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From the 9/10/2021 release of VAERS data:

Found 686,636 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 114 out of 6,867

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VAERS ID: 1651232 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood sodium decreased, Blood test, Computerised tomogram, Echocardiogram, Electrocardiogram, Extra dose administered, Heart rate increased, Loss of consciousness, Magnetic resonance imaging, Myocardial ischaemia, Pyrexia, Urine analysis
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), Hyponatraemia/SIADH (narrow), Other ischaemic heart disease (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Chronic kidney disease (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Pyridostigmine, lamotrigine, prednisone, memantine, mirabegron, losartan, amlodipine, potassium, D-3, B complex, aspirin 81, calcium
Current Illness:
Preexisting Conditions:
Allergies: Pi
Diagnostic Lab Data: ECG, ct, mri echocardiogram, blood tests, urine tests
CDC Split Type:

Write-up: Fever 104.7, loss of consciousness, high heart rate, low sodium, cardiac ischemia


VAERS ID: 1651347 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Hypoaesthesia, Neuropathy peripheral, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Immune-mediated/autoimmune disorders (broad), Sexual dysfunction (broad)

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

Write-up: Peripheral Neuropathy. Numbness, burning, pins and needles in arms, hands and one leg.


VAERS ID: 1651371 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-04-09
Onset:2021-08-18
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: xrays
CDC Split Type:

Write-up: Patient admitted with Covid Pneumonia lots of oxygen steroids etc Not much info from the facility


VAERS ID: 1651379 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-14
Onset:2021-08-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Hypoaesthesia, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Sexual dysfunction (broad)

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

Write-up: Pain in joints and swelling in hands. Both thumbs, index fingers, middle fingers, and palms are numbe with no feeling.


VAERS ID: 1651419 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-11
Onset:2021-08-18
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH CANNOTREAD / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Dyspnoea, Electric shock sensation, Electrocardiogram abnormal, Heart rate increased, Hypoaesthesia, Paraesthesia, Sinus arrhythmia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Disorders of sinus node function (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: No known illnesses
Preexisting Conditions: None
Allergies: Hard shell sea food. Not tested but gets hives after eating mussels or clams.
Diagnostic Lab Data: I went to urgent care on 8/28/2021, Doctor did EKG which showed SINUS ARRHYTHMIA . Blood was drawn send to lab. I was referred to neurologist for further tests to rule out MS.
CDC Split Type:

Write-up: Six days after receiving pfizer-biontech Covid19 first dose, I started have numbness, tingling sensation all over my body more on the left arm/leg. Location of the sensation changes comes and goes through out the day. It started first across my torso then arms, legs. There is no pain only numbness and tingling. Describing the feeling is difficult it is like electric moves around my body. Recently I feel numbness on my legs thigh/ calf areas more on the left leg but still have it on my arms less then the legs again more on the left arm. I also have short of breath after climbing stairs my heart rate goes up to 130-140 bpm after climbing stairs. Heart rate goes down to 95-85 after 5 minutes rest. I went to urgent care on 8/28/2021, Doctor did EKG which showed SINUS ARRHYTMIA . Blood was drawn send to lab.


VAERS ID: 1651610 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-24
Onset:2021-08-18
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Nasal congestion, SARS-CoV-2 test positive, Sneezing
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: NAME: Removed Last Day Worked: 8/13/21, sick 8/16/21 Dept: RT Symptoms: cough, sneeze, stuffy nose started 8/18. S/s resolved 8/23 Covid Vaccine Series: completed 4/2021 Covid tested: 8/21/21, results: POSITIVE Medications: none S/S resolved: yes, 8/23/21 Son was cleared from quarantine and currently back in school. was tested covid pos 8/21 and done with quarantine 8/28/21. asymptomatic since 8/23/21. has not taken any fever reducing medications for over 24hrs. calling for clearance. does not have a PCP- he retired. did not call hotline to report covid pos results or symptom resolution. Advised to seek clearance at clinic.


VAERS ID: 1653800 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness unilateral, Dizziness
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (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: Eliquis Spironolactone Levothyroxine Crestor Vitamin C vitamn B12
Current Illness: none
Preexisting Conditions: heart disease Valve disease afib
Allergies: none known
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Complete vision loss in right eye for about 1 minute. Diziness. no residual effect. possibility of clot?


VAERS ID: 1654133 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Hot flush, Myalgia, Nausea, Tinnitus, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Vertigo, muscle aches, chills, headaches, nausea, hot flashes, fatigue, tinnisitis


VAERS ID: 1655060 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-02-20
Onset:2021-08-18
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 RA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: IVIGLOB-EX
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Celiac disease; Contrast media allergy; Gluten sensitivity; Isaacs syndrome (Rare autoimmune disease called Isaacs syndrome)
Allergies:
Diagnostic Lab Data: Test Date: 20210818; Test Name: Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202101072597

Write-up: Tested positive for COVID on 8/18/21; Tested positive for COVID on 8/18/21; This is a spontaneous report from a contactable consumer or other non-health care professional (patient). A 43-year-old non pregnant female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/lot number: En6198) via an intramuscular route of administration in Arm Right on 20Feb2021 07:00 (age at vaccination 43-year-old) as single dose, and second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/lot number: En6208) via an unspecified route of administration in Arm Right on 11Mar2021 (age at vaccination 43-year-old) as single dose for COVID-19 immunisation. Medical history included Rare autoimmune disease called Isaacs syndrome from an unknown date and unknown if ongoing, asthma from an unknown date and unknown if ongoing, coeliac disease from an unknown date and unknown if ongoing, gluten sensitivity from an unknown date and unknown if ongoing, contrast media allergy from an unknown date and unknown if ongoing. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The most recent COVID-19 vaccine was administered in Pharmacy or Drug Store. Concomitant medication(s) included immunoglobulin human normal (IVIGLOB-EX) taken for an unspecified indication, start and stop date were not reported. Since the vaccination, the patient had been tested positive for COVID-19. The patient tested positive for covid on 18Aug2021. Date of start of reaction/event was reported as 17Aug2021 16:00. The patient did not receive any treatment for the adverse event. The clinical outcome of the event was not resolved. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1655087 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-18
Onset:2021-08-18
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Appendicitis
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101081999

Write-up: appendicitis; This is a spontaneous report from a contactable consumer (the patient). An 18-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported) via an unspecified route of administration, administered in Arm Right on 18Jul2021 14:00 at age of 18-year-old at single dose for COVID-19 immunisation, it also reported the patient received other vaccine at first dose on 18Jul2021 in right arm. Medical history was none. No known allergies, no other medical history. There were no concomitant medications (no other vaccine in four weeks, no other medications in two weeks). No prior COVID vaccination. No COVID tested post vaccination. The patient experienced appendicitis on 18Aug2021 18:00. The event resulted in hospitalization, life threatening illness (immediate risk of death from the event). The patient was hospitalized for the event for 2 days. Treatment for the event included surgery. The outcome of the event was recovered with sequelae (Recovered with lasting effects) in Aug2021. The lot number for BNT162B was not provided and will be requested during follow up.


VAERS ID: 1655121 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-18
Onset:2021-08-18
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 RA / -

Administered by: Military       Purchased by: ?
Symptoms: Drug ineffective, SARS-CoV-2 test, SARS-CoV-2 test positive
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: INFLECTRA [INFLIXIMAB DYYB]; AZATHIOPRINE
Current Illness: Crohn''s disease (Diagnosed Spring 2018.)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210818; Test Name: tested positive; Test Result: Positive
CDC Split Type: USPFIZER INC202101095688

Write-up: tested positive after being fully vaccinated; tested positive after being fully vaccinated; This is a spontaneous report from contactable consumer (Patient wife). A 44-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection) via an unspecified route of administration in Arm Right on 27Apr2021 (Batch/Lot Number: EW0167, NDC number and Expiry Date: Unknown) as dose 1, single (Age at Time of Vaccination: 44-years-old) and dose 2 via an unspecified route of administration in Arm Right on 18May2021 (late morning) (Batch/Lot Number: EW0178, NDC number and Expiry Date: Unknown) as dose 2, single (Age at Time of Vaccination: 44-years-old) both taken for COVID-19 immunisation. Medical history included crohn''s disease (Diagnosed Spring 2018) from 2018 and ongoing. Concomitant medications included infliximab dyyb (INFLECTRA [INFLIXIMAB DYYB]) taken for crohn''s disease from an unspecified start date and ongoing; azathioprine taken for crohns disease from an unspecified start date and ongoing. The patient previously took remicade on an unknown date. The patient underwent lab test and procedure which included tested positive (SARS-CoV-2 test): Positive on 18Aug2021. There was no history of all previous immunization with the Pfizer vaccine considered as suspect, there were no additional vaccines administered on same date of the Pfizer suspect, there were no prior vaccinations (within 4 weeks) the patient took. The vaccine was administered at Military facility. The patient did not have adverse event following prior vaccinations. The reporter stated that her husband was fully vaccinated, He had the second dose on 18May2021 and since tested positive for the virus (18Aug2021). They have 4 other friends who are fully vaccinated who tested positive. The reporter would give them the number to call and added that the phone tree was horrific to try to get through on. The patient did not go to Emergency Room and Physician Office. The events were considered as serious (Medically Significant). The outcome for events was unknown. Follow-up attempts are completed. No further information was expected.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101095815 same reporter/drug/AE, different patients.;US-PFIZER INC-202101095813 same reporter/drug/AE, different patients.;US-PFIZER INC-202101095814 same reporter/drug/AE, different patients.;US-PFIZER INC-202101095816 same reporter/drug/AE, different patients.


VAERS ID: 1655123 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Michigan  
Vaccinated:2021-05-18
Onset:2021-08-18
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: Tested positive after being fully vaccinated; Test Result: Positive
CDC Split Type: USPFIZER INC202101095814

Write-up: who are fully vaccinated who tested positive; who are fully vaccinated who tested positive; This is a spontaneous report from a contactable consumer. A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, solution for injection), dose 2 via an unspecified route of administration, administered in Arm Right on 18May2021 (Batch/Lot Number: EW0178) as dose 2, single for covid-19 immunization. The patient medical history and concomitant medications were not reported. The patient previously took first dose of bnt162b2 via an unspecified route of administration, administered in Arm Right on 27Apr2021 (Batch/Lot Number: EW0167) as for covid-19 immunization. Any other vaccinations within four weeks prior to the first administration date of the suspect vaccine reported as none. AEs following prior vaccinations reported as none. On 18Aug2021, the patient experienced who are fully vaccinated who tested positive (medically significant). Reporter states her husband is fully vaccinated. He had the second dose since tested positive for the virus. They have 4 other friends who are fully vaccinated who tested positive. The patient did not visit emergency room or physician office for AEs. The patient underwent lab tests and procedures which included sars-cov-2 test as positive on an unspecified date in 2021. The outcome of events was not recovered. Follow-up attempts are completed. No further information is expected.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101095688 same reporter/drug/AE, different patients.


VAERS ID: 1655383 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA O99E21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Blood urine present, Chills, Culture urine negative, Haematuria, Headache, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tubulointerstitial diseases (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:
Other Medications: Metamucil capsules Tri-lo-sprintec
Current Illness: None
Preexisting Conditions: Diverticulitis
Allergies: None
Diagnostic Lab Data: Culture for a urinary tract infection came back negative
CDC Split Type:

Write-up: Fever, headache, nausea, muscle aches, joint aches, chills, hematuria. I started peeing blood Wednesday the 18th and had to go see a doctor. He took a urine sample, put me on 5 day antibiotic until the culture came back, it still showed no growth. Bloody urine cleared up by Saturday.


VAERS ID: 1655566 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Cough, Decreased appetite, Headache, Injection site rash, Lethargy, Nausea, Pain, Rhinorrhoea, Sneezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, promethazine, phentermine, metoprolol succinate, Omeprazole, buspirone, Topiramate, Cymbalta, acarbose, Zyrtec, Medical Cannabis, collagen powder
Current Illness: Unknown
Preexisting Conditions: Gastroparesis, fibromyalgia, Cushing''s Syndrome, PTSD, HBP, hyperproteinemia, gerd
Allergies: High sensitivity to azithromycin, ibuprofen, Reglan, pseudoephedrine, chlorine. Steroids cause Cushing''s Syndrome
Diagnostic Lab Data: None yet, planning doctor or hospital visit today. My husband has most of the same adverse events I do.
CDC Split Type:

Write-up: Site pain 24hr-went away on own Lethargy/weakness starting day after inj. and still happening Nausea & not hungry- comes and goes since 8/18/21 Body aches, severe- since 8/17/21 Headache worsening daily since 8/18/21 Sneezing & runny nose, frequently-started 8/28/21 Cough, painful- started 8/29/21 Rash at inj. Site- 8/30/21


VAERS ID: 1655650 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Cough, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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: 1st Pneumonia vaccine a couple of years ago, chills, shakes & fever
Other Medications: None that day.
Current Illness: Limited Scleroderma and Osteoarthritis
Preexisting Conditions: Limited Scleroderma and Osteoarthritis
Allergies: Nexxium and Thimersol
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I have been suffering from shortness of breath with a feeling like my heart is skipping a beat, which is progressing to a tightness in my upper chest & some coughing, particularly at night. I contacted my primary care Dr.; however, he told me it wasn''t a side effect of the vaccine and that those should only last about 3 days anyway, and mine has not, so I wasn''t seen, but I didn''t not have these symptoms prior to the vaccine.


VAERS ID: 1655702 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient on Glipizide 5 mg and amlodipine/benazepril 5/20 and toviaz 4 mg
Current Illness: none
Preexisting Conditions: Diabetes, Hypertension, overactive bladder
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports numbness in fingers and arm on right hand about a week following vaccination. Referred to report online and to seek medical attention from Primary Care Physician as soon as possible to evaluate the numbness and cause and to monitor him


VAERS ID: 1655987 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-27
Onset:2021-08-18
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstruation delayed, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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: Prenatal vitamin Magnesium oxide 500mg daily
Current Illness: None
Preexisting Conditions: Von Willebrand''s disease
Allergies: Doxycycline
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had vaginal spotting 3 days after first moderna vaccine. I have now missed my period. Not pregnant


VAERS ID: 1656003 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-15
Onset:2021-08-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abnormal uterine bleeding, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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: Extreme and abnormal vaginal bleeding unrelated to menstrual cycle after Pzifer-BioNTech COVID-19 Vaccine shot in the left arm


VAERS ID: 1656027 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-09
Onset:2021-08-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ear discomfort, Lymphadenopathy, Oropharyngeal pain, Productive cough, Pulmonary congestion, SARS-CoV-2 test negative
SMQs:, Cardiac failure (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi Vitamin , Culturelle Probiotic, Latin Fe
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Sulfa antibiotics
Diagnostic Lab Data: Tested negative twice on Saturday 21,2021 for covid, was given an antibiotic cause I also have green mucus that I was coughing up
CDC Split Type:

Write-up: I woke up 10 days after having my first shot woth a sore throat congestion in my chest clogged ears a swollen lymph nodes in my left arm pit


VAERS ID: 1656037 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Pain in extremity, Pelvic pain, Sciatica, Sleep disorder
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Alprazolam ER .5 mg 1x daily, Duloxetine HCL DR 30 mg 1x daily, Montelukast Sodium tablets,USP 10 mg 1x daily, Rosuvastatin Calcium 10 mg 1xdaily, Omeprazole Delayed release 40 mg 1x daily, Alprazolam .5 mg 1x daily, Xhance fluticasone pro
Current Illness: Sinus Infection, 2 weeks prior to vaccine.
Preexisting Conditions: none
Allergies: Codine , upset stomach
Diagnostic Lab Data: Non yet , Dr not in today , we discussed an MRI if not better.
CDC Split Type:

Write-up: Sever Sciatia Pain in left hip ,pelvic, and left leg, Pain was so bad I was unable to sleep, went to Er Saturday morning around 3 am, received steroid shot, toradol shot, script for steroid pack, Meloxicam 7.5 . also Tramadol 50 mg (which I can not and have not taken the Tramadol) Followed up with my GP, prescribed more Meloxicam. wait to see if it doesnt get better. finished steriod pack , Leg and hip continued in pain , not as bad as day I went to er, Pain started to get worse again 8/29/2021. again could not sleep


VAERS ID: 1656043 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Haemophagocytic lymphohistiocytosis, Hepatic enzyme increased, Interleukin-2 receptor increased, Pancytopenia, Pyrexia, Serum ferritin increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Agranulocytosis (narrow), Haematopoietic cytopenias affecting more than one type of blood cell (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Myelodysplastic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Immune-mediated/autoimmune 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient developed pancytopenia, fevers, elevated liver enzymes, elevated ferritin suggestive and elevated solubleIL2R of HLH (hemphagocytic lymphohistiocytosis.)


VAERS ID: 1656126 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Product storage error
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 left out of temperature for an extended amount of time.


VAERS ID: 1656138 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Product storage error
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 was left out of temperature for an extended amount of time


VAERS ID: 1656305 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH SC3180 / 3 LA / SYR
FLU4: INFLUENZA (SEASONAL) (AFLURIA QUADRIVALENT) / SEQIRUS, INC. - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Computerised tomogram normal, Dysarthria, Extra dose administered, Muscular weakness, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Wellbutrin XL 300 mg once a day, Xanax .25 mg at bed time, Singulair 10 mg at bed time, Oxycodone ER 20 mg twice a day, Hydrocodone as needed every 6 hours, Leucovorin, Evoxac 3 times a day, Hydroxychloroquine once a day, Torsemide once d
Current Illness: None
Preexisting Conditions: rheumatoid arthritis, asthma, COPD, saleucemia, stage 3 kidney disease
Allergies: ACE inhibitors, trendomyzine, morphine injection, insects, Exelon
Diagnostic Lab Data: CT scan- normal
CDC Split Type: vsafe

Write-up: My arm was sore. The first day I had absolutely no energy. In the next 2 days, at around 11:00 I told my husband I did not have any energy. I did not think about the booster. I had to lay down. I slept for like 3-4 hours straight and I never do that. The next day I came out of the shower and suddenly I felt the energy coming out of my body. My legs buckle and I could not stay on my feet. I was slurring, no speech. I was trying to say words and I could see the words in my head but I could not say them. Both my arms and legs felt like jelly. I went to bed and slept for 3 hours. I woke up feeling a lot better. I called the pharmacy and they told me to call their hotline. I told them what happened, and they told me to call my doctor. My doctor told me to go to the ER, which I did on 08/24/2021. By 3:30-4 I could feel my energy coming back to where I normally are. They did a CT scan and checked me for a stroke. Everything was normal but they called the neurologist and he said that I might have had a stroke. He wanted to do further studies. They admitted me for 2 days. They said they could not see any signs of a stroke. They found that people have some weird side effects after the vaccine so they said it was probably the booster. I went home on 08/26/2021. Every day I have an episode, some stronger than others.


VAERS ID: 1656498 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: My doctor showed no concerned what so ever and I am still numb on the left side almost 2 weeks later. Didn''t want to see me, didn''t want to talk about the 2nd dose other than to recommend it. Although I have a couple friends in the medical field I spoke with and they are skeptical on if the 2nd shot would be a good idea, without wanting to step on the toes of my PCP.
CDC Split Type:

Write-up: I left and my face started feeling tingly, then my tongue started feeling swollen. After about an hour it felt like I had been to the dentist and it was settling in the center and left side of my face, neck and shoulder. The next day I called my doctors office, they said I was fine. I asked if I should follow through with getting the 2nd dose and was told "most definitely, it is recommended". It has been almost 2 weeks and I still have numbness and tingling in the left side of my face.


VAERS ID: 1657002 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: PCN
Diagnostic Lab Data: Blood platelet count 36 hours later was 100k
CDC Split Type:

Write-up: Just true blood test results. Felt fine otherwise.


VAERS ID: 1657621 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-13
Onset:2021-08-18
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / -

Administered by: School       Purchased by: ?
Symptoms: Facial paralysis
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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type: PRPFIZER INC202101090158

Write-up: suffered facial paralysis on the right side; This is a spontaneous report from a contactable consumer (patient). A 35-year-old non pregnant female patient received bnt162b2 (Pfizer-BioNTech COVID-19 Vaccine, solution for injection), dose 1 via an unspecified route of administration, administered in left arm on 13Aug2021 (at the age of 35-years-old) (Batch/Lot Number: FA7484) as dose 1, single for covid-19 immunisation. Medical history included hypertension from an unknown date and unknown if ongoing. There were no concomitant medications. The patient experienced facial paralysis on the right side on 18Aug2021. The visited healthcare professional office for Emergency room/department or urgent care . Patient had no known allergies. Patient did not receive any other vaccines within 4 weeks prior and other medications 2 weeks prior to the COVID vaccine. The patient did not have COVID prior and post vaccination. Patient received treatment with unspecified medicine. The outcome of the event was recovering. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1657831 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-08-18
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Fatigue
SMQs:, 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Little bit of diarrhea; Mild fatigue; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a physician and describes the occurrence of DIARRHOEA (Little bit of diarrhea) and FATIGUE (Mild fatigue) 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 an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Aug-2021, the patient experienced DIARRHOEA (Little bit of diarrhea) and FATIGUE (Mild fatigue). At the time of the report, DIARRHOEA (Little bit of diarrhea) and FATIGUE (Mild fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication reported . No treatment medication reported by the reporter.


VAERS ID: 1657835 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / 3 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PLAQUENIL S; PREGABALIN; PREDNISONE; CELLCEPT [MYCOPHENOLATE MOFETIL HYDROCHLORIDE]; CELEBREX; VITAMIN B12 NOS; BELIMUMAB; LANSOPRAZOLE; IRON; RIBOFLAVIN
Current Illness:
Preexisting Conditions: Comments: No Medical History information was reported.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Left arm hurts more than when they got the second dose; Pain feels muscular and inflamed and has spread across the chest, mostly over the left breast area; The pain feels muscular and inflamed; Headache; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Left arm hurts more than when they got the second dose), PAIN (Pain feels muscular and inflamed and has spread across the chest, mostly over the left breast area), INFLAMMATION (The pain feels muscular and inflamed) and HEADACHE (Headache) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 045C21A) for COVID-19 vaccination. No Medical History information was reported. Concomitant products included HYDROXYCHLOROQUINE SULFATE (PLAQUENIL S), PREGABALIN, PREDNISONE, MYCOPHENOLATE MOFETIL HYDROCHLORIDE (CELLCEPT [MYCOPHENOLATE MOFETIL HYDROCHLORIDE]), CELECOXIB (CELEBREX), VITAMIN B12 NOS, BELIMUMAB, LANSOPRAZOLE, IRON and RIBOFLAVIN for an unknown indication. On 17-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Aug-2021, the patient experienced HEADACHE (Headache). On an unknown date, the patient experienced PAIN IN EXTREMITY (Left arm hurts more than when they got the second dose), PAIN (Pain feels muscular and inflamed and has spread across the chest, mostly over the left breast area) and INFLAMMATION (The pain feels muscular and inflamed). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. On 18-Aug-2021, HEADACHE (Headache) had resolved. At the time of the report, PAIN IN EXTREMITY (Left arm hurts more than when they got the second dose), PAIN (Pain feels muscular and inflamed and has spread across the chest, mostly over the left breast area) and INFLAMMATION (The pain feels muscular and inflamed) outcome was unknown. This case was linked to MOD-2021-290856 (Patient Link).


VAERS ID: 1658441 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Neuralgia, Product administered at inappropriate site, Vaccination site reaction
SMQs:, Peripheral neuropathy (narrow), Drug abuse and dependence (broad), Medication errors (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient developed nerve pain in his left arm around the site of the vaccination, which he believes is due to improper administration "too close to the triceps."


VAERS ID: 1658938 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-12
Onset:2021-08-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: C-reactive protein increased, Chest X-ray normal, Chest pain, Dizziness, Dyspnoea, Electrocardiogram abnormal, Headache, Pericarditis, Red blood cell sedimentation rate normal, Troponin normal
SMQs:, Anaphylactic reaction (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 (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine and omeprazole
Current Illness: none
Preexisting Conditions: Hodgkin''s lymphoma, hypothyroid,
Allergies: amoxicillin, Ancef, Augmentin
Diagnostic Lab Data: 8/18/2021 EKG had diffuse ST elevations and PR depressions. There was noted to be some J-point notching. TP line consistent with spodick sign concerning for acute pericarditis. troponin was less than 6. D-dimer within normal limits. He did have mildly elevated CRP, but normal ESR. Patient had no significant leukocytosis. Chest x-ray did not reveal acute pathology including pneumonia, pneumothorax. Repeat troponin also within normal limits at 7. Bedside echocardiogram also completed without evidence of regional wall motion abnormalities or notable effusion. There is no significantly dilated right ventricle. colchicine and ASA was also prescribed for likely pericarditis.
CDC Split Type:

Write-up: 8/18/2021 complaints of chest pain, SOB, (0600) and headache (1700) with dizziness off and on through the day. Seen in ER 8/18/2021 (2300)diagnosed with acute pericarditis


VAERS ID: 1658953 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy, Oropharyngeal pain, Pain, Pain in extremity, Paraesthesia, Restlessness
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MultiVitamin 1 tab po qd Metformin ER 500mg po qd
Current Illness: None
Preexisting Conditions: PCOS Auto-immune Uticaria Arthritis (family hx of RA- not followed up in years but experience discomfort) Carpel tunnel- R wrist
Allergies: Keflex Femera latex sensitivity
Diagnostic Lab Data: UNK- Doctor visit scheduled for Sept. 2, 2021
CDC Split Type:

Write-up: Within minutes bilat legs tingling (on and off for 3+ days), two to three hours after vaccine admin. bilat arms and crown of head tingling (on and off for approx 48hrs), three nights in a row when lying flat in bed sharp shooting pain on the top of bilat feet then pins and needles sensation with restlessness, morning after inj bilat neck lymph nodes swollen and sore throat both lasting for approx 4 to 5 days.


VAERS ID: 1659222 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Eye pain, Headache, Hypoaesthesia, Pain, Pruritus, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitafusion Multi-vitamin
Current Illness: none
Preexisting Conditions: none
Allergies: none known
Diagnostic Lab Data: none, called doctor''s office for advice
CDC Split Type:

Write-up: Arm and chest numbness within first hour, resolved within first 24 hours Itching arms and torso, lasted for first 48 hours Headache, intense paid behind the eyes and temples, first 96 hours acetaminophen, next 96 hours alternating acetaminophen and ibuprofen. Tongue swelling, lasted for first 36 hours.


VAERS ID: 1659234 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphagia, Ear discomfort, Pharyngeal swelling, Pruritus, Swelling, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), 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), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Alprazolam; esomeprazole; famotidine
Current Illness: Pneumonia
Preexisting Conditions: Asthma; IBS; PND; acid reflux; anxiety
Allergies: Pork; shrimp; codeine; Keflex; cephalexin; Cipro; doxycycline; dust mites
Diagnostic Lab Data: No
CDC Split Type: vsafe

Write-up: 08/17/2021 - The day of the vaccine I contributed having a hard time swallowing to mucous from previously having pneumonia. The next morning, 08/18/2021 when my throat was swollen, and it was hard to swallow. It was hard to swallow food or water or saliva. My head was swollen, and my ears were clogged. I had itchy hands, but I did not have a rash and me throat was itchy and swollen, and that concerned me to go to the emergency room. On 08/18/2021, I went to Hospital, they treated me with an EpiPen and an IV for Benadryl and Prednisone and prescribed me Prednisone to bring home. I was monitored for 4 hours. It''s unknow it I have recovered from the AEs because my throat still swells now and then. I was prescribed an EpiPen.


VAERS ID: 1659689 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Endotracheal intubation, Heart rate increased, Mydriasis, Palpitations, Peripheral swelling, Pyrexia, Unresponsive to stimuli
SMQs:, Cardiac failure (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), 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), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: buspirone, prazosin, tramadol, potassium, topiramate,
Current Illness: denies
Preexisting Conditions: history of migraines, increased ICP, asthma
Allergies: penicillin tizanidine
Diagnostic Lab Data: please contact hospital, patient doesn''t remember exact dates and times
CDC Split Type:

Write-up: Noticed swelling/edema in lower and upper extremities around 5:30 pm on 8/18/2021, eyes were delilated, increased heart rate, and called 911. Patient went unresponsive and was rushed to the ER. Gave numerous does of epinephrine and was intubated at the Hospital. Was discharged on 8/20/2021. Reports fever off and on, racing heart since receiving the vaccination


VAERS ID: 1659717 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-19
Onset:2021-08-18
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN9263 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Groin pain, Pollakiuria, Urinary tract infection
SMQs:, Osteonecrosis (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: AVENOVA EYE WASY, CYCLOBENZAPRINE, DOXYCYCLINE, FISH OIL, FLOUCINONIDE, FLUTICASONEPROPIONATE CREAM, HYDROCORTISONE, LORATADINE, METRONIDAZOLE, NAPROXIN, RESTASIS, TETAINE MGD EYE DROPS, ZOLOFT, TRAZODONE, DIOVAN, METFORMIN, TRULICITY
Current Illness: NO
Preexisting Conditions: SLEEP APNEA, FIBROMYALGIA, DIABETIC, HIATAL HERNIA, SJOGREN''S SYNDROME, DIVERTICULOSIS, COLON POLYPS, THORACIC ARTHRITIS OSTEOPENIA
Allergies: HYDROCHOLOROTHIIAZIDE, AMITRIPTYLINE, STATINS, WOOL
Diagnostic Lab Data:
CDC Split Type:

Write-up: FREQUENT URINATION, GROIN PAIN - 2 WEEKS - UTI - PRESCRIBED ANTIBIOTICS


VAERS ID: 1660977 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-18
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthritis, Gait disturbance, Joint stiffness, Neurological symptom, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Arthritis (narrow), Tendinopathies and ligament disorders (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: Alcohol use; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: Total knee replacement (3 years, 3 months ago); Comments: Patient have no known drug allergies
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210858464

Write-up: HARD TO WALK; STIFF KNEES; SUSPECTED GUILLAIN BARRE SYNDROME; TINGLING IN KNEES; INFLAMMATION IN KNEES; This spontaneous report received from a patient concerned a 69 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included: knee replacement surgeries, and concurrent conditions included: alcohol user, and non smoker, and other pre-existing medical conditions included: Patient have no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821286 expiry: 21-OCT-2021) dose was not reported, administered on 21-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 18-AUG-2021, the patient experienced inflammation in knees. On an unspecified date, the patient experienced hard to walk, stiff knees, suspected guillain barre syndrome, and tingling in knees. Treatment medications (dates unspecified) included: tramadol hydrochloride, and diclofenac. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from inflammation in knees, hard to walk, tingling in knees, stiff knees, and suspected guillain barre syndrome. This report was non-serious.


VAERS ID: 1661066 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002A21A / 1 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: today a vaccine was administered and it expired on August 11th; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (today a vaccine was administered and it expired on August 11th) in a 46-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002A21A) for COVID-19 vaccination. No Medical History information was reported. On 18-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (today a vaccine was administered and it expired on August 11th). On 18-Aug-2021, EXPIRED PRODUCT ADMINISTERED (today a vaccine was administered and it expired on August 11th) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant concomitant medications were reported. No treatment information was provided.


VAERS ID: 1661085 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088021A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Pain in extremity, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVETIRACETAM; DIVALPROEX
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by the reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Headaches over the weekend; Seizure; Left arm was sore for about 4 days; This spontaneous case was reported by a consumer and describes the occurrence of SEIZURE in a 48-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088021A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. Concomitant products included LEVETIRACETAM and DIVALPROEX for an unknown indication. On 18-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Aug-2021, the patient experienced PAIN IN EXTREMITY. On 19-Aug-2021, the patient experienced SEIZURE (seriousness criterion medically significant). On 21-Aug-2021, the patient experienced HEADACHE. On 19-Aug-2021, SEIZURE had resolved. On 22-Aug-2021, PAIN IN EXTREMITY and HEADACHE had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information was not provided.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. 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: 1661164 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Eye injury, Fall, Nervousness, Rash
SMQs:, Anaphylactic reaction (broad), Accidents and injuries (narrow), Corneal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: CT scan; Result Unstructured Data: Test Result:unknown; Comments: CT scan done for the eye.
CDC Split Type: USPFIZER INC202101071061

Write-up: Patient was really nervous to begin with; After receiving second dose within 2-3 minutes patient fell from chair face on hitting her head against the floor and a minor cut on the outer eye was observed.; After receiving second dose within 2-3 minutes patient fell from chair face on hitting her head against the floor and a minor cut on the outer eye was observed.; The arms and neck area broke out into rash.; This is a spontaneous report from a contactable pharmacist. A 15-year-old non pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE solution for injection), dose 2 via intramuscular, administered in left arm on 18Aug2021 16:45 (age at vaccination was 15years) (Batch/Lot Number: ew0185) as dose 2, single for covid-19 immunization at pharmacy or drug Store. Medical history included drug hypersensitivity to penicillin from an unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient did not test COVID-19 positive prior to vaccination. It was unknown that the patient had been tested for COVID-19 since the vaccination. The patient received first dose bnt162b2 (BNT162B2), dose 1 via intramuscular, administered in left arm on 27Jul2021 (Batch/Lot Number: ew0186) as dose 1, single for covid-19 immunization and did not experienced any reaction. On 18Aug2021 Patient was nervous to begin with. After receiving second dose within 2-3 minutes patient fell from chair face on hitting her head against the floor and a minor cut on the outer eye was observed. The arms and neck area broke out into rash. gave her a benadryl tablet, tylenol for the fall, and we iced the eye and monitored patient for 30 minutes. The patient''s mom took patient to the ER where she was getting a CT scan done for the eye. Events resulted in Doctor or other healthcare professional office/clinic visit. Patient received benadryl, tylenol, and iced the area as treatment. The event nervousness was medically significant. The patient underwent lab tests and procedures which included computerized tomogram: unknown on unspecified date in Aug2021 CT scan done for the eye. The outcome of the events was unknown.; Sender''s Comments: based on the close temporal relation ship the causality between the events rash , fall , eye injury and the suspect vaccine BNT162B2 cannot be ruled out The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees, and Investigators, as appropriate


VAERS ID: 1661180 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN0171 / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Colitis ulcerative, Extra dose administered, Off label use
SMQs:, Gastrointestinal ulceration (narrow), Ischaemic colitis (broad), Medication errors (narrow), Immune-mediated/autoimmune 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: USPFIZER INC202101075397

Write-up: I swear of ulcerative colitis at my booster third shot; booster third shot has been administered; booster third shot has been administered; This is a spontaneous report from a contactable consumer (patient). A 44-year-old female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; solution for injection, Lot Number: en0171) via an unspecified route of administration on 18Aug2021 (age at vaccination 44-years-old) as dose 3, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient previously took BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; solution for injection, Batch/Lot number was not reported) via an unspecified route of administration on unspecified date as dose 1, single and dose 2 single for covid-19 immunization. On 19Aug2021, the patient stated that she swear of ulcerative colitis at her booster third shot. On 18Aug2021, the patient administered booster third shot. The outcome of the event of ulcerative colitis was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1661208 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-15
Onset:2021-08-18
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, Inappropriate schedule of product administration, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Medication errors (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: PROBIOTICS
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210819; Test Name: Covid 19; Test Result: Positive; Comments: Nasal Swab.
CDC Split Type: USPFIZER INC202101082518

Write-up: This is a spontaneous report from a contactable consumer (patient). A 51-years-old non pregnant female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number: EN6207, Expiry date was not reported) via an unspecified route of administration, administered in arm left on 15Apr2021 07:00 as dose 2, single and first dose via an unspecified route of administration, administered in arm left on 22Feb2021 07:00 (Lot Number: Ew0169, Expiry date was not reported) (age at the vaccination 51-year-old) as dose 1, single for COVID-19 immunization. The patient was not pregnant at time of vaccination. The patient medical history was not reported. The patient had no known allergies. Concomitant medications included PROBIOTICS taken for an unspecified indication, start and stop date were not reported. The patient had experienced covid test result as positive on 19Aug2021, 1st dose 22feb2021/2nd dose 15apr2021, cold like symptoms, cough, runny nose on 18Aug2021 05:00. The patient did not receive treatment for the adverse event. The patient underwent lab tests and procedures which included sars-cov-2 test as positive on 19Aug2021 Nasal Swab. The patient received probiotics medications in two weeks. The patient had not received any other vaccine within 4 weeks. Patient had not been diagnosed with COVID-19 prior to vaccination and had been tested positive since the vaccination. The outcome of the event Covid test result: Positive was unknown and rest of the events was recovering. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1661224 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Dizziness, Dysgeusia, Feeling abnormal, Headache, Heart rate, Heart rate increased, Hyperhidrosis, Laboratory test, Limb discomfort, Lip swelling, Malaise, Peripheral swelling, Piloerection, Respiratory tract congestion, SARS-CoV-2 test, Speech disorder, Swollen tongue, Thyroid function test, Vision blurred, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (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: SYNTHROID; CYTOMEL; OMEPRAZOLE; LORAZEPAM; ZOLOFT; METRON [METRONIDAZOLE]; PREDNISONE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Bee sting (she is allergic to: bees); Biopsy; Colonoscopy (she just had an endoscopy. She does not remember the name of the other one.); Endoscopy (she just had an endoscopy. She does not remember the name of the other one.); Food allergy (she is allergic to: rice (reaction: cough for over a year) - found out 8 weeks ago); Goiter (She had a goiter years ago); Hysterotomy; Itching; Opioid toxicity (Allergic to opioids); Rash (With the insulation, she got a prickly rash and she does not mess with insulation anymore); Surgery
Allergies:
Diagnostic Lab Data: Test Name: heart rate; Result Unstructured Data: Test Result:Rapid; Test Name: Milza test; Result Unstructured Data: Test Result:showed Molivern and nickel; Test Name: COVID test; Result Unstructured Data: Test Result:Negative; Comments: She had a test for Covid which was negative; Test Name: Thyroid test; Result Unstructured Data: Test Result:unknown
CDC Split Type: USPFIZER INC202101091062

Write-up: heart rate rapid; vision blurry; threw up; congestion in upper chest; She has not been feeling too good; could hardly talk; coughed a little; her feet swelled up; Her arm was killing her when she got up that Thursday morning after. She couldn''t lift it right after; the left and right sides of her tongue started swelling and eventually the entire tongue; bitter taste in mouth; dizziness; goosebumps in her armpits; sweating; Fuzzy; Headache; arm pits sweating; lip swelling and they blew up; 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, Lot number: FC3181, Expiration date: not reported) via an unspecified route of administration in left arm on 18Aug2021 as dose 1, single for COVID-19 immunization. The patient medical history included allergic to opioids from 2003, surgery on 08apr2021, goiter, allergic to rice, bees, itching, prickly rash. The patient previously took Ambien and Gabapentin and had an allergy to Ibuprofen and Tylenol. Concomitant medications included Synthroid, Cytomel taken for goiter, Omeprazole taken for acid, Zoloft taken for muscle twitches, Lorazepam taken when she can''t sleep, Metronidazole gel taken as allergic to face masks. Prior Vaccinations (within 4 weeks) was none. Family Medical History Relevant to AE(s) was none. When She had her appendix out they had stapled her and she had adhesions. They did a metal test, a Milza test. She tried to get those records. The test showed Molivern and nickel. She can''t remember what else. She had a food allergy test and is allergic to rice. She had a cough for over a year that nothing would clear up. Her PCP, (Name withheld) said to get an allergy test. She is also allergic to insulation and bees. With the insulation, she got a prickly rash and she does not mess with insulation anymore. On 18Aug2021, patient experienced Swelling of tongue, Taste bitter, Dizziness, Goose bumps, Sweating, Fuzzy, Headache, Sweating increased armpits, Lip swelling, Heart rate high, Blurry vision, Vomiting, Respiratory tract congestion, Feeling unwell, Speech disorder, Cough, Swelling of feet, Arm discomfort. Patient stated she had a reaction within the first 5 to 6 minutes, with the sides of her tongue swelling and a bitter taste and dizziness. It was at (Pharmacy name withheld). They told her to have a seat because she had allergies. 30 minutes later, she got goosebumps on her arm and her arm pits started sweating so bad that she had to go wash her hands. She was told by (Pharmacy name withheld), to start Benadryl 4 times a day, which she has done. If she misses anything she still gets swelling in her tongue and her lips are swelling and her veins blew up. She went urgent care in (town name withheld), (state name withheld) for a Covid test because her throat was red. She had a test for Covid which was negative and they went ahead and prescribed her with steroids. They were having a shortage of steroids but she did have it filled which was the right thing to do. She needed to take them. She had 6 of those, the pills, then starting with 5 pills today at 2PM and titrating down. She is still taking the Benadryl and her vision is blurry. She does not take a lot of medication. She has not been feeling too good and could hardly talk. She had some congestion in her upper chest. Only coughed a little. It seems like the steroid is clearing everything, along with the Benadryl. She got allergies and had been prescribed an Epi pen. She had it with her, it was new to her and she has never used it. Besides her tongue being swollen, and the bitter feeling, that is when the swelling continues to come back. She then threw up after she ate. Then, after that, Wednesday, 18Aug2021, her lip started swelling and the veins in her hands and feet were puffy and swollen. That night, when she was trying to sleep, her feet swelled up and her arm pits were sweaty. The sides of her tongue swelling and the bittery taste and the dizziness. Then, the goosebumps on her arms started sweating and she had to wipe her hands. She would say after 45 minutes, her body adjusted and she stopped sweating. The goosebumps went away but her tongue never stopped swelling up. It swelled up to the tip of her tongue and the bottom lip swelled up, she is waiting for it to peel and the upper lip was swollen as well. She has an allergy to Ibuprofen and Tylenol. It makes her lips swell. If she misses Benadryl, the sides of her tongue swell. Her arm was killing her when she got up that Thursday morning after. She couldn''t lift it right after. She knows the first day, people that use inhalers and have trouble breathing, mentioned drinking black coffee. She started drinking coffee, which made the pain in the arm go away. It helped her tongue, but she couldn''t continued with the caffeine. Aside from the Benadryl and steroids, she is on medications she takes daily. She takes Synthroid, Cytomel, Omeprazole, and Zoloft for muscle twitches. Her heart racing before and it started pretty much right away. She though it was nervousness. The heart racing occurred with the initial reaction. It wasn''t really racing but, she could feel it getting more rapid. She figured it was because she was getting nervous about doing it. She had been quarantined for over a year. The Benadryl and steroids from (pharmacy name withheld) where she got the vaccination. She checked with the pharmacist each time something happened. She stuck out her tongue and went back each time before leaving. She showed them her arm with the goosebumps and that her arm pits were sweaty. She did get a headache. She felt 40 percent better after starting the Benadryl. Her headache, tongue and throat and neck glands started hurting around 4:45pm. She took 2 tablets of the Benadryl. The reactions first with the side of the tongue swelling was the vaccination, while at (pharmacy name withheld). She got something to eat and threw it up. She tried to sleep, when she realized her feet were swelling and she woke up. She started the steroids yesterday, the Prednisone, 10mg. She just took 6 pills yesterday. She will take 5 pills today but, she hasn''t taken them yet. She takes it at 2pm. She will be titrating them down every day as directed, from 6 to 5, to 4 to 3 to 2 to 1. When queried start date of omeprazole She responds stating that she was taking another one and she just had an endoscopy. She does not remember the name of the other one. She had a colonoscopy and had like 20 biopsies. It was pre-cancerous. They just switched her in May2021. She does not have the bottle anymore so she does not know what she was on. It was a small square, white tablet. She took it for the same thing. They tried her on Ambien and she had seen a counselor for stress and differences in her marriage. The Ambien knocked her down and she can''t take Gabapentin either she is just sensitive. She took one Gabapentin after a hand surgery. The tongue sides started swelling at 2:05pm and she got that dizzy, fuzzy feeling. The fuzzy and dizzy, she does not know if she got used to it but, it seemed like it went away during the day, that same day. She actually drove to get chicken parm. She felt like it was safe. Prior to the test, her throat was a little irritating. The outcome of event swelling of tongue, taste bitter, dizziness, goose bumps, sweating, fuzzy, headache, sweating increased armpits, lip swelling, heart rate high, blurry vision, vomiting, respiratory tract congestion, feeling unwell, speech disorder, cough, swelling of feet, arm discomfort was unknown.


VAERS ID: 1661244 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: South Carolina  
Vaccinated:2021-06-01
Onset:2021-08-18
   Days after vaccination:78
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210818; Test Name: Covid 19; Result Unstructured Data: Test Result:Covid -9; Comments: On Aug 18th the patient was diagoned with Covid-19
CDC Split Type: USPFIZER INC202101098476

Write-up: On 18Aug2021 I was diagoned with Covid 19; I was exposed at my place; This is a spontaneous report received from a contactable consumer or other non HCP (patient) via Epsilon Escalation team. A patient (consumer) of unspecified age and gender received bnt162b2 (BNT162B2, Formulation: Solution for injection, and Batch/Lot numbers was not reported), dose 2 via an unspecified route of administration on Jun2021 (age at the time of each vaccination was not provided) as DOSE 2, SINGLE and dose 1 via an unspecified route of administration on May2021 as DOSE 1, SINGLE for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. On the patient assistance program, the patient stated received both doses of the vaccine. The first dose was taken in May2021 and the second was taken in Jun2021. On 18Aug2021, the patient was diagnosed with Covid 19. The patient was exposed at the place of employment in 2021. The patient underwent lab tests and procedures which included SARS-COV-2 test, the patient was diagnosed with Covid-19 on 18Aug2021. The outcome of the event was reported as unknown. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.


VAERS ID: 1662135 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-03
Onset:2021-08-18
   Days after vaccination:137
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Antibody test positive, COVID-19
SMQs:, Vasculitis (broad), Hypersensitivity (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Hospitalization due to COVID-19 Reported per Pfizer COVID-19 Vaccine EUA


VAERS ID: 1662190 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-13
Onset:2021-08-18
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Adenovirus test, Angiogram pulmonary abnormal, Aortic arteriosclerosis, Arteriosclerosis coronary artery, Bordetella test negative, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chlamydia test negative, Computerised tomogram, Condition aggravated, Convalescent plasma transfusion, Cough, Dizziness, Dyspnoea, Enterovirus test negative, Human metapneumovirus test, Human rhinovirus test, Hypoxia, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Lung opacity, Lymph node calcification, Mycoplasma test negative, Pain, Pulmonary granuloma, Respiratory syncytial virus test negative, Respiratory viral panel, SARS-CoV-2 test positive, Scan with contrast abnormal, Sepsis, Viral test negative
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Anticholinergic syndrome (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), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL EXTRA STRENGTH) 500 mg tablet alogliptin 25 mg tablet aspirin 81 mg tablet atorvastatin (LIPITOR) 40 mg tablet clopidogrel (PLAVIX) 75 mg tablet empagliflozin (JARDIANCE) 25 mg tablet tablet finasteride (PROSCAR
Current Illness:
Preexisting Conditions: Nervous Benign neoplasm of pituitary gland Hypopituitarism Knee pain Acute lacunar stroke Pituitary mass Circulatory Benign essential hypertension Intracranial atherosclerosis Ventricular ectopy Digestive Obesity (BMI 35.0-39.9 without comorbidity) Adenomatous polyp of colon Other dysphagia Genitourinary Enlarged prostate with lower urinary tract symptoms (LUTS) Musculoskeletal Disc degeneration, lumbar Internal derangement of right knee Endocrine/Metabolic Gout Hypercholesterolemia Hypothyroidism Type 2 diabetes mellitus Testosterone deficiency in male Hypoxemia Infectious/Inflammatory COVID-19 Immune Sepsis Other Vertigo
Allergies: NKA
Diagnostic Lab Data: 08/26/21 0637 Respiratory virus detection panel Collected: 08/26/21 0537 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected X-ray chest 1 view - Portable Result Date: 8/26/2021 XR CHEST 1 VW PORT IMPRESSION: No evidence of acute cardiopulmonary disease. END OF IMPRESSION: INDICATION: COVID plus hypoxic. TECHNIQUE: Portable AP view of the chest is acquired. COMPARISON: 7/10/2018. FINDINGS: The cardiomediastinal silhouette is unremarkable. No consolidation, effusion, nor pneumothorax is identified. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. CT angiogram chest pulmonary embolism with and without contrast Result Date: 8/26/2021 CTA CHEST WITH ATTENTION TO THE PULMONARY ARTERIES WITH IV CONTRAST IMPRESSION: No obvious central pulmonary neoplasm. Suboptimal evaluation of the more peripheral pulmonary arterial branches due to study limitations. Consider repeat imaging or CT scan as clinically indicated. Mild scattered groundglass opacities suspicious for Covid 19 pneumonia. END OF IMPRESSION: INDICATION: Acute shortness of breath. Concern for pulmonary emboli. TECHNIQUE: Enhanced helical CT scan of the chest was performed from the lung apices to below the diaphragm. 2 mm axial reconstruction with MPR reconstructions. 3D shaded surface display, Maximum Curved Intensity Projection (MIP) and multiplanar reconstructions were performed on an independent workstation and permanently recorded. CONTRAST: 80mL of IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION administered INTRAVENOUS. Quality of contrast opacification was suboptimal opacification of pulmonary arterial system limits sensitivity for detection of pulmonary embolism. Other limitations: Respiratory motion artifact grades image quality and contributes to study limitations. COMPARISON: None available. FINDINGS: No obvious central pulmonary embolism. Evaluation of the segmental and subsegmental pulmonary arterial branches is limited due to suboptimal contrast opacification and extensive bilateral respiratory motion artifact. There are mild scattered groundglass opacities in the lungs bilaterally with rounded morphology and predominantly peripheral distribution; findings are nonspecific but typical of Covid 19 pneumonia. There is calcified granuloma in the right lower lobe. Central airways are patent. No pleural nor pericardial effusion. Coronary arterial calcification and atherosclerosis of the aortic arch. Heart and great vessels are otherwise unremarkable. Thyroid gland and thoracic inlet are within normal limits. There are calcified right hilar lymph nodes with no pathologically enlarged adenopathy in the chest. Review of images on bone windows demonstrates degenerative change with no suspicious osseous abnormality. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient.
CDC Split Type:

Write-up: COUGH, BODY ACHES, ED to Hosp-Admission Discharged 8/26/2021 - 8/28/2021 (2 days) Hospital COVID-19, Hypoxemia Sepsis HPI: Patient is a 74 y.o. male with past medical history of type 2 diabetes mellitus, hypertension, hyperlipidemia, obesity, BPH who was admitted to the Hospital with acute respiratory insufficiency with hypoxia secondary to COVID-19 pneumonia. The patient began to have symptoms last Thursday difficulty breathing, shortness of breath, cough, and dizziness when sitting up and was found to be positive for COVID-19. Hospital Course: Acute respiratory insufficiency with Hypoxia secondary to COVID-19 Pneumonia. o He was consented for complete COVID-19 Pneumonia treatment and agreed to treatment with Convalescent Plasma, Dexamethasone, Remdesivir o He has improved with COVID-19 pneumonia treatment including 3 days of IV Remdesevir. He did receive 1 unit of convalescent plasma. o His breathing has remained stable off oxygen. o He will not need oxygen on discharge. o No further need to complete IV Remdesevir treatment or dexamethasone treatment.


VAERS ID: 1662452 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray, Cough, Dizziness, Electrocardiogram, Headache, Infusion, Laboratory test, Nausea, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), 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), Infective pneumonia (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroid
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: After 12 days of these varying symptoms the nausea and dizziness became noticeably worse. During a telemed conversation with patient''s doctor?s office, he was advised to go to ER. I took him to Hospital where he had a chest x-ray, lab work, and an EKG. He also had a PCR COVID test at the same time. He was diagnosed with Covid pneumonia. The Covid test results the next day showed positive. He was prescribed doxycycline. The next day, with doctors?s office approval he received the monoclonal antibody infusion. He is finally after 3 weeks from the date of vaccination experiencing symptoms lessening.
CDC Split Type:

Write-up: Fever, cough, headache, nausea, dizziness


VAERS ID: 1662863 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-14
Onset:2021-08-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Induration, Pain in extremity, Peripheral swelling, Pruritus, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), 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: Sirolimus 2 mg every morning; Tacrolimus 2 mg morning and night; Plavix 75 mg once a day; Folic acid 1 mg once a day; Allopurinol100 mg once a day; baby aspirin once a day; vitamin D3 25 mg twice a day; vitamin E 180 mg once a day; Vitamin
Current Illness: Bladder Infection
Preexisting Conditions: I had a heart transplant in 2015
Allergies: Sulfa; Sotalol; Lidocaine
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: Initial reaction was a sore arm. Then it would start itching and it would not go away. It was on and off. I went to the doctor 08/18/2021. Then my arm started to get swollen, hard, and red. They did not do any medical tests they just gave me an antibiotic. I started Keflex on the 18th, 500 mg 3 times a day. She only gave it to me for 7 days. It''s still itching and warm so I am trying to get a refill.


VAERS ID: 1663100 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-03-03
Onset:2021-08-18
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine (NORVASC) 10 MG tablet Take 10 mg by mouth Daily . 4/7/21 aspirin 81 mg chewable tablet Chew and swallow 81 mg Daily. atenolol (TENORMIN) 25 mg tablet Take 25 mg by mouth 2 times daily . atorvaSTATin (LIPITOR) 40 mg
Current Illness: None
Preexisting Conditions: ? Anemia ? Bladder cancer (HCC) ? Diabetes (HCC) ? Hypertension ? Peptic ulcer ? Stroke (HCC)
Allergies: ? Amoxicillin Hives
Diagnostic Lab Data: SARS-CoV-2 RNA Resp Ql NAA+probe DETECTED Ordered Test: SARS-CoV-2 RNA Resp Ql NAA+probe Ordered Test Codes: 94500-6 (LN LOINC)/ Status: Final Accession Number: 212300094LP-198922 Specimen Source: SOFT TISSUE SAMPLE Specimen Site: ENTIRE NASOPHARYNX(181200003) Specimen Collection Date/Time: 2021-08-18 18:09:00.0
CDC Split Type: 88333

Write-up: Case completed Covid vaccine series on 3/3/2021, then was admitted to hospital on 8/18/2021 for Covid related complications of comorbidities.


VAERS ID: 1663199 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Glossodynia, Lymph node pain, Lymphadenopathy, Pharyngeal swelling, Tongue erythema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: vitamin C, Vitamin B12, B complex, acidophilus, birth control pills
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: throat began to feel swollen thirty minutes post-vaccination. The next day, the right lymph node was swollen and tender, which resolved the following day. Repeat episodes of throat swelling sensation 5 days post-vaccination and redness/pain on tip and side of the tongue. Both issues have not resolved.


VAERS ID: 1663394 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Fatigue, Lip swelling, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Half an hour after vaccine my body started getting covered in hives, few hours later I has so many hives you couldn?t see unaffected skin, I started taking Benadryl which seems to move hives from one parts of body to another. Next day my lips swell up and I had difficulty breathing. I went to urgent care and was given prednisone plus Benadryl. Two days later I developed chest pressure, and difficulty breathing still persisted. I went to ER and was given another steroid injection and more prednisone. My chest pressure still exist more than a week after vaccination, I get out of breath easily and get tired faster.


VAERS ID: 1665603 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Wrong technique in product usage process
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Vial was not completely in liquid state prior to the administration; This spontaneous case was reported by a consumer and describes the occurrence of WRONG TECHNIQUE IN PRODUCT USAGE PROCESS (Vial was not completely in liquid state prior to the administration) in a 61-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 021C21A) for COVID-19 vaccination. No Medical History information was reported. On 18-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Aug-2021, the patient experienced WRONG TECHNIQUE IN PRODUCT USAGE PROCESS (Vial was not completely in liquid state prior to the administration). On 18-Aug-2021, WRONG TECHNIQUE IN PRODUCT USAGE PROCESS (Vial was not completely in liquid state prior to the administration) had resolved. No concomitant medication was provided. No treatment medication was provided. Reporter reported that the vial was not fully thawed and the administrator warmed it in her hand "was almost fully liquid" before administration. Nurse stated that she took the vial out of the freezer in the morning around 7AM and the vial thawed for 2 hours but was not completely in liquid state prior to the medical assistant administering the dose to the patient. Most recent FOLLOW-UP information incorporated above includes: On 23-Aug-2021: Follow-up received and contains nonsignificant information.


VAERS ID: 1665709 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Delaware  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / -

Administered by: Military       Purchased by: ?
Symptoms: Condition aggravated, Faeces discoloured, Gastric ulcer, Gastric ulcer haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal ulceration (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious diarrhoea (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: Stomach ulcer (Verbatim: Stomach ulcer)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101074949

Write-up: He has had a ulcer in his stomach,and he had bleeding inside; and his stomach liner opened up; Black stools; Black stools was reported as worsened.; This is a spontaneous report from a contactable consumer or other non hcp. A 51-years-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection, Lot Number: EW0169; Expiration Date: 31Aug2021) via an unspecified route of administration at arm left on 17Aug2021 (at the age of 51-years-old) as a single dose for COVID-19 immunisation. Medical history included gastric ulcer from an unknown date and unknown if ongoing Verbatim: Stomach ulcer. There were no concomitant medications. The patient did not receive any other vaccines within four weeks prior to the vaccination. He got the Pfizer COVID shot on Tuesday 17Aug2021. Then, he noticed the next day his stool was black. He had this before, and he had bleeding inside. His stool is really black. It is really bad now. The dark stools started 18Aug2021. It had worsened. He hasn''t seen a doctor or went to the Emergency room. He hasn''t had treatment yet. He just went to the bathroom and noticed it was really bad. He just came from the bathroom. He will probably tell his boss today he will need to go get checked out. He has had a ulcer in his stomach, and his stomach liner opened up (gastric disorder). They asked if he had ever had an issue with bleeding before. on 18Aug2021 condition aggravated. Outcome of the events faeces discoloured and condition aggravated was not recovered, gastric ulcer and gastric disorder was unknown.


VAERS ID: 1665713 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-16
Onset:2021-08-18
   Days after vaccination:124
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 RA / OT

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, Inappropriate schedule of product administration, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Medication errors (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: 20210818; Test Name: Nasal Swab Antigen Test/ Nasal Swab PCR Test; Test Result: Positive ; Test Date: 20210818; Test Name: Nasal Swab Antigen Test/ Nasal Swab PCR Test; Result Unstructured Data: Test Result:Pending for results; Comments: Nasal Swab PCR Test was pending for results
CDC Split Type: USPFIZER INC202101075387

Write-up: covid test result was positive; covid test result was positive; First dose on 08Apr2021 and second dose on 16Apr2021; This is a spontaneous report from a contactable consumer (patient). A 30 years old non -pregnant female patient received bnt162b2 (BNT162B2, solution for injection, Lot Number: EN6207) on 16Apr2021 (at the age of 29 years old) as dose 2, single and on 08Apr2021 (Lot Number: EW0151, at the age of 29 years old) as dose 1, single, both administered in right arm via an intramuscular route of administration for covid-19 immunisation. The patient medical history was not reported. There were no concomitant medications. No other vaccine was given in four weeks. No other medications were in two weeks. It was reported that the patient did not have covid prior to vaccination. The patient was tested for covid post vaccination. There were no known allergies. The patient was not pregnant at time of vaccination. On 18Aug2021, the patient experienced covid test result was positive. The patient received first dose on 08Apr2021 and second dose on 16Apr2021. The patient underwent lab tests and procedures which included nasal swab Antigen Test was positive on 18Aug2021 and nasal Swab PCR test was pending for results on 18Aug2021. The outcome of the event was reported as unknown. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1665728 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1665734 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1665758 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1665760 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1665980 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1665983 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1666081 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1666085 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1666089 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1666093 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1666127 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Poor quality product administered, Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1666160 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW017S / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure increased, Chills, Dizziness, Musculoskeletal stiffness, Nausea, Tachycardia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad), Arthritis (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:
Current Illness:
Preexisting Conditions: none reported
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient complained of lightheadedness, nausea and chills and stiffness to bilateral arms. VS with noted non-resolving tachycardia 126-140 bpm and elevated BP 140-150/80-90. EMS contacted and patient transported to hospital. Symptoms began at 3:25p and continued with EMS transfer at 3:50p.


VAERS ID: 1666199 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-25
Onset:2021-08-18
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002A21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2, Malaise
SMQs:, COVID-19 (narrow)

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

Write-up: Symptoms for Covid. Community Contact


VAERS ID: 1666269 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Pain in extremity, Product administered to patient of inappropriate age
SMQs:, Tendinopathies and ligament disorders (broad), 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient was agreeable to Moderna; parental consent was given; patient is 17 years old and Moderna is specifically for individuals 18 yo and older There were no complications nor post-injection reactions; patient reported only a sore arm the following day and went to the beach to enjoy himself. No adverse reaction thereafter. Vaccine was administered


VAERS ID: 1666287 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-14
Onset:2021-08-18
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID 19 Positive.


VAERS ID: 1666301 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-12
Onset:2021-08-18
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026A21A / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid 19 Postive 8/18/2021


VAERS ID: 1666419 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-21
Onset:2021-08-18
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Aphasia, COVID-19, Chest X-ray normal, Confusional state, Mental status changes, Muscular weakness, Respiratory symptom, SARS-CoV-2 test negative, SARS-CoV-2 test positive, Speech disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Patient is an 86-year-old woman with a history of T2DM, bicuspid aortic valve s/p AVR, CHF (EF 70%), HTN, and CKD stage 3 who presents with altered mental status including expressive aphasia with the last known normal of 7:30 a.m.. Per daughter, patient developed URI like symptoms on August 18th. Chest x-ray was obtained at that time which did not show any evidence of pneumonia. Her COVID test at that time was negative. However, she was started on Augmentin, prednisone, and Tessalon Perles. This Friday she noted worsening URI like symptoms and again returned to the doctor and was tested for COVID which came back positive on Saturday. They had transitioned her to Levaquin and started a 2nd prednisone burst out of concern for COPD exacerbation and pneumonia. Daughter did speak with her this morning and noted she was conversant answering questions appropriately and texting appropriately at approximately 7:30 a.m.. Throughout the day she stopped responding to text messages. the facility contacted the daughter to notify her that she was altered. Per report, she is confused using inappropriate words and has word-finding difficulty. There is no weakness in the upper or lower extremities other than left arm weakness from a known previous injury.


VAERS ID: 1666460 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-01
Onset:2021-08-18
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN8737 / 2 LA / IM

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

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

Write-up: Positive covid-19 test on 8/18/2021


VAERS ID: 1666494 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-02-05
Onset:2021-08-18
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 2 LA / IM

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

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

Write-up: Positive COVID-19 Test on 08/18/2021


VAERS ID: 1666619 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA-6180 / 3 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Chills, Decreased appetite, Night sweats, Pain, Pyrexia, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: Ibuprofen Acetaminophen Famotidine Levothyroxine Atorvastatin Loratadine Prozac Calcium Vitamin D-3 Bee propolis Multivitamin
Current Illness: Cancer
Preexisting Conditions:
Allergies: Tetracycline Erythromycin Iodine dye
Diagnostic Lab Data: Bloodwork 8/23 Urin analysis 8/23 Bloodwork 9/2
CDC Split Type:

Write-up: Body aches Fever Chills Loss of appetite Night sweats and fever went on for two weeks Currently still going on


VAERS ID: 1667134 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Nebraska  
Vaccinated:1980-05-30
Onset:2021-08-18
   Days after vaccination:15055
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest pain, Chills, Dyspnoea, Headache, Lymphadenopathy, Pain, Pyrexia, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Pfizer
Other Medications: ENBREL 50mg prednisone 5mg duloxetine 60mg lisinopril 10mg levothyroxine 25mh
Current Illness: No
Preexisting Conditions: RA thyroid
Allergies: Penicillin meperidine hydromeephone morphine oxycodone ketorolac preabalin metoclopramide hydroxychoroquine venafaxine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash chills chest pain headache fever body pain shortness of breath fast beating weakness armpits swollen


VAERS ID: 1667357 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oedema peripheral, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient described severe underarm and shoulder swelling in left arm


VAERS ID: 1667364 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received 1st dose Pfizer vaccine right deltoid @ 1034. Post vaccination pt felt dizziness, lightheaded, shortness of breath, and chest tightness. Hx anxiety & hypotension per pt. VS 130/90-98.3-103-20-99% RA. Sips of PO fluids given. Denies tongue/throat swelling, rash, redness, or wheezing. @ 1050 HR 92, 98%. @ 1105 BP 108/72, HR 93, 98% RA. Pt c/o ongoing dizziness and " some chest tightness". Offered pt UC services, pt agreed. RRT notified @ 1113, RN-to-RN nurse report given. Pt v/s stable at this time. Pt transferred down to UC via wheelchair. Pt transferred from exam table to wheelchair with steady gait. Significant other at bedside.


VAERS ID: 1667889 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (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: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: I began spotting heavily as if I had my period almost instantly. I never ever get my period early or spot unless I miss a birth control pill which I did not. I also got intense back pains, what I felt when I am about to get my period, which I was not going to get for 2 weeks. Again, I?ve had a very exact schedule for 10+ years. Very concerning.


VAERS ID: 1669185 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA 7484 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Dyspnoea, Eye swelling, Eyelids pruritus, Speech disorder, Swelling face, Swelling of eyelid, Vision blurred
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: PRPFIZER INC202101075027

Write-up: Constant cough; Itching and swelling of the eyelids; Itching and swelling of the eyelids; Swelling of the face; Shortness of breath/Suffocation could not breathe; Barely speak; Blurred vision due to swelling of the eyes; Blurred vision due to swelling of the eyes; This is a spontaneous report from a contactable consumer (patient). A 58-year-old female patient received the second dose of BNT162B2 (PFIZER COVID-19 VACCINE, lot number: FA 7484), at the age of 58 years old, in left arm on 17Aug2021 at 19:15 at single dose for COVID-19 immunisation. The patient was not pregnant at time of vaccination. Medical history included known allergies penicillin. There was no other medical history. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient did not receive any other medications within 2 weeks of vaccination. The patient previously received the first dose of BNT162B2 (lot number: FA 7484), at the age of 58 years old, in left arm on 27Jul2021 at 09:00 at single dose for COVID-19 immunisation. On 18Aug2021 at 08:00, the day after the vaccination in the morning hours, the patient started with a constant cough, then itching and swelling of the eyelids, then swelling of the face, shortness of breath. Suffocation could not breathe and barely speak. Blurred vision due to swelling of the eyes. Events resulted in emergency room / department or urgencies. Events were reported as non-serious. Since the vaccination, the patient had not been tested for COVID-19. Therapeutic measures were taken as a result of events and included treatment with intravenous diphenhydramine hydrochloride (BENADRYL) / dexamethasone (DECADRON) and salbutamol (ALBUTEROL) therapy. The outcome of events was recovering.


VAERS ID: 1669790 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Hypotension, Injection site pain, Presyncope
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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: Site: Pain at Injection Site-Mild, Systemic: near syncope-Medium, Systemic: Hypotension-Medium, Systemic: Weakness-Medium


VAERS ID: 1670213 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E214 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anal incontinence, Condition aggravated, Confusional state, Disorientation, Dysstasia, Extra dose administered, Feeling abnormal, Gait disturbance, Slow response to stimuli, Urinary incontinence
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Noninfectious diarrhoea (broad), Medication errors (narrow), Hypoglycaemia (broad), Dehydration (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: moderate brain fog day after 2nd Modurna shot on 2/17/2021. This cleared by next day
Other Medications: Prolia, mirabegron, ,levothyroxin, Namenda, galantamine, prozac, buspar, restasis eye drops, estradiol vaginal cream, calcium, vitamin D, miralax, AREDs eye vitamins, GasX, B12
Current Illness: Alzheimers Dementia, Depression, Hypothyroid, Osteoporosis , Osteoarthritis, Spastic bladder
Preexisting Conditions: above plus chronic bursitis L hip, chronic low back pain treated with spinal neurostimulator implant
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Fecal and urinary incontinence, extreme confusion, disorientation, severe "brain fog", difficulty walking requiring assistance, inability to get our of bed without assistance, minimal response to questions or commands. She did have some "brain fog" the day after her 2nd shot with Madurna 7 months before, but this was much more severe following this 3rd (booster) shot. Lasted all day, but resolved by next morning.


VAERS ID: 1670276 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-01
Onset:2021-08-18
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022M20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Cough, Decreased appetite, Dyspnoea exertional, Fatigue, Hypophagia, Malaise, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: 76 year old female who presented to the emergency room with malaise, weakness for two weeks; she took her covid vaccine in February and tested positive a week ago; she has had a cough and fatigue; she had fevers but not for the last few days; she has had poor appetite and poor po intake; she has been short of air with exertion. Required inpatient admission to telemetry unit.


VAERS ID: 1670286 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fear of injection, Migraine
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: MIGRAINES
Preexisting Conditions:
Allergies: PENICILLIN PEANUTS
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient felt dizzy and sat on floor. May have lost consciousness. Pulse oximeter on finger showed 90%+ oxygen and pulse of 69-72. Called ambulance and patient was transported to hospital. Phone call to patient on 8/19/21 - "stressed from chiropractic appointment migraine and fear of needles/shot" reported by patient. He was feeling well.


VAERS ID: 1670555 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1670585 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error, Improper Storage temperature.


VAERS ID: 1670609 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1670658 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1670684 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1670688 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1670696 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1670703 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1670709 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1670736 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1670810 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Immediate post-injection reaction, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (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: shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: immediate light headed feeling and nausea. She sat down and then went to bathroom about 15 minutes later and said felt much better. She stayed for 30 minutes until we were comfortable with her leaving. I put wet rag on head and neck. She went home and laid down and took zoran. I checked on her 4 times that day and she was fine later. The next day she was still fine.


VAERS ID: 1670926 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Feeling hot, Headache, Lymphadenopathy, Nausea, Pain, Paraesthesia, Pyrexia, Tremor
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Similar effects from Moderna COVID-19 shot #2 on 3/3/21
Other Medications: dasatnib 100 mg/day fluoxetine 50 mg/day
Current Illness:
Preexisting Conditions: chronic myeloid leukemia (CML)
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nausea, body aches, hot + chills. Fever of 101.3, which continued for a couple days and then went to low grade fever for several more days. Tingling and shaking in hands and feet. Body aches, headache. Swollen lymph nodes, especially in quadrant where I had the shot. Most of these effects passed after one week, but some lingered for two weeks.


VAERS ID: 1671895 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-15
Onset:2021-08-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Dyspepsia, Flatulence, Gastrointestinal sounds abnormal
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific dysfunction (narrow), 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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Food sensitivity
Allergies: Food sensitivity
Diagnostic Lab Data: None yet. Waiting to see a doctor.
CDC Split Type:

Write-up: Extreme diarrhea 3-5 times (pure liquid) a day since a few days after vaccine, constant rumbling and cramping and the feeling of extreme heat in my stomach. Gas with uncontrollable diarrhea. I?ve began taking fiber supplements, probiotics, prebiotic, vitamin c, d3, and zinc, diarrhea is still occurring to this day 9/3 . Intensity and frequency has subsided but mentioned is still correcting at least 2 time a day


VAERS ID: 1672522 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-02-26
Onset:2021-08-18
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014M20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, Extra dose administered, Inappropriate schedule of product administration
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: PREDNISONE
Current Illness: Immunocompromised
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: second on 15Apr2021 and third dose of the vaccine on 18Aug2021; third dose of the vaccine on 18Aug2021; gave patient their 3rd vaccine dose from the expired vial; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (gave patient their 3rd vaccine dose from the expired vial), INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second on 15Apr2021 and third dose of the vaccine on 18Aug2021) and EXTRA DOSE ADMINISTERED (third dose of the vaccine on 18Aug2021) in a 67-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014M20A) for COVID-19 vaccination. Concurrent medical conditions included Immunocompromised. Concomitant products included PREDNISONE for an unknown indication. On 26-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (gave patient their 3rd vaccine dose from the expired vial) and EXTRA DOSE ADMINISTERED (third dose of the vaccine on 18Aug2021). On an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second on 15Apr2021 and third dose of the vaccine on 18Aug2021). At the time of the report, EXPIRED PRODUCT ADMINISTERED (gave patient their 3rd vaccine dose from the expired vial) outcome was unknown and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second on 15Apr2021 and third dose of the vaccine on 18Aug2021) and EXTRA DOSE ADMINISTERED (third dose of the vaccine on 18Aug2021) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment information were not provided by the reporter. Patient received 3rd dose of vaccine on 18th Aug 2021 at 02:50 PM (Batch#: 088D21A) in the left arm. Vial has been dispose as of now confirmed by the pharmacist. Patient received second dose of vaccine on 15th April 2021 (Batch#: 036B21A) This case was linked to MOD-2021-291158 (Patient Link).


VAERS ID: 1672525 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-20
Onset:2021-08-18
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A-1 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Chills, Dizziness, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: body temperature; Result Unstructured Data: 100.4 degrees Farenheight
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: feel dizzy/dizzy; Headache; Chills; Sore left deltoid muscle; Fever 100.4 degrees Farenheight; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (feel dizzy/dizzy), HEADACHE (Headache), CHILLS (Chills), MYALGIA (Sore left deltoid muscle) and PYREXIA (Fever 100.4 degrees Farenheight) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 021B21A-1) for COVID-19 vaccination. No Medical History information was reported. On 20-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, the patient experienced DIZZINESS (feel dizzy/dizzy), HEADACHE (Headache), CHILLS (Chills), MYALGIA (Sore left deltoid muscle) and PYREXIA (Fever 100.4 degrees Farenheight). At the time of the report, DIZZINESS (feel dizzy/dizzy), HEADACHE (Headache), CHILLS (Chills), MYALGIA (Sore left deltoid muscle) and PYREXIA (Fever 100.4 degrees Farenheight) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 100.4 (High) 100.4 degrees Farenheight. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) and mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported. The treatment information was unknown.


VAERS ID: 1672529 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-07-20
Onset:2021-08-18
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Limb discomfort, Muscular weakness, Pyrexia, Swelling, Vaccination complication
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (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: Test Name: Body temperature; Result Unstructured Data: 101.7F
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: side effects; Hand muscles are weak after second shot; Trouble holding things in his hands after second shot; Dropsy after second shot; Fever 101.7F unresponsive to Excedrin after second shot; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (side effects), MUSCULAR WEAKNESS (Hand muscles are weak after second shot), LIMB DISCOMFORT (Trouble holding things in his hands after second shot), SWELLING (Dropsy after second shot) and PYREXIA (Fever 101.7F unresponsive to Excedrin after second shot) in a 70-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 002F21A and 052C21A) for COVID-19 vaccination. No Medical History information was reported. On 20-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, the patient experienced MUSCULAR WEAKNESS (Hand muscles are weak after second shot), LIMB DISCOMFORT (Trouble holding things in his hands after second shot), SWELLING (Dropsy after second shot) and PYREXIA (Fever 101.7F unresponsive to Excedrin after second shot). On an unknown date, the patient experienced VACCINATION COMPLICATION (side effects). The patient was treated with ACETYLSALICYLIC ACID, CAFFEINE, PARACETAMOL (EXCEDRIN EXTRA STRENGTH) for Fever, at a dose of Extra Strength. At the time of the report, VACCINATION COMPLICATION (side effects), MUSCULAR WEAKNESS (Hand muscles are weak after second shot), LIMB DISCOMFORT (Trouble holding things in his hands after second shot), SWELLING (Dropsy after second shot) and PYREXIA (Fever 101.7F unresponsive to Excedrin after second shot) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 101.7 (High) 101.7F. No concomitant medications were provided by the reporter. This case was linked to MOD-2021-290928 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 18-Aug-2021: FU received on 18-AUG-2021 contains no new information


VAERS ID: 1672542 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, Extra dose administered, Off label use
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: Kidney disorder (Kidney issues.)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: gave patient a dose from an expired vial; gave patient their 3rd vaccine dose; Extra dose adminstered; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (gave patient a dose from an expired vial), OFF LABEL USE (gave patient their 3rd vaccine dose) and EXTRA DOSE ADMINISTERED (Extra dose adminstered) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Kidney disorder (Kidney issues.). On 18-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (gave patient a dose from an expired vial), OFF LABEL USE (gave patient their 3rd vaccine dose) and EXTRA DOSE ADMINISTERED (Extra dose adminstered). At the time of the report, EXPIRED PRODUCT ADMINISTERED (gave patient a dose from an expired vial), OFF LABEL USE (gave patient their 3rd vaccine dose) and EXTRA DOSE ADMINISTERED (Extra dose adminstered) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. Treatment information was not provided.


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