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VAERS_ID | RECVDATE | STATE | AGE_YRS | CAGE_YR | CAGE_MO | SEX | RPT_DATE | SYMPTOM_TEXT | DIED | DATEDIED | L_THREAT | ER_VISIT | HOSPITAL | HOSPDAYS | X_STAY | DISABLE | RECOVD | VAX_DATE | ONSET_DATE | NUMDAYS | LAB_DATA | V_ADMINBY | V_FUNDBY | OTHER_MEDS | CUR_ILL | HISTORY | PRIOR_VAX | SPLTTYPE | FORM_VERS | TODAYS_DATE | BIRTH_DEFECT | OFC_VISIT | ER_ED_VISIT | ALLERGIES | Link 1 | Link 2 |
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0937469 | 01/12/2021 | MD | 87.0 | 87 | F | Patient received Covid vaccine 12/31/2021 at Nursing facility by representatives from Pharmacy. on Jan 2nd patient started with bruising on Left arm and Back, Patient noted as developing shingles. Jan 4th bruising noted buttock. Bruising continued to be | N | 12/31/2020 | 01/02/2021 | 2 | SEN | Acetaminophen 325mg 2 tabs q 6 hr prn Amlodipine 5mg daily Aspirin 81mg daily Atenololol 50mg daily Atorvastatin 40mg daily Bimatoprost 0.01% OS daily Cyanocobalamin 1000mcg daily Desvenlafaxine ER 25mg daily Clopedigrel ( Plavix) 75mg dail | Nursing home resident hx past Acute CVA Dysphagai Right Renal Artery Stenosis Peripheral Vascular Disease HTN Hyperlipidemia GAD Depression Osteoarthritis | 2 | 01/12/2021 | Y | Y | NKDA | 2021VAERSSYMPTOMS | 2021VAERSVAX | 0968623 | 01/24/2021 | MD | 87.0 | 87 | F | Woke up early (around 2-3 am ) Friday, January 22 feeling muscle and joint pain . Nausea and vomiting followed at 4: am. Severe fatigue, weakness and upper back and shoulder aches, with a fever of 99.7. which climbed to 100. On Friday evening @ 11:00 | U | 01/20/2021 | 01/22/2021 | 2 | PVT | None | 4th stage Kidney Disease, Cardiomyopathy, Hypothyroidism | 2 | 01/24/2021 | Sulphur | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1046856 | 02/22/2021 | MD | 87.0 | 87 | M | Patient was admitted for AMS, possible UTI. Patient also tested positive for COVID-19 at this time. He stayed overnight, was felt to be stable and was discharged. He was readmitted 1 day later under observation for weakness, treated, and discharged to a nu | Y | 5 | Y | 02/11/2021 | 02/12/2021 | 1 | PVT | CAD, dementia, GERD, Parkinson's | 2 | 02/22/2021 | Sulfa antibiotics (itching) | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1075286 | 03/05/2021 | MD | 87.0 | 87 | F | Patient presents to ER from EMS for SOB and confusion. Of note, patient's husband passed this morning. Troponins elevated. Chest xray shows edema and likely left lower infiltrate. Patient admitted and started on IV antibiotics, Lasix, aspirin, nitroglyceri | Y | 03/03/2021 | 03/04/2021 | 1 | PVT | stage III chronic renal insufficiency, non-O2 dependent COPD, hypertension, CAD, hyponatremia, and chronically elevated troponin | 2 | 03/05/2021 | Y | nkda | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1076981 | 03/05/2021 | MD | 87.0 | 87 | F | Dizziness, headache | U | 02/25/2021 | 03/02/2021 | 5 | PUB | Benecar, others | No | Hypertension, respiratory | 2 | 03/05/2021 | Not typically | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1091530 | 03/11/2021 | MD | 87.0 | 87 | F | Pt felt nauseous and lightheaded about 15 min after receiving 2nd dose of moderna. Pt taken to urgent care on site, given Zofran, symptoms resolved. | Y | 03/11/2021 | 03/11/2021 | 0 | Glucose tested (fingerstick) 80 | PVT | Per Record: Losartan 100mg, On record-but Rx expired/not recently filled: Chlorthalidone 25 mg, Omeprazole 20 mg, Multivitamin, Atorvastatin 20 mg, Fluticasone, Calci Chew, Vit D3, Cymbalta 30 mg | Dizziness- Seen 1/29. Received 1st vaccine 2/11/21. | HTN, Atherosclerosis of aorta, H/o Mitral valve repair, syncope, near syncope, hypercholesterolemia, Osteopenia, Tension headache, GERN, Hiatal hernia, Diverticulosis of colon, colon polyp, h/o colonoscopy, cholelithiasis, gastroparesis, abnl mammography, | nausea/lightheadedness | 2 | 03/11/2021 | Y | Atenolol, Codeine Phosphate, Gabapentin, Heparins, Hydralazine Hydrochloride, Percocet, Terazosin hct | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1107463 | 03/17/2021 | MD | 87.0 | 87 | M | 03/15/2021: Presented to the emergency department for chest pain. Patient was admitted for observation and discharged the following day. The chest pain had resolved and multiple troponins were negative. | Y | 2 | 02/16/2021 | 03/15/2021 | 27 | PVT | hypertension, hyperlipidemia, CAD status post CABG in 1993 and multiple coronary stents "10 or 11" with last stent placed in 2016 | 2 | 03/17/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1150166 | 03/31/2021 | MD | 87.0 | 87 | F | Stroke (blood clot in right brain), resulting in slurred speech and left-side weakness | Y | Y | 4 | Y | Y | 02/27/2021 | 03/16/2021 | 17 | Multiple hospital scans | OTH | Mitigare, sertraline, amlodipine, prednasone, folic acid, gabapentine, losartin, carvedilol, lorasapam, tramidol, methotrexate, acetaminophen | Asthma, high-blood pressure, arthritis, weak esophogus | 2 | 03/31/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1297569 | 05/07/2021 | MD | 87.0 | 87 | F | Extreme exhaustion, weakness. Ultimately death on 4/29/2021 | Y | 04/29/2021 | N | 04/13/2021 | 04/15/2021 | 2 | PVT | Imdur, metoprolol, chlorthalidone, atorvastatin, novolog, levemir, vit E, vit B12, calcium vit d3, simethecone, hawthorn berry | CAD, Hypertension, Diabetes | 2 | 05/07/2021 | Y | HCTZ | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1380734 | 06/08/2021 | MD | 87 | F | Not responsive at all; Sleeping; Took her to the bathroom at 5 o?clock this morning and she was wet, she is in pull ups; This morning put her back to bed and then told me she is not herself today; Her eyes kind of closing; Threw up; She was tired about 7 o | U | 05/26/2021 | 05/26/2021 | 0 | UNK | LISINOPRIL; ATORVASTATIN; INSULIN | Insulin dependent diabetic | Medical History/Concurrent Conditions: Hypercholesterolemia; Hypertension | USMODERNATX, INC.MOD20211 | 2 | 06/07/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1396412 | 06/14/2021 | MD | 87.0 | 87 | F | Patient was admitted after a fall at home. A door swung open and hit her from behind. | Y | 4 | 04/02/2021 | 04/02/2021 | 0 | PVT | 2 | 06/14/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1410721 | 06/18/2021 | MD | 87.0 | 87 | F | Pt was admitted to ED with complaints of chest pain on 4/4/21, after receiving the second dose of vaccine on 3/30/21. Per guidelines, all hospitalizations are reported. | Y | 4 | Y | 03/30/2021 | 04/04/2021 | 5 | PVT | 2 | 06/18/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1526186 | 08/04/2021 | MD | 87.0 | 87 | M | Patient received 2 Pfizer vaccines 13 days apart. | Y | 07/26/2021 | 08/04/2021 | 9 | PHM | 2 | 08/04/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1567415 | 08/15/2021 | MD | 87.0 | 87 | F | Localized inflammation; Elevated temperature of 102; Itchiness in the injection site; Swelling/ Injection site is slightly raised; Redness in the injection site; This spontaneous case was reported by a consumer and describes the occurrence of INFLAMMATION | Y | 03/09/2021 | 03/09/2021 | 0 | UNK | MULTIVITAMINS [VITAMINS NOS]; VITAMIN D [VITAMIN D NOS] | Blood pressure abnormal | Medical History/Concurrent Conditions: Bone marrow disorder; Chemotherapy (8 years ago) | USMODERNATX, INC.MOD20210 | 2 | 08/11/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1570023 | 08/15/2021 | MD | 87.0 | 87 | M | cannot sleep since getting vaccine; can' walk straight; Feel so weak and pathetic; This spontaneous case was reported by a consumer and describes the occurrence of INSOMNIA (cannot sleep since getting vaccine), GAIT DISTURBANCE (can' walk straight) and FAT | U | 03/01/2021 | 03/01/2021 | 0 | UNK | Medical History/Concurrent Conditions: Diabetes | USMODERNATX, INC.MOD20210 | 2 | 08/12/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1570373 | 08/15/2021 | MD | 87.0 | 87 | M | Can't even sleep; Weak; Tired; Dizziness; Headache; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizziness), SLEEP DISORDER (Can't even sleep), ASTHENIA (Weak), HEADACHE (Headache) and FATIGUE (Tired) in an 87 | N | 03/01/2021 | 03/01/2021 | 0 | UNK | Diabetes | USMODERNATX, INC.MOD20210 | 2 | 08/12/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1581642 | 08/18/2021 | MD | 87.0 | 87 | F | Tested positive for COVID-19 virus; This spontaneous case was reported by a health care professional and describes the occurrence of COVID-19 (Tested positive for COVID-19 virus) in an 87-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vac | U | 01/27/2021 | 02/12/2021 | 16 | Test Date: 20210212; Test Name: COVID-19; Test Result: Positive ; Result Unstructured Data: unknown | UNK | USMODERNATX, INC.MOD20210 | 2 | 08/13/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1604848 | 08/22/2021 | MD | 87.0 | 87 | F | weakness; sleepiness; tiredness; fever of 101?F/elevated temperature of 102 for a few days; headaches; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA, SOMNOLENCE, FATIGUE, PYREXIA, and HEADACHE in an 88-year-old f | Y | 03/09/2021 | 04/06/2021 | 28 | Test Name: Body temperature; Result Unstructured Data: 102; Test Date: 20210406; Test Name: Body temperature; Result Unstructured Data: fever of 101. | UNK | MULTIVITAMIN; VITAMIN D | Blood pressure | Medical History/Concurrent Conditions: Bone marrow disorder; Chemotherapy | USMODERNATX, INC.MOD20210 | 2 | 08/12/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1615063 | 08/22/2021 | MD | 87.0 | 87 | F | felt real real weak; not be able to do house and yard work; she is not going to receive the second dose; felt like a different person; felt real real weak; nose hemorrhage around 1:45 AM and lost at least half a pint of blood, bleeding really hard; This sp | Y | 03/24/2021 | 05/04/2021 | 41 | UNK | HYDROCHLOROTHIAZIDE; THYROID | Comments: No medical history was provided by the reporter. | USMODERNATX, INC.MOD20211 | 2 | 08/14/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1620488 | 08/22/2021 | MD | 87.0 | 87 | M | Patient developed hemichorea (L hemibody and face) approximately 3 weeks after vaccination, confirmed at initial neurological consultation of 4/29/21 (referred by PCP). Chorea steadily improved without medical intervention and was minimal at follow-up on 6 | Y | 03/01/2021 | 04/08/2021 | 38 | Extensive w/u for underlying causes including imaging (MRI Brain with and without contrast, MRA Head and Neck on 4/15/21), labwork (including Huntington's and paraneoplastic screening [anti-CV2], DM evaluation, B12, TFTs, CBC, CMP, parathyroid hormone, Hb | UNK | EQL VITAMIN D3 50 MCG (2000 UT) ORAL CAPSULE (CHOLECALCIFEROL) daily; Route: ORAL TIMOLOL MALEATE 0.5 % OPHTHALMIC SOLUTION (TIMOLOL MALEATE) qAM; Route: OPHTHALMIC LATANOPROST 0.005 % OPHTHALMIC SOLUTION (LATANOPROST) qhs; Route: OPHTHALMI | No acute illness or COVID-19 symptoms | Diabetes High Blood Pressure High Cholesterol Arthritis Glaucoma | 2 | 08/22/2021 | Y | NKDA | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1639002 | 08/27/2021 | MD | 87.0 | 87 | F | Swollen arm; Rash on the site of the injection; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Swollen arm) and VACCINATION SITE URTICARIA (Rash on the site of the injection) in an 87-year-old female p | N | 01/01/2021 | UNK | USMODERNATX, INC.MOD20210 | 2 | 08/26/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX |