNA-1273. Treatment with ibuprofen. Based on the current available information and temporal association between the use of mRNA-1273 and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1031582 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-01-13
Onset:2021-01-25
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Humira albuterol diclofenac gel fluticasone inhaler (flovent) Probiotic Multivitamin Sumatriptan Medrol dose pak (finished on 1/17/21) Weaned off Lexapro ~ 1 month prior
Current Illness: Psoriatic Arthritis and Cervical DJD
Preexisting Conditions: Psoriatic Arthritis and Cervical DJD
Allergies: hydromorphone - hives
Diagnostic Lab Data:
CDC Split Type:

Write-up: 35 yo woman with new onset pericarditis. Possibly related to the covid vaccine - had second dose 1/13/21. There are case reports of pericarditis with the covid virus, but none so far with covid vaccine. No known covid exposure recently. Covid test on 1/24/21 (date of admission) = not detected. Or more likely presentation could be related to Humira (started December 2020 for psoriatic arthritis and had 3 doses total). There have been case reports of pericarditis with Humira. Also, pt was on a medrol dose pack for radicular symptoms after injuring her neck, she finished the dose pack on 1/17/21. Since stopping solumedrol she has had increasing hip pain and also has costochondral pain. Per H&P, It is possible that weaning off of solumedrol dose pack caused a flare up in her psoriatic arthritis leading to increase hip pain, costochondritis and pleuritis and/or pericarditis. Pt was admitted for further treatment and monitoring.


VAERS ID: 1032062 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-02-10
Onset:2021-02-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram ST segment elevation, Fatigue, Headache, Myocarditis, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: After receiving the Moderna vaccine on 2/10/2021, traditionally expected symptoms developed on 2/11/2021 and 2/12/2021 including fatigue, fever, headache, and general achiness. On 2/12/2021 and into the morning of 2/13/2021 I developed a persistent aching chest pain - Saturday morning (2/13/2021) I went to convenient urgent care in for a quick once-over including vitals and an EKG. The EKG showed ST elevations, and I was taken via ambulance to the hospital emergency room. With blood lab value analysis and an echocardiogram performed, the hospitalist and cardiologist determined the diagnosis to be peri myocarditis. I was admitted to the hospital for 24 hours of observation and was released on 2/14/2021.


VAERS ID: 1032693 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-03
Onset:2021-02-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: C-reactive protein normal, Drug screen negative, Dry skin, Intensive care, Myocarditis, Pruritus, Red blood cell sedimentation rate increased, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Admission HS Trop 1295 on 7 Feb 2021. Peaked 2179 on 7 Feb 2021. Discharge Troponin 1327. ESr 24. CRP 0.3. Urine Drug Screen normal.
CDC Split Type:

Write-up: 26 yo Male developed a laboratory confirmed myocarditis on/about 7 February 2021 after receiving the 2nd dose of Moderna COVID19 Vaccine on 3 Feb 2021. His HS-Tropin peaked at 2179. He was admitted to the ICU for care. Discharged at 72 hour admission. Seen today (16 Feb 2021) for follow-up. Reports no sequela other than the development of dry skin that is pruritic. Multiple pending lab studies ordered/collected to identify other etiologies (Lyme, RPR, Coxsackie, parvo ...). Denies any vaping products.


VAERS ID: 1032740 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-20
Onset:2021-01-28
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Pericarditis, Pyrexia, Tachycardia, Troponin T increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall
Current Illness: None
Preexisting Conditions: ADHD
Allergies: None
Diagnostic Lab Data: troponin levels, 2d echo
CDC Split Type:

Write-up: Patient developed fever on day 8 post-vaccine followed by tachycardia, dyspnea and chest pain. Elevated troponin in the ER. ED echo confirmed pericarditis with likely myocarditis.


VAERS ID: 1033091 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-01-04
Onset:2021-01-22
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Blood alkaline phosphatase increased, C-reactive protein increased, Chest pain, Computerised tomogram, Dyspnoea, Echocardiogram abnormal, Electrocardiogram, Fibrin D dimer increased, Full blood count abnormal, Hepatitis, Laboratory test, Liver function test abnormal, Liver function test increased, Pericardial effusion, Pericarditis, Platelet count increased, Pleural effusion, Pneumonitis, White blood cell count increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatitis, non-infectious (narrow), Anaphylactic reaction (broad), Haematopoietic leukopenia (broad), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Chronic kidney disease (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (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? No
Previous Vaccinations:
Other Medications: Zinc, vit D3, vit C
Current Illness: None, was exposed to Covid 19 just prior to getting the vaccination
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ct with PE protocol, EKG, labs, echo documented moderate to severe pericardial effusion no tamponade, documented pleural effusions with pneumonitis documented d dimer in the thousands and elevated CRP above 100, abnormal liver function tests and cbc.
CDC Split Type:

Write-up: approximately 2.5 wks after vaccination, development of severe increasing back pain and chest pain and shortness of breath Dx acute moderately severe pericarditis with pericardial effusion, pneumonitis with bilateral small pleural effusions, hepatitis with elevated alk phos and LFT, bone marrow reaction with elevated WBC, new anemia and elevated platelets, markedly elevated d dimer and CRP with normal troponin and negative imaging for PE.


VAERS ID: 1034558 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-20
Onset:2021-02-08
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram head, Computerised tomogram thorax, Dehydration, Diarrhoea, Electrocardiogram, Eye pain, Facial paralysis, Glassy eyes, Glossodynia, Headache, Nausea, Ocular discomfort, Pain, Pericarditis constrictive, Visual impairment
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Listed above: 2/12 CT of chest and EKG. 2/16 CT of brain.
CDC Split Type:

Write-up: 2/8: Onset of extreme headache (lasting through today, 2/16, with ZERO relief) which has spread into my eye sockets. Extreme nauseous, 6 days of diarrhea, unalbe to even keep water down at day 4. Body aches, heart constrictions on 2/12. On 2/12 the heart constrictions and severe deydration resulted to call to Advise Nurse with direction to report to ER. In ER EKG, CT of chest and lungs. 2/12: Returned home and slept for several days and continued to attempt to relieve massive entire head pounding. 2/14: Head ache traveled into eye sockets creating massive eye pressure. 2/16: Sudden pain in left tongue and vision change. Noticed facial drooping and eyes glassy. Called and then 911 as concerned.


VAERS ID: 1038358 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-30
Onset:2021-01-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Aspiration pleural cavity, C-reactive protein increased, Chest pain, Dyspnoea, Echocardiogram, Echocardiogram normal, Inflammation, Pericardial drainage, Pericardial effusion, Pericarditis, Pleural effusion, Red blood cell sedimentation rate increased, Thoracic cavity drainage
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Medication Details Provider Last Reconciliation Status gabapentin (NEURONTIN) 300 MG capsule Take 1,200 mg by mouth nightly. 900mg morning, afternoon 1200mg bedtime Historical Zzzprovider, MD Needs Review Reviewed Prior to Admission Medica
Current Illness: NO
Preexisting Conditions: ? Asbestosis (CMS/HCC) ? BPH (benign prostatic hyperplasia) ? Chronic sinusitis ? CKD (chronic kidney disease) ? Diabetes mellitus (CMS/HCC) Type 2 ? MGUS (monoclonal gammopathy of unknown significance) ? Nephrolithiasis ? Neuropathy Lower Extremity ? Osteopenia ? Proteinuria ? PVD (peripheral vascular disease) (CMS/HCC) ? Rheumatoid arthritis (CMS/HCC) stem cell knees ? Sleep disorder
Allergies: No
Diagnostic Lab Data: thoracentesis 2/16, pericardiocentesis 2/16, echo 2/15
CDC Split Type:

Write-up: Development of chest pain and dyspnea. Large pleural and pericardial effusions requiring drainage. No evidence of CHF by echo or BNP. Fluid was found to be exudative rather than transudative. No growth of infectious agents found to be causal. ESR and CPR extremely elevated. All self resolving after thoracentesis and pericardiocentesis.


VAERS ID: 1040340 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-11
Onset:2021-02-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Bacterial test, Blood test, Cardiomegaly, Dehydration, Echocardiogram, Myocarditis, Pulmonary oedema, Viral test, Vomiting
SMQs:, Cardiac failure (narrow), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bi-polar medications
Current Illness: None
Preexisting Conditions: Obesity
Allergies: unknown
Diagnostic Lab Data: Echocardiogram, testing for bacterial and viral infections, bloodwork
CDC Split Type:

Write-up: Enlarged or inflamed heart, lungs full of fluid, myocarditis, vomiting, dehydration


VAERS ID: 1040918 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:2021-01-16
Onset:2021-01-23
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-02-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site pain, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Extravasation events (injections, infusions and implants) (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (No reported medical history)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Acute pericarditis; Soreness on the left shoulder (injection site); A spontaneous report was received from a consumer who was also a 75-years-old, male patient, who received Moderna''s COVID-19 Vaccine (mRNA-1273) and who experienced soreness on the left shoulder (injection site)/ injection site soreness and acute pericarditis/ pericarditis. The patient''s medical history was not provided. Concomitant medications were not reported. On 16 Jan 2021, seven days prior to onset of the events, the patient received their first two planned doses of mRNA-1273 (Batch number: 039K20A) intramuscularly for the prophylaxis of COVID-19 infection. On 23 Jan 2021, the patient experienced soreness on the left shoulder (injection site), tiredness, headache, and chest pain. On 02 Feb 2021, he had difficulty breathing even with his continuous positive airway pressure (CPAP) machine and called 911. He was taken to emergency room (ER) and was diagnosed with acute pericarditis. Treatment included ibuprofen, pantoprazole, and colchicine. Action taken with mRNA-1273 in response to the events was not reported. The outcome of events, soreness on the left shoulder (injection site and acute pericarditis, was not reported.; Reporter''s Comments: This case concerns a 75 year old male subject, who experienced a serious unexpected event of Pericarditis and a non-serious expected event of injection site pain after first dose of mRNA1273 (Lot# 039K20A). Very limited information has been provided regarding the event of pericarditis at this time. Further information has been requested.


VAERS ID: 1041804 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-02-15
Onset:2021-02-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-02-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Arteriogram coronary normal, Blood creatine phosphokinase increased, Blood lactic acid, Brain natriuretic peptide increased, Chest X-ray normal, Chest discomfort, Chills, Computerised tomogram normal, Dyspnoea, Electrocardiogram abnormal, Electrocardiogram normal, Fibrin D dimer increased, International normalised ratio normal, Lipase normal, Lymphadenopathy, Magnetic resonance imaging abnormal, Myocarditis, Nausea, Platelet count decreased, Pyrexia, SARS-CoV-2 test negative, Troponin increased, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Immune-mediated/autoimmune disorders (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: MVI Vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: Labs: Troponin 600.3 -$g 609.9 COVID negative Lipase 24 PT 13.5, INR 1.0 140/4.6|100/28|10.4/0.87<114 D-Dimer 0.54 10.1$g14.3/42.9<200, 83% neutrophils Pro BNP 524.6 CK 556 EKG: t-wave inversions in lead II and leads V3-V6 Radiology: 2/17 CXR IMPRESSION: No radiographic evidence of acute cardiopulmonary process. CT PE IMPRESSION: 1. No evidence of pulmonary embolism. 2. Asymmetric left axillary lymphadenopathy for which malignancy is a differential consideration. A regional reactive, inflammatory, or infectious process may be considered after the exclusion of malignancy. Further evaluation with PET/CT would be useful for further imaging evaluation as clinically needed. 3. Incidental, indeterminate liver findings as above. Recommend nonemergent liver MRI for further evaluation. 19FEB2021 TTE Summary Normal LV cavity dimensions, wall thickness, global and segmental systolic function. Normal LVEF estimated at 60-65%. Normal diastolic filling pattern. Normal right ventricular size and function. Normal valvular structure and function. Intracardiac pressures: Unable to estimate pulmonary artery systolic pressure due to lack of tricuspid regurgitation. Normal IVC, normal right atrial pressure. 19FEB2021 Coronary CTA CONCLUSIONS: 1. No coronary artery disease, normal coronary arteries. 2. Bibasilar atelectasis. Otherwise, unremarkable visualized extra cardiac structures. CAD-RADS 0: No plaque or stenosis. RECOMMENDATIONS: Recommend therapeutic lifestyle changes and medical therapy as clinically indicated. 2/19/2021 Cardiac MRI Consistent with myocarditis
CDC Split Type:

Write-up: 30 yo man with no significant past medical history presents to the ED for chest pressure and SOB that started this morning when he woke up. It was a constant 8/10 pressure squeezing at the sides of his sternum with the sensation of a plate pushing down on his sternum, that worsened by taking deep breaths. He had never experienced anything like it before. The pain was neither worsened with exertion nor relieved by rest. It did not change with position, and it did not radiate to his arm/neck. He denies any tenderness to palpation of his chest. Ibuprofen 400 mg did not provide any relief. At time of interview denies SOB and reports decrease in chest tightness to 2/10. CP was significantly relieved with a bolus of normal saline in the ED. Tylenol also effectively reduced his pain. Of note, the patient received the second Moderna COVID vaccine shot 3 days ago. For 2 days after receiving the second shot he experienced fevers, chills, nausea, and intermittent vomiting (10 bouts of non-bloody emesis).


VAERS ID: 1043948 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-02-18
Onset:2021-02-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-02-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031M20A / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Blood creatine phosphokinase increased, Chest X-ray normal, Chest pain, Dyspnoea, Electrocardiogram ST segment elevation, Electrocardiogram normal, Fatigue, Headache, Nausea, Pericarditis, SARS-CoV-2 test negative, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: TROPONIN 4.7 @0816 21FEB2021. TROPININ 10.8 @1023 21FEB2021. CK 595 @0951. RAPID SARS-COV2 NEGATIVE BY BIOFIRE MACHINE. CKR UNREMARKABLE.
CDC Split Type:

Write-up: PT EXPERIENCED NAUSEA, HA, FATIGUE 1 DAY POST VACCINE. REPORTS HE FELT BETTER 2 DAYS POST VACCINE AND WENT FOR A REGULAR WORK-OUT WITHOUT COMPLICATIONS. PT WOKE-UP 3 DAYS POST VACCINE WITH CHEST PX, SOB, FATIGUE. HE CALLED 911 AND WAS BROUGHT TO HOSPITAL VIA AMBULANCE. PT HAD UNREMARKABLE EKG INITIALLY, LABS DRAWN. INITIAL TROPONIN 4.7, EKG REPEATED WITH SOME MINIMAL ST ELEVATION, 324MG ASA GIVEN. COORDINATING TRANSPORT TO ANOTHER HOSPITAL WITH CARDIOLOGY SERVICES, TROPONIN REPEATED AND FOUND TO BE 10.8 WITH GLOBAL ST ELEVATIONS ON EKG. PT TRANSPORTED TO HOSPITAL FOR PRESUMED PERICARDITIS. AWAITING UPDATES ON PT CONDITION TOMORROW.


VAERS ID: 1044420 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-01-09
Onset:2021-01-31
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-02-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Aphasia, Blood creatinine normal, Blood fibrinogen increased, Blood lactic acid, Blood sodium decreased, C-reactive protein increased, Cardiac arrest, Death, Diarrhoea, Fibrin D dimer increased, Multiple organ dysfunction syndrome, Myocarditis, Oropharyngeal pain, Platelet count decreased, Pyrexia, SARS-CoV-2 antibody test positive, Serum ferritin increased, Transaminases, Troponin increased, White blood cell count increased
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad), Sepsis (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-08
   Days after onset: 8
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Sodium 131, creatinine 1.2 on admission, transaminases initially normal, lactic acid 2.6, white blood count 11.0, platelets 110, coronavirus nucleocapsid IgG positive, troponin 18, ferritin 1435, fibrinogen 642, D-dimer 5.22, CRP 284
CDC Split Type:

Write-up: Please reference separately submitted MIS-A form. He had sore throat, high fever, diarrhea, deteriorating in to multisystem failure and apparent acute myocarditis, notably with relative initial sparing of the lungs. He suffered cardiac arrest in radiology after developing aphasia and was transferred to Hospital after cannulation for VA ECMO; he died there 2/8/21.


VAERS ID: 1045176 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-09
Onset:2021-01-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: C-reactive protein normal, Chest X-ray normal, Dyspnoea, Echocardiogram abnormal, Full blood count normal, Oedema peripheral, Pericarditis, Red blood cell sedimentation rate normal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra PRN Lunesta PRN MiraLax.
Current Illness: NONE
Preexisting Conditions: Insomnia SAR intermittent constipation.
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient is a 34yo female seen about 1 month ago for SOB - it developed 1 week after the COVID vaccine. She was sent to Cardiology and they diagnosed her with pericarditis and she was started on scheduled NSAIDS. - Cardiology recommended ESR, CRP and CBC and they were negative. - CXR was normal - Echocardiogram was suggestive of pericarditis. Cardiology told her to follow up in 1 month is symptoms did not improve and they have not. Also she stated she has developed mild, intermittent peripheral edema that resolves without intervention but this is new. I am also ordering the cardiac MRI which the cardiologist recommended if symptoms did not improve with NSAIDs.


VAERS ID: 1045178 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-18
Onset:2021-02-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Angiogram, Blood creatine phosphokinase, Blood creatine phosphokinase MB, C-reactive protein increased, Chest pain, Computerised tomogram thorax, Dyspnoea, Electrocardiogram, Fibrin D dimer, Full blood count, Inflammatory marker increased, Lipase, Metabolic function test, Myocarditis, Red blood cell sedimentation rate, SARS-CoV-2 test, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: SMOKER 1 PACK/DAY X3 YEARS
Allergies: NONE
Diagnostic Lab Data: EKG; ESR; CRP; LIPASE; TROPONIN; CBC; CMP; CPK; CK-MB; CK; COVID; D-DIMER; CTA (CHEST R/O PE)
CDC Split Type:

Write-up: CHEST PAIN; SOB; ELEVATED INFLAMATORY MARKERS; ELEVATED TROPONIN; MYOCARDITIS


VAERS ID: 1046026 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-11
Onset:2021-02-14
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Headache, Hypertension, Myalgia, Pericarditis
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Hypertension (narrow), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Coconut
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed acute pericarditis on 2/14/2021. Completely healthy 42 yr old with no recent illnesses other then the vaccine. Developed myalgia, severe headache, and slightly elevated blood pressures 24 hours post second vaccine. Then 4 weeks later acute pericarditis.


VAERS ID: 1046576 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-02-12
Onset:2021-02-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK AR / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood creatine phosphokinase increased, Catheterisation cardiac normal, Echocardiogram normal, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Myocarditis, Pericarditis, Red blood cell sedimentation rate increased, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations: 1st dose Moderna Covid 19 - sore arm and rash
Other Medications: ELURYNG, over the counter eye drops
Current Illness: n/a
Preexisting Conditions: Sjogren''s Syndrome - mild, mostly with just dry eyes
Allergies: No
Diagnostic Lab Data: Elevated troponin, CK, ESR. ECG with 1 mm ST elevations throughout. Cardiac Catheterization and Echocardiogram normal.
CDC Split Type:

Write-up: She developed pericarditis/myocarditis and was diagnosed 4 days after receiving second dose of Covid19 Moderna vaccine


VAERS ID: 1046636 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-02-12
Onset:2021-02-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004M20A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest pain, Computerised tomogram, Dyspnoea, Electrocardiogram abnormal, Myocardial necrosis marker increased, Myocarditis, X-ray normal
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: After first moderna shot, vomiting, chills, body aches
Other Medications: Lamictal- 100 MG Trileptal- 300 mg AM 600 PM Prozac- 10 MG Birth control contraceptive
Current Illness: None
Preexisting Conditions: None
Allergies: Gluten
Diagnostic Lab Data: EKG- abnormal day 1, more normal day 2 2/19 and 2/20 Bloodwork- high cardiac enzymes 2/19 and 2/20, heart in distress and inflamed Cat scan- normal Xray- normal
CDC Split Type:

Write-up: 12 hours after my second Moderna shot, had severe chest pain and shortness of breath. Admitted to emergency room later in the week for myocarditis as a result of the vaccine.


VAERS ID: 1047627 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-18
Onset:2021-02-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ibuprofen prn
Current Illness: 20 YOM with COVID infection early dec 2020. No symptoms on day of vaccination.
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Troponin 11. EKG as above
CDC Split Type:

Write-up: 20 YOM with prior COVID vaccine Dec 2020 presents 4 days after COVID vaccination (First dose) with constant substernal chest pressure, ST early repol vs elevation in ST segment and troponins 11. Onset of chest pain occurred 3 hours after covid vaccine-- 5/10, constant, not positional. Transferred to cardiology inpatient for suspected myocarditis. No prior troponin obtained given prior covid illness.


VAERS ID: 1047631 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-01-11
Onset:2021-01-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test abnormal, Chest pain, Computerised tomogram normal, Electrocardiogram abnormal, Feeling abnormal, Fibrin D dimer increased, Myocardial infarction, Pericarditis
SMQs:, Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertriline, Desvenlafaxine, Omeprazole, Vit C, Vit D, Elderberry
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG : Anterior Infarct Blood work : elevated d-diter CT scan : no PE or cardiac clot
CDC Split Type:

Write-up: Two days after the 2nd injection I started to have chest pain and not feel right. I went to the Station where I volunteer. I did and EKG which showed Anterior Infarct. I went to the ER. They gave me 4 baby aspirin to take and some blood work. I was told the blood work showed elevated levels consistent with a blood clot as well. I had a CT scan to rule out a clot in my heart or lungs. Which it was negative. I was released and told to see a cardiologist in the next few days. I saw the cardiologist two days later who said I ended up with Pericarditis and that it should resolve on its own. I was feeling better until two days ago when I developed chest pain again. I again went to my fire station I volunteer for and did an EKG which showed Anterior Infarct. I am currently waiting for treatment from my cardiologist.


VAERS ID: 1048204 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-01-22
Onset:2021-01-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic reaction, Blood pressure measurement, Chest discomfort, Discomfort, Dizziness, Fatigue, Head discomfort, Hypertension, Impaired work ability, Myocardial necrosis marker, Myocardial necrosis marker increased, Myocarditis, Troponin, Troponin increased
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data: Test Date: 20210122; Test Name: Blood pressure; Result Unstructured Data: Test Result:128/73; Test Date: 20210122; Test Name: Blood pressure; Result Unstructured Data: Test Result:220/116; Test Date: 20210122; Test Name: Cardiac enzymes; Result Unstructured Data: Test Result:Elevated; Test Date: 20210122; Test Name: Troponin; Result Unstructured Data: Test Result:increasing
CDC Split Type: USPFIZER INC2021129982

Write-up: Heart enzymes were elevated; Anaphylactic reaction; Blood pressure was 220/116/ her blood pressure was out of control; dizziness does not allow her to go to work; lingering dizziness; Get a tightening in her chest; Fatigue; Left side of temple toward the crown of head she has pressure on the left side of the body; Left side of temple toward the crown of head she has pressure on the left side of the body; lightheadedness; troponin kept increasing; Inflammation around heart; This is a spontaneous report from two contactable consumers or other non health professional (including patient self, a healthcare worker works with patients with lymphomas, a licensed massage/lymphatic therapist). This 53-years-old female received her 1st dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number EL1283, Expiry Date: 30Apr2021) at 0.3 ml single dose intramuscular injection in left arm on 22Jan2021 10:28 (also reported as 10:38) for Covid-19 vaccination. Medical history was none (also reported as no patient history). Concomitant drug was none (reported as no other products). Family Medical History Relevant to AE(s) was none. Historical vaccine included flu shot in Nov2020 for immunisation. History of all previous immunization with the Pfizer vaccine considered as suspect (or patient age at first and subsequent immunizations if dates of birth or immunizations are not available) was none. Additional Vaccines Administered on Same Date of the Pfizer Suspect was none. No other vaccines given the same day or 4 weeks prior. AE(s) following prior vaccinations was none. Patient never had a reaction to any vaccine or shot before. Patent experienced anaphylactic reaction on 22Jan2021, heart enzymes elevated on 22Jan2021, blood pressure was out of control on 22Jan2021, get a tightening in her chest on an unknown date, lingering dizziness on an unknown date, dizziness did not allow her to go to work on an unknown date, inflammation around heart on 22Jan2021, troponin kept increasing on 22Jan2021, fatigue on an unknown date, lightheadedness on an unknown date, left side of temple toward the crown of head she has pressure on the left side of the body on an unknown date. Seriousness for heart enzymes elevated and anaphylactic reaction was hospitalization from 22Jan2021 to 23Jan2021. The events anaphylactic reaction required a visit to Emergency Room, but not Physician Office. The event clinical course was as follows: patient received her 1st dose of the Pfizer vaccine she had an anaphylactic reaction. She was given 3-4 Epis on site (on 22Jan2021) before being transferred to the ER. In the ambulance, she was administered a 4th EpiPen (on 22Jan2021) before getting to the ER, and then admitted to the cardiac unit on 22Jan2021 for observation. Patient also reported Given 3-4 EpiPens on 22Jan2021 and EpiPen auto-injector was Lack of Effect. No Return Sample Received. When she first started having symptoms, her blood pressure was 128/73. When the symptoms got worse her blood pressure started increasing. Her blood pressure was 220/116, they had to admit her to the cardiac unit because her heart enzymes were elevated and her blood pressure was out of control. Her troponin kept increasing and had inflammation around her heart. Her symptoms of anaphylactic reaction went away that same day, 22Jan2021, at the vaccination from her anaphylactic reaction. Patient was discharged and released from the cardiac unit on that Saturday (23Jan2021 ) around 7:30pm. No one could tell her anything about this since she was still having lingering effects and was getting ready to locate a cardiologist and still has tightness in the chest. She mentioned the dizziness did not allow her to go to work. She experiences it on and off, not consistent but less severe than initially. She still had lingering dizziness and she had to drive for a majority of her day and that was concerning. She said that on the left side she will get a tightening in her chest. She said that no one knows what this means moving forward. Patient was concerned about the severity of the reaction and was still not back to normal. She had never had a reaction to any vaccine or shot before and has been in the military. She needed help, direction since she was still not at the full potential to work. She was still fatigued and has tightness of her chest and those are concerns for her. Patient mentioned a part of the symptoms she also had were lightheadedness and dizziness and that started after the vaccine and it''s not as severe, but she still had it. On left side of her temple toward the crown of her head she had pressure on the left side of the body and that was the same side where she received the injection, on that left side. Outcome of anaphylactic reaction was resolved with sequel on 22Jan2021. Outcome of heart enzymes elevated was resolved on 23Jan2021. Outcome of blood pressure was out of control was resolved with sequel on 23Jan2021. Outcome of lingering dizziness was resolving. Outcome of left side of temple toward the crown of head she had pressure on the left side of the body, lightheadedness was not resolved. Outcome of tightness in the chest and fatigue was not resolved. Outcome of inflammation around heart and troponin kept increasing was resolved with sequel on an unknown date. Outcome of the other event was unknown.


VAERS ID: 1051653 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-01-28
Onset:2021-02-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-02-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Painful respiration, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Rosuvastatin 20 mg 1tab/day Lisinopril/HCTZ 10-12.5 mg 1 tab/day Melatonin 10mg Vitamin D3 25 mg
Current Illness: None
Preexisting Conditions: High cholesterol High Blood pressure
Allergies: None
Diagnostic Lab Data: Numerous. Treatment seems to be working regarding pain. Complete recovery from pericarditis to be determined following 3 month use of colchicine.
CDC Split Type:

Write-up: Moderate pain in chest behind sternum when breathing. Admitted to Hospital on 1 February 2021. Diagnosed as pericarditis. Treatment: Ibuprofen 600 mg 3x/day for 2 weeks, and Colchicine 0.6 mg 2x/day for 3 months.


VAERS ID: 1051710 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-02
Onset:2021-02-14
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-02-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiocardiogram, Biopsy heart abnormal, Cardiac disorder, Diarrhoea, Myocarditis, Nausea, SARS-CoV-2 antibody test, SARS-CoV-2 test negative, Troponin increased, Urine retinol binding protein increased, Vomiting
SMQs:, Acute pancreatitis (broad), Myocardial infarction (narrow), Pseudomembranous colitis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (narrow), Noninfectious diarrhoea (narrow), Tubulointerstitial diseases (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multivitamins
Current Illness: None
Preexisting Conditions: Pancreatic cyst Spondylosis Osteoarthritis Ulcerative colitis-not on medication
Allergies: None
Diagnostic Lab Data: Nasopharyngeal PCR negative for covid 19 on 2/14 and 2/17. 2/18 COVID IgG titer to the spike receptor binding protein was. 1:6400 . Trop
CDC Split Type:

Write-up: On 2/2 received 1 st dose of vaccine. On 2/14 developed nausea, vomiting and diarrhea. Admitted to hospital and found to have a troponin of 72 and coronary angiogram done. Endomyocardial biopsy revealed myocyte damage and mixed inflammatory infiltrate concerning for myocarditis. Patient ultimately has started to recover with treatment of methylpred 1 gram x 3 days.


VAERS ID: 1055368 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-20
Onset:2021-02-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 02YM20A / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebral artery stenosis, Chest pain, Electrocardiogram ST segment elevation, Myocarditis, Troponin increased, Vision blurred, Visual field defect
SMQs:, Myocardial infarction (narrow), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Marijuana Vyvanse
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented with bilateral blurry peripheral vision that resolved over several days. He was found to have P1 PCA stenosis. Additional imaging showed this to be resolved and a normal variant. Additionally, patient diagnosed with myopericarditis. Found to have elevated troponin up to 6, diffuse ST segment elevation on EKG and chest pain. Started on ibuprofen and colchicine with relief. Discharged from the hospital on hospital day 2.


VAERS ID: 1056448 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Maryland  
Vaccinated:2021-01-20
Onset:2021-01-30
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Angina pectoris, Heart rate increased, Myocarditis, Pericarditis
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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: PHENYLPROPANOLAMINE; ANTI-INFLAMMATORY; COLCHICINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (No medical history reported.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: myocarditis; pericarditis; Chest pain; rapid heartbeat; A spontaneous report was received from a 20-year- old male patient who experienced chest pain, myocarditis, pericarditis, inflammation of pericardium. The patient''s medical history was not provided. Concomitant medications included phenylpropanolamine, diclofenac sodium, and colchicine. The patient received their first of two planned doses of mRNA-1273 (Batch number: unknown) on 20 Jan 2021 intramuscularly for the prophylaxis of COVID-19 infection. On 30 Jan 2021, the patient experienced chest pain, rapid heartbeat and went to emergency room (ER). He was hospitalized and was diagnosed with myocarditis, pericarditis, inflammation of pericardium. The patient was discharged on 31 Jan 2021. Treatment information was not provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the events, chest pain, myocarditis, pericarditis, inflammation of pericardium, was considered not resolved.; Reporter''s Comments: Very limited information regarding this event has been provided at this time. Further information has been requested. The use of concomitant medication, Pnenylpropanolamine, which is a sympathomimetic agent, is a risk factor and confounding factor for causality.


VAERS ID: 1057780 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-01-29
Onset:2021-02-21
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Magnetic resonance imaging heart, Myocarditis
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None reported
Preexisting Conditions: None reported
Allergies: Bactrim
Diagnostic Lab Data: Cardiac MRI 2/25/21
CDC Split Type:

Write-up: Acute myocarditis


VAERS ID: 1058476 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-02-07
Onset:2021-02-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Autoimmune disorder, Blood creatine phosphokinase increased, C-reactive protein increased, Chest X-ray normal, Chest pain, Chills, Computerised tomogram normal, Condition aggravated, Electrocardiogram abnormal, Euphoric mood, Fatigue, Feeling drunk, Fibrin D dimer increased, Hyperaesthesia, Hypoaesthesia, Myocarditis, Nausea, Pain, Pyrexia, Sensory disturbance, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow), Sexual dysfunction (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Birth Control Pill (with estrogen) Melatonin Women''s multivitamin gummy
Current Illness: None
Preexisting Conditions: Undiagnosed Autoimmune Disorder
Allergies: None
Diagnostic Lab Data: EKG (4x): First test was slightly abnormal Chest X-Ray: normal CT Scan: normal, no blood clots Troponin level: 14 CRP level: 2.71 D-Dimer: 0.59 ANA: positive CK level: 534 Medical Diagnosis: Myocarditis R/T unknown autoimmune disorder
CDC Split Type:

Write-up: Day of vaccine, 4hrs post vaccine: felt drunk/high/intoxicated (touch was intensified, numbing feeling) Day 2-3: exhausted and fever of 102F, body aches, chills, nausea Day 4: started feeling better, fever went down with Tylenol Day 5 3am: woke up with chest pain (3.5-4/10), went away with Tums; 0930pm chest pain 6/10 while sitting at desk, increased to 7/10, lasting 2 hours by the time I went to the ER


VAERS ID: 1058628 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-02-22
Onset:2021-02-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Echocardiogram abnormal, Electrocardiogram normal, Fibrin D dimer normal, Left ventricular hypertrophy, Neck pain, Pain in extremity, Right ventricular hypertrophy, Troponin normal, Ventricular enlargement, Viral pericarditis
SMQs:, Pulmonary hypertension (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Uroxatral 10mg daily Zyrtec 10mg daily
Current Illness:
Preexisting Conditions:
Allergies: Pollen
Diagnostic Lab Data: 2D Echo of Heart - showed mildly enlarged right and left ventricles EKG - Normal sinus rhythm Normal troponin and ddimer
CDC Split Type:

Write-up: Patient received 2nd dose of Moderna Covid Vaccine at 1pm. At 2:30pm he started to develop chest pain and left side neck and arm pain. He was admitted to the hospital for further work-up. While in the hospital the patient had relief only from sitting up and forward. The doctor decided to transfer the patient to another facility that had specialist. At the next hospital it was determined that the patient had Viral Pericarditis, associated with the Covid Vaccine.


VAERS ID: 1058830 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-02-22
Onset:2021-02-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram, Dyspnoea, Magnetic resonance imaging, Paraesthesia, Pericarditis, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Could not breathe sharp pains in chest tingling in arms. Inflammation of heart muscle


VAERS ID: 1059800 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-22
Onset:2021-02-25
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Computerised tomogram thorax, Drug screen, Electrocardiogram, Full blood count, Metabolic function test, Myalgia, Myocarditis, Pain, Pyrexia, Troponin increased, Urodynamics measurement
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Drug abuse and dependence (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: CBC, CMP, troponin, UDS, Chest Xray, CT scan of chest. EKG
CDC Split Type:

Write-up: Patient developed typical fever, myalgias, body aches in the days after his vaccine. He would describe them as severe. This was followed by chest pains. These chest pains prompted him to seek care in the ER. Upon workup, I found the patient to have developed myocarditis with a significantly elevated troponin prompting hospitalization.


VAERS ID: 1060242 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-01-12
Onset:2021-02-01
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Pericardial drainage, Pericardial drainage test normal, Pericardial effusion, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Plavix,
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: No
Diagnostic Lab Data: She had fluid removed and it showed no sign of cancer so most likely it was a pericardial effusion?s from Pericarditis
CDC Split Type:

Write-up: The patient developed back pain one month after the first injection on February 24 she was diagnosed with pericardial effusion?s and 750 mL was drained from the pericardium. The work up is on going but it seems to be Pericarditis which occurred after the vaccination


Result pages: 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