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You are viewing patients aged: 79, in state: WI

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VAERS_IDRECVDATESTATEAGE_YRSCAGE_YRCAGE_MOSEXRPT_DATESYMPTOM_TEXTDIEDDATEDIEDL_THREATER_VISITHOSPITALHOSPDAYSX_STAYDISABLERECOVDVAX_DATEONSET_DATENUMDAYSLAB_DATAV_ADMINBYV_FUNDBYOTHER_MEDSCUR_ILLHISTORYPRIOR_VAXSPLTTYPEFORM_VERSTODAYS_DATEBIRTH_DEFECTOFC_VISITER_ED_VISITALLERGIESLink 1Link 2
093600701/11/2021WI79.079FPatient's Daughter reports Nausea and VomittingU01/06/202101/06/20210PHM201/11/2021EGGS2021VAERSSYMPTOMS2021VAERSVAX
097918401/27/2021WI79.079FShortly after vaccination, patient developed dizziness and tingling sensation along jawline. Patient mildly hypertensive. Approximately 15 minutes later, dizziness developed but tingling sensation also experienced in bilateral feet. Evaluated in ER and Y01/26/202101/26/20210N/A (EKG offered by declined)PVTMultivitamin (AREDS formula), lactobacillus supplement, Lovaza 4 gramsN/AN/A201/27/2021YSulfonamide2021VAERSSYMPTOMS2021VAERSVAX
097950001/27/2021WI79.079MWriter administered vaccine using manufacturer pre-assembled needle-syringe. Upon administration, some of the vaccine leaked out between the syringe and needle hub, enough to form a drop of vaccine on patient's arm.01/27/202101/27/20210PUB201/27/20212021VAERSSYMPTOMS2021VAERSVAX
100138702/04/2021WI79.079FShingles in left thigh radiating to left lower abdomen two days after vaccine Went to Urgent care 2 days after pain/rash started Treated with Acyclovir for 1 week 10 days later, rash improved. Pain continues, somewhat improved.N01/21/202101/23/20212PVTsimvastatin citalaprim zolpidem fish oil herblaxarthritis202/04/2021Ybactrim2021VAERSSYMPTOMS2021VAERSVAX
102071502/10/2021WI79.079MAt just after 5 o'clock, pt received his 1st dose of the COVID-19 vaccine and about 10 minutes later he began to feel flushed in his face. This was associated with some chest tightness as well. He was referred to the emergency department. He had no diffY02/08/202102/08/20210PVTCAD202/10/2021YNone2021VAERSSYMPTOMS2021VAERSVAX
102906802/14/2021WI79.079MPatient was given vaccine the following day he died ,Y02/09/2021N02/07/202102/08/20211Covid-19 positiveOTHN/AMental health, dementia202/14/2021No known2021VAERSSYMPTOMS2021VAERSVAX
104009002/18/2021WI79.079Mlip swelling and itching of jawU02/01/202102/03/20212n/aPVTamLODIPine (NORVASC) 10 MG tablet Take 1 tablet by mouth daily. isosorbide mononitrate (IMDUR) 30 MG 24 hr tablet Take 1 tablet by mouth daily. tamsulosin (FLOMAX) 0.4 MG Cap Take 1 capsule by mouth daily after a meal. sertraline (ZOLOFT) 1noneUnspecified chest pain ? Coronary atherosclerosis of unspecified type of vessel, native or graft ? Reflux esophagitis ? Anxiety state, unspecified ? Trigger finger (acquired) ? Other and unspecified hyperlipidemia ? Unspecified transient cerebral ischemia 202/18/2021lisinopril and plavix2021VAERSSYMPTOMS2021VAERSVAX
104142602/19/2021WI79.079FLocalized itching since day of vaccine. 3 days ago area became red, slightly swollen. Patient seen by PCP, prescribed doxycycline twice daily for 10 days.01/29/202101/29/20210PVT202/19/2021Y2021VAERSSYMPTOMS2021VAERSVAX
104420502/21/2021WI79.079FOn Feb. 20th noticed a big red circle where I had been given the shot. It is not hard but is very warm to the touch. Does not hurt but i know that it is there. This is 12 days after the shotU02/09/202102/20/202111UNKfurosemide and sometimes cetirizneNone202/21/2021No2021VAERSSYMPTOMS2021VAERSVAX
104490402/21/2021WI79.079FRash 2"x4" red and very itchy on the arm around the injection site; Took about 24 hr to become red, and warm. Still itchy today 2/21, but less red, and less warm.U02/12/202102/19/20217PHMSynthroid, vitamin D3, vitamin b12, vitamin C, lutein Magnesium, turmeric Zinc, Phillips stool softnernonehypothyroidzoster shingle on 11/29/2011202/21/2021sulfa, nitofurantoin2021VAERSSYMPTOMS2021VAERSVAX
104679702/22/2021WI79.079Msevere rash both arms swelling of lips rash both hips-armpitsY02/05/202102/14/20219nonePUBatenolol simvastatinnonenone202/22/2021lisinopril2021VAERSSYMPTOMS2021VAERSVAX
104894602/23/2021WI79.079FDifficulty breathing as a result of swelling back of nose, diarreha, nausea,Y02/12/202102/13/20211NonePVTClonidine, Trazadone,Tolter0dine Tartrate,Ropinirole Hcl, Omeprazole, Olanzapine, Metformin HCL, Lovastatin,Fluvoxamine Maleate, Cevimeline HCL, Alparazolam, Womens 50 plius vitamin, Polethylene glycol,Melatonin,Loratadine, Glucosamine ChoNoneMajor Depression, Obsesvive compulsion D., Borderline Diabetes, Barretts,202/23/2021Sulfa, Cipro,2021VAERSSYMPTOMS2021VAERSVAX
105910802/26/2021WI79.079Fday after shot--fatigue, headache, body aches, no appetite, no energyY02/01/202102/25/202124PVTcarvidolol, vitamin d3, co1010, baby aspirin,zerohigh blood pressure202/26/2021dyphenhydromine, fragrances2021VAERSSYMPTOMS2021VAERSVAX
106117402/28/2021WI79.079FHEADACHE, FEVER,CHILLS, TIRED,Y02/25/202102/25/20210PVTHydrochlorothiazide, Sertraline, Amlodipine, Oxybutynin-er ,Parkinsons202/28/20212021VAERSSYMPTOMS2021VAERSVAX
106300003/01/2021WI79.079MPatient passed away within 60 days of receiving a COVID vaccineY02/27/202101/25/202102/27/202133PHM203/01/20212021VAERSSYMPTOMS2021VAERSVAX
107172603/04/2021WI79.079FAchy body, backache, neck ache, weak, low appetite, losing weight, no energyN02/24/202102/25/20211PVTCarvedilol, vitamin d, baby aspirinHigh blood pressure203/04/2021YSulpha drugs, fragrances, side effects, turmeric2021VAERSSYMPTOMS2021VAERSVAX
107304703/04/2021WI79.079MPatient recieved 2nd dose COVID vaccine and had unresponsive episode in car after monitoring period, staff assessed in car and patient had recovered, staff encouraged family to take to ED for evaluation. From ER MDs note: EKG was normal sinus rhythm, narYU03/03/202103/03/20210PVT203/04/2021YY2021VAERSSYMPTOMS2021VAERSVAX
108530203/09/2021WI79.079MPatient was admitted to Hospital on 3/1/21. Blood Sugar of 758. Patient diagnosis with Acute respiratory failure with hypoxia and acute heart failure and Metabolic encephalopathy. Patient put on ventilator and passed away on 3/2/21 at 17:04.Y03/02/2021Y1N02/26/202103/01/20213PVTAspirin 81 mg oral tablet Atorvastatin Calcium 80 MG Oral Tablet Empagliflozin (Jardiance) 10 MG Oral Tablet Fiber FluoGlimepiride 4 MG Oral Tablet Propranolol HCl (Propranolol HCl ER) 60 MG Oral Capsule Extended Release 24 Hour SitagliptinDiabetes, Hyperlipidemia, Hypertension, Hyperpotassemia, Chronic Kidney Disease, Tremors203/09/2021Lisinopril2021VAERSSYMPTOMS2021VAERSVAX
108809303/10/2021WI79.079FHeadache the evening of the vaccination. The next day I had headache, chills, whole body ache, stomach upset. I took Tylenol, as directed, for two days.Y03/01/202103/01/20210NoneOTHTylonal, atorvastatin, calcium &magnesium carbonates, coQ10, Essie?s tea, echinacea, losartan, melatonin, vitamin D, vitamin K2, refresh eye drops, polysorbate 80-glycerin op.ShinglesHigh blood pressure, slightly elevated chorestral203/10/2021Sulfa, all pain killers2021VAERSSYMPTOMS2021VAERSVAX
108973003/10/2021WI79.079FThis was a contracted visit to a long term care facility. We were notified by the Immunization Record Registry that she had received her first dose from Public Health on 2/26/21. We were advised that she should not receive another dose. There was no adv03/05/202103/05/20210PHM203/10/20212021VAERSSYMPTOMS2021VAERSVAX
109858703/14/2021WI79.079Fshortness of breath, pain in chest increasingly more severe as time went on. Noticed shortness of breath about 12 days after the vaccine was given. I am a 2 mile a day walker and very healthy. It was below freezing and I attributed the shortness of breath N02/12/202102/20/20218Too many to list. Blood tests in ER plus EKG, CT scan and others.PVTmuti vitimin, Mag64, amlodipine 5mg, tylenolnonecancer surgery 5/2017203/14/2021various- latex allergy, amoxicillin, doxycycline2021VAERSSYMPTOMS2021VAERSVAX
109887603/14/2021WI79.079FSon reports the day after the vaccination, the patient had a stroke while waiting in the pre-op area for a trigger finger surgery. Patient had not been asked about pending surgeries or other medications on day of vaccination. Son reports patient stopped taY01/26/202101/27/20211PVTUnknown, other than patient had stopped taking "blood thinning medications" after Monday's dose because was scheduled for trigger finger surgery on 1/27203/14/2021YNone Known2021VAERSSYMPTOMS2021VAERSVAX
110166903/15/2021WI79.079Ffatigue, diarrhea, body aches, chills, sore throat, runny nose, headache, abdominal pain lasting for 2 weeks and not improvingN02/24/202102/25/20211NonePVTalbuterol, alprazolam, amlodipine, aspirin, effexor, vit. D, esomeprazole, iron, furosimide, potassium, pregabalin, tylenolnoneAnxiety Asthma Vitamin B12 deficiency without anemia Depression Fatigue Gastroesophageal reflux Headache(784.0) Hypertension, essential Fatigue Mitral valve regurgitation Muscle spasm Sciatica of left side palpitations TIA (trans203/15/2021Yomeprazole, rofecoxib, codeine, penicillin, tizanidine, morphine, oxycodone, ranitidine, propoxyphene2021VAERSSYMPTOMS2021VAERSVAX
110281703/15/2021WI79.079MPatient is an 79 year old male who had his 2nd Moderna vaccination in his dominant right arm Thursday afternoon. Upon awakening Friday morning, he had difficulty walking. His legs were strong enough to hold him, but he was unstable. He also had some numYU03/11/202103/12/20211CT the head suggest a right pontine infarct. CT angiogram of the head neck show posterior circulation stenoses in inclusions, but likely none that coincide with pontine infarct. He has had no episodes of sensing palpitations. He has not had previous TIAPVTallopurinol, amlodipine, aspirin, atorvastatin, levothyroxine, lisinoprilhypertension, hyperlipidemia, hyperglycemia, hypothyroid, history of gout203/15/2021NKDA2021VAERSSYMPTOMS2021VAERSVAX
110515103/16/2021WI79.079FAfter 1st vaccine a rash started on arms the next day. Used Anti Itch lotions and rash was eliminated by February 25. Second dose taken on March 3rd. Rash and welts over arms back and legs started the same day. Saw PA on the 5th and prescribed HydroxyzineN02/03/202102/03/20210Biopsy done on the 8th. Phoned report on 15th indicated rash was reaction to Covid Vaccine.PVTCalcium Citrate, Magnesium, Ibondrondate, Synthroid, Aspirin 81 mgThyroidectomy, OesteoporosisFlu203/16/2021YAdhesives, Alendronate Sodium, Codeine, Epinephrine, Tamoxifen Citrate2021VAERSSYMPTOMS2021VAERSVAX
111680403/19/2021WI79.079FEvery part of body hurt one day after the injection, didn't eat, Second day everything ran out of me until I pooped yellow liquid. Third day started to eat and be up more and moving around. Felt like flu. Day 4 checked weight and lostY03/16/202103/17/20211nonePVTmetoprolol succinate 50 MG 24 hr tablet,ALPRAZolam 0.25 MG tablet,oxyCODONE 10 mg immediate release tablet.warfarin 5 MG ,tablet,amLODIPine 5 MG tablet,furosemide 40 MG tablet,potassium chloride SA 20 MEQ tablet,omeprazole 20 MG capsule,spiLumbosacral spondylosis without myelopathychronic pain, back, neck, peripheral neuropathies , a fib203/19/2021Please review your allergies and verify that the list is up to date. Call 911 if you have an emergency. Duloxetine Other (See Comments) Added 2/7/2012 Learn more Remove Gabapentin Other (See Comments) Added 9/17/2012 Learn more Remove Amitriptyline Other (2021VAERSSYMPTOMS2021VAERSVAX
112636103/23/2021WI79.079MI received the first dose Moderna, and it started off with left ear being plugged up and it wouldn?t clear subsequently I get a strong solid tone, I?ve gotten amplified sounds out of the left ear, If I?m watching tv the voice comes through in a burbling waN02/25/202102/25/20210Basil endoscopy and no determination Scheduled for brain scan March 30thUNKL - Thyroxine 100mcg, Vit D, Multivitamin, Aspirin 325mg, Simvastatin 20mgnono203/23/2021YAleve, Tylenol, Tramadol, Lipitor, Sertraline2021VAERSSYMPTOMS2021VAERSVAX
112722403/23/2021WI79.079FPatient tested positive for COVID-19 after being fully vaccinated. Symptoms started on 3/18 with runny nose, sore throat, cough and minor loss of smellN02/22/202103/18/202124Positive COVID-19 test - 3/22UNK203/23/20212021VAERSSYMPTOMS2021VAERSVAX
113770503/26/2021WI79.079FHospitalization within 6 weeks after receiving vaccineY203/03/202103/18/202115OTH203/26/20212021VAERSSYMPTOMS2021VAERSVAX
114750503/30/2021WI79.079FSyncope. about twelve hour later she developed some chills and fever and dizziness which was not unexpected. Overnight into Saturday morning 3/27/2021 however she fell a few times and believes that she did pass out. She injured her face in the fall but Y03/26/202103/27/20211nonePVTLexapro, glucosamine with chondroitin, vitamin.nonedepression, anxiety.203/30/2021Ynone2021VAERSSYMPTOMS2021VAERSVAX
115167003/31/2021WI79.079FPt admitted to the hospital with fever, cough, chills, diarrhea, and fatigue with an abnormal chest X-Ray.Y03/17/202103/23/20216UNKHypertension HLD DVT203/31/20212021VAERSSYMPTOMS2021VAERSVAX
115396804/01/2021WI79.079FThis spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of GAIT DISTURBANCE (Felt her legs start to wobble and needed her cane to walk.), DIARRHOEA (Diarrhea), COUGH (Cough), FATIGUE (Tired), PAIN (BY2U02/26/2021UNKMedical History/Concurrent Conditions: COVID-19USMODERNATX, INC.MOD20210203/31/20212021VAERSSYMPTOMS2021VAERSVAX
115532804/01/2021WI79.079FPatient admitted to local hospital for new onset atrial fibrillation/flutter with rapid ventricular response. Patient last known well at time of vaccination (no reported complications with 1st vaccination). After 24 hrs, began feeling fatigued, with geneY3Y03/25/202103/26/20211see abovePVTlisinopril 40mg daily simvastatin 40mg daily multivitamin + folatenonehypertension204/01/2021atorvastatin (adverse event - myalgias)2021VAERSSYMPTOMS2021VAERSVAX
115591804/01/2021WI79.079MPatient received first covid vaccination today, at around 1140 Volunteer monitoring patients noted that individual scooted down in his chair. She asked if he was okay and stated he was feeling dizzy. Vaccination clinic staff responded. Patient was able U04/01/202104/01/20210Being evaluated in ERPVTUnknownPer problem list: Afib, HTN, Hypothyroidism204/01/2021YBee Venom Penicillin G2021VAERSSYMPTOMS2021VAERSVAX
116201004/02/2021WI79.079MSignificant hearing problem in left ear / loss of hearing in left ear; Gets loud ringing in the ear; Amplified sounds after taking first dose; A spontaneous report was received from a consumer concerning himself, 79-year-old, patient, who received Moderna'U01/28/202101/28/20210UNKACETYLSALICYLIC ACID; SIMVASTATIN; VITAMIN D [VITAMIN D NOS]; MULTIVITAMIN [VITAMINS NOS]; L-THYROXINE [LEVOTHYROXINE]Medical History/Concurrent Conditions: No adverse event (No prior medical history was reported.)USMODERNATX, INC.MOD20210204/02/20212021VAERSSYMPTOMS2021VAERSVAX
120964104/14/2021WI79.079Mpatient was administered Moderna vaccine (initial shot) and within 48-72 hours became short of breath. He presented to my office for evaluation 4/14/2021 and found to have right leg DVT and massive bilateral pulmonary emboli with left lung infarction.YYU04/07/202104/09/20212D-dimer 9800 Lower extremity ultrasound positive for femoral vein DVT. CTA of chest- positive for bilateral lung pulmonary emboli in each lung lobe with left lower lobe infarctionPHMPantoprazole, Pravastatin, ParoxetineNoneChronic lymphocytic leukemia, History of prostate cancer--s/p prostatectomy, Hyperlipidemia, depression with anxiety204/14/2021YYNone2021VAERSSYMPTOMS2021VAERSVAX
122027104/16/2021WI79.079FDELAYED HIVESY01/30/202102/03/20214UNKNOWNPHMCULTURELLE, SERTRALINE, METOPROLOL, SPIRONOLACTONE, ALENDRONATE, TRIAMCINOLONE LOTION, ALBUTEROL INHALER, LORAZEPAM, FUROSEMIDE, ESCITALOPRAM,UNKNOWNUNKNOWN204/16/2021YPENICILLINS, SULFA, CLINDAMYCIN2021VAERSSYMPTOMS2021VAERSVAX
124373704/22/2021WI79.079Mloss of hearing in right ear after first shot and loss of hearing in left ear after second shot. two other males in our small community have same issue that I know ofYN02/07/202102/09/20212many and on-goingPVTnonenone204/22/2021Ynone2021VAERSSYMPTOMS2021VAERSVAX
126365704/27/2021WI79.079FPatient was fully vaccinated. Presented to ED on 4/24/2021 with fever of 101.8, chills, weakness, malaise/fatigue. Pt tested and COVID-19 PCR positive. Patient remains hospitalized04/02/202104/24/202122UNK204/27/20212021VAERSSYMPTOMS2021VAERSVAX
127045304/29/2021WI79.079FPatient had both doses of Covid vaccine, 02/02/2021 and 02/25/2021, and was symptomatic and PCR positive for Covid 19 on 4/21/2021. No known exposure.U02/25/202104/19/20215304/21/2021 PCR positive for Covid 19. Received antibody infusion 04/22/2021UNKunknownunknownS/P treatment for lymphoma, last treatment 7/2020204/29/2021Yunknown2021VAERSSYMPTOMS2021VAERSVAX
127145404/29/2021WI79.079MPatient presented to the ED and was subsequently hospitalized within 6 weeks of receiving COVID vaccination.Y403/03/202103/18/202115OTH204/29/2021Y2021VAERSSYMPTOMS2021VAERSVAX
129000005/05/2021WI79.079Mextreme body aches all over body, raise blood vessel in back of left hand and sharp pain in the areaY04/08/202104/09/20211NonePHMlorazepam, oxycodone/acetaminophen, flomax, eliquis, metoprolol, sotalol, omeprazole, isosorbide mononitrate, tramadol, vitamin B12, D3, magnesium oxideNonechronic back/shoulder pain, anxiety/panic attacks, acid reflux, atrial fibrillation205/05/2021YNone2021VAERSSYMPTOMS2021VAERSVAX
130201605/10/2021WI79.079FPatient presented the ED and was subsequently hospitalized within 6 weeks of receiving COVID vaccination. Diagnosis was hyponatremia and intractable vomiting.Y204/07/202104/13/20216OTH205/10/2021Y2021VAERSSYMPTOMS2021VAERSVAX
131816805/14/2021WI79.079Fpatient had enormous pain over her entire body, she could not hold food down, she could not sit or lay down . She went to the emergency room that evening, vitals were OK, no fever, she was not dehydrated. ER treated the event like a migraine. On SundayY05/07/202105/07/20210PHMLosartan/HCTZ 100/25 one daily, Meloxicam 15mg daily, Lorazepam 0.5mg the night beforenoneHypertension, Arthritis, Undeferentiated Asthma, Migraines,205/14/2021Ynone2021VAERSSYMPTOMS2021VAERSVAX
132097505/15/2021WI79.079FPatient had been working all day in her flower gardens. At 4:30 p.m. she felt like she had double vision and difficulty talking. She does not remember much of what happened after that, but her husband said she had sudden onset of right arm weakness, leg Y204/12/202105/14/202132CT of head 5/13: no acute findings, CT-angiogram: No evidence of intracranial large vessel occlusion. MRI Brain 5/14: Left thalamus 2 subcentimeter small regions of recent ischemic infarct. No hemorrhagic transformation. No evidence of acute hemorrhage. UNKTrospium chloride tablets, estradiol cream, triamcinolone ointment, ascorbic acid tablets, esomeprazole capsule, magnesium oxide, potassium supplement, cholecalciferol tablet, received denosumab injection 2/3/21Barrett's esophagus, PFO205/15/20212021VAERSSYMPTOMS2021VAERSVAX
139946906/15/2021WI79.079FDeep vein ThrombosisYY15Y03/25/202103/29/20214PVTdementia206/15/20212021VAERSSYMPTOMS2021VAERSVAX
141296806/19/2021WI79.079MShinglesY01/26/202105/17/2021111PVTSimvastain, metoprolol, triamterene Vitamin d3, fish oil, bYNoneNone206/19/2021None2021VAERSSYMPTOMS2021VAERSVAX
141708406/22/2021WI80.079FTested at hospital outpatient on 6/13/21/ Unclear why there was a delay in lab reporting of result.U03/16/202106/13/202189PVT206/22/2021Y2021VAERSSYMPTOMS2021VAERSVAX
142041906/23/2021WI79.079FEmergency hospital visit on 6/22/2021 for high blood sugar and symptomatic. Glucose at bedside point of care was 548 on 6/22/2021 at 2153 and 395 on 6/22/2021 at 2304. During emergency encounter, based on EHR record, sodium chloride 0.9% infusion at 200 mLU04/26/202106/22/202157STAT priority labs requested included rainbow draw, light green top, gold top, POCT metered blood glucose, CT chest abdomen pelvis w contrast and blood culture all on 6/22/2021. Lab results, resulted on 6/22/2021, that were above or below reference range iPVTSquamous cell carcinoma of right tonsil206/23/2021Y2021VAERSSYMPTOMS2021VAERSVAX
143397006/29/2021WI79.079MRe infection after being vaccinatedY03/10/202106/25/2021107PVThx CVA206/29/20212021VAERSSYMPTOMS2021VAERSVAX
148481107/19/2021WI79.079MTested prior to hospital admission. Started with a cough on 7/17/21 and fell at home. Was brought to ER for evaluation. Per nurse on the floor, he was admitted for fall and COVID, and has no issues from fall so continued admission is due to COVID treatmentY2N02/04/202107/17/2021163o Test date: 7/17/2021 o Test performed: SARS-COV-2 RNA PNL XXX NAA+PROBE~CORONAVIRUS (COVID 19) o Route: Nasopharyngeal o Result: POSITIVEPVT207/19/2021Y2021VAERSSYMPTOMS2021VAERSVAX
151276907/29/2021WI79.079MSx onset 7/21/21 with cough. Visited son, his wife & newborn. Son and DIL are both + cases. Tested on 7/26/21 which resulted as positive.01/28/202107/21/2021174Specimen Collection Date: 07/26/2021 Specimen Source: nasopharyngeal swab Test Performed: SARS-COV-2 RNA TMA Result: Detected Lab:PVT207/29/2021Y2021VAERSSYMPTOMS2021VAERSVAX
151277107/29/2021WI79.079MSx onset 7/21/21 with cough. Visited son, his wife & newborn in . Son and DIL are both + cases. Tested on 7/26/21 which resulted as positive.02/18/202107/21/2021153Specimen Collection Date: 07/26/2021 Specimen Source: nasopharyngeal swab Test Performed: SARS-COV-2 RNA Result: DetectedPVT207/29/2021Y2021VAERSSYMPTOMS2021VAERSVAX
152003608/02/2021WI79.079MDeveloped severe rash around Cpap mask, ears, neck and various outbreaks on legs and chest. Went to Dr. for wellness visit on May 13 and he prescribed a mild steroid salve. That helped some. Face and neck reddened and swelled and began to subside aftY02/01/202103/03/202130biopsy - July 20PVTFomax, Finesteride,nonenone208/02/2021none2021VAERSSYMPTOMS2021VAERSVAX
155044508/12/2021WI79.079MFelt sicker than hell for 2 days/stayed in bed for day and half; Back hurt like someone dropped a box on it; Shaking; Felt so cold; Felt like he had a vibrator on his back; Feels weak; Arm is still tender; This spontaneous case was reported by a consumer aN01/27/202101/27/20210UNKMedical History/Concurrent Conditions: COVID-19; Heart attack; Pacemaker insertion (cardiac)USMODERNATX, INC.MOD20210208/10/20212021VAERSSYMPTOMS2021VAERSVAX
155245808/13/2021WI79.079MFelt sicker than hell; Back hurt like someone dropped a box on it; Shaking/Felt like he had a vibrator; Stayed in bed for day and half; Feels weak; Arm is still tender; Felt so cold; This spontaneous case was reported by a consumer and describes the occurrY01/27/202101/27/20210UNKHeart disorderMedical History/Concurrent Conditions: COVID-19; Heart attack; Pacemaker complicationUSMODERNATX, INC.MOD20210208/10/20212021VAERSSYMPTOMS2021VAERSVAX
156083308/15/2021WI79.079FAchiness; Loss of appetite; Cough with bitter taste; Cough with bitter taste; Flu like symptoms; Ache in fingers; Ache above eyeballs; Sweating; Nausea; Headache; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (AchineU02/25/202102/28/20213UNKUSMODERNATX, INC.MOD20210208/11/20212021VAERSSYMPTOMS2021VAERSVAX
156209508/15/2021WI79.079MDizziness; Weakness; Mild headache; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizziness), ASTHENIA (Weakness), HEADACHE (Mild headache) and FATIGUE (Fatigue) in a 79-year-old male patient who receiU02/15/202102/27/202112UNKUSMODERNATX, INC.MOD20210208/11/20212021VAERSSYMPTOMS2021VAERSVAX
156300008/15/2021WI79.079Fa little bit sore; a patch which is bright pink; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE PAIN (a little bit sore) and INJECTION SITE ERYTHEMA (a patch which is bright pink) in a 79-year-old female patU01/28/202102/07/202110UNKUSMODERNATX, INC.MOD20210208/11/20212021VAERSSYMPTOMS2021VAERSVAX
158707208/19/2021WI79.079MCLIENT CONTRACTED COVID DESPITE BEING FULLY VACCINATED AT TIME OF EXPOSURE/POSITIVE PCR TEST ON 8/11/2103/23/202108/11/2021141POSITIVE PCR COVID TEST ON 8/11/21PVTN/AN/AN/A208/19/2021YN/A2021VAERSSYMPTOMS2021VAERSVAX
159138408/20/2021WI79.079FPatient contracted COVID after being fully vaccinated03/09/202108/16/2021160PVTAspirin 81mg daily gipizide daily lisinopril 5mg daily lovastatin 20mg HS metformin 1,000mg BID multivitamin daily fish oil dailyNone documentedHyperlipidemia History of breast cancer diabetes mellitus208/20/2021No known allergies2021VAERSSYMPTOMS2021VAERSVAX
159652008/21/2021WI79.079FFeeling hot; Cold; Chills; Fever; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (Chills), PYREXIA (Fever), FEELING HOT (Feeling hot) and NASOPHARYNGITIS (Cold) in a 79-year-old female patient who received mRNA-1273U02/26/2021UNKMedical History/Concurrent Conditions: No adverse event (Medical history was not reported)USMODERNATX, INC.MOD20210208/13/20212021VAERSSYMPTOMS2021VAERSVAX
159861708/21/2021WI79.079Mhurting between shoulder and elbow; soreness in left arm; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of PAIN (hurting between shoulder and elbow) and PAIN IN EXTREMITY (soreness in left U03/04/2021UNKUSMODERNATX, INC.MOD20210208/12/20212021VAERSSYMPTOMS2021VAERSVAX
161504008/22/2021WI79.079Fshe has been itching ever since and it wont; Redness on arm; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (she has been itching ever since and it wont) and ERYTHEMA (Redness on arm) in a 79-year-old female patieU05/05/202105/05/20210UNKPLAVIXComments: No medical history was provided by the reporter.USMODERNATX, INC.MOD20211208/14/20212021VAERSSYMPTOMS2021VAERSVAX
161674308/22/2021WI79.079Mfelt paralyzed and could barely walk; left and right hand as well as index finger and baby finger were also painful.; loss of balance, loss of balance and it feels as if his legs wouldn't take him in the direction he wants to go in. This sometimes gets betY01/30/202102/28/202129Test Name: X-ray; Result Unstructured Data: NormalUNKUSMODERNATX, INC.MOD20211208/14/20212021VAERSSYMPTOMS2021VAERSVAX
163142008/25/2021WI79.079Farm was itching below the injection site - left arm; rash where the shot was administered - left arm - It's about 6 inches long, 5 inched across; red rash - area has grown to 6 inches across the bottom of the arm past the top of the injection site; This spU02/04/202102/12/20218UNKUSMODERNATX, INC.MOD20210208/24/20212021VAERSSYMPTOMS2021VAERSVAX
164168308/27/2021WI79.079FPatient presented to hospital on 8/24/2021 with a 3-day history of worsening shortness of breath, wheezing, and fatigue. She is COVID-19 vaccinated but tested positive for COVID-19 in the ED. She also has subjective fevers, chills, headache, and change iY3Y02/11/202108/24/20211948/24/21: CORONAVIRUS SARS COV 2 PCR (RESP) - positivePHM208/27/20212021VAERSSYMPTOMS2021VAERSVAX
167908709/07/2021WI79.079FPt received both doses of the Pfizer COVID-19 vaccine (on 1/26/2021 and 2/16/2021). On 8/31/2021, pt tested positive for COVID-19 at her PCP's office, with mild symptoms. On 9/6/2021, pt presented to the ER with worse symptoms and was subsequently admittYN02/16/202108/31/2021196PVTcalcium carbonate, citalopram, clobetasol ointment, Vitamin B12, estradiol vaginal cream, fexofenadine, folic acid, melatonin, memantine, mometasone furoate, multivitamin, pravastatin, pseudoephedrine-Guaifenesin.Seasonal and perennial allergic rhinitis, GAD, mild intermittent asthma without complications, HTN, balance problems, chronic gastritis, macular degeneration (wet), GERD, knee pain (chronic), Mild cognitive impairment, peripapillary atrophy, rectocele, HX Lump at injection site for a TDaP vaccine, brand unspecified.209/07/2021YYdust mite extract, sulfa antibiotics, rabeprazole, ranitidine, TDaP (hard lump at injection site)2021VAERSSYMPTOMS2021VAERSVAX
169054409/10/2021WI79.079F2 EPISODES OF SHORTNESS OF BREATH, LIGHTHEADED, RAPID HEARTRATE, NAUSEA. WENT TO ER AND CT SCAN SHOWED MULTIPLE BLOOD CLOTS IN LUNGS AFFECTING RT VENTRICLE, BLOOD CLOTS IN LEFT LEG. TRANSFERRED PER AMBULANCE TO ANOTHER HOSPITAL. MASSIVE BLOOD CLOT AFFECTIYY5Y08/04/202109/04/202131SEPT 5 CT SCAN , EKG,ECHO, TROPONIN BLOOD TEST SEPT 6 EKG, ECHO, CBC, URINE TEST, ULTRA SOUND LEGS SEPT 7 EKG,PTT SEPT 8 ECHO, CBCPVTSIMVASTATIN, OMEGA 3, VITAMIN C, VITAMIN D, BIOFLEX,HERBLAXATIVENONEARTHRITISMODERNA VACCINE 1/21/2021 SHINGLES 79 YRS OLD209/10/2021YYBACTRIM2021VAERSSYMPTOMS2021VAERSVAX
169321509/11/2021WI79.079FModerna COVID-19 Vaccine EUA Moderna first dose 9/02, following symtoms occured 7 days later on 9/09 Fever, redness, swelling at injection site, itchy, hot, hard raied area, Was told this was called Covid arm, told to use heat, take pain med, and if area gU09/02/202109/09/20217WRKdiabetes209/11/2021Penicillin Latex2021VAERSSYMPTOMS2021VAERSVAX
170836709/17/2021WI79.079MPatient contracted COVID after being fully vaccinated 9/12/2021 start of symptoms - shortness of breath, fever, diarrhea, fatigue, cough Admitted to the hospital on 9/16/2021Y03/31/202109/12/2021165CBC, CMP, on 9/16/2021 Chest xray and EKG on 9/16/2021PUBallopurinol 300mg daily alprazolam 1mg TID amlodipine 10mg daily in PM aspirin 81mg daily carvedilol 25mg BID Cyanocobalamin 500mcg daily escitalopram 20mg BID ferrous sulfate 325mg three times per week furosemide 20mg daily gabapentin 100mNone documentedhypertension, hypercholesterolemia, hypothyroidism, anxiety, gout, urinary incontinence, radiation proctitis, lipoma of colon, actinic keratosis, acute eczema, edema, chronic renal failure, impaired glucose tolerance, hyperkalemia, leukopenia, macrocytosis209/17/2021Yamitriptyline - hyperactivity amoxicillin - nausea atenolol - bradycardia Lipitor - elevated liver enzymes nortriptyline - Hyperactivity Pravachol - myalgia tenormin - shaking, anxiety cough toprol -xr = shaking, anxiety, cough tranexamic acid - contraindi2021VAERSSYMPTOMS2021VAERSVAX
173150209/24/2021WI79.079FPt received full vaccination series for the Moderna COVID-19 vaccine. Pt subsequently still became ill with covid and needed treatment. She began having symptoms of COVID on 9/9/2021 and tested positive for the virus on 9/13/2021. Pt presented 9/16/2021Y6Y03/01/202109/13/2021196PVTamlodipine, aspirin, atorvastatin, calcium acetate, cefadroxil, clopidogrel, dexamethasone, docusate sodium, doxazosin, famotidine, furosemide, insulin glargine, losartan, metoprolol tartrate, neosporin topical, vitamin D.anemia in CKD, anxiety, arthritis, asthma, BPPV due to bilateral vestibular disorder, bilateral hearing loss, obesity, cataract, CKD (end stage, on dialysis), CAD, diabetes, chronic edema of right lower extremity, HTN, GERD, osteoarthrosis, hypercholestero209/24/2021Yacarbose, morphine, lisinopril2021VAERSSYMPTOMS2021VAERSVAX
173753009/27/2021WI79.079Fredness - 3"x4" oval down tricep. can still see injection site injection site on arm warm pain - feels like a bruise when touched. can't sleep on that side started 2 days after vaccination (9/24), called pharmacy to report on 9/25 upon follow up with patieU09/22/202109/22/20210nonePHMVitamin C, Calcium, Magnesium, Zinc, Vitamin D, Amlodipine, Fenofibrate, Benazepril, Allopurinol, Clonidine, Gabapentin, Levothyroxine, Omeprazole, Simvastatin, Lorazepamnonehigh bp, gout, high cholesterol209/27/2021none2021VAERSSYMPTOMS2021VAERSVAX
175007509/30/2021WI79.079MPatient received Pfizer Covid 19 "booster" although he did not qualify for this administration because his original series was Moderna. Booster dose should not have been administered.09/28/202109/28/20210N/APVTAspirin, cetirizine, cholecalciferol, metoprololN/AN/A209/30/2021None2021VAERSSYMPTOMS2021VAERSVAX
175914510/04/2021WI79.079MLost motor function and fever over 102F, hospital admission next day after injection, currently still hospitalized.Y4N09/29/202109/30/20211Blood culturesPHMXarelto, Allopurinol, Acetazolamide, OmperazoleNo other illnessesHeart Disease210/04/2021YNo Known Drug Allergies2021VAERSSYMPTOMS2021VAERSVAX
176148910/05/2021WI79.079MAdmitted for procedure 10/4/2021-BPH with obstructions Discharged 10/5/2021 Asymptomatic for COVIDY104/05/202110/04/2021182Coronavirus 2 PCR Detect, V asymptomatic POSITIVEUNK210/05/20212021VAERSSYMPTOMS2021VAERSVAX
177892610/12/2021WI79.079M4-5 days after my vaccine, my arm started to swell and get red and itchy at the injection site, and it stayed that way for about a week until gradually the redness and itchiness went away.Y02/10/202102/15/20215None.PVTHydrocortisone; beta blockers; metoprolol; Eliquis; Plavix; pantoprazoleNoneCoronary Disease; chronic renal failure; ACT insufficiencyTetanusvsafe210/12/2021Cipro; Flagyl; Sulfa; Cats; Mold; Tetanus shot agent2021VAERSSYMPTOMS2021VAERSVAX
178803810/15/2021WI79.079FThe booster dose was given to the patient, and after that, we found that there is less than 6 months interval between the second dose and the booster, No side effects or reactions happened to the patient.Y10/11/202110/11/20210PHM210/15/20212021VAERSSYMPTOMS2021VAERSVAX
179816810/19/2021WI79.079MDeathY10/13/2021N01/17/202110/13/2021269PUBParkinson's disease; COPD; CKD Stage 3; HTN; HLD, TIA210/19/20212021VAERSSYMPTOMS2021VAERSVAX
180841110/22/2021WI79.079FPt was given an expired high dose flu vaccine. No harm was done.Y10/14/202110/14/20210PVT210/22/20212021VAERSSYMPTOMS2021VAERSVAX
185114911/08/2021WI79.079MPatient was admitted to reporting hospital on 11/2/21 and died on 11/6/21. Patient arrived with approx 5-6 days of chest tightness, dyspnea on exertion, and perhaps some radiation of this feeling to the left side of sternum and back. Patient had fever, couY11/06/2021Y4N05/15/202111/02/2021171COVID-19 PCR positive 11/1/21 Chest Xray 11/2/21: Slightly enlarged right main pulmonary artery. Adenopathy not region not excluded. Cardiac silhouette slightly enlarged. Some of this may be projectional. Lungs show no consolidation. Minimal blunting of boUNKTylenol 1000mg nightly, Norvasc 5mg, Aspirin 81mg, Vitamin D3, Aricept 5mg, Gabapentin 600mg, Cozaar 50mg, Melatonin, Namenda 5mg, Centrum vitamin, Zoloft 25mg, Zyloprim 300mg, Indocin 25mgOSA, HLD, HTN, Cerbral aneurysm.OSA, HLD, HTN, Cerbral aneurysm.211/08/2021Bee venom2021VAERSSYMPTOMS2021VAERSVAX