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From the 6/11/2021 release of VAERS data:

Found 352,386 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 110 out of 3,524

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VAERS ID: 1365304 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Injection site pain, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Injection site pain, Nausea, Body aches, Fever, & Headache


VAERS ID: 1365496 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-20
Onset:2021-05-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Allergic to Germ-X hand sanitizer.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: A bubble/bump in collar bone area (near middle of the collar bone) formed underneath the skin on the ipsilateral side two days after second dose of the Pfizer vaccine. The bubble was able to move from below the collarbone to above, and vice versa, with manual manipulation and with regular movement of the upper body. I suspect that it was an inflamed supraclavicular lymph node. It hurt to touch and move. I did not see a healthcare provider for treatment. It gradually reduced in size and it took 11 days to disappear.


VAERS ID: 1365688 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-13
Onset:2021-05-22
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Alanine aminotransferase decreased, Amylase normal, Aspartate aminotransferase normal, Basophil count normal, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood potassium normal, Blood sodium normal, Blood urea normal, Calcium ionised normal, Carbon dioxide normal, Eosinophil count normal, Haematocrit normal, Haemoglobin normal, Lymphocyte count, Lymphocyte count normal, Mean cell haemoglobin concentration, Mean cell haemoglobin decreased, Mean cell volume abnormal, Mean platelet volume normal, Monocyte count, Monocyte count increased, Neutrophil count, Neutrophil count decreased, Papule, Platelet count normal, Protein total normal, Rash, Red blood cell count increased, Red blood cell sedimentation rate normal, Red cell distribution width increased, White blood cell count normal
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Haematopoietic leukopenia (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: obesity, BMI 30
Allergies: none
Diagnostic Lab Data: Component Latest Ref Rng & Units 5/27/2021 White Blood Count 3.8 - 10.8 THOU/UL 7.9 RED BLOOD CELL COUNT 4.20 - 5.80 MIL/UL 6.19 (H) Hemoglobin 13.2 - 17.1 G/DL 15.8 Hematocrit 38.5 - 50.0 % 45.0 MCV 80.0 - 100.0 FL 72.7 (L) QUEST MCH 27.0 - 33.0 PG 25.5 (L) QUEST MCHC 32.0 - 36.0 G/DL 35.1 QUEST RDW 11.0 - 15.0 % 15.1 (H) Platelet 140 - 400 Thous/uL 276 NEUTROPHILS % 49.0 QUEST LYMPHOCYTES % 39.5 QUEST MONOCYTES % 9.4 EOSINOPHILS % 1.3 BASOPHILS % 0.8 ABSOLUTE NEUTROPHILS 1.50 - 7.80 THOU/UL 3.87 ABSOLUTE LYMPHOCYTES 0.85 - 3.90 THOU/UL 3.11 ABSOLUTE MONOCYTES 0.20 - 0.95 THOU/UL 0.74 ABSOLUTE BASOPHILS 0.00 - 0.20 THOU/UL 0.06 ABSOLUTE EOSINOPHILS 0.02 - 0.50 THOU/UL 0.10 MPV 7.50 - 11.50 FL 9.70 Sodium 138 - 146 mmol/L 141 Potassium 3.5 - 4.9 mmol/L 4.2 Chloride 98 - 109 mmol/L 106 CO2 24 - 29 mmol/L 24 Glucose 70 - 105 mg/dL 99 Bun 8 - 26 mg/dL 19 Creatinine 0.6 - 1.3 mg/dL 0.9 CALCIUM IONIZED 4.5 - 5.3 mg/dL 5.0 SGOT (AST) 11 - 38 U/L 27 SGPT (ALT) 10 - 47 U/L 8 (L) Amylase 14 - 97 U/L 89 BILIRUBIN, TOTAL 0.2 - 1.6 MG/DL 0.9 Alk Phos 53 - 128 U/L 82 Albumin 3.3 - 5.5 G/DL 4.0 Total Protein 6.4 - 8.1 G/DL 7.6 Sed Rate 2 - 10 mm/Hr 2
CDC Split Type:

Write-up: 38-year-old man who is otherwise healthy received his Pfizer mRNA Covid vaccines on April 22 and May 13. On May 22 he noted a nonitching rash on his left foot that then extended up his legs. Rash is mostly on legs and a few papules on the arms. He presented to emergency department on May 27 for evaluation of a rash. labs stable (CBC you possibly indicating a thalassemia), PTT and ESR normal He was medicated with 125mg IV Solumedrol with mild improvement of rash and started in Prednisone 60mg daily for 4 days. 5/28/2021- presented to PCP office for f/u. He is taking medications as directed rash has not improved but has not significantly worsened. No other concerning symptoms. Presentation monomorphic papules consistent with a viral exanthem likely secondary to the mRNA vaccine. Advised to Continue prednisone 60 mg and follow-up with PCP on June 1


VAERS ID: 1366901 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-04-21
Onset:2021-05-22
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Generalised tonic-clonic seizure, Myocardial infarction, Nasopharyngitis, Vomiting
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Convulsions (narrow), Embolic and thrombotic events, arterial (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (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? No
Previous Vaccinations:
Other Medications: VIMPAT
Current Illness:
Preexisting Conditions: Comments: No medical history provided by the reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: heart attack; grand mal seizure episodes "for the first time in over 2 years", he didn''t remember the episode; he was freezing and was cold; throwing up profusely; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of MYOCARDIAL INFARCTION (heart attack) and GENERALISED TONIC-CLONIC SEIZURE (grand mal seizure episodes "for the first time in over 2 years", he didn''t remember the episode) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history provided by the reporter. Concomitant products included LACOSAMIDE (VIMPAT) for Seizure. On 21-Apr-2021 at 3:30 PM, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 milliliter. On 22-May-2021, the patient experienced MYOCARDIAL INFARCTION (heart attack) (seriousness criteria hospitalization, disability, medically significant, life threatening and intervention required), GENERALISED TONIC-CLONIC SEIZURE (grand mal seizure episodes "for the first time in over 2 years", he didn''t remember the episode) (seriousness criteria hospitalization, disability, medically significant, life threatening and intervention required), NASOPHARYNGITIS (he was freezing and was cold) and VOMITING (throwing up profusely). The patient was hospitalized on 22-May-2021 due to GENERALISED TONIC-CLONIC SEIZURE and MYOCARDIAL INFARCTION. At the time of the report, MYOCARDIAL INFARCTION (heart attack), GENERALISED TONIC-CLONIC SEIZURE (grand mal seizure episodes "for the last time in over 2 years", he didn''t remember the episode), NASOPHARYNGITIS (he was freezing and was cold) and VOMITING (throwing up profusely) outcome was unknown. Patient was admitted to hospital on 22-may-2021.patient lips were purple and had no pulse for 12 minutes, but was resuscitated.The hospital took out patient''s breathing tube at on 23May2021, and hospital staff stated he will remain there for a while. Based on the current available information which shows a temporal association between the use of mRNA-1273 and the onset of the reported events, a causal relationship cannot be excluded. Vomiting is consistent with the known safety profile of the product.; Sender''s Comments: Based on the current available information which shows a temporal association between the use of mRNA-1273 and the onset of the reported events, a causal relationship cannot be excluded. Vomiting is consistent with the known safety profile of the product.


VAERS ID: 1366910 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Washington  
Vaccinated:2021-05-01
Onset:2021-05-22
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Loss of consciousness, Seizure
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VITAMIN D [COLECALCIFEROL]
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Passed out; Seizure; This spontaneous case was reported by a consumer and describes the occurrence of LOSS OF CONSCIOUSNESS (Passed out) and SEIZURE (Seizure) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004C21A) for COVID-19 vaccination. Concomitant products included COLECALCIFEROL (VITAMIN D [COLECALCIFEROL]) for an unknown indication. On 01-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-May-2021, the patient experienced LOSS OF CONSCIOUSNESS (Passed out) (seriousness criterion medically significant) and SEIZURE (Seizure) (seriousness criterion medically significant). On 22-May-2021, LOSS OF CONSCIOUSNESS (Passed out) and SEIZURE (Seizure) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided. Company comment: Very limited information regarding this event/s has been provided at this time. Further information has been requested.; Sender''s Comments: Very limited information regarding this event/s has been provided at this time. Further information has been requested.


VAERS ID: 1367277 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Heart rate irregular, Pyrexia, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiac arrhythmia terms, nonspecific (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021584834

Write-up: Heart beat is irregular.; Throwing up; severe shaking; achy joints; Really high fever; This is a spontaneous report from a contactable consumer or other non-hcp (Patient). A 31-year-old female patient (non-pregnant) received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation solution for injection; Batch/Lot Number: Unknown, Expiration date: Unknown) via an unspecified route of administration, administered in Arm Left on 21May2021 12:45 (at the age of 31-years-old) as 2nd dose, single dose for COVID-19 immunization. Historical vaccine includes first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation solution for injection; Batch/Lot Number: Unknown, Expiration date: Unknown) via an unspecified route of administration, administered in the left arm on 30Apr2021 at 02:00 PM. The patient medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. On 22May2021 at 06:00 AM, the patient experienced with heartbeat was irregular, throwing up, severe shaking, achy joints and really high fever. No therapeutic measures were taken as a result of events caused. The outcome of the events was recovering. Information on batch number has been requested.


VAERS ID: 1367309 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021592663

Write-up: She had a sore left arm after her first COVID-19 Vaccine dose, but other than that felt fine; She had a sore left arm after her first COVID-19 Vaccine dose, but other than that felt fine; This is a spontaneous report from a contactable consumer or other non hcp and from Pfizer-sponsored program. A 59-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), via an unspecified route of administration, administered in arm left on 21May2021 09:00 (Batch/Lot Number: EW0169) as 1st dose, single for Covid-19 immunization. The patient medical history and concomitant medications were not reported. The patient had a sore left arm after her first Covid-19 vaccine dose, but other than that felt fine on 22May2021. Patient asked if it would be ok for her to take a herbal cleanse after receiving the first COVID-19 Vaccine, stating she wanted to make sure there wouldn''t be any problem doing so. Patient also wants to know if the following ingredients would effect the vaccine: Magnesium Citrate, vitamin B6 (pyridoxine HCI) vitamin B12 (cyanocobalamin), sodium, potassium citrate, potassium sorbate, hexametaphosphate, sodium benzoate. Patient said she didn''t notice the left arm soreness until upon waking on Saturday morning, 22May2021. She said her left arm was still tender, but the left arm soreness had improved. It was reported patient took TYLENOL (clarified as generic Acetaminophen 500mg), and (generic) Ibuprofen 200mg to treat her left arm soreness. She said she did not have the generic Acetaminophen 500mg and generic Ibuprofen 200mg NDC Numbers, Lot Numbers, and Expiration Dates to provide because she had transferred the generic Acetaminophen 500mg and generic Ibuprofen from their original product bottles to a smaller bottle that she kept in her purse. It was reported patient found a Manufacturer''s Date (Oct2020), but did not see a Expiration date on the product''s outer packaging or product bottle. She stated she purchased the Herbal Cleanse liquid directly from the manufacturer (It Works), and only had the Herbal Cleanse liquid for about 5 weeks or so. She said she did not see a UPC Number listed on the product packaging. She said she was using the Herbal Cleanse liquid as a kick start to weight loss. She said she had planned to take the Herbal Cleanse liquid over a 2-day period, taking one-4 oz. bottle before breakfast, and one-4 oz. bottle before dinner over two days. The outcome for event sore arm (pain in extremity) was unknown and outcome for limb discomfort was recovering. Follow-up attempts are needed. Further information is expected.


VAERS ID: 1367328 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0618 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chest pain
SMQs:, Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021593101

Write-up: has been experiencing chest and back pain; has been experiencing chest and back pain; This is a spontaneous report from a contactable consumer (patient himself). A 37-year-old male patient received BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number- EW0618) via an unspecified route of administration in left arm on 21May2021 12:00 as 2nd dose single and had previously received BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number- EW0173) via an unspecified route of administration in right arm on 30Apr2021 as 1st dose single for COVID-19 immunization. Patient experienced pain in right arm after the 1st dose of the vaccine on 30Mar2021 (as reported). Patient was 37-years-old at the time of immunization. Vaccination facility type was reported as Pharmacy/Drug Store. Vaccine was not administered at military facility. Patient medical history and concomitant medications were not reported. Patient had been experiencing chest and back pain. It had been 3 days now. He asked was that normal, how long will it last. Patient stated that he just got the second Pfizer vaccine shot and is experiencing chest pain (22May2021 at 24:00) and back pain (24May2021 at 24:00). Is wondering if this is normal. He stated that he got the first vaccine three weeks before on 30Apr2021. Patient describing about the adverse events stated that the chest pain is spreading into his back. Stated that the right arm pain lasted for four days and he recovered completely. The patient did not receive any treatment for the adverse events. The adverse events resulted in a visit to urgent care. The outcome of the events was not resolved. Information on Lot/Batch number is available; Further information has been requested.


VAERS ID: 1367342 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blister, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021593478

Write-up: He developed rash and fluid-filled blisters on one leg, which has then **extended to both arms**; He developed rash and fluid-filled blisters on one leg, which has then **extended to both arms**; This is a spontaneous report from a contactable consumer or other non hcp. A 58-year-old male patient received bnt162b2 (BNT162B2, solution for injection), dose 2 via an unspecified route of administration on 21May2021 as SINGLE DOSE, 2ND DOSE for covid-19 immunisation. The patient medical history was not reported. The patient''s concomitant medications were not reported. The patient experienced he developed rash and fluid-filled blisters on one leg, which has then extended to both arms on an unspecified date, he developed rash and fluid-filled blisters on one leg, which has then extended to both arms on 22May2021. She explained since the following day, Saturday, he developed rash and fluid-filled blisters on one leg, which has then extended to both arms. She explained his symptoms are getting worst with time but is not severe. She described the blisters as: small, filled with liquid, some are appearing and disappearing and there are about ten of them. The action taken in response to the event for bnt162b2 was not applicable. The outcome of the event he developed rash and fluid-filled blisters on one leg, which has then extended to both arms was unknown and he developed rash and fluid-filled blisters on one leg, which has then extended to both arms with outcome of not recovered. Follow-up attempts are needed. Additional information has been requested.


VAERS ID: 1367359 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Dizziness, Hyperhidrosis, Pain in extremity
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy (Verbatim: Juniper); Fish allergy (Verbatim: Salmonids)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021596976

Write-up: Lot of pain in arm; Bit woozy; Hot/cold sweats; Sore back; This is a spontaneous report from a non-contactable consumer or other non hcp. A 57-years-old non-pregnant female consumer (patient) reported for herself that who received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), intramuscular on 22May2021 11:00 (Batch/Lot number unknown) (Age at Vaccination: 57 years) as unknown, single dose for covid-19 immunization. Medical history included allergic to salmonids and juniper. The patient''s concomitant medications were not reported. Any other vaccines within 4 weeks prior to the COVID vaccine as unknown. The patient was not diagnosed with COVID-19 prior to vaccination. Since the vaccination, the patient had not been tested for COVID-19. On 22May2021, the patient developed lot of pain in arm, bit woozy, hot/cold sweats and sore back for which she did not received any treatment. The outcome of the events was reported as recovering. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1367534 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-05-22
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Antibody test, COVID-19, SARS-CoV-2 test, Therapy non-responder
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210322; Test Name: Antibody test; Result Unstructured Data: Negative; Test Date: 20210322; Test Name: COVID-19 antigen test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210556637

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; TESTED POSITIVE FOR COVID; This spontaneous report received from a patient concerned an elderly male of unspecified Ethnicity. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported) dose was not reported, 1 total dose administered on 12-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 22-MAR-2021, the patient had antigen test and he was tested positive for covid. On 22-May-2021 he had antibody test and result was negative (confirmed immunological vaccine failure). He was afraid of getting infected once again as he was old and the vaccine did not produce antibodies. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the tested positive for covid and confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000181111.; Sender''s Comments: V0. 20210556637-COVID-19 VACCINE AD26.COV2.S. Confirmed immunological vaccine failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1367709 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Exposure during pregnancy, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 237mcg, Labetalol 100mg 2x/day, Citrizine 10mg, prenatal vitamin 91/iron/folic/dha (prenatal + DHA Oral), Vitamin D3 2,000 Unit, Fish Oil 1,000mg
Current Illness:
Preexisting Conditions: hypothyroidism, high blood pressure, PCOS
Allergies: Nickel
Diagnostic Lab Data: Ultrasound completed to determine if any health problems were present for self and the baby on 5/24/2021.
CDC Split Type:

Write-up: The morning after receiving the COVID-19 vaccine I began experiencing vaginal bleeding. This lasted approximately 5-6 hours, then started again the following day and lasted overnight, for approximately 12 hours. I was pregnant at the time of the vaccine being administered, just over 14 weeks. The day the bleeding stopped (day 3) was the first day of week 15. I contacted the on call OB who suggested I follow-up with my regular OB on Monday, or to go to the ER if it got worse. During the exam on 5/24/2021 the OB was unable to determine anything wrong with the placenta, baby or my heath and was unable to explain the bleeding other than a potential side effect of the vaccine.


VAERS ID: 1367917 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chills, Fatigue, Flushing, Hyperhidrosis, Hypoaesthesia, Injection site pain, Injection site pruritus, Lethargy, Neurological symptom, Neuropathy peripheral, Pain, Paraesthesia, Pruritus, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Arthritis (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Chills-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Fever-Medium, Systemic: Pain and Neuropathy-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Neurological Disorder (diagnosed by MD)-Medium, Systemic: Numbness (specify: facial area, extremities)-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Systemic: Weakness-Medium, Additional Details: Pt states they are experiencing tingling sensations and pain in joints


VAERS ID: 1367942 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-01-08
Onset:2021-05-22
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042L20A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Biopsy bone marrow, Blood pressure systolic increased, Blood test abnormal, Contusion, Hypertension, Immunoglobulin therapy, Laboratory test, Oral blood blister, Petechiae, Platelet count decreased, Platelet transfusion
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Accidents and injuries (narrow), Hypertension (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Estradiol vaginal cream topical to vulva two times per week
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Bone marrow biopsy, numerous other lab tests
CDC Split Type:

Write-up: I noticed lower extremity petechiae, and blood blisters in my mouth on 5/22/2021. Next day, on 5/23/2021, the blood blister in my mouth was significantly larger, size of my thumb. Also blood blisters on my tongue. Petechiae was all over lower legs, and cropping up around bra line, scattered over torso. I went to urgent care where they drew my blood and told me my platelet count was zero. I have no previous history of any of this. They instructed me to go to the Emergency Department. At the hospital, more labs were drawn, and I was admitted to the oncology unit. I was given a transfusion of platelets. My blood pressure was extremely high, systolic 214. They started giving me IV hydralazine and metoprolol and I needed these IV blood pressure meds each day while there, although the metoprolol was only used a few times. They started me on lisinopril 5 mg around the 3rd day because IV meds didn''t control my blood pressure for very long. They had to increase the dose to Lisinipril 10 mg on my 5th day in the hospital. I developed numerous large bruises all over my arms and some other areas, with more petechiae on my face. On the day after admission, I was given IVIG and more platelets, and started on a regimen of dexamethasone 40 mg IV times daily 4 days. The course of therapy was completed. I was discharged to home with a platelet count of 24 on 5/27/2021 with follow up with hematology and primary MD follow ups. Platelet count on 6/1/2021 was up to 185.


VAERS ID: 1368131 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Delaware  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Disturbance in attention, Dizziness, Electric shock sensation, Electrocardiogram normal, Fall, Fatigue, Feeling abnormal, Gait inability, Heart rate increased, Hyperhidrosis, Influenza like illness, Laboratory test normal, Memory impairment, Muscular weakness, Nausea, Speech disorder, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: GERD
Allergies: None
Diagnostic Lab Data: EKG on 5/27, 5/29 Bloodwork on 5/27, 5/29
CDC Split Type:

Write-up: 16 hours after my second shot, I woke up with some nausea. I went to the bathroom, did not vomit, however in the middle of urinating I collapsed on the floor, couldn''t walk, couldn''t form full sentences, started sweating profusely, had to crawl back to my bed, and my pulse was through the roof. I almost went to the ER, but the episode subsided within 15 minutes. When I tried to fall back asleep, it felt like I was blacking out and not drifting asleep. The next day, I experienced the typical flu like symptoms. Followed by 4 days of normalcy. On the 4th day, while working, I experienced a sharp 3 second "electric shock" feeling in my left side of my chest. On the 5th day, I already had previously scheduled an appointment with my primary for a physical. I told her about my episode; she took an EKG which yielded normal results. Lab work also looked ok. On the 6th day, I started feeling some more nausea and fatigue. On the 7th day, the vertigo intensified tenfold, and the room was spinning. That''s when I started experiencing the following symptoms: ? More nausea. ? Dizzy spells that come and go, especially after eating. ? Persistent periodic electric shock feeling in my left chest. It?s dull but annoying. And just when I think it?s gone for good, another 1 second shock happens. ? Left arm is weak - the entire arm. ? When I try to sleep, the left side of my head feels as though I?m blacking out when I start drifting. It almost feels like I?m getting anesthesia or something like that. But just the left side. ? Basically the left side of my body (I got the jab in my left arm) from the waist up just feels off. ? One of my arms is numb when I wake up until I shake it out. It?s not one particular arm. ? Energy levels are low. Especially when I wake up and start moving around. On the 8th day, I went to the ER thinking perhaps it was a heart attack. Nothing - EKG was again normal and lab work was normal. The doctor told me it''s all in my head - anxiety. However, I''m not anxious and I''m a very level headed individual. It''s now day 12 and I feel overall awful. I can''t concentrate on anything. I''m not thinking clearly and forgetting simple things. The dull feeling and electric shocks on my left side continue. I''ve never felt this bad before. I''m a healthy 34 year old that exercises regularly, has never smoked or done drugs, rarely drinks alcohol, and eats generally very healthy. If given a second chance I would not take the covid shot. I am praying this goes away.


VAERS ID: 1368189 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: South Dakota  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Janssen COVID vaccine given to person under the age of 18. No treatment, no adverse reactions, patients mother was called and notified, pts mother states no issues, pt is doing fine, no reaction.


VAERS ID: 1368494 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-26
Onset:2021-05-22
   Days after vaccination:57
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Bilevel positive airway pressure, COVID-19 pneumonia, Chest discomfort, Computerised tomogram thorax abnormal, Continuous positive airway pressure, Culture negative, Dyspnoea, Lung opacity, Pneumonia viral
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Admit 5/22. Vaccine 3/1, 3/26. Admit for chest pressure, SOB, COVID PNA. CT showed mild opacities.Tx w/ antibiotics, zinc, singulair, Vit C. Used CPAP and BIPAP. DC home w/home health. Patient was admitted with COVID-19 pneumonia without respiratory failure. He was treated with supplemental medications including vitamin-C, zinc, singular. He did not required steroids. CT scan of the chest showed mild viral pneumonia patches. He was ruled out bacterial pneumonia and his antibiotics were discontinued at the time of discharge. His culture remained all negative till the time of discharge. He was feeling markedly better. His chest pressure was presumed from COVID-19 pneumonia and he was ruled out of acute coronary syndrome. Overall patient was feeling much better and he was discharged home with home health.


VAERS ID: 1368531 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-22
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Computerised tomogram, Costochondritis, Electrocardiogram abnormal, Headache, Laboratory test, Nausea, Osteitis, Pain, Painful respiration, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Osteonecrosis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine 60mg OD, Vitamin D
Current Illness: Asthma
Preexisting Conditions: Asthma
Allergies: Cats, bugs
Diagnostic Lab Data: EKG x-ray of the chest CT scan of the chest
CDC Split Type: vsafe

Write-up: On 05-22-2021, participant''s mother states her daughter pain started at about 1:00AM. I took her to Urgent care because she was having chest pain, nausea and headaches. She also had 99.2F of fever but no congestion or cough. At the ER an EKG was done and it was a bit off, lab work was also performed, x-ray of the chest was also done and they gave her an Albuterol treatment. She was given IV fluids and steroids and a CT scan of the chest was also performed. After 9 hours, she was discharged home and could not find anything wrong. On 05-25-2021 I took her to her pediatrician who pushed on her chest and it hurt her when he did this, her pain level was between 5 and 8 out of 10 on VAS scale. EKG''s were performed as well as lab work, x-ray of the chest at the pediatrician office. Her daughter also said her chest hurt her to exhale and inhale. The pediatrician said that her rib cage and breast bone where inflamed upon pressing on her daughter''s chest and that she has s costochondritis. As of today my daughter still has nausea that comes and goes and also continues with the headaches and takes Ibuprofen as pain medication.


VAERS ID: 1368757 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-15
Onset:2021-05-22
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Itching and Tingling on hands, arms, head, Lips. Moderate. Sometimes feels as though its a sticking sensation like pins and needles. Using Cortisone 10 to relieve itch and tingling, somewhat effective, its been almost 11 days now. Unsure if
Current Illness: None
Preexisting Conditions: PTSD
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itchy TIngling skin approximately 1 week after vaccine, using Cortisone 10


VAERS ID: 1368775 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Epididymal enlargement, Heterogeneous testis, Hyperaemia, Orchidectomy, Orchidopexy, Scrotal exploration, Testicular disorder, Testicular pain, Testicular torsion, Ultrasound testes abnormal
SMQs:, Anticholinergic syndrome (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Fertility disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol Ciclesonide
Current Illness: 5/16/21 had appointment for LLQ abdominal pain but no testicular pain reported. KUB showed significant constipation. Began using stool softener. Also sensation of something in his throat/intermittent throat pain.
Preexisting Conditions: Asthma and seasonal allergies
Allergies: Hazelnuts
Diagnostic Lab Data: U/S 5/23: "Relative enlargement of a diffusely heterogeneous and relatively hypoechoic left testicle. As there is no significant flow in the testicle, this is more consistent with testicular torsion than a mass. The left epididymis is enlarged and hyperemic."
CDC Split Type:

Write-up: Patient had had abdominal pain for ~1 week but 1 day after vaccination (5/22) developed new pain in left testicle. Was seen in early hours of 5/23 where U/S showed likely torsion. Patient underwent scrotal exploration and right orchidopexy and left simple orchiectomy.


VAERS ID: 1368778 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Dizziness, Dyspnoea, Electrocardiogram, Feeling abnormal, Pain
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Fibromyalgia, chronic back pain, arthritis
Allergies: Narcotics and Keflex
Diagnostic Lab Data: Labs done Medical center, Ekg, chest x-ray.
CDC Split Type:

Write-up: I''ve been really dizzy, hard to breathe, chest pains, weird sensation going through my body and head. I''ve been to the e..r. twice in a week. My whole body aches.


VAERS ID: 1369045 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Paraesthesia, Paraesthesia oral, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin C vitamin D
Current Illness: none
Preexisting Conditions: cervical herniations
Allergies: pineapple
Diagnostic Lab Data: general physical exam 5/27/2021 - told to take Zyrtek and Pepcid
CDC Split Type:

Write-up: Neurological: tingling in arms, legs, face, tongue. Effects still persist and have not subsided (12 days later so far) General: Low grade fever 100.1 within 24 hours lasting no more than 4 hours, mild joint pain


VAERS ID: 1369360 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-14
Onset:2021-05-22
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish oil, vitamin D
Current Illness: None
Preexisting Conditions: Rash on hand digits based on my diet
Allergies: Gluten
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Itchy pustular all over body rash. Swollen lymph node on L side between neck and shoulder. Treatment- veggie and fruit fast for 3 days.


VAERS ID: 1369967 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWOL172 / UNK RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWOL177 / UNK RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstruation irregular, Vertigo
SMQs:, Vestibular disorders (narrow), Fertility disorders (broad)

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

Write-up: Vertigo, 24 hours since second shot, lasted 48 hours Missed Period, ongoing


VAERS ID: 1369990 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: First shot I had a slight fever on and off of 100 degrees starting at 11:59pm and lasting approximately 24 hours. Second shot on and off I had a 101 degree fever, severe cold chills, severe tired feeling, nausea, and dizziness starting around 11:55pm and lasting approximately 36 hours.


VAERS ID: 1370679 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Dizziness, Mass, Mobility decreased, Pain, Peripheral swelling, Pharyngeal swelling, Vaccination site pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021592816

Write-up: right now what is swollen more and more is at the base of his neck, that lump, on his low throat. Caller states its hurting; right now what is swollen more and more is at the base of his neck, that lump, on his low throat. Caller states its hurting; little lump on the base of his neck where his chest starts; arm was swollen/feels like a swollen tendon; unable to raise his arm because of the pain; pain on the injection site on the arm; dizziness; mild diarrhea; This is a spontaneous report received from contactable consumer (patient). A 38-year-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot Number and Expiration Date not reported), via unspecified route on left arm on 22May2021 at 11:00 as for covid-19 immunisation. The patient medical history was not reported. The patient''s concomitant medications were not reported. On 22May2021, two to three hours after receiving the covid vaccine, the patient had some of the side effects marked on product information such as dizziness mild diarrhea. On 23May2021, the patient had pain on the injection site on the arm, arm was swollen/ felt like a swollen tendon and was unable to raise his arm because of the pain. It was stated it just hurts a little in the area where they put the vaccine, but not like yesterday. On 24May2021, when he woke up, the patient had little lump on the base of his neck where his chest started. It was stated right now what was swollen more and more was at the base of his neck, that lump, on his low throat and stated it was hurting, it was not going away, it just started today. It was also stated that the lump was just persisting, it just hurted when he bended down or presses it, it just hurted. Now he reported that he had a lump in his left bone that goes down from his shoulder to his throat and that felt like a swollen tendon, he also mentioned that he can''t lift his arm due to discomfort, he had an appointment with his chiropractor today. The outcome of the events arm was swollen, unable to raise his arm because of the pain, little lump on the base of his neck where his chest starts, pain on the injection site, unable to raise his arm because of the pain on the arm, right now what is swollen more and more is at the base of his neck, that lump, on his low throat and it was hurting was not resolved. The outcome of the events mild diarrhea and dizziness was resolved on 22May2021. Information on the lot/batch number has been requested.


VAERS ID: 1370681 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-19
Onset:2021-05-22
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021592865

Write-up: fatigue; nausea; This is a spontaneous report from a contactable consumer reported for herself. A 61-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on 19May2021, in the night as single dose for covid-19 immunization. The patient''s medical history included first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration as single dose for COVID-19 immunization. The patient''s concomitant medication history was not reported. The patient was okay until the night of 22May2021 after receiving the vaccine. On 22may2021, in the night, the patient experienced fatigue and nausea. The outcome of events was unknown. No follow-up attempts are possible. Information on the batch/lot number has been requested.


VAERS ID: 1370708 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 11263 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Body temperature, Dyspnoea, Erythema, Fatigue, Headache, Malaise, Myalgia, Nausea, Oropharyngeal pain, Pyrexia, Rash, Rhinorrhoea, Vaccination site swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210522; Test Name: body temperature; Result Unstructured Data: Test Result:increased; Comments: fever
CDC Split Type: USPFIZER INC2021609509

Write-up: not feeling well; Headache; Rashes; feel weak; fatigued; Difficulty breathing, short of breath when she walks; Fever; swollen injection in the arm; muscle pain; redness; runny nose; sore throat; nausea; This is a spontaneous report from a contactable consumer (patient). A non-pregnant 46-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; solution for injection; Lot number: 11263) via an unspecified route of administration in left arm on 22May2021 at 14:30 as single dose for COVID-19 immunization. Medical history included known allergies (unspecified). Concomitant medication included in two weeks which included food supplement. Patient did not receive any other vaccine in four weeks. Patient did not had COVID before vaccination and was not tested for COVID post vaccination. Patient previously received first dose of BNT162B2 (Lot number: 11263) in left arm on 01May2021 at 14:15 as single dose for COVID-19 immunisation and experienced headache, rash. On 22May2021 (Saturday), at 16:00, patient experienced swollen injection in the arm, rashes, headache, fever, muscle pain, redness, runny nose, sore throat, nausea, shortness of breath. Reportedly, after second shot patient developed fatigue, fever, rash, headache, felt weak and fatigued and if walks, becomes short of breath and had difficulty breathing. Patient was supposed to go to work but since Monday (24May2021), she could not go to work, because she was not feeling well. States she still has a headache. Due to the events, patient visited doctor or other healthcare professional office/clinic visit. Therapeutic measures taken in response to the event included treatment with Tylenol. Outcome of the events were resolving. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1371041 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-05-01
Onset:2021-05-22
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Catheterisation cardiac, Chest pain, Chills, Dizziness, Dyspnoea, Hyperhidrosis, Laboratory test, Myocardial necrosis marker increased, Pyrexia, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Trazodon
Current Illness: No
Preexisting Conditions:
Allergies: Robaxin
Diagnostic Lab Data: Ultrasound lab work in a heart cath and multiple other tests
CDC Split Type:

Write-up: Fever of a 101.8 dizziness chest pains shortness of breath chills sweats hospitalized or elevated enzymes and heart


VAERS ID: 1371133 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

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

Write-up: Patient had anxiety and nausea. Did vomit 1X. Patient was given water and crackers. 25 min later feel better


VAERS ID: 1371183 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-04
Onset:2021-05-22
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Acute respiratory failure, Blood creatinine increased, COVID-19, Convalescent plasma transfusion, Endotracheal intubation, Fibrin D dimer increased, Intensive care, SARS-CoV-2 antibody test, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage laboratory terms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Chronic kidney disease (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Mycophenolate + sirolimus + prednisone + cyclosporine
Current Illness:
Preexisting Conditions: ESRD 2/2 diabetes s/p renal transplant (2014) now with CKD IV of transplant kidney, DM, HLD, HTN, and GERD
Allergies: Lisinopril, losartan, tuberculin purified protein derivative
Diagnostic Lab Data: COVID-19 IGG - SARS-COV-2 Spike (S) Protein Antibody NOT detected (5/28/2021) Novel Coronavirus PCR - SARS-COV-2 detected (5/28/2021)
CDC Split Type:

Write-up: 57 YO female pt presented to outside institution on 5/22 with acute respiratory failure, found to be COVID positive, also w AKI on admission (Cr 4.9). Denies cough, sputum production or fevers at home prior to presentation. She was intubated on arrival to outside institution 5/22 and admitted to ICU. She has been treated with dexamethasone 6mg IV and Remdesivir x1, convalescent plasma. Treated with empiric vanc/zosyn since admission for possible superimposed bacterial PNA. Also were empirically treating for PE due to elevated D-dimer though no CTPE. Transferred to this institution on 5/28. Pt is s/p mRNA vaccination on 4/13 and 5/4, but on immunosuppression with mycophenolate + sirolimus + prednisone...


VAERS ID: 1371421 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Cough
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: BUPROPION XL 150MG, ZOLPIDEM ER 12.5 MG, HYDROCODONE/ACETAMINOPHEN 10/325MG TAB, ALPRAZOLAM 1MG TABLET, ATORVASTATIN 20MG, SERTRALINE 100MG TAB, LATUDA 60MG, LISINOPRIL 10MG, ATENOLOL 100MG, VYVANSE 60MG CAPSULE
Current Illness: NONE REPORTED
Preexisting Conditions: CHRONIC PAIN, BIPOLAR DISORDER, MAJOR DEPRESSIVE DISORDER, HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, SLEEP DISORDER
Allergies: SHELLFISH, SULFA DRUGS, ZOHYDRO ER, PENICILLIN
Diagnostic Lab Data: Not known- would need to contact healthcare faciltiy.
CDC Split Type:

Write-up: 8 AM THE DAY FOLLOWING VACCINATION, When she woke up, she had slight chest pain and cough (results from the shot). The chest pain got worse during the day (5/22/2021). Every breath by around 5 p.m., felt like she was getting stabbed in the heart and chest pain felt worse and then she sought out the Emergency room. By around 7 p.m., the ER reported it was not a heart attack, but a reaction the Covid 19 shot (Moderna). They proceeded to give her an IV (unsure of the doses) that calmed her and the chest pain was still there and not as bothersome. By 3 days later (72 hours), her chest pain went completely away..


VAERS ID: 1371440 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-18
Onset:2021-05-22
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW1082 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Pneumothorax spontaneous, X-ray
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 5-23-22 X-rays 5-24-21 cat scan
CDC Split Type:

Write-up: Spontaneous pneumothorax- hospitalization chest tube


VAERS ID: 1371546 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0768 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Vaccine give to an underage individual. No reactions noted


VAERS ID: 1371562 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Vaccine given to underage individual. No adverse reaction noted.


VAERS ID: 1371815 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Alanine aminotransferase normal, Aspartate aminotransferase normal, Blood creatine phosphokinase increased, Blood creatinine normal, Cardiac imaging procedure abnormal, Chest X-ray normal, Chest pain, Decreased appetite, Echocardiogram abnormal, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Fibrin D dimer normal, Haemoglobin decreased, Headache, Inflammation, Laboratory test, Left ventricular dysfunction, Lymphocyte count normal, Magnetic resonance imaging heart, Mitral valve incompetence, Mitral valve prolapse, Myocarditis, Neutrophil count normal, Pain, Pericardial effusion, Platelet count normal, Troponin increased, Urine analysis, Urine leukocyte esterase, Vomiting, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (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), 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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: fluoxetine
Current Illness: None
Preexisting Conditions: Marfan syndrome aortic root dilation ADHS
Allergies: None
Diagnostic Lab Data: Labs at Doctor 5/24/2021 WBC of 6.6 Hemoglobin of 12.7 Platelets of 182 Absolute neutrophils of 3.28 Absolute lymphocytes of 2.06 ALT of 12 AST of 23 D-dimer less than 0.19 UA negative for leukocytes, and nitrates Creatinine of 0.62 Troponin of 7.26 Troponin of 11.8 CPK 312. No cultures Radiology results: ECG at Doctor 5/24/2021 Normal sinus rhythm with ST elevation, Chest x-ray at Doctor 5/24/2021 Negative for cardiopulmonary disease. XR Portable Chest 1 View Event Date: 05/24/2021 17:18:26 The cardiothymic silhouette is normal in size and configuration. The lungs are clear. No pleural effusions are identified. A mild dextrocurvature of the thoracic spine is present. CONCLUSION: No evidence of acute cardiopulmonary process. Echocardiogram Complete Congenital Event Date: 05/25/2021 12:54:00 CONCLUSIONS: - Marfan syndrome. Myocarditis s/p COVID-19 immunization. Patent foramen ovale seen previously. Mitral valve prolapse with mild-to-moderate mitral regurgitation. Mildly dilated aortic root. Qualitatively low-normal left ventricular systolic function. New trivial pericardial effusion. 5/26 Cardiac MRI - findings consistent with acute nonischemic inflammation such as that seen in myocarditis
CDC Split Type:

Write-up: 15 year old male with a passed medical history significant for Marfan syndrome, aortic root dilation, and ADHS transferred to our facility for further evaluation and management of chest pain with elevated troponin. Father reports patient recieved the first dose of the COVID-19 Pfizer vaccine on 5/21/2021. On 5/22 patient developed a mild headache as per father that self resolved with rest. On 5/23 as per patient he was feeling back to baseline with some mild body aches. On the night of 5/23 patient felt some mild chest pain prior to going to bed that had self resolved. This morning patient refused to eat breakfast, and complained of stomach pain. Patient took Tylenol, however began to complain of severe chest pain and asked father to take him to the hospital. Patient was taken to his Doctor where his labs were significant for a WBC of 6.6, creatinine of 0.62, normal LFTs, troponin of 7.26, CPK of 312, D-dimer less than 0.19. EKG at Doctor was significant for normal sinus rhythm with an ST elevation, and chest x-ray was negative for cardiopulmonary disease. Patient had an episode of emesis at Doctor. A troponin was repeated prior to transferring to our facility and it had increased to 11.8. Father/patient denies chills, fever, diarrhea, sore throat, nasal congestion, and cough. ID consulted for further recommendations on management of myocarditis in the setting of recent Pfizer COVID-19 vaccination. Troponin repeated upon arrival to our facility, and has improved with no interventions. Interval History 5/27/21 No acute events overnight. Denies chest pain, SOB, cough, or palpitations. Cardiac MRI yesterday describing inflammation related to possible myocarditis, along with stable findings of MVP and aortic root dilation. Troponin this morning dowtrending to 0.28. No fever. He received a Mg Sulfate bolus yesterday due to low Mag on BMP


VAERS ID: 1371999 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-07
Onset:2021-05-22
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019B21A / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Angiogram pulmonary abnormal, Anticoagulant therapy, Arteriogram carotid, Cerebrovascular accident, Dyspnoea, Haemoptysis, Pneumonia, Pulmonary embolism, Sinus disorder, Thrombectomy, Venous occlusion
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

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? No
Previous Vaccinations:
Other Medications: zoloft, xanax, omeprazole
Current Illness: URI-?sinusitis
Preexisting Conditions: depression with anxiety
Allergies: keflex, PCN, bactrim,codeine, erythromycin
Diagnostic Lab Data: CTA chest, CTA head/neck
CDC Split Type:

Write-up: Patient started with c/o sinus symptoms @4/25-went to Urgent care and given zpack. Traveled out of town. called office on 5/18 stating was in airport getting ready to fly back. Stated that never improved with zpack and was now SOB and coughing up blood. She was advised to got to hospital as soon as could when arrived back. Patient presented to ED on 4/22 and was diagnosed with bilateral PEs/pneumonia. She was admitted on aBx and lovenox. On 5/24 she had left sided CVA. CTA showed right M! large vessel occlusion. Tpa was not option and she was transferred to Health care and underwent emergent thrombolectomy. Patient currently still hospitalized


VAERS ID: 1372107 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-03-24
Onset:2021-05-22
   Days after vaccination:59
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Atrioventricular block complete, Cardiac assistance device user, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Hypokalaemia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: On 5/22/21 patient presented to Emergency Room. Pt was diagnosed with the following: Syncope secondary to third-degree AV block, permanent atrial fibrillation, history of recurrent gastrointestinal bleed, morbid obesity, type 2 diabeties mellitus with peripheral neuropathy, chronic ataxia, coronary artery disease, obstructive sleep apnea, gout, hypertension, multiple contusions of lower extremities, community aquired pneumonia (recovered) and, Anemia chronic but stable. Pt give pacemaker and dischared to nursing home for after care.


VAERS ID: 1372293 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Burning sensation, Chest pain, Dry eye, Dyspnoea, Erythema, Eye movement disorder, Feeling hot, Feeling of body temperature change, Headache, Lacrimation increased, Palpitations, Rash, Sensation of foreign body, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Corneal disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Ocular motility disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: skin rash on both arms 5 minutes after vaccination, throat tightening sx''s, globus sensation, headache and palpitations 5-15 minute after vaccine administration. 8 hours later, sensation of chest burning, throat burning and dyspnea; watery eyes and facial warmth. Associated facial erythema and eyes rolling in head X 5 minutes. Had alternating cold and warmth sensation - now still. Sx''s continued - especially globus sensation. + abdominal pain continued for few days. One week later, patient with dyspnea. + eye dryness.


VAERS ID: 1372763 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-05-18
Onset:2021-05-22
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site infection, Injection site rash, Nausea, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: red spot at injection site evolving into infection 4-10 post vaccine, visited walkin clinic and received cephalexin antibiotic plus ondansetron ODT for nausea


VAERS ID: 1372777 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-20
Onset:2021-05-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atelectasis, Breath sounds abnormal, Bronchitis, Bronchospasm, Chest X-ray abnormal, Chest discomfort, Condition aggravated, Cough, Dyspnoea, Hypersensitivity, Nasopharyngitis, Respiration abnormal, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol HFA (ALBUTEROL) 108 (90 Base) MCG/ACT inhaler benzonatate (TESSALON) 100 MG capsule benzonatate (TESSALON) 200 MG capsule Cholecalciferol (VITAMIN D3) 2000 UNIT CAPS cholestyramine light 4 g packet estradiol (ESTRACE VAGINAL) 0.1
Current Illness: COVID + in April (4/1/21)
Preexisting Conditions: Dyslipidemia Menopausal syndrome (hot flashes) History of pleural empyema History of pneumonia Restrictive lung disease History of diabetes mellitus, type II History of suburethral sling procedure
Allergies: NKDA
Diagnostic Lab Data: DR CHEST 2 VIEWS FRONTAL AND LATERAL Final Result Mild right-sided atelectasis.
CDC Split Type:

Write-up: Symptoms started 2 weeks ago. Symptoms include: Complaint of having COVID the first week of April. She''s been coughing on and off since then. She received her first dose of the Pfizer COVID vaccine on 5/20. Two days later she started coughing more severely, which makes her SOB, and having cold symptoms. She''s only SOB when coughing. Today she started wheezing and when she takes a deep breath she feels a "pop" in her chest. Pertinent Medical History: Restrictive lung disease from pneumonia in 2015, usually only needs her inhaler 3 times a year. Went to ED for evaluation - CHIEF COMPLAINT: WHEEZING (pt reports wheezing starting today with cold symptoms since may 22. had first dose of pfizer vaccine may 20, had covid back in april) FINAL DIAGNOSIS & DISPOSITION 1. Bronchitis 2. History of COVID-19 MEDICAL DECISION MAKING Patient presents for evaluation of wheezing with mild cough and shortness of breath. She had COVID-19 in April, followed by the 1st dose of the Pfizer vaccine on 05/20/2021. She states her symptoms initially started with what she thought was allergies, but then moved to her chest more recently. Lung sounds are coarse bilaterally with bronchospastic cough. Clinical presentation consistent with bronchitis, suspect this is more allergic rather than infectious based on the history. I did not test for COVID-19, since she is still within the 90 day window of confirmed infection. Chest x-ray is obtained and shows mild atelectasis on the right, but no pneumonia. She was given 4 puffs albuterol MDI with improvement in her symptoms. She has an inhaler at home, advised her to use this as needed for respiratory symptoms. Patient given 60 mg prednisone in the emergency department, I prescribed for additional days of 40 mg daily to start tomorrow. She was also prescribed Tessalon Perles for the cough. Patient advised to follow up closely with primary care for further evaluation and management, she will return if worse or any other concerns. All questions were answered. Patient verbalizes good understanding, comfort, and agreement with the plan of care as described. Patient is discharged home in stable condition.


VAERS ID: 1372900 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-06
Onset:2021-05-22
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Tightness/soreness in chest around heart. Unable to exert a lot of force. At times shortness of breath.


VAERS ID: 1373132 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspnoea, Fatigue, Injection site erythema, Injection site induration, Injection site inflammation, Injection site mass, Injection site pain, Lethargy, Nasal congestion, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: The day after the shot (05/22/2021), I felt like I had Covid again - chills that I could not get rid of even by sitting in front of a heater, fever that spiked to 102?, body aches, difficulty catching my breath (used an inhaler), resting bpm at 103, fatigue/lethargy, nasal congestion. These symptoms lasted approximately 36 hours. On the third day after the shot (05/24/2021), my left arm started hurting and was red, inflamed, hard, and swollen at injection site. The area affected was about the size of my right hand. Days later, (as of 06/04/2021), I still have a finger sized lump at the injection site.


VAERS ID: 1373141 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling abnormal, Headache, Hypoaesthesia, Impaired work ability, Loss of personal independence in daily activities, Mental impairment, Pain in extremity, Tearfulness, Thermal burn
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertension, allergies
Allergies: Corn, soy, buckwheat, pinto beans, trees and grass.
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5/22 9pm 10 out of 10 pain headache at back left side behind ear, like a threaded plug was being screwed into my skull. Never felt pain like that before. Could think, brought me to tears. 5/23 brain fog continued. 2pm Burned myself cooking because I wasn''t myself. 5/24 5am screwball headache returned (10 out of 10 pain) Could not work. Called off sick. 5/25 brain fog all-day. 9am slight headache (same area). 6/3 4pm left arm pain (injection site arm). Feels like arm numb. Intense pain (7/10). 10pm Took 3 baby aspirin. 1030pm arm pain still intense (7/10), no relief yet.


VAERS ID: 1373811 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-15
Onset:2021-05-22
   Days after vaccination:68
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Dyspnoea, Oxygen saturation decreased, Pain, Pulmonary oedema, Pyrexia, SARS-CoV-2 test
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COPD; Immunosuppression (immunosuppression with lung cancer); Lung cancer (immunosuppression with lung cancer); Rheumatoid arthritis
Allergies:
Diagnostic Lab Data: Test Name: SARs-COV-2; Result Unstructured Data: Test Result:unknown results
CDC Split Type: USPFIZER INC2021612593

Write-up: feels like lungs are filled up with water; could not breathe; reduction in oxygen; achy; fever; diarrhea; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 65-years-old female patient received BNT162B2 (Pfizer-Biontech Covid-19 Vaccine, Formulation: solution for injection, Batch/Lot Number unspecified, expiration date unspecified), dose 2 via an unspecified route of administration on 15Mar2021(at the age of 65-years-old) as 2ND DOSE, SINGLE DOSE for covid-19 immunization. Medical history included immunosuppression with lung cancer. rheumatoid arthritis, and COPD all from an unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. On 22May2021, the patient experienced signs of SARs-COV-2 including could not breathe", achy, fever, feels like lungs are filled up with water, diarrhea and reduction in oxygen. On an unknown date, the patient was tested for SARs-COV-2 today (reported as) and was awaiting results. Therapeutic measures were taken as a result of the events which included antibiotics, a Medrol dose pack and vitamin C. Caller was asked when she can return to work and a recommendation on a potential booster dose of product. Seriousness reported as NO, by consumer. The outcome of the events was reported as unknown. Information about lot/batch number has been requested.


VAERS ID: 1374069 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose increased, Blood test, Blood urine, Carbon dioxide increased, Chest X-ray, Electrocardiogram, Pyrexia, SARS-CoV-2 test negative
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: High fever developed 2-3 days after shot (104.7). Now 12 days with a fever in range 102-104.7 degrees. Rapid COVID test day 1 of fever - negative Doctor visit day 3 - (5/27) Rapid COVID test - negative Antibiotics prescribed 5/27 Back to doctor 6/1 (day 8 of fever - antibiotics not helping) PCR COVID test sent out (result - negative) High protein in urine - sent to ER at CHOP ER at CHOP: Performed EKG, chest x-ray, full blood workup, tested for Mono, Epstein Barr, etc. Results normal, other than elevated glucose, asparatame aminotransferase, and carbon dioxide in blood. Sent home to return for repeat testing and full body scan/imaging if fever still present after 14 days.


VAERS ID: 1374132 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Heart rate decreased
SMQs:, Arrhythmia related investigations, signs and symptoms (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: Percocet, Multi-vitamin, also takes medication for an eating disorder
Current Illness:
Preexisting Conditions: Eating disorder, anorexia
Allergies: Sulfa, bananas, red wine
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: After my second day of receiving my J&J vaccine, I felt very tired. On the 3rd and 4th day, I went to see my PCP and went for a routine check up where I was found to have a low heart rate. My heart rate had dropped to 34. I went to the ER due to my low heart rate and not because of the J&J vaccine. Also due to my anorexia condition, I could not sleep, drink fluids and also had diarrhea. To this day I still have low heart rate.


VAERS ID: 1374250 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Diplopia, Headache, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Ocular motility disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: sometimes he gets angioedema after vaccines but that did not happen this time
Other Medications: Zoloft 37.5 mg daily
Current Illness:
Preexisting Conditions: angioedema alpha 1 antitrypsin deficiency
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe headache 10 out of 10 started the following day with vertigo. During this time he developed an episode of sudden onset double vision and vomiting which resolved after approximately 10 minutes. The headache and the vertigo lasted for several days.


VAERS ID: 1374282 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L21A / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Aneurysm, Arthralgia, Fatigue, Feeling cold, Neck pain, Pain in extremity, Swelling, Thrombosis, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZYBAN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: The vaccine is affecting young people; My son felt like he had an aneurysm in his neck/He had pain in the large artery on the right side of his neck like a myocardial inflammation or something; The right side of his neck, between the shoulder and neck, on the inside, he felt swelling, pressure pain, dull pain that comes and goes; On Tuesday, on the right side of his neck, between the shoulder and neck, on the inside, he felt swelling, pressure pain, dull pain that comes and goes; shoulder pain; On Saturday night he was feeling tired and cold; feeling cold; On Saturday his legs were very heavy and had pain, like he had blood clots or thrombosis in his veins; On Saturday his legs were very heavy and had pain; This spontaneous case was reported by a patient and describes the occurrence of THROMBOSIS (On Saturday his legs were very heavy and had pain, like he had blood clots or thrombosis in his veins) and ANEURYSM (My son felt like he had an aneurysm in his neck/He had pain in the large artery on the right side of his neck like a myocardial inflammation or something) in a 23-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027L21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included BUPROPION HYDROCHLORIDE (ZYBAN) for an unknown indication. On 21-May-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-May-2021, the patient experienced THROMBOSIS (On Saturday his legs were very heavy and had pain, like he had blood clots or thrombosis in his veins) (seriousness criterion medically significant), PAIN IN EXTREMITY (On Saturday his legs were very heavy and had pain), FEELING COLD (feeling cold) and FATIGUE (On Saturday night he was feeling tired and cold). On 25-May-2021, the patient experienced ANEURYSM (My son felt like he had an aneurysm in his neck/He had pain in the large artery on the right side of his neck like a myocardial inflammation or something) (seriousness criterion medically significant), NECK PAIN (The right side of his neck, between the shoulder and neck, on the inside, he felt swelling, pressure pain, dull pain that comes and goes), SWELLING (On Tuesday, on the right side of his neck, between the shoulder and neck, on the inside, he felt swelling, pressure pain, dull pain that comes and goes) and ARTHRALGIA (shoulder pain). On an unknown date, the patient experienced VACCINATION COMPLICATION (The vaccine is affecting young people). At the time of the report, THROMBOSIS (On Saturday his legs were very heavy and had pain, like he had blood clots or thrombosis in his veins), ANEURYSM (My son felt like he had an aneurysm in his neck/He had pain in the large artery on the right side of his neck like a myocardial inflammation or something), VACCINATION COMPLICATION (The vaccine is affecting young people), PAIN IN EXTREMITY (On Saturday his legs were very heavy and had pain), NECK PAIN (The right side of his neck, between the shoulder and neck, on the inside, he felt swelling, pressure pain, dull pain that comes and goes), SWELLING (On Tuesday, on the right side of his neck, between the shoulder and neck, on the inside, he felt swelling, pressure pain, dull pain that comes and goes), FEELING COLD (feeling cold), ARTHRALGIA (shoulder pain) and FATIGUE (On Saturday night he was feeling tired and cold) outcome was unknown. No treatment information was provided. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. This case was linked to MOD-2021-182543 (Patient Link).; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1374312 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-18
Onset:2021-05-22
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Migraine, Nausea, Pain in extremity, Visual impairment, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: She got her vaccine, nothing happened after the first 15 minutes, everything was fine. Her arm was sore for about 2 1/2 days and then 4 days later she was nauseous, had vomiting, and that next morning and ever since she has had a terrible migraine. Her vision has either started to swirl and miss some spots in her vision, and then migraine pain and nausea that starts shortly after that. She has not gone to her doctor for her symptoms. She has taken Tylenol, Excedrin, and a Goodies powder with some relief, but they have not relieved the pain entirely.


VAERS ID: 1374521 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling jittery, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 1977 Pertussis
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: PCN, Demerol, Cephlasporins, Pertussis, Walnuts Sensitivity to Vicodin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tachycardia, jittering. After taking antihistamine, symptoms lessened. Continued for two more days, continual use of antihistamines and resolved completely after 4 days


VAERS ID: 1375506 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: New York  
Vaccinated:2021-04-21
Onset:2021-05-22
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: PVIUS2021001023

Write-up: diarrhea; stomach is very bad/lot of pain; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of ABDOMINAL PAIN UPPER (stomach is very bad/lot of pain) and DIARRHOEA (diarrhea) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 21-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 22-May-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced ABDOMINAL PAIN UPPER (stomach is very bad/lot of pain) (seriousness criterion hospitalization). On an unknown date, the patient experienced DIARRHOEA (diarrhea) (seriousness criterion hospitalization). At the time of the report, ABDOMINAL PAIN UPPER (stomach is very bad/lot of pain) and DIARRHOEA (diarrhea) had not resolved. Concomitant medication usage was not reported. Treatment information was not reported. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1375845 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-04-27
Onset:2021-05-22
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amenorrhoea, Menstrual disorder
SMQs:, Fertility disorders (broad)

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

Write-up: Although I am 53 I have still been menstruating every month. I had all the symptoms for begins my menses and after receiving my first shot, all symptoms disappeared and I never bled. I was due to start my next cycle 3 days prior to the second vaccine and I have now missed two cycles. This may seem normal given my age, however I didn?t start my period till 16 years of age ( just like my mother and also my daughter) and have still never missed a period.


VAERS ID: 1376012 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-14
Onset:2021-05-22
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Herpes zoster, Pain in extremity, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: D3 K2 Melatonin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: No tests or lab results.
CDC Split Type:

Write-up: Soreness developed on my right side in the evening on Saturday, May 22nd, approximately one week after receiving the second dose of the COVID vaccine. The next day on Sunday, May 23rd, I noticed the rash where the soreness was on the right side. A day or two later, a rash appeared on my back on the right side. I called the doctor on Monday, May 24th, received a video conference appointment and received a prescription for Valtrex on Monday, May 24th, which I started on that day. I was on this for 5 days. My doctor examined me on June 4th an confirmed that it was shingles. My 80 year old mother with whom I live had shingles two weeks before I experienced my first symptoms. She got sick 2 weeks after her first Pfizer dose. About 2 weeks after she got sick, she then developed shingles. She had shingles a couple of years before.


VAERS ID: 1376319 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Dizziness, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Medium


VAERS ID: 1376793 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Dizziness, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Medium


VAERS ID: 1376904 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Fatigue, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: There were no symptoms on the evening of the day of the injection and the morning of the next day. So I went out with my daughter at 3:00 p.m. She and stood in line at clothing store after walking for an hour and a half and then suddenly she felt dizziness and 20 seconds later she lost consciousness. And then she woke up a minutes later while an employee called 911. She was fine and felt well but when we came back to our house, she was tired and slept 15 minute in my car. The next day, my daughter was fine, but after dinner we walk out near my house after 10 minutes she felt dizziness again. She sat there for 10 minutes and she was fine. After that day, there were no symptoms.


VAERS ID: 1377043 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthma, Condition aggravated, Exposure during pregnancy, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (broad), Tendinopathies and ligament 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: Prenatal vitamins
Current Illness: none
Preexisting Conditions: Asthma Gestational Diabetes
Allergies: Sulphur
Diagnostic Lab Data: none
CDC Split Type: vsafe

Write-up: Asthma progressed the next day Started using Asthma pump 4X a day Following Monday called doctor and the Doctor added a second inhaler. Sore arm No complications of pregnancy


VAERS ID: 1377672 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 05/22/2021
CDC Split Type:

Write-up: Bells Palsy Diagnosis


VAERS ID: 1377742 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Baby Aspirin 81mg Cardival
Current Illness: Heart problems
Preexisting Conditions: Heart attack/ stent 2019 6/28
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient was fearful coming to vaccine event. Said she could "hardly enter room". "Anxious". Has had anxiety issues. Talked about mother''s recent death. Asked to have BP checked after injection. Apears nervous. Discussed heart attack and surgery in 2019. Currently without insurance. Lost hotel job during Covid. Recently started new employment, but missed enrollment. Has had elevated BP in past, but not taking BP med. Discussed normal vaccine reactionq and gave literature. After talking with the monitor for about 20 minutes seemed relaxed an said she felt fine. Directed patient to a Health Care Representative for resources to insurance and health care during this insurance group. Symptoms: Sweating. Vitals 12:30p : bp 142/82, p 72 strong; 12:42: bp 142/80, p 70 strong, r 16; Left monitoring area feeling better, was given bottled water to drink. Will rest and take fluids. Able to call PCP and Heart Specialist if concerning symptoms. Seemed relaxed and smiling. Encourage special program enrollment.


VAERS ID: 1378032 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Cardiac stress test, Chest pain, Chills, Diarrhoea, Dyspnoea, Electrocardiogram, Fatigue, Inappropriate schedule of product administration, Laboratory test, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: ATHLERSCLEROSIS, OCCASIONAL IRREGULAR HEART BEAT
Allergies: NONE
Diagnostic Lab Data: EKG STRESS TEST BLOOD WORK MORE FOLLOW UP THIS WEEK
CDC Split Type:

Write-up: AS LISTED IN #17 , I RECEIVED A TEXT AND EMAIL FROM THE COUNTY ON THE 20TH TO REPORT FOR THE 2ND SHOT ON THE 21ST, WHICH I DID, WHICH WAS A WEEK TO SOON AND NOT 1 OF THE 4 PEOPLE WHO LOOKED AT MY VACCINE CARD TOLD ME I WAS THERE TO SOON. AND THEY PROCEEDED TO GIVE ME THE SHOT. I WAS ALSO UNAWARE THAT I WAS THERE TO SOON UNTIL THE ADVERSE AFFECTS STARTED THE NEXT DAY. THAT''S WHEN I LOOKED AT MY CARD AND NOTICED THE MISTAKE. THE ADVERSE AFFECTS WERE AS FOLLOWS: FIRST CAME SHARP STABING PAINS MOVING TO VARIOUS PARTS OF MY BODY THEN CAME COMPLETE FATIGUE WITH INTERMITTENT FEVER AND CHILLS THEN CAME STOMACH ISSUES WITH DIARREA THEN CAME SEVERE SHORTNESS OF BREATH AND SOME CHEST PAIN I AM RECOVERING SLOWLY BUT STILL FATI


VAERS ID: 1378109 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-05-12
Onset:2021-05-22
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia
SMQs:, Taste and smell disorders (narrow)

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

Write-up: PATIENT HAS HAD LOSS OF TASTE STARTING 7-10 DAYS AFTER VACCINATION AND IS STILL EXPERIENCING LOSS OF TASTE AS OF 6/7/21


VAERS ID: 1378272 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Arthralgia, Back pain, Dizziness, Feeling hot
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Vestibular disorders (broad), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: Patient was feeling "hot" immediately after vaccination. Sitting in waiting area/ Put head down on knees. Feels room is "too close". Pulse and BP normal. Reports anxiety in past. Encouraged slow deep breathing. Relaxes after conversing about normal symptoms. Gave literature on symptoms, v-safe. Encouraged V-safe enrollment. Gave bottled water. Encouraged plenty of fluids and rest today. C/o "tightness" in shoulders and back. Encouraged relaxation and rest. Symptoms present: Lightheadedness. Anxiety. Orientation x 3, Back and shoulders were achy. "Hot" right after shot, then resolved.


VAERS ID: 1378443 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Electric shock sensation, Influenza like illness
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

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

Write-up: The next day I started having flu like symptoms that went away in a few days but my head felt like I was being electrocuted which at times I can feel throughout my body. That symptom still persists to this day


VAERS ID: 1378445 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Abdominal discomfort, Fatigue, Injection site erythema, Injection site pruritus, Peripheral swelling, Somnolence
SMQs:, Cardiac failure (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad)

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

Write-up: Swelling on the left hand (fingers) - a ring couldn''t be taken off. The injection site was red and very itchy - that lasted for about three days. There was a lot of drowsiness; fatigue; upset stomach - lasted about a week. Went to Primary care doctor; he said it was a side affect. He told us to keep an eye on it. The swelling lasted three or four days.


VAERS ID: 1378475 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-20
Onset:2021-05-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO177 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blepharospasm, Blood test normal, Computerised tomogram normal, Electrocardiogram normal, Hypoaesthesia, Transient ischaemic attack
SMQs:, Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)

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: Clonaxapan 1mg
Current Illness: None
Preexisting Conditions: Dust,mold allergies
Allergies: None
Diagnostic Lab Data: EKG, CT Scan, blood work. All results were negative
CDC Split Type:

Write-up: 22nd- left eye twitch, 23rd- eye twitch plus cheek numbness, 24th- same with numbness into forehead, 25th- same with numbness into neck, 26th- same with numbness of left arm (elbow to fingers). ER visit on 26th. Diagnosed as mini stroke.


VAERS ID: 1378739 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: checked yes to having a reaction including fainting and feeling dizzy. When counseled they said they usually pass out but need a companion with them to comfort them. She was asked if she ate, and she said No. After administration, patient head tilted back, eyes closed fist clenched. Later patient recovered and said would report to doctor.


VAERS ID: 1379712 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A GCPH / 2 RA / SYR

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

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

Write-up: My arm broke out in red rash and hives. Over the next couple days it spread all the way to my ankles.


VAERS ID: 1380733 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-21
Onset:2021-05-22
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Back injury, Contusion, Decreased appetite, Gait inability, Head injury, Loss of consciousness, Musculoskeletal stiffness, Myalgia, Pain
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MELOXICAM; TRAMADOL; ATORVASTATIN; TURMERIC CURCUMIN [CURCUMA LONGA]
Current Illness:
Preexisting Conditions: Comments: No past medical history provided.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: bruised; have hit his head because his head was sore; was in lots of pain; sore all over; stiff neck; no appetite; passed out; heard his back crunch when he fell; could not walk; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of LOSS OF CONSCIOUSNESS (passed out) in a 71-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No past medical history provided. Concomitant products included MELOXICAM, TRAMADOL, ATORVASTATIN and CURCUMA LONGA (TURMERIC CURCUMIN [CURCUMA LONGA]) for an unknown indication. On 21-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-May-2021 at 11:12 AM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 22-May-2021, the patient experienced GAIT INABILITY (could not walk). On 22-May-2021 at 8:00 AM, the patient experienced LOSS OF CONSCIOUSNESS (passed out) (seriousness criterion medically significant) and BACK INJURY (heard his back crunch when he fell). On 23-May-2021, the patient experienced MUSCULOSKELETAL STIFFNESS (stiff neck), DECREASED APPETITE (no appetite), PAIN (was in lots of pain) and MYALGIA (sore all over). On 24-May-2021, the patient experienced CONTUSION (bruised) and HEAD INJURY (have hit his head because his head was sore). At the time of the report, LOSS OF CONSCIOUSNESS (passed out), GAIT INABILITY (could not walk), MUSCULOSKELETAL STIFFNESS (stiff neck), DECREASED APPETITE (no appetite), CONTUSION (bruised), HEAD INJURY (have hit his head because his head was sore), BACK INJURY (heard his back crunch when he fell), PAIN (was in lots of pain) and MYALGIA (sore all over) outcome was unknown. No treatment information reported. Additional concomitant medications included cardanol and water tablet. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. This case was linked to MOD-2021-182269 (Patient Link).; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1381145 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZYRTEC [CETIRIZINE HYDROCHLORIDE]; VITAMIN C [ASCORBIC ACID]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactose intolerance (known_allergies: Lactose intolerance); Seasonal allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021586251

Write-up: Fainted; This is a spontaneous report from a contactable consumer (patient). A 13-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), first dose at the age of 13-years-old via an unspecified route of administration, administered in arm right on 22May2021 10:30 (Batch/Lot Number: EW0185) as 1st dose, single dose for covid-19 immunisation. Medical history included seasonal allergy and known allergies: lactose intolerance from an unknown date and unknown if ongoing. Concomitant medications included cetirizine hydrochloride (ZYRTEC) and ascorbic acid (VITAMIN C); both taken for an unspecified indication, start and stop date were not reported. The patient fainted within 5 minutes of receiving Pfizer Covid-19 vaccine on 22May2021 10:45 (as reported). The patient recovered from the event on an unspecified date.


VAERS ID: 1381211 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-05
Onset:2021-05-22
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021616295

Write-up: I end up getting shingles; This is a spontaneous report from a contactable consumer (patient). A 59-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for Injection, Batch/Lot Number was not reported), via an unspecified route of administration on 05May2021 (at the age of 59-year-old) at a 2nd dose, single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient previously took first dose of BNT162B2 for COVID-19 immunization. Patient stated, patient was just calling you know just to, report a side effect of the Pfizer vaccine that patient had done 05May2021, patient had second dose of it and this week patient end up getting shingles on 22May2021. Patient was almost 60-year-old woman and patient looked it up when its, sometime people do end up getting shingles after getting the Covid vaccine and patient just want you guys would be aware that, of course she was treating it right now, to aware research and just you know, take a quick look at the vaccine. Outcome of the event was unknown. Information about lot/batch number cannot be obtained. Additional information has been requested.


VAERS ID: 1381221 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-19
Onset:2021-05-22
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Chills, Cough, Dyspnoea, Headache, Malaise, Pulmonary pain, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (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: Non-smoker; Type 2 diabetes mellitus
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021619548

Write-up: Headache; Chills; Feeling unwell; Tightness in chest; Wheezing; A lot of coughing; Lungs hurt and are kind of sore; It makes breathing difficult; This is a spontaneous report from a contactable consumer (patient) reported for himself. A 55-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot Number: unknown, Expiration date: unknown), via unspecified route, on 19may2021 (at the age of 55-year-old) as 2nd dose, single dose for COVID-19 immunization. Patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot Number: unknown, Expiration date: unknown), via unspecified route, on 28apr2021. The patient medical history includes type 2 diabetes and patient is not a smoker. Concomitant medications were not reported. On 22may2021, 3 days after the second vaccination, the patient experienced headache, chills, feeling unwell, tightness in the chest, a lot of coughing, wheezing, lungs hurt and kind of sore and breathing difficulty. The coughing is usually dry with something coming up occasionally, but it''s not much. It''s been a lot of coughing and he was feeling rundown. He wants to know if this was normal after having the shot a week ago. The patient stated that his lungs begin to hurt after coughing a lot and it makes breathing difficult. He is a non-smoker, so it has nothing to do with smoking. He has tightness in the chest from coughing and his lungs are kind of sore. It just comes on and he feels fine for a while. But it just comes on and sticks with him for a while. Patient stated headache started on Saturday afternoon and it kept with him till Wednesday. After ibuprofen it stayed down but, occasionally it is off and on. It has gotten better. He had it for 3 days straight and it will come back and then it is gone away again. Patient also stated that chills happened once or twice and not sure on the day the chills stopped. Patient stated that he was at work and for a while and started feeling unwell on 22may2021 morning. And he starts with the coughing, it just comes and goes. His blood sugar has been okay. Patient received ibuprofen as treatment option for the events (headache). The seriousness of the events was unspecified. The outcome of the events headache was recovering and outcome of all other events was mentioned as unknown. No follow-up attempts possible. No further information expected.


VAERS ID: 1381247 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:0000-00-00
Onset:2021-05-22
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal
SMQs:, Dementia (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: FLUOXETINE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021623465

Write-up: patient started it thing really bad and it will not stop; This is a spontaneous report received from a contactable consumer (patient) reported that 19-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection), first dose (lot number: Ew0151) and second dose (lot number: Er8731) both via an unspecified route of administration in right arm on unknown date in 2021 (at the age of 19 years) as a single dose for COVID-19 immunisation. The patient medical history was not reported. Patient was not pregnant at time of vaccination. Concomitant medications included fluoxetine. Patient has taken birth control medications in two weeks and has not taken any other medications in four weeks. Patient previously took lactose and had allergies. It was reported that on 22May2021, the patient started it thing really bad and it will not stop and this event resulted in Doctor or other healthcare professional office/clinic visit. Prior to vaccination the patient was not diagnosed with COVID-19 and since the vaccination the patient has not been tested for COVID-19, has not received any other vaccines within 4 weeks prior to the COVID vaccine. The outcome of the event was not recovered. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1381284 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Anxiety; Blood pressure; Diabetes
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021633890

Write-up: is experiencing a rash after getting the second dose of the Pfizer COVID-19 vaccine; This is a spontaneous report from a contactable consumer (patient herself) via Medical Information Team. A 64-year-old female patient received BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number- ER8736) via an unspecified route of administration in right arm on 22May2021 12:00 as 2nd dose, single dose (at the age of 64-years-old) for COVID-19 immunization. Vaccine was not administered at military facility. Patient did not receive any prior vaccinations within 4 weeks. Patient medical history included blood pressure, diabetes, anxiety all of which were ongoing. The concomitant medications were not reported. Historical vaccine included BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number- EH0150) via an unspecified route of administration in right arm on 01May2021 12:00 as 1st dose, single dose for COVID-19 immunization. On 22May2021, patient was experiencing a rash after getting the second dose of the Pfizer COVID-19 vaccine. She is trying to see if it could be a reaction to the vaccine and what she should do for the rash. Rash was reported as worsened. Patient states she started noticing it in the evening on 22May2021 then she really started to notice it more that 24May2021, like where it was getting kind of bad and stuff. Patient states she received the vaccine on the 22May2021 and so right now she was experiencing a rash and so she was trying to see if the rash was part of could be a symptom of an outbreak or adverse reaction to it. She states because on her arm, it started on her right arm, where she did have the vaccine at, and now it was on her chest and on her neck and everything. She states so she was trying to see if it was related. The adverse events did not result in emergency room or physician office visit. The treatment for the adverse event included use of Hydrocortisone cream by the patient. The outcome of the event was not recovered. Follow-up attempts are possible, additional information has been requested.


VAERS ID: 1381404 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Cough, Headache, Nasopharyngitis, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021649885

Write-up: Headache; Runny nose; Cough; Back pain; Cold; This is a spontaneous report from a contactable consumer. This 68-year-old female consumer (patient) reported for herself that she received first dose of BNT162B2 (bnt162b2, formulation: Solution for injection, Batch/Lot Number: ER8737), via an unspecified route of administration on 21May2021 at 10:30 as 1ST DOSE, SINGLE for covid-19 immunization. The patient medical history and concomitant medications were not reported. On 22May2021 the patient experienced headache, runny nose, cough, back pain and cold. Patient had undergone unspecified lab tests a month ago before the shot on an unspecified date and not recently. Patient had mentioned the second dose will be taken on 09Jun2021. Patient didn''t receive any other vaccinations with in 4weeks of vaccination. The outcome of the events headache, back pain was recovering whereas outcome of other events was unknown.


VAERS ID: 1381780 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-10
Onset:2021-05-22
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Ear discomfort, Fatigue, Headache, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad)

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

Write-up: 5/10/21-25/12/21: dizziness, fatigue, headache 5/15/21, onward: ear fullness 5/22/21, onward: sudden tinnitus 5/26/21, onward: dizziness, tinnitus, ear fullness


VAERS ID: 1381937 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-18
Onset:2021-05-22
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electrocardiogram normal, Emotional poverty, Feeling abnormal, Metabolic function test normal
SMQs:, Dementia (broad), Psychosis and psychotic disorders (broad), Depression (excl suicide and self injury) (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: Lisinipril, Florent, albuturol
Current Illness: No
Preexisting Conditions: Asthma, high blood pressure
Allergies: None
Diagnostic Lab Data: EKG, Full Panel Blood tests
CDC Split Type:

Write-up: Over the course of two weeks after vaccination and present, I have no feeling of heart functioning. My heart is functioning good though. I can''t feel any normal heart patterns such as when exercising, or adrenaline increases, I can''t feel my heart rate increase. Which is dangerous. I also can''t feel my heart strings when I get emotional in my heart. When I get sad, I can cry but no longer feel it in my heart. I had an EKG and full panel blood tests done on 6/72021, all came back normal. This all started after the last vaccination. There is a disconnect to my heart.


VAERS ID: 1382091 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-15
Onset:2021-05-22
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Chills, Computerised tomogram neck, Headache, Laboratory test, Lymph node pain, Lymphadenopathy, Nausea, Ultrasound scan, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Lab work Ultra sound of neck CT scan Further testing
CDC Split Type:

Write-up: Series 1 : Enlarged lymph notes bulging from Left side of neck Series 2: severe abdominal pain, severe vomiting, nausea, H/A, chills. Swollen lymph nodes in neck are tender and painful to touch.


VAERS ID: 1382240 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-23
Onset:2021-05-22
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / UNK RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Computerised tomogram, Ear pain, Facial paralysis, Magnetic resonance imaging
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (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: Zyrtec, adderall xr, bupropion hcl, terbinafine hcl, azelastine hci, Ambien
Current Illness: None
Preexisting Conditions: High cholesterol
Allergies: None
Diagnostic Lab Data: MRI & CT Scan to rule out stroke, included with & without contrast and blood work. No sign of stroke, diagnosed with Bell?s Palsy.
CDC Split Type:

Write-up: Bell?s Palsy, right side of face is paralyzed, severe pain around and behind right ear.


VAERS ID: 1382339 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-05-12
Onset:2021-05-22
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038CE1A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Fibrin D dimer increased, Pulmonary embolism
SMQs:, Haemorrhage laboratory terms (broad), Embolic and thrombotic events, venous (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: Zyrtec, singular, dexilant, levonorgestrel and ethinyl estradiol
Current Illness: Anemia due to extreme vaginal bleeding
Preexisting Conditions: Asthma, gerd
Allergies:
Diagnostic Lab Data: High D-dimer test followed by CT scan
CDC Split Type:

Write-up: Diagnosis of small blood clots in right lung


VAERS ID: 1382414 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Insomnia, Myalgia, Poor quality sleep
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Had flu-like symptoms from both injections of the shingles vaccine. Never had the vaccine previously. I was 52.
Other Medications: Lisinopril 20mg daily, Phentermine 37.5 mg daily (just started month 3 of a 3 month program), Vitamin D 1.25 mg weekly, fish oil 2000 mg daily
Current Illness: Had minor food poisoning more than a week before.
Preexisting Conditions: Am over-weight, and am actively losing weight. Eat properly and exercise daily. All of my vitals are in the normal range (BP, sugars, heart rate, etc.)
Allergies: chocolate, soy, pollen, animal dander, dust, mold, also lactose intolerant
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Had insomnia and did not sleep at all for 37 hours. Then slept fitfully for 2 hours. The slowly went back to normal after 5 days or so. Some muscular soreness that has gone slowly down but am still minorly experiencing.


VAERS ID: 1382486 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Unknown  
Location: North Carolina  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: none reported
Preexisting Conditions: none reported
Allergies: NKDA
Diagnostic Lab Data: vital signs obtained at 1220 Pulse 74, BP 110/74 and oxygen saturation 100% on room air.
CDC Split Type:

Write-up: Patient stated she felt faint and dizzy.


VAERS ID: 1382560 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-18
Onset:2021-05-22
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Brain natriuretic peptide, C-reactive protein, Cardiac telemetry, Chest pain, Echocardiogram, Electrocardiogram, Magnetic resonance imaging heart, Palpitations, Red blood cell sedimentation rate, Troponin
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: No medication
Current Illness: None
Preexisting Conditions: Father reported history of asthma as a young child for patient. Requiring albuterol nebulizer use.
Allergies: none
Diagnostic Lab Data: 6/4/21 - ECHO, EKG, Troponin, ESR, CRP, BNP. sent to ER 6/8/21 - ECHO, EKG. Troponin. Admitted to hospital for inpatient telemetry and Cardiac MRI
CDC Split Type:

Write-up: Pt complained of heart palpitations and chest pain approximately 4 days after receiving dose.


VAERS ID: 1382881 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Aspiration pleural cavity, Atelectasis, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Dyspnoea, Musculoskeletal chest pain, Pain, Pleural effusion, Tachycardia, Tachypnoea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), 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), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Presented to ED who presents for evaluation of several complaints. Patient endorses having her first phase of vaccination early morning/afternoon yesterday. Becoming last night tachypneic and tachycardic per the husband to keep a close eye on her vital signs due to her extended complicated medical history. She began feeling short of breath yesterday evening which has persisted into the morning as well. She has been having about 12 hours of progressive now constant moderate/severe left-sided rib/left upper quadrant abdominal pain that radiates about this area and is stabbing in nature. Tachypnea because of most likely bilateral pleural effusion left more than right. Patient admitted. Bilateral pleural effusions left greater than the right. Patient underwent thoracentesis and about 600 cc of turbid fluid was removed. Fluid is neutrophilic exudate which is raised the possibility of acute inflammatory process. No pneumonia seen on the CAT scan but only compressive atelectasis. It is very concerning that patient''s presentation is related to the Covid vaccination as an adverse effect. Initially she was placed on Maxipime and Flagyl but have been discontinued since. She was empirically started on high-dose steroids for this inflammatory state and eventually switched to tapering dose of prednisone. She will follow up with pulmonary in 2 weeks time with repeat chest x-ray.


VAERS ID: 1382932 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Blood test, Chest X-ray, Chest pain, Electrocardiogram, Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MULTI-VITAMINS (D, B12)
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: PENICILLIN, BEE STINGS
Diagnostic Lab Data: EKG, BLOOD WORK FOR BLOOD CLOTS CHEST AND LUNGS X-RAY
CDC Split Type:

Write-up: THREE DAYS AFTER SHOT, HAVE TINGLING FINGERTIPS ON LEFT HAND, SENSATION ON AND OF FOR COUPLE OF DAYS. WEEK AFTER THE SHOT, STABBING PAIN UNDER LEFT ARMPIT ACROSS MIDDLE OF LEFT CHEST. LEFT HAND FEELING NUMB


VAERS ID: 1383097 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 44B21A / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (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: eczema and TMJ headaches
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headaches, bodyaches, severe chills, injection site pain, fatigue for 48 hours.


VAERS ID: 1383790 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthma, Chills, Cough, Hypertension, Paraesthesia oral, Pharyngeal swelling, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypertension (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Codine, sulpha, naproxen, ibuprofen, all egg derived drugs. Latex. Food allergies consist of tree nuts and egg.
Diagnostic Lab Data: 5/24/21; 5/28/21; 6/07/21.
CDC Split Type:

Write-up: Fever, chills, tingling in the lips, throat swelling, hives, high blood pressure, coughing, asthma attack. The lip tingling was within 30 minutes of my vaccine, and continued for 2 weeks. Throat swelling lasted the first week. Hives lasted 1 week 4 days. Coughing started on day 3 and lasted 3 days. Asthma attack happened one time, during the coughing phase. High blood pressure started the evening of the vaccine and has continued. Doctor has prescribed a low dose of blood pressure medication to help combat it. Fever and chills started on the first day and lasted through the second day.


VAERS ID: 1384293 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Connecticut  
Vaccinated:0000-00-00
Onset:2021-05-22
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210611833

Write-up: PAIN IN THE LEFT ARM / SHOULDER AT THE INJECTION SITE; This spontaneous report received from a patient concerned a 67 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, and batch number: 202A21A expiry: UNKNOWN) dose was not reported, administered on 21-MAY-2021 13:30 for prophylactic vaccination. No concomitant medications were reported. On 22-MAY-2021, the subject experienced pain in the left arm / shoulder at the injection site. Treatment medications (dates unspecified) included: camphor/menthol/methyl salicylate, and paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from pain in the left arm / shoulder at the injection site. This report was non-serious.


VAERS ID: 1384565 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-20
Onset:2021-05-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: No
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021592584

Write-up: Hives after ~48 hours on both arms. Hives continue to spread after 72 hours covering 30% of back area and 25% of arms. Benadryl 25 mg PO appears to be controlling the hives now.; This is a spontaneous report from a contactable consumer. A 12-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Right on 20May2021 08:00 (Batch/Lot Number: EW0168) as 1st dose, single for covid-19 immunization. The patient has no medical history and concomitant medications. The patient has no known allergies. On 22May2021 at 08:00, the patient experienced hives after 48 hours on both arms. Hives continue to spread after 72 hours covering 30% of back area and 25% of arms. Benadryl 25 mg P.O appears to be controlling the hives now. The outcome of the events was recovering.


VAERS ID: 1384594 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-20
Onset:2021-05-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure measurement, Chest discomfort, Choking sensation, Dysphagia, Hypertension
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Hypersensitivity (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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Name: Blood pressure; Result Unstructured Data: Test Result:170/63; Test Date: 20210522; Test Name: Blood pressure; Result Unstructured Data: Test Result:165/95
CDC Split Type: USPFIZER INC2021593295

Write-up: high blood pressures 170/63, 165/95; He is feeling like a choking type of feeling on the base of his chest; chest discomfort; Hard for him to swallow; This is a spontaneous report from a contactable consumer (patient''s mother). A 12-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration in left arm on 20May2021 18:15 (Batch/Lot Number: EW0168) as 1st dose, single for COVID-19 immunisation. The patient had no relevant medical history and no concomitant medications. No additional vaccines was administered. The first day, the patient was fine but on day second (22May2021), he was feeling like a choking type of feeling on the base of his chest, like in the lower base of his throat. He said that it was hard for him to swallow. He was breathing normally. Patient''s mother took his oxygen, he had enough oxygen but he says it felt weird and then he was having high blood pressure. Patient''s mother wanted to know if it was normal. The patient experienced high blood pressures and chest discomfort on 22May2021. He has had blood pressures of 170/63. Today, it was 165/95. Events did not require visit to emergency room or physician office. The chest discomfort resolved on 23May2021 however the high blood pressures continue and have remained about the same. Patient''s mother stated she does not want to give her son anything because she was not sure about the vaccine. Outcome of chest discomfort was recovered on 23May2021, of high blood pressure was not recovered, of remaining events was unknown.


VAERS ID: 1384623 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-20
Onset:2021-05-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Pain in extremity, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Sulfonamide allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021596110

Write-up: Arm hurt; Tired; Rash all over both of her legs; This is a spontaneous report from a contactable consumer (patient''s grandparent). A 17-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration in the left arm on 20May2021 16:30 (Batch/Lot number was not reported), at the age of 17-years-old as 2nd dose, single for COVID-19 immunization. Medical history included allergic reaction of Sulphur drugs. The patient''s concomitant medications were not reported. Historical vaccine included first dose of BNT162B2 on an unspecified date for COVID-19 immunization. The patient had her second Pfizer shot on Thursday 20May2021 at 4:30, the only side effect she seem to have, was her arm hurt and she was tired and the reporter don''t know, her aunt was a pharmacist and said that circle that she developed at the site of the shot, and called it as a Covid bullseye. On Saturday 22May2021, the patient had rash about the size of a diameter of a lemon on the inside of her leg, the reporter didn''t think anything out she has been out in the sun so they just observed until Sunday, 23May2021 she got the rash all over both of her leg. Previously she was has an allergic reaction of Sulphur drugs so with this rash all over both of her legs what they did was they called her doctors office Sunday and they haven''t answering. They have a service that you can call about medical things, person that answers, there was a woman and said she know nothing about a rash they thought it would may be side effect from Pfizer because the reporter looked on the website and in the website rash was listed, usually rare. The patient does not have anaphylactic shock any of that there was a rash they think it was 0.001 they tried to explain this to the woman and she insisted it was something called Petechiae rash, which is a serious rash. She insisted not take the patient to the urgent care, she said they should take her to the ER and not urgent care, they took her to the ER they said they didn''t know, it was definitely not the Petechiae rash which was a released that''s a serious problem. They said it was okay to just give her Benadryl which they could have decided to give at home, but they didn''t know if Benadryl was okay to take if the patient took the COVID vaccine. They were advised to bring her back to the doctor in 2 days if it doesn''t go away. ER said they had never seen anyone who had a rash, they don''t know any rash. The reporter tried to tell that it''s on the website it''s on a Pfizer website and thought she was thinking she should alert them about this because this was a lot of lot of gut ranching and anxiety that if this person calling from the doctor saying that the rash was a Petechiae rash which was a serious blood disease. The outcome of the events was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1384657 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-23
Onset:2021-05-22
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER 8735 / 2 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthma, COVID-19, Diarrhoea, Polymerase chain reaction, Vaccination failure
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Lack of efficacy/effect (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210525; Test Name: Pcr; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC2021619783

Write-up: On 25May2021, patient undergone pcr nasal swab test and tested positive for covid with symptoms (loss of smell and taste, malaise, runny nose); On 25May2021, patient undergone pcr nasal swab test and tested positive for covid with symptoms (loss of smell and taste, malaise, runny nose); And I have the COVID I feel really bad asthma is cronic now; diarrhea; This is a spontaneous report from a contactable consumer (patient) from a Pfizer sponsored program. A 34-years-old non pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), dose 2 intramuscular, administered in Arm Left on 23Apr2021 (Batch/Lot Number: ER 8735) as single dose, dose 1 intramuscular, administered in Arm Left on 02Apr2021 (Batch/Lot Number: ER 8730) as single dose, both at the age of 34-years-old, for COVID-19 immunisation. The patient medical history was not reported. There were no concomitant medications. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine and any other medications within 2 weeks of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. It was reported that the patient had the vaccine double shot. And she had the COVID, she felt really bad asthma was cronic now. Since 22May2021 9.00, the patient had all COVID symptoms. Loss of smell and taste, diarrhea, malaise, runny nose and asthma. Since the vaccination, the patient had been tested for COVID-19. The patient underwent lab tests and procedures post vaccination which included PCR test (Nasal Swab): positive on 25May2021. The patient took treatment with Seretide inhalation, Tylenol nose drops. Outcome of the events was not recovered. Information on batch/lot number was obtained. Further information has been requested.; Sender''s Comments: The efficacy of a drug varies from patient to patient and can be affected by different factors; however, a contributory role of the suspect product BNT162B2 or comirnaty to the reported event vaccination failure and covid-19 cannot be ruled out.


VAERS ID: 1384698 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Unknown  
Location: Florida  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Neck pain, Pain, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: AMLODIPINE
Current Illness: Hypertension (Takes Amlodipine 5mg to control blood pressure.)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021640832

Write-up: everything is shift on left side of my body and I am feeling this pretty much since I would say the second day of the Vaccine but pain has been more afterwards; feel the pain going from my shoulder, the top of my shoulder towards my neck it gets around my collar area; pain I would say shoulder cup area in the back and on the mid back area where that shoulder was going; pain, I would say around my shoulder cup area, I would say the cup area, sometimes its there, sometimes like the pain was running down my from shoulder cup area down my arm towards my wrist/felt it in my left hip; sore arm/I am feeling pain in my thigh area and in the back of my thigh/have feel the pain in the top of my hand and just to the back of my hand from around my finger bone area to the middle left; This is a spontaneous report via Pfizer-sponsored program from a contactable consumer (patient). A 30-year-old patient of an unspecified gender received first dose of BNT162B2 (PFIZER-BIONTECH COVID-119 VACCINE, Solution for injection, Lot Number: EW0185), intramuscularly on 22May2021 16:30 as 1st dose, single dose in left arm (on left shoulder as reported) for COVID-19 immunisation at pharmacy. Patient didn''t receive any other vaccinations within 4weeks. Medical history included ongoing blood pressure measurement (takes Amlodipine 5mg to control blood pressure). Concomitant medications included amlodipine at 5 mg taken for blood pressure. It was reported that when I got the vaccine I had the normal side effect which was the sore arm which, I received like 12 hours later and it lasted for 25 hours but its been, I had the vaccine administered on 22nd and since then pretty much I have been having pain, I would say around my shoulder cup area, I would say the cup area, sometimes its there, sometimes like the pain was running down my from shoulder cup area down my arm towards my wrist. And sometimes I have feel the pain in the top of my hand and just to the back of my hand from around my finger bone area to the middle left and if I say feel the pain going from my shoulder, the top of my shoulder towards my neck it gets around my collar area. Then sometimes I am feeling pain I would say shoulder cup area in the back and on the mid back area where that shoulder was going. I would say I am feeling pain in my thigh area and in the back of my thigh, worried about my knee and the back of my thigh. Sometimes I feel it down and I also felt it in my left hip all on 22May2021. So everything was shift on left side of my body and I am feeling this pretty much since I would say the second day of the Vaccine but pain has been more afterwards." Therapeutic measures were taken for the adverse events was Tylenol. The outcome of the events was unknown. Information about batch number has been requested.


VAERS ID: 1384707 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-20
Onset:2021-05-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: SARS-CoV-2 test, Urticaria, Vaccination site lymphadenopathy
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MULTIVITAMINS [ASCORBIC ACID;ERGOCALCIFEROL;FOLIC ACID;NICOTINAMIDE;PANTHENOL;RETINOL;RIBOFLAVIN;THI
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210601; Test Name: covid test; Test Result: Negative ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC2021641373

Write-up: I broke out in hives all over my legs. Since day 5 until today which is day 13; Lymphadenopathy under my left arm which was the vaccination site; This is a spontaneous report from a contactable consumer or other non hcp (patient, self-reporting). A 45-year-old non-pregnant female patient received first dose BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection, Lot number: EW0177 and expiration dates were not reported), via an unspecified route of administration, in arm left on 20May2021 at 16:00 (age at vaccination 45-year-old) as 1ST dose, single for COVID-19 immunization. Facility type vaccine: facility. The patient did not receive any other vaccine in four weeks. The patient unknown whether tested covid prior vaccination and COVID tested post vaccination. The patient medical history was not reported. Concomitant medication(s) included ascorbic acid, ergocalciferol, folic acid, nicotinamide, panthenol, retinol, riboflavin, thiamine hydrochloride (MULTIVITAMINS [ASCORBIC ACID;ERGOCALCIFEROL;FOLIC ACID;NICOTINAMIDE;PANTHENOL;RETINOL;RIBOFLAVIN;THIAMINE HYDROCHLORIDE]). On 22May2021 at 12:00 the patient experienced broke out in hives all over her legs. Since day 5 until today which is day 13, lymphadenopathy under left arm which was the vaccination site. The patient underwent lab tests and procedures which included sars-cov-2 test: negative on 01Jun2021. Adverse event resulted in doctor or other healthcare professional office/clinic visit. Treatment was not received for the events. The outcome of event was not recovered.


VAERS ID: 1384851 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-05-22
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Body temperature, Headache, Nausea, Pyrexia, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Endometriosis; Factor V Leiden carrier (Not active and not on any medications for it.)
Preexisting Conditions: Medical History/Concurrent Conditions: Laparoscopic surgery (For diagnosis of en)
Allergies:
Diagnostic Lab Data: Test Date: 20210523; Test Name: Body temperature; Result Unstructured Data: 101.7 F
CDC Split Type: USJNJFOC20210614207

Write-up: HEADACHE; NAUSEA; FEVER; STOMACH CRAMPS; VOMITING; REALLY BAD SHAKES; This spontaneous report received from a patient concerned a 22 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included laparoscopic surgery, and concurrent conditions included endometriosis, and factor v leiden carrier, and other pre-existing medical conditions included the patient was not pregnant at the time of reporting. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1816022, and expiry: 01-JUL-2021) dose was not reported, administered on 22-MAY-2021 10:30 to the left arm for prophylactic vaccination. No concomitant medications were reported. On 22-MAY-2021, the subject experienced stomach cramps. On 22-MAY-2021, the subject experienced vomiting. On 22-MAY-2021, the subject experienced really bad shakes. On 22-MAY-2021, the subject experienced nausea. On 22-MAY-2021, the subject experienced fever. On 23-MAY-2021, the subject experienced headache. Laboratory data included: Body temperature (NR: not provided) 101.7 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from vomiting on 22-MAY-2021, and fever on 23-MAY-2021, was recovering from nausea, and stomach cramps, had not recovered from headache, and the outcome of really bad shakes was not reported. This report was non-serious.


VAERS ID: 1384902 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-20
Onset:2021-05-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (narrow)

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

Write-up: Ringing in ears. Tinnitus. Intermittent ringing in ears, chirping, cricket sounds in left ear.


VAERS ID: 1385863 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-02-27
Onset:2021-05-22
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Pneumonia
SMQs:, Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Pneumonia, unspecified organism


VAERS ID: 1385961 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-15
Onset:2021-05-22
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Joint swelling, Peripheral swelling, Rash erythematous, Rash pruritic, Urticaria
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu shot - flu-like symptoms after it; that was about four years ago
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: Bactrim antibiotics
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: I have pictures I can upload. She had severe hives - flat, red rash on legs and arms. Very itchy; swollen ankles and swollen wrists and hands. She could barely move her feet they were so swollen. That happened within 12 hours. And at the doctor''s appt online, she said to give her a double dose an antihistamine - I think it was Zyrtec - and Benadryl at night and to be on Cortosteriod cream on the swollen parts. We did that for about three or four days until it was bearable and it stopped. About three days after it stopped and she wasn''t taking meds she had another break out - it almost looked more like blisters - on torso and on arm. We did the same treatment with meds and cream and it went away within 24 hours. I showed to Pharmacist and the Pharmacist said to give an extra week for the next dose of vaccine to give body a chance to rest.


VAERS ID: 1385967 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-22
Onset:2021-05-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Communication barrier existed and after vaccine was administered it was discovered that true DOB showed that patient was 14 years old which is underage for the moderna vaccine (vaccination age $g18 year old per guidelines currently) Pt did not vaccine any adverse reactions that were reported


VAERS ID: 1386080 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Monoplegia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: pain
Allergies: NKDA
Diagnostic Lab Data: Patient is scheduled for an ultrasound this week.
CDC Split Type:

Write-up: Patient states she experienced arm pain and tingling post vaccination that is still occurring 3 weeks later. Her primary physician suspects she has SIRVA and has scheduled an ultrasound to determine if it is an injury such as muscle tear or an allergic reaction.


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