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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 115 out of 6,867

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VAERS ID: 1672561 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-03-07
Onset:2021-08-18
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003A21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Extrasystoles, Inappropriate schedule of product administration, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tachyarrhythmia terms, nonspecific (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: FLUTICASONE
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: my heart is skipping/it stops beating for a second; Inappropriate schedule of vaccine administered; fever; This spontaneous case was reported by a consumer and describes the occurrence of EXTRASYSTOLES (my heart is skipping/it stops beating for a second), INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered) and PYREXIA (fever) in a 48-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 026A21A and 003A21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included FLUTICASONE for an unknown indication. On 07-Mar-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 PYREXIA (fever). On an unknown date, the patient experienced EXTRASYSTOLES (my heart is skipping/it stops beating for a second). an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered). At the time of the report, EXTRASYSTOLES (my heart is skipping/it stops beating for a second) and PYREXIA (fever) outcome was unknown and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered) had resolved. Treatment information was not provided. This case was linked to MOD-2021-291503 (Patient Link).


VAERS ID: 1672571 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-04
Onset:2021-08-18
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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

Write-up: woke Up this morning with a tenderness behind my ear; morning with a tenderness behind my ear that radiates down my neck; lymph node that''s a little swollen/I pressed behind my ear and it seems like it''s a lymph node; This spontaneous case was reported by a consumer and describes the occurrence of TENDERNESS (woke Up this morning with a tenderness behind my ear), PAIN (morning with a tenderness behind my ear that radiates down my neck) and LYMPHADENOPATHY (lymph node that''s a little swollen/I pressed behind my ear and it seems like it''s a lymph node) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 04-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Aug-2021, the patient experienced TENDERNESS (woke Up this morning with a tenderness behind my ear), PAIN (morning with a tenderness behind my ear that radiates down my neck) and LYMPHADENOPATHY (lymph node that''s a little swollen/I pressed behind my ear and it seems like it''s a lymph node). At the time of the report, TENDERNESS (woke Up this morning with a tenderness behind my ear), PAIN (morning with a tenderness behind my ear that radiates down my neck) and LYMPHADENOPATHY (lymph node that''s a little swollen/I pressed behind my ear and it seems like it''s a lymph node) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Concomitant medications were reported. No Treatment information was reported.


VAERS ID: 1672576 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-03-07
Onset:2021-08-18
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003A21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Heart rate, Heart rate abnormal, Inappropriate schedule of product administration, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FLUTICASONE
Current Illness:
Preexisting Conditions: Comments: No Medical history was provided by the reporter.
Allergies:
Diagnostic Lab Data: Test Date: 20210818; Test Name: heart rate; Result Unstructured Data: my heart is skipping/ it stops beating for a second/ tried to palpate the pulse it skips every 10 beats
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: First dose was given on 07-Mar-2021 and second dose was given on 17-Aug-2021; fever; my heart is skipping/ it stops beating for a second/ tried to palpate the pulse it skips every 10 beats; This spontaneous case was reported by a consumer and describes the occurrence of HEART RATE ABNORMAL (my heart is skipping/ it stops beating for a second/ tried to palpate the pulse it skips every 10 beats), INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (First dose was given on 07-Mar-2021 and second dose was given on 17-Aug-2021) and PYREXIA (fever) in a 48-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 026A21A and 003A21A) for COVID-19 vaccination. No Medical history was provided by the reporter. Concomitant products included FLUTICASONE for an unknown indication. On 07-Mar-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 HEART RATE ABNORMAL (my heart is skipping/ it stops beating for a second/ tried to palpate the pulse it skips every 10 beats) and PYREXIA (fever). On an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (First dose was given on 07-Mar-2021 and second dose was given on 17-Aug-2021). At the time of the report, HEART RATE ABNORMAL (my heart is skipping/ it stops beating for a second/ tried to palpate the pulse it skips every 10 beats) and PYREXIA (fever) outcome was unknown and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (First dose was given on 07-Mar-2021 and second dose was given on 17-Aug-2021) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 18-Aug-2021, Heart rate: my heart is skipping/ it stops beating for a secon (abnormal) my heart is skipping/ it stops beating for a second/ tried to palpate the pulse it skips every 10 beats. Treatment product information was not provided. This case was linked to MOD-2021-291325 (Patient Link).


VAERS ID: 1672591 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-19
Onset:2021-08-18
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939676 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Gastrooesophageal reflux disease, Headache, Muscle strain, Oropharyngeal discomfort
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Accidents and injuries (narrow), Gastrointestinal nonspecific dysfunction (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BYSTOLIC; TRULICITY; CYMBALTA; LEVOTHYROXINE; LOSARTAN; TRAMADOL; TRAZODONE
Current Illness:
Preexisting Conditions: Comments: Medical history was not provided
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: has been feeling anxious/very very anxious; has some discomfort in the chest; t''s more like a strain, like when you lift something heavy and it strains you in the chest, in the muscle; has some discomfort in the throat; acid reflux; headaches; This spontaneous case was reported by a consumer and describes the occurrence of ANXIETY (has been feeling anxious/very very anxious), CHEST DISCOMFORT (has some discomfort in the chest), MUSCLE STRAIN (t''s more like a strain, like when you lift something heavy and it strains you in the chest, in the muscle), OROPHARYNGEAL DISCOMFORT (has some discomfort in the throat) and GASTROOESOPHAGEAL REFLUX DISEASE (acid reflux) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939676) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Medical history was not provided. Concomitant products included NEBIVOLOL HYDROCHLORIDE (BYSTOLIC), DULAGLUTIDE (TRULICITY), DULOXETINE HYDROCHLORIDE (CYMBALTA), LEVOTHYROXINE, LOSARTAN, TRAMADOL and TRAZODONE for an unknown indication. On 19-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Aug-2021, the patient experienced ANXIETY (has been feeling anxious/very very anxious), CHEST DISCOMFORT (has some discomfort in the chest), MUSCLE STRAIN (t''s more like a strain, like when you lift something heavy and it strains you in the chest, in the muscle), OROPHARYNGEAL DISCOMFORT (has some discomfort in the throat), GASTROOESOPHAGEAL REFLUX DISEASE (acid reflux) and HEADACHE (headaches). At the time of the report, ANXIETY (has been feeling anxious/very very anxious), CHEST DISCOMFORT (has some discomfort in the chest), MUSCLE STRAIN (t''s more like a strain, like when you lift something heavy and it strains you in the chest, in the muscle), OROPHARYNGEAL DISCOMFORT (has some discomfort in the throat), GASTROOESOPHAGEAL REFLUX DISEASE (acid reflux) and HEADACHE (headaches) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment details were provided by reporter.


VAERS ID: 1672592 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Alabama  
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 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Off label use
SMQs:

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

Write-up: Received 3rd dose on an Unknown reason; This spontaneous case was reported by an other health care professional and describes the occurrence of OFF LABEL USE (Received 3rd dose on an Unknown reason) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Osteoporosis. 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 OFF LABEL USE (Received 3rd dose on an Unknown reason). On 18-Aug-2021, OFF LABEL USE (Received 3rd dose on an Unknown reason) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Patient prescribed to take PROLEA shots as she took vaccine changed appointment for a PROLEA shot for osteoporosis. No treatment medications were provided by reporter. No concomitant medications were provided by reporter. Reporter did not allow further contact


VAERS ID: 1672625 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Vomiting nonstop, can''t keep anything down, not even water; Nauseousness; Headache; Fever all day; This spontaneous case was reported by a consumer and describes the occurrence of VOMITING (Vomiting nonstop, can''t keep anything down, not even water), NAUSEA (Nauseousness), HEADACHE (Headache) and PYREXIA (Fever all day) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 17-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Aug-2021, the patient experienced VOMITING (Vomiting nonstop, can''t keep anything down, not even water), NAUSEA (Nauseousness), HEADACHE (Headache) and PYREXIA (Fever all day). On 19-Aug-2021, PYREXIA (Fever all day) had resolved. At the time of the report, VOMITING (Vomiting nonstop, can''t keep anything down, not even water), NAUSEA (Nauseousness) and HEADACHE (Headache) outcome was unknown. Concomitant medication was not provided by the reporter. Treatment information were not reported. Reporter did not allow further contact


VAERS ID: 1672692 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Alabama  
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 026C21A / UNK - / 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: 7 patients vaccinated with a vial that was Greater than 12 hours after initial vial puncture; 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 EXPIRED PRODUCT ADMINISTERED (7 patients vaccinated with a vial that was Greater than 12 hours after initial vial puncture) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026C21A) 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) (unknown route) 1 dosage form. On 18-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (7 patients vaccinated with a vial that was Greater than 12 hours after initial vial puncture). At the time of the report, EXPIRED PRODUCT ADMINISTERED (7 patients vaccinated with a vial that was Greater than 12 hours after initial vial puncture) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medication was not provided Treatment information was not reported It was reported that the vial was removed from the fridge on 17Aug2021 in the morning, punctured at 3:00 PM and put back in the fridge around 5:00PM. On 18Aug2021, the punctured vial was taken out of the fridge at 8:00 AM, administered to 7 patients between 8:00AM - 12:00 PM. 2 patients received their first dose, and 5 received their second dose. Duration of excursion - 15 hrs between 3:00 AM and 12:00 PM


VAERS ID: 1672747 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-01-02
Onset:2021-08-18
   Days after vaccination:228
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Body temperature, Chills, Headache, Nausea, Pyrexia, Vaccination complication
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210818; Test Name: Body temperature; Result Unstructured Data: Fever was 99 to 99.7 degrees F; Test Date: 20210819; Test Name: Body temperature; Result Unstructured Data: Fever went up to 101.2 degrees F
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: had all of the side effects after the 3rd dose; upset stomach; headache; Fever; nausea; chills; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (had all of the side effects after the 3rd dose), ABDOMINAL DISCOMFORT (upset stomach), HEADACHE (headache), PYREXIA (Fever) and NAUSEA (nausea) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 029L20A and 013L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Asthma. On 02-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 18-Aug-2021 at 9:30 AM, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Aug-2021, the patient experienced VACCINATION COMPLICATION (had all of the side effects after the 3rd dose), ABDOMINAL DISCOMFORT (upset stomach), HEADACHE (headache), PYREXIA (Fever), NAUSEA (nausea) and CHILLS (chills). The patient was treated with PARACETAMOL (TYLENOL) in August 2021 for Fever, at a dose of 1 dosage form. On 19-Aug-2021, CHILLS (chills) had resolved. At the time of the report, VACCINATION COMPLICATION (had all of the side effects after the 3rd dose), ABDOMINAL DISCOMFORT (upset stomach), HEADACHE (headache), PYREXIA (Fever) and NAUSEA (nausea) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 18-Aug-2021, Body temperature: 99 (High) Fever was 99 to 99.7 degrees F. On 19-Aug-2021, Body temperature: 101.2 (High) Fever went up to 101.2 degrees F. Concomitant product use was not provided by the reporter.


VAERS ID: 1672847 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-18
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Muscle swelling, Vaccination site discolouration, Vaccination site pruritus, Vaccination site rash, Vaccination site swelling, Vaccination site warmth
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Her muscles are still swollen 3-4 inches to the side; It broke out into a rash; Arm is still swelling; Very itchy/3 inches down from the shot site of the upper left arm; The shot location has turned kind of greenish at the injection site; It has gotten very hot; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE DISCOLOURATION (The shot location has turned kind of greenish at the injection site), VACCINATION SITE WARMTH (It has gotten very hot), MUSCLE SWELLING (Her muscles are still swollen 3-4 inches to the side), VACCINATION SITE PRURITUS (Very itchy/3 inches down from the shot site of the upper left arm) and VACCINATION SITE RASH (It broke out into a rash) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 13-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 VACCINATION SITE DISCOLOURATION (The shot location has turned kind of greenish at the injection site), VACCINATION SITE WARMTH (It has gotten very hot), VACCINATION SITE PRURITUS (Very itchy/3 inches down from the shot site of the upper left arm) and VACCINATION SITE SWELLING (Arm is still swelling). On an unknown date, the patient experienced MUSCLE SWELLING (Her muscles are still swollen 3-4 inches to the side) and VACCINATION SITE RASH (It broke out into a rash). At the time of the report, VACCINATION SITE DISCOLOURATION (The shot location has turned kind of greenish at the injection site), VACCINATION SITE WARMTH (It has gotten very hot), VACCINATION SITE PRURITUS (Very itchy/3 inches down from the shot site of the upper left arm) and VACCINATION SITE RASH (It broke out into a rash) outcome was unknown and MUSCLE SWELLING (Her muscles are still swollen 3-4 inches to the side) and VACCINATION SITE SWELLING (Arm is still swelling) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. On 22Aug2021, patient pressed the vaccination site to feel what was going on, just touched it and aggravated it more. No treatment information was provided.


VAERS ID: 1672891 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-17
Onset:2021-08-18
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023M20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Got 3rd dose; She and her husband have both received 3 doses of the moderna covid-19 vaccine by injection on 17FEB2021 (023M20A), 19MAR2021 (046A21A), and 18AUG2021; This spontaneous case was reported by a consumer and describes the occurrence of EXTRA DOSE ADMINISTERED (Got 3rd dose) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (She and her husband have both received 3 doses of the moderna covid-19 vaccine by injection on 17FEB2021 (023M20A), 19MAR2021 (046A21A), and 18AUG2021) in an 84-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 052E21A, 046A21A and 023M20A) for COVID-19 vaccination. No Medical History information was reported. On 17-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, the patient experienced EXTRA DOSE ADMINISTERED (Got 3rd dose) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (She and her husband have both received 3 doses of the moderna covid-19 vaccine by injection on 17FEB2021 (023M20A), 19MAR2021 (046A21A), and 18AUG2021). On 18-Aug-2021, EXTRA DOSE ADMINISTERED (Got 3rd dose) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (She and her husband have both received 3 doses of the moderna covid-19 vaccine by injection on 17FEB2021 (023M20A), 19MAR2021 (046A21A), and 18AUG2021) had resolved. No concomitant and treatment medication was reported by patient. Patient reported that she was not immunocompromised. Patients had not experienced any other side effects.


VAERS ID: 1672922 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-02-17
Onset:2021-08-18
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023M20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, 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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: This spontaneous case was reported by a consumer and describes the occurrence of OFF LABEL USE (Received a 3rd dose / Caller is not immunocompromised and has not received an organ transplant) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (received 3 doses of the moderna covid-19 vaccine by injection on 17FEB2021 (023M20A), 19MAR2021 (046A21A), and 18AUG2021 (052E21A).) in an 89-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 052E21A, 046A21A and 023M20A) for COVID-19 vaccination. No Medical History information was reported. On 17-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, the patient experienced OFF LABEL USE (Received a 3rd dose / Caller is not immunocompromised and has not received an organ transplant) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (received 3 doses of the moderna covid-19 vaccine by injection on 17FEB2021 (023M20A), 19MAR2021 (046A21A), and 18AUG2021 (052E21A).). At the time of the report, OFF LABEL USE (Received a 3rd dose / Caller is not immunocompromised and has not received an organ transplant) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (received 3 doses of the moderna covid-19 vaccine by injection on 17FEB2021 (023M20A), 19MAR2021 (046A21A), and 18AUG2021 (052E21A).) had resolved. concomitant and treatment drugs were not provided


VAERS ID: 1672954 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017ELIA / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Nausea, Vaccination site pain, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: nausea; throwing up; headache; pain in left arm increased; arm started to hurt a little bit; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (arm started to hurt a little bit), VACCINATION SITE PAIN (pain in left arm increased), HEADACHE (headache), NAUSEA (nausea) and VOMITING (throwing up) in a 34-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 017ELIA) for COVID-19 vaccination. No Medical History information was reported. On 17-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 VACCINATION SITE PAIN (arm started to hurt a little bit). On 19-Aug-2021, the patient experienced VACCINATION SITE PAIN (pain in left arm increased). On 20-Aug-2021, the patient experienced HEADACHE (headache). On 21-Aug-2021, the patient experienced NAUSEA (nausea) and VOMITING (throwing up). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) for Adverse event, at an unspecified dose and frequency. At the time of the report, VACCINATION SITE PAIN (arm started to hurt a little bit), VACCINATION SITE PAIN (pain in left arm increased), NAUSEA (nausea) and VOMITING (throwing up) outcome was unknown and HEADACHE (headache) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication information was provided by the reporter.


VAERS ID: 1673000 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-02-11
Onset:2021-08-18
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Fatigue, Feeling abnormal, Headache, Polymerase chain reaction, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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: LOSARTAN [LOSARTAN POTASSIUM]; CRESTOR OD
Current Illness: Blood pressure abnormal
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: 102.6 F temperature; Test Date: 20210823; Test Name: Body temperature; Result Unstructured Data: 99.4 F; Test Name: PCR; Test Result: Negative ; Result Unstructured Data: Negative
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: She still doesn''t feel like her self; Extreme fatigue (described as 5 out of 5)/ the fatigue is not as bad as before (described as 3 out of 5); 102.6 F temperature/ Now (23Aug2021), she has a tiny bit of fever, 99.4 F; Headache/ Now (23Aug2021), she has a tiny bit of fever, 99.4 F, the headache is pretty much gone; This spontaneous case was reported by a physician and describes the occurrence of FEELING ABNORMAL (She still doesn''t feel like her self), FATIGUE (Extreme fatigue (described as 5 out of 5)/ the fatigue is not as bad as before (described as 3 out of 5)), PYREXIA (102.6 F temperature/ Now (23Aug2021), she has a tiny bit of fever, 99.4 F) and HEADACHE (Headache/ Now (23Aug2021), she has a tiny bit of fever, 99.4 F, the headache is pretty much gone) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013M20A) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure abnormal. Concomitant products included LOSARTAN POTASSIUM (LOSARTAN [LOSARTAN POTASSIUM]) for Blood pressure abnormal, ROSUVASTATIN CALCIUM (CRESTOR OD) for an unknown indication. On 11-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Aug-2021, the patient experienced FATIGUE (Extreme fatigue (described as 5 out of 5)/ the fatigue is not as bad as before (described as 3 out of 5)), PYREXIA (102.6 F temperature/ Now (23Aug2021), she has a tiny bit of fever, 99.4 F) and HEADACHE (Headache/ Now (23Aug2021), she has a tiny bit of fever, 99.4 F, the headache is pretty much gone). On an unknown date, the patient experienced FEELING ABNORMAL (She still doesn''t feel like her self). At the time of the report, FEELING ABNORMAL (She still doesn''t feel like her self) outcome was unknown and FATIGUE (Extreme fatigue (described as 5 out of 5)/ the fatigue is not as bad as before (described as 3 out of 5)), PYREXIA (102.6 F temperature/ Now (23Aug2021), she has a tiny bit of fever, 99.4 F) and HEADACHE (Headache/ Now (23Aug2021), she has a tiny bit of fever, 99.4 F, the headache is pretty much gone) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 23-Aug-2021, Body temperature: 99.4 (High) 99.4 F. On an unknown date, Body temperature: 102.6 f (High) 102.6 F temperature. On an unknown date, Polymerase chain reaction: negative (Negative) Negative. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment medication was not reported. This case was linked to MOD-2021-294235 (Patient Link).


VAERS ID: 1673006 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-01-01
Onset:2021-08-18
   Days after vaccination:229
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dyspnoea, Hyperhidrosis, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypoglycaemia (broad)

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

Write-up: sweating; labored breathing, could not catch his breath; chills; not feeling well; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (not feeling well), HYPERHIDROSIS (sweating), DYSPNOEA (labored breathing, could not catch his breath) and CHILLS (chills) in a 58-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 015C21A, 030M21A and 030L20A) for COVID-19 vaccination. Concurrent medical conditions included COPD. In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 19-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, the patient experienced VACCINATION COMPLICATION (not feeling well) and CHILLS (chills). On 19-Aug-2021, the patient experienced HYPERHIDROSIS (sweating) and DYSPNOEA (labored breathing, could not catch his breath). At the time of the report, VACCINATION COMPLICATION (not feeling well), HYPERHIDROSIS (sweating), DYSPNOEA (labored breathing, could not catch his breath) and CHILLS (chills) outcome was unknown. Concomitant medications were not reported. Treatment medications were not reported. This case was linked to MOD-2021-294237 (Patient Link).


VAERS ID: 1673021 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:2021-08-03
Onset:2021-08-18
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site erythema, Urticaria, Vaccination site swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: redness of the injection site for a few days; Swelling of the injection site; developed hives on her legs and under her arms; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE SWELLING (Swelling of the injection site), URTICARIA (developed hives on her legs and under her arms) and INJECTION SITE ERYTHEMA (redness of the injection site for a few days) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) for COVID-19 vaccination. The patient''s past medical history included Bronchitis. Concurrent medical conditions included Egg allergy. On 03-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Aug-2021, the patient experienced URTICARIA (developed hives on her legs and under her arms). On an unknown date, the patient experienced VACCINATION SITE SWELLING (Swelling of the injection site) and INJECTION SITE ERYTHEMA (redness of the injection site for a few days). The patient was treated with DIPHENHYDRAMINE, PARACETAMOL, PHENYLPROPANOLAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE;PARACETAMOL;PHENYLPROPANOLAMINE HYDROCHLORIDE]) for Hives, at an unspecified dose and frequency. At the time of the report, VACCINATION SITE SWELLING (Swelling of the injection site), URTICARIA (developed hives on her legs and under her arms) and INJECTION SITE ERYTHEMA (redness of the injection site for a few days) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications were not reported. Patient stated that, on 18/19th August she developed hives on her legs and under arms. When she took Benadryl it went away and returned when the Benadryl wears off . She states that she had lot of allergies and did not take flu shots as she ended up in the hospital with bad bronchitis.


VAERS ID: 1673053 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-10
Onset:2021-08-18
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Headache, Migraine, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FENTANYL; MORPHINE; TOPAMAX
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cough (believes they had COVID-19 because they suffered having a bad cough back in 24Jan2020 through 15Feb2020); Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: Migraine, Continue: true
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Migraines; Explosive diarrhea; Somnolence; Headaches; This spontaneous case was reported by a health care professional and describes the occurrence of MIGRAINE (Migraines), DIARRHOEA (Explosive diarrhea), SOMNOLENCE (Somnolence) and HEADACHE (Headaches) in a 52-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 049E21A and 036A21A) for COVID-19 vaccination. The patient''s past medical history included Cough (believes they had COVID-19 because they suffered having a bad cough back in 24Jan2020 through 15Feb2020) from 24-Jan-2020 to 15-Feb-2020. Concurrent medical conditions included Migraine. Concomitant products included FENTANYL, MORPHINE and TOPIRAMATE (TOPAMAX) for an unknown indication. On 10-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 17-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, the patient experienced MIGRAINE (Migraines), DIARRHOEA (Explosive diarrhea), SOMNOLENCE (Somnolence) and HEADACHE (Headaches). The patient was treated with LOPERAMIDE HYDROCHLORIDE (IMODIUM) at an unspecified dose and frequency. On 22-Aug-2021, MIGRAINE (Migraines), DIARRHOEA (Explosive diarrhea), SOMNOLENCE (Somnolence) and HEADACHE (Headaches) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Patient taken migraine medications. This case was linked to MOD-2021-294571, MOD-2021-294576 (Patient Link).


VAERS ID: 1673067 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site pain
SMQs:

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: LENVIMA; KEYTRUDA
Current Illness: Endometrial carcinoma
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: soreness at injection site; This spontaneous case was reported by a physician and describes the occurrence of VACCINATION SITE PAIN (soreness at injection site) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Endometrial carcinoma. Concomitant products included LENVATINIB MESILATE (LENVIMA) from 22-Jul-2021 to an unknown date for Endometrial carcinoma, PEMBROLIZUMAB (KEYTRUDA) for an unknown indication. On 16-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Aug-2021, the patient experienced VACCINATION SITE PAIN (soreness at injection site). At the time of the report, VACCINATION SITE PAIN (soreness at injection site) outcome was unknown. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product was not provided. Treatment information was not provided.


VAERS ID: 1673259 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-17
Onset:2021-08-18
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, Infection, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LISINOPRIL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high (Verbatim: Blood pressure high)
Allergies:
Diagnostic Lab Data: Test Date: 20210818; Test Name: Covid 19 test; Test Result: Positive
CDC Split Type: USPFIZER INC202101077608

Write-up: Tested positive for Covid 19; Tested positive for Covid 19; breakthrough infection; This is a spontaneous report from a contactable consumer (patient) reported for herself. A 71-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EN6208; Expiration Date: Jun2021), dose 2 intramuscular, administered in Arm Left on 17Mar2021 16:00 (at the age of 71-years-old) as a single dose for covid-19 immunization and received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EN6198; Expiration Date: Jun2021), dose 1 intramuscular, administered in Arm Left on 24Feb2021 16:00 (at the age of 71-years-old) as a single dose for covid-19 immunization. Medical history included hypertension: Blood pressure high. Concomitant medication(s) included lisinopril taken for hypertension. Since the vaccination, the patient been tested for COVID-19. 5 months later she has a breakthrough infection and has tested positive for Covid 19. The patient tested positive for covid 19 on 18Aug2021. The patient underwent lab tests and procedures which included sars-cov-2 test positive: positive on 18Aug2021. No more information available. The adverse event doesn''t require to visit emergency room and required to visit physician office for covid-19. Outcome of the event was unknown. Description of Product Complaint: Calling about the Pfizer BioNTech Covid Vaccine. States that she received her 1st dose on 24Feb2021 and her 2nd dose on 17Mar2021. Now, 5 months later she has a breakthrough infection and has tested positive for Covid 19. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1673262 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-04
Onset:2021-08-18
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness transient, Body temperature, Migraine, Pyrexia, Rash, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Chronic migraine (Other medical history: Chronic migraines); Sulfonamide allergy (Known allergies: Sulfa)
Allergies:
Diagnostic Lab Data: Test Date: 20210818; Test Name: fever; Result Unstructured Data: Test Result:101.2
CDC Split Type: USPFIZER INC202101080621

Write-up: I lost my vision for about 30 min; broke out in a rash; got a migraine like no migraine I have ever had before; couldn''t get out of bed let alone set up without vomiting; had a fever of 101.2; This is a spontaneous report from a contactable other healthcare professional (patient). A 42-years-old non-pregnant female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot number: FA7484), via an unspecified route of administration, administered in right arm on 04Aug2021 at 11:45 as dose 1, single (at the age of 42 years) for covid-19 immunization, at pharmacy or drug store. Medical history included chronic migraines from an unknown date and unknown if ongoing and Drug allergy: Sulfa and Rexalti. Concomitant medications were not reported. The patient previously took rexulti on an unknown date and experienced known allergy. There were no other vaccines in four weeks. The patient did not have covid prior vaccination and did not get tested for Covid post vaccination. The patient reported that, on 18Aug2021, 02 weeks after receiving the first vaccine shot, she broke out in a rash, got a migraine like no migraine she has ever had before, she could not get out of bed let alone set up without vomiting, lost her vision for about 30 minutes and had a fever of 101.2, because of which she had miss work. Adverse events did not result in emergency room or physician office visit. The patient underwent lab tests and procedures which included body temperature: 101.2 on 18Aug2021. There was no corrective treatment received for the events. The outcome for all the events was reported as recovering at the time of report. Information on lot/batch number was available; additional information has been requested.; Sender''s Comments: Based on the current available information and the plausible drug-event temporal association, a possible contributory role of the suspect product BNT162B2 to the development of event Blindness transient cannot be totally excluded.This case will be reassessed once additional information is available.The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1673306 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Dyspnoea, Feeling abnormal, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VITAMIN D3
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Diverticulosis; Lyme disease; Polycystic ovarian syndrome
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101084020

Write-up: my heart is fluttering; I had horrible air hunger; a rapid heart rate; I awoke from a nap because it was causing my body to freak out; This is a spontaneous report from a contactable consumer or other non-hcp (Patient). A 30-year-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: solution for injection; Batch/Lot Number: Unknown, Expiration date: Unknown) via an unspecified route of administration (age at vaccination 30-year) in Left Arm on 17Aug2021 at 01:15 PM as dose 1, single for COVID-19 immunization. Medical history included Lyme disease, diverticulum, Possible PCOS, all from an unknown date and unknown if ongoing. Concomitant medications included vitamin d3/k/a, app+, bart+, dtc+, tbb+, o.n.e, taken for an unspecified indication, start and stop date were not reported. No known allergies were reported. No COVID prior vaccination was reported. The patient was not tested COVID post vaccination. On 18Aug2021 the patient experienced her heart was fluttering, she had horrible air hunger, a rapid heart rate, she awoke from a nap because it was causing my body to freak out. It was reported by the patient that "she received her shot Tuesday. Wednesday night she had horrible air hunger and a rapid heart rate. That was Friday and after working, during sleep, her heart was fluttering so much so that she awoke from a nap because it was causing her body to freak out. Have had air hunger episodes since Wednesday". No treatment was received for the adverse events. The clinical outcome of the events was not recovered. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1673365 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-01
Onset:2021-08-18
   Days after vaccination:109
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Postmenopausal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (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 INC202101091748

Write-up: Breakthrough bleeding 30 years after having last period; This is a spontaneous report from a contactable consumer (patient). A 74-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), via an unspecified route of administration, in May2021 at a single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced breakthrough bleeding 30 years after having last period on 18Aug2021. The patient reported that 3 months after receiving the first dose and 30 years after her last period, she had breakthrough bleeding and had to go to the gynecologist. The clinical outcome of breakthrough bleeding 30 years after having last period was recovering. The batch/lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.


VAERS ID: 1673425 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH RA1987 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Corneal disorder, Hypoaesthesia, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Corneal disorders (narrow), Retinal disorders (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: Naproxen; Mirtazapine
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Arthritis; Depression; Gout.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101115969

Write-up: I had Cornea transplant in my eye in my left and right eye and it affected my left cornea transplant. So, now I have 70% vision in my left eye. I do not have full vision in my left eye; I had Cornea transplant in my eye in my left and right eye and it affected my left cornea transplant. So, now I have 70% vision in my left eye. I do not have full vision in my left eye; I received the swelling of the face, left side, tremendously and it is numb; I received the swelling of the face, left side, tremendously and it is numb; This is a spontaneous report from a contactable consumer (patient). A 54-year-old male patient received the first dose of BNT162B2 (PFIZER BIONTECH COVID 19 VACCINE ) via an unspecified route of administration on the left arm on 16Aug2021 at 01:00 (Lot Number: RA1987; Expiration Date: Unknown) at the age of 54-year-old as single dose for COVID-19 immunization. Medical history included depression, arthritis and gout. Investigation assessment was none. Prior vaccination, the patient haven''t had the vaccination in 25 years. Concomitant medications included naproxen taken for arthritis and ongoing and mirtazapine. On 18Aug2021 at 01:00, 48 hours after the shot, the patient experienced swelling of the face, left side, tremendously and it is numb. On 20Aug2021, the patient had cornea transplant in eye in left and right eye and it affected left cornea transplant. So, now, the patient had 70% vision in left eye. The patient didn''t had full vision in left eye. So, the patient was seeing an eye specialist regarding this matter and trying to get vision back. The patient couldn''t wear eye glasses any longer because he gone to get new prescription and everything to correct he cornea. The patient stated "all this because of this Pfizer injection". The patient also stated the anatomical site was left arm and that''s why he was affected on the left side of face and he didn''t think of that and it''s possible. The patient stated the due date of the second dose of BNT162B2 was 01Sep2021. NO treatment was received for vision loss, numbness in face and facial swelling and the patient stated he was going to see the doctor on Monday. The patient have had read the Pfizer paper work. He wanted to known how he get the compensation for his illness. And he stated that he have seen the program, the Pfizer has compensation for his injury. The outcome of vision loss and corneal disorder was unknown. The outcome of other events was recovering. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1674459 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-22
Onset:2021-08-18
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Headache, Nasal congestion, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 10 mg once a day Rosuvastatin 10 mg once a day, evening Omeprazole DR 20 mg once per day, morning Vitamin B12 500 mcg once per day
Current Illness: None
Preexisting Conditions: High blood pressure GERD
Allergies: Neosporin
Diagnostic Lab Data: COVID19 positive 8/20/21
CDC Split Type:

Write-up: Fevers, body aches, headache, stuffiness, cough, fatigue


VAERS ID: 1674543 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Louisiana  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Decreased appetite, Diarrhoea, Disturbance in attention, Fatigue, Headache, Injection site pain, Insomnia, Musculoskeletal stiffness, Myalgia, Neck pain, Pain, Pain in extremity, Sluggishness
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: After 4 hours or so after getting vaccine my arm began to hurt at injection site and progressively got worse to the point of hurting just to lift it and attempt to roll over in bed. The next day pain was spreading through shoulder, upper back and neck along with an exhausted feeling, loss of appetite, diarrhea and sluggishness. The third day, arm still hurt at injection site, soreness in neck upper back and shoulder while the soreness was creeping down into elbow and forearm along with very bad muscle aches as if the joints were swollen and overall body soreness. The fourth day all the same symptoms but soreness and pain was creeping into hands and fingers making my knuckles very stiff. Then the flickering headaches began with mild inability to focus on anything. This lasted at least 2 weeks. Arm is still a little sore at injection site.


VAERS ID: 1674629 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-14
Onset:2021-08-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 10820096 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Areflexia, Balance disorder, Blood test, Coordination abnormal, Eye pain, Magnetic resonance imaging, Muscular weakness, Pain in extremity, Paraesthesia, Ultrasound scan, X-ray
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Terazosin; Flowmax Vitamin E Codliver Oil
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: MRI, Xray; Ultrasound; blood tests.
CDC Split Type:

Write-up: onset of tingling on both hands... pain in legs... muscle weakness... unsteadiness... loss of reflex in major tendons... eyeballs hurt (eye pain). Loss of coordination.


VAERS ID: 1674664 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-02
Onset:2021-08-18
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / SYR

Administered by: Pharmacy       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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Home test and PCR test positive for COVID-19 on August 20, 2021.
CDC Split Type:

Write-up: I had no reaction to the vaccine at all, not even a sore arm. Three months later I tested positive for COVID-19. I had moderate symptoms for about a week. I''m reporting this in case this pharmacy has a record of mishandling vaccines or the lot number was bad or improperly stored.


VAERS ID: 1674737 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Utah  
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 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Vitamin B-12
Current Illness: None
Preexisting Conditions: None
Allergies: Hazel Nuts, Pine Nuts, Walnuts,
Diagnostic Lab Data: Dr. visit, prescribed prednisone, cortisone cream, and antihistamine
CDC Split Type:

Write-up: Itchy feeling all over, red welts and hives on torso, limbs, neck and head. coughing


VAERS ID: 1674856 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-03
Onset:2021-08-18
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood glucose increased, Blood test normal
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Guillain-Barre 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: High blood pressure medicine, Quercetin, zinc, Vit D3, Vit C
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: Took a blood test and came out normal except for a little high on blood sugar
CDC Split Type:

Write-up: Weakness, upon waking in the morning, weakness throughout the body and legs feeling like jelly. No energy. Lasts an hour or two, Fine again during the day till next morning. Sometimes feeling weak again in the evening. Some days better than others.


VAERS ID: 1674891 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest discomfort, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (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: Multivitamins
Current Illness: Nil
Preexisting Conditions: Nil
Allergies: Nil
Diagnostic Lab Data: Nil - note I have not consulted my doctor or any medical prosssional about this to date as we are currently in lockdown and I don''t consider this urgent. It was only after finding out my sister has had the exact same issues as me I have decided to report this.
CDC Split Type:

Write-up: Persistent Tight chest day after vaccination. Uncomfortable but not painful. Occasional elevated heartbeat when under stress but quickly returned to normal when stress gone. Symptoms finally gone today after almost 3 weeks after vaccination. I have still been able to exercise without problems or pain while exercising - the tight chest has been more of a persistent background discomfort, not painful or problematic for exertion.


VAERS ID: 1674946 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-13
Onset:2021-08-18
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Blood test normal, Dysphonia, Gait disturbance, Headache, Hypoaesthesia, Laboratory test normal, Loss of personal independence in daily activities, Magnetic resonance imaging spinal normal, Muscular weakness, Myalgia, Pain, Pain in extremity, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Labs all normal, normal 9/02/21: normal MRI of the spine
CDC Split Type:

Write-up: Patient is a 29-year-old lady with no significant past medical history who presented today to my clinic for the first time with complaints of lower extremity weakness; She. got her first dose of Moderna on August 13 and had a sore arm for couple of days but otherwise felt okay. 4 days after the vaccine she developed severe headache that lasted all day and night, radiating down her back. She took over-the-counter medications with typically help her usual headaches, but they didnt offer any relief; She then developed intense muscle aches and pains. She went to her nurse practitioner who did some blood work, which was reportedly all normal and was started muscle relaxer. This did not help much. She continue to have


VAERS ID: 1675031 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye irritation, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acyclovir
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Eye exam on 8/31/21
CDC Split Type:

Write-up: Blurred vision + eye irritation started the day after second Covid shot and continues to present. Started Maxitrol Rx on 9/2/21


VAERS ID: 1675094 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-15
Onset:2021-08-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Injected limb mobility decreased, Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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

Write-up: After receiving the booster Moderna shot I began to feel a crazy pain above and to the left of the original sight. It is quiet annoying but only happens when I move that arm or try to raise it.


VAERS ID: 1676641 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Inappropriate schedule of product administration, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), 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: Headache for 9 days after 2nd Moderna Covid vaccine on 03/03/2021
Other Medications: L-Thyroxine -b75 mcg AM Misoprostol - 200 mcg AM and PM Naproxyn - 500 mg AM and PM Trazadone - 50 mg PM Privigen 60 grams by infusion every 4 weeks Align probiotics Vitamin C Biotin
Current Illness: None
Preexisting Conditions: CIDP
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue, headache, muscle and joint ache


VAERS ID: 1677075 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-18
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Plaque psoriasis
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210903779

Write-up: BODY ACHES; NAUSEA; HEADACHE; This spontaneous report received from a patient concerned a 60 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: moderate to severe chronic plaque psoriasis. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: Unknown) dose was not reported, administered on 18-AUG-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. Non-company suspect drugs included: risankizumab (form of admin unknown, subcutaneous, batch number was not reported) dose and frequency were not reported from 23-JUL-2021 for moderate to severe chronic plaque psoriasis. No concomitant medications were reported. On 18-AUG-2021, the patient experienced body aches. On 18-AUG-2021, the patient experienced nausea. On 18-AUG-2021, the patient experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable; and treatment with risankizumab was withdrawn. The patient recovered from body aches, nausea, and headache on 20-AUG-2021. This report was non-serious.


VAERS ID: 1677094 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-18
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Balance disorder, Blood pressure measurement, Chills, Contusion, Dizziness, Headache, Heart rate, Heart rate increased, Impaired driving ability, Nausea, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ARMOUR THYROID
Current Illness: Abstains from alcohol; Non-smoker; Pollen allergy; Thyroid disorder
Preexisting Conditions: Comments: The patient not had any drug abuse or illicit drug usage
Allergies:
Diagnostic Lab Data: Test Date: 20210818; Test Name: Heart rate; Result Unstructured Data: 108-111 bpm; Test Date: 20210818; Test Name: Blood pressure; Result Unstructured Data: 120/80 mmHg; Test Date: 20210824; Test Name: Heart rate; Result Unstructured Data: 97-111bpm; Test Date: 20210825; Test Name: Heart rate; Result Unstructured Data: 97-111bpm
CDC Split Type: USJNJFOC20210907676

Write-up: BRUISING ARMS AND LEGS; SHE COULD NOT GO TO WORK OR DRIVE HER CAR; CHILLS; RASH ON RIGHT ARM; NAUSEATED; HEADACHE; FEVER; BALANCE DISTURBANCES ("FELT OFF BALANCE, KIND OF LIKE BEING DRUNK"); DIZZY; HEART RATE WAS GOING UP; This spontaneous report received from a patient concerned a 43 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: thyroid, pollen seasonal allergies, non alcoholic, and non-smoker, and other pre-existing medical conditions included: The patient not had any drug abuse or illicit drug usage. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 201A21A expiry: 21-SEP-2021) dose was not reported, administered on 18-AUG-2021 for prophylactic vaccination. Concomitant medications included thyroid for thyroid. On 18-AUG-2021, the patient experienced dizzy. On 18-AUG-2021, the patient experienced heart rate was going up. On 18-AUG-2021, the patient experienced balance disturbances ("felt off balance, kind of like being drunk"). On 18-AUG-2021, the patient experienced chills. On 18-AUG-2021, the patient experienced rash on right arm. On 18-AUG-2021, the patient experienced nauseated. On 18-AUG-2021, the patient experienced headache. On 18-AUG-2021, the patient experienced fever. Laboratory data included: Blood pressure (NR: not provided) 120/80 mmHg, and Heart rate (NR: not provided) 108-111 bpm. Treatment medications included: paracetamol. On 19-AUG-2021, the patient experienced bruising arms and legs. On 19-AUG-2021, the patient experienced she could not go to work or drive her car. On 24-AUG-2021, Laboratory data included: Heart rate (NR: not provided) 97-111bpm. On 25-AUG-2021, Laboratory data included: Heart rate (NR: not provided) 97-111bpm. The action taken with covid-19 vaccine was not applicable. The patient recovered from dizzy, she could not go to work or drive her car, chills, nauseated, and fever on 2021, heart rate was going up, bruising arms and legs on 29-AUG-2021, balance disturbances ("felt off balance, kind of like being drunk") on 21-AUG-2021, rash on right arm on 22-AUG-2021, and headache on 25-AUG-2021. This report was non-serious.


VAERS ID: 1677163 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Dose administered to a 14 year old/Moderna COVID-19 vaccine was administered to a consumer under the age of 18; This spontaneous case was reported by an other health care professional and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Dose administered to a 14 year old/Moderna COVID-19 vaccine was administered to a consumer under the age of 18) in a 14-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040A21A) 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) (unknown route) 1 dosage form. On 18-Aug-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Dose administered to a 14 year old/Moderna COVID-19 vaccine was administered to a consumer under the age of 18). On 18-Aug-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Dose administered to a 14 year old/Moderna COVID-19 vaccine was administered to a consumer under the age of 18) had resolved. 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 medications were provided. Treatment information was not provided.


VAERS ID: 1677185 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dyspnoea, Extra dose administered, Headache, Nasopharyngitis
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: OXYGEN; MUCINEX; SINGULAIR; ELIQUIS; BAYER ASPIRIN; TYLENOL ARTHRITIS; ALLEGRA; VITAMIN D2; ZOFRAN [ONDANSETRON]; ADVAIR; OXYCODONE; XANAX; PREDNISONE
Current Illness: Allergy; Arthritis; COPD; Nausea
Preexisting Conditions: Medical History/Concurrent Conditions: Lung cancer; Vocal cord disorder NOS
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Difficulty breathing; Cold; Headache; Chills; Extra dose; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNEA (Difficulty breathing), NASOPHARYNGITIS (Cold), HEADACHE (Headache), CHILLS (Chills) and EXTRA DOSE ADMINISTERED (Extra dose) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Lung cancer and Vocal cord disorder NOS in 2013. Concurrent medical conditions included Arthritis since 2013, Allergy, Nausea and COPD. Concomitant products included FEXOFENADINE HYDROCHLORIDE (ALLEGRA) for Allergy, FLUTICASONE PROPIONATE, SALMETEROL XINAFOATE (ADVAIR) for COPD, PREDNISONE for Dyspnea, ONDANSETRON (ZOFRAN [ONDANSETRON]) for Nausea, OXYGEN, GUAIFENESIN (MUCINEX), MONTELUKAST SODIUM (SINGULAIR), APIXABAN (ELIQUIS), ACETYLSALICYLIC ACID (BAYER ASPIRIN), PARACETAMOL (TYLENOL ARTHRITIS), ERGOCALCIFEROL (VITAMIN D2), OXYCODONE and ALPRAZOLAM (XANAX) for an unknown indication. 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 DYSPNEA (Difficulty breathing), NASOPHARYNGITIS (Cold) and CHILLS (Chills). 18-Aug-2021, the patient experienced HEADACHE (Headache) and EXTRA DOSE ADMINISTERED (Extra dose). On 18-Aug-2021, EXTRA DOSE ADMINISTERED (Extra dose) had resolved. At the time of the report, DYSPNEA (Difficulty breathing), NASOPHARYNGITIS (Cold), HEADACHE (Headache) and CHILLS (Chills) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. The treatment history was not reported. Patient took the Fentanyl with saline and Advair 500/50 for COPD. Antibiotics once daily to help clear the lungs and prevent from pneumonia This case was linked to MOD-2021-294195 (Patient Link).


VAERS ID: 1677229 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Chills, Erythema, Fatigue, Illness, Inappropriate schedule of product administration, Influenza like illness, Malaise, Nausea, Night sweats, Pain in extremity, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210818; Test Name: Body Temperature; Result Unstructured Data: 101 F
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: First dose on 13-JAN-2021 and second dose on 10Feb2021 and third dose on 18Aug2021; very sore arm; Swollen arm; Could not get out of bed; Flu like symptoms; Night sweats and was waking up soaking wet head to toe; got really sick; Nausea; Chills; Fever; very tired; Arm red as a beet; This spontaneous case was reported by a non-health professional and describes the occurrence of PAIN IN EXTREMITY (very sore arm), PERIPHERAL SWELLING (Swollen arm), MALAISE (Could not get out of bed), INFLUENZA LIKE ILLNESS (Flu like symptoms) and NIGHT SWEATS (Night sweats and was waking up soaking wet head to toe) in a 75-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 017E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. 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 PAIN IN EXTREMITY (very sore arm), PERIPHERAL SWELLING (Swollen arm), MALAISE (Could not get out of bed), INFLUENZA LIKE ILLNESS (Flu like symptoms), NIGHT SWEATS (Night sweats and was waking up soaking wet head to toe), ILLNESS (got really sick), NAUSEA (Nausea), CHILLS (Chills), PYREXIA (Fever), FATIGUE (very tired), VACCINATION SITE ERYTHEMA (Arm red as a beet) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (First dose on 13-JAN-2021 and second dose on 10Feb2021 and third dose on 18Aug2021). On 18-Aug-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (First dose on 13-JAN-2021 and second dose on 10Feb2021 and third dose on 18Aug2021) had resolved. On 22-Aug-2021, PAIN IN EXTREMITY (very sore arm), PERIPHERAL SWELLING (Swollen arm), MALAISE (Could not get out of bed), INFLUENZA LIKE ILLNESS (Flu like symptoms), NIGHT SWEATS (Night sweats and was waking up soaking wet head to toe), ILLNESS (got really sick), NAUSEA (Nausea), CHILLS (Chills), PYREXIA (Fever), FATIGUE (very tired) and VACCINATION SITE ERYTHEMA (Arm red as a beet) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 18-Aug-2021, Body temperature: high (High) 101 F. Patient had her first Moderns vaccine on 13-Jan-2021 in her right arm with no side effects. She had her second injection 10-Feb-2021 lot was 015M20A again in the right arm. No concomitant medications were provided by reporter. No treatment medications were provided by reporter. This case was linked to MOD-2021-294643 (Patient Link).


VAERS ID: 1677474 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Pain in extremity
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: OLANZAPINE; MELATONIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Schizoaffective disorder
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101091172

Write-up: chest pain; arm pain; This is a spontaneous report from a contactable other HCP (patient). A 52-year-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration, administered in left arm on 18Aug2021 at 08:00 (at the age of 52-years-old) as dose 2, single for COVID-19 immunisation. The patient previously received the first dose of bnt162b2 (lot number er8731) on an unspecified date in Jul2021 for Covid-19 immunisation. Medical history included schizoaffective disorder and allergies to compazine. Th epatient did not have COVID prior vaccination. Concomitant medications included olanzapine and melatonin, bot taken for an unspecified indication, start and stop date were not reported. On 18Aug2021 at 08:00 the patient experienced chest pain and arm pain. Th patient stated that she had stabbing pain in chest right and left side. The events resulted in Emergency room/department or urgent care and were treated with rest in bed. The patient was not COVID tested post vaccination. The outcome of events was not recovered. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1677549 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-15
Onset:2021-08-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Intermenstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101127313

Write-up: Heavy abnormal vaginal bleeding weeks before menstrual cycle; This is a spontaneous report from a contactable consumer, the patient. A 30-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FA7485) via an unspecified route of administration in the left arm on 15Aug2021 at 18:00 (at the age of 50-years-old) as a single dose for COVID-19 immunisation. The patient did not have any relevant medical history. The patient had no known allergies. The patient did not receive any concomitant medication within two weeks of vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 18Aug2021, the patient experienced heavy abnormal vaginal bleeding weeks before menstrual cycle. The event did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the event. The clinical outcome of the event heavy abnormal vaginal bleeding weeks before menstrual cycle was not resolved at the time of this report.


VAERS ID: 1678274 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 3 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CELEBREX
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: Scabs on some lesions on the legs after 3rd shot; Red blisters get bigger after 3rd shot; Existing rash got worst after 3rd shot and spread to both arms; Red rash on Legs, Thighs, and both arms after 3rd shot; Red blisters after 3rd shot; Some lesions itch intensely sometimes after 3rd shot; Some lesions itch intensely sometimes after 3rd shot; This spontaneous case was reported by a consumer and describes the occurrence of RASH ERYTHEMATOUS (Red rash on Legs, Thighs, and both arms after 3rd shot), BLISTER (Red blisters after 3rd shot), SKIN LESION (Some lesions itch intensely sometimes after 3rd shot), PRURITUS (Some lesions itch intensely sometimes after 3rd shot) and SCAB (Scabs on some lesions on the legs after 3rd shot) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 035C21A) 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 CELECOXIB (CELEBREX) for Rash. 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 RASH ERYTHEMATOUS (Red rash on Legs, Thighs, and both arms after 3rd shot), BLISTER (Red blisters after 3rd shot), SKIN LESION (Some lesions itch intensely sometimes after 3rd shot), PRURITUS (Some lesions itch intensely sometimes after 3rd shot), ERYTHEMA (Red blisters get bigger after 3rd shot) and RASH (Existing rash got worst after 3rd shot and spread to both arms). On 25-Aug-2021, the patient experienced SCAB (Scabs on some lesions on the legs after 3rd shot). The patient was treated with BETAMETHASONE at a dose of 0.05 % and DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at an unspecified dose and frequency. At the time of the report, RASH ERYTHEMATOUS (Red rash on Legs, Thighs, and both arms after 3rd shot), BLISTER (Red blisters after 3rd shot), SKIN LESION (Some lesions itch intensely sometimes after 3rd shot), PRURITUS (Some lesions itch intensely sometimes after 3rd shot), SCAB (Scabs on some lesions on the legs after 3rd shot) and ERYTHEMA (Red blisters get bigger after 3rd shot) outcome was unknown and RASH (Existing rash got worst after 3rd shot and spread to both arms) had not resolved. The patient also states that she is also using Sarna lotion for itching. This case was linked to MOD-2021-296629 (Patient Link).


VAERS ID: 1678788 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Chest discomfort, Hypoaesthesia, Palpitations, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (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: none
Current Illness: none
Preexisting Conditions: gastroparesis
Allergies: gluten
Diagnostic Lab Data:
CDC Split Type:

Write-up: By 5 p.m., had chest tightness and left arm numbness. By 10 p.m., numbness in left hand and fingers, heart palpitations (sensation of someone blowing bubbles under water but in my heart). By 2 p.m., heart palpitations continued with burning sensation on bottoms of both lungs. Still having some chest tightness and some palpitations, with left arm occasionally tingling. Some tightness in lungs still present now when running.


VAERS ID: 1681509 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-02-23
Onset:2021-08-18
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Expired product administered, Inappropriate schedule of product administration, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), 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: MYCOPHENOLATE; HYDROXYCHLOROQUINE; FLUOXETINE; PREDNISONE; TRAZODONE; SPIRONOLACTONE; ABILIFY; VITAMIN D [VITAMIN D NOS]; FOLIC ACID
Current Illness: Drug allergy (Allergy to Prevacid, reaction is chest pain.); Knee pain; SLE nephritis; Tension headache (once a week usually, can''t recall (tension type headache))
Preexisting Conditions: Medical History/Concurrent Conditions: Hypertension (constant for a while)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: This spontaneous case was reported by a pharmacist and describes the occurrence of DIZZINESS (Lightheadedness), PAIN IN EXTREMITY (Sore arm), MYALGIA (Muscle soreness), EXPIRED PRODUCT ADMINISTERED (gave patient a dose from an expired vial) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Second dose taken on 23-Mar-2021, third dose taken on 18-Aug-2021) in a 28-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939901) for COVID-19 vaccination. The patient''s past medical history included Hypertension (constant for a while). Concurrent medical conditions included Drug allergy (Allergy to Prevacid, reaction is chest pain.), SLE nephritis since 24-Jun-2021, Tension headache (once a week usually, can''t recall (tension type headache)) since 28-Feb-2021 and Knee pain. Concomitant products included FLUOXETINE for Depression, TRAZODONE for Tension headache, MYCOPHENOLATE MOFETIL (MYCOPHENOLATE), HYDROXYCHLOROQUINE, PREDNISONE, SPIRONOLACTONE, ARIPIPRAZOLE (ABILIFY), VITAMIN D [VITAMIN D NOS] and FOLIC ACID for an unknown indication.On 23-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 23-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 18-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (gave patient a dose from an expired vial). On 19-Aug-2021, the patient experienced PAIN IN EXTREMITY (Sore arm) and MYALGIA (Muscle soreness). On an unknown date, the patient experienced DIZZINESS (Lightheadedness) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Second dose taken on 23-Mar-2021, third dose taken on 18-Aug-2021). On 18-Aug-2021, EXPIRED PRODUCT ADMINISTERED (gave patient a dose from an expired vial) had resolved. On 21-Aug-2021, DIZZINESS (Lightheadedness) had resolved. At the time of the report, PAIN IN EXTREMITY (Sore arm) and MYALGIA (Muscle soreness) had not resolved and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Second dose taken on 23-Mar-2021, third dose taken on 18-Aug-2021) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Reported that the pharmacist believes the patient must have had some type of transplant. Reported that the patient hadn''t taken any medications to alleviate symptoms. This case was linked to MOD-2021-293779, MOD-2021-293783 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 22-Aug-2021: Patient demographic details, medical history, concurrent conditions, concomitant medications were added. First dose and second dose details and events were updated.


VAERS ID: 1681511 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-07-13
Onset:2021-08-18
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Bone pain, Chills, Dizziness, Fatigue, Headache, Hot flush, Hyperhidrosis, Insomnia, Myalgia, Nasopharyngitis, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Osteonecrosis (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? 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: Fever; Fatigue; Dizzy spells every 15 minutes/dizziness; Chills/severe chills; Aches and pains, entire body is aching every muscle; Headache/severe pounding headache; Nausea; Sweats/really sweaty; Entire body is aching every muscle and bone; Hot flashes; Then getting really cold; Haven''t been able to sleep; This spontaneous case was reported by a consumer and describes the occurrence of HYPERHIDROSIS (Sweats/really sweaty), BONE PAIN (Entire body is aching every muscle and bone), HOT FLUSH (Hot flashes), NASOPHARYNGITIS (Then getting really cold) and INSOMNIA (Haven''t been able to sleep) in a 45-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 939901 and 026D21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 13-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-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 HYPERHIDROSIS (Sweats/really sweaty), BONE PAIN (Entire body is aching every muscle and bone), HOT FLUSH (Hot flashes), NASOPHARYNGITIS (Then getting really cold), INSOMNIA (Haven''t been able to sleep), CHILLS (Chills/severe chills), MYALGIA (Aches and pains, entire body is aching every muscle), HEADACHE (Headache/severe pounding headache) and NAUSEA (Nausea). On 19-Aug-2021, the patient experienced DIZZINESS (Dizzy spells every 15 minutes/dizziness). On an unknown date, the patient experienced PYREXIA (Fever) and FATIGUE (Fatigue). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) for Adverse event, at a dose of UNK dosage form and PARACETAMOL (TYLENOL) for Adverse event, at a dose of UNK dosage form. At the time of the report, HYPERHIDROSIS (Sweats/really sweaty), BONE PAIN (Entire body is aching every muscle and bone), HOT FLUSH (Hot flashes), NASOPHARYNGITIS (Then getting really cold), INSOMNIA (Haven''t been able to sleep), DIZZINESS (Dizzy spells every 15 minutes/dizziness), CHILLS (Chills/severe chills), PYREXIA (Fever), FATIGUE (Fatigue), MYALGIA (Aches and pains, entire body is aching every muscle), HEADACHE (Headache/severe pounding headache) and NAUSEA (Nausea) outcome was unknown. Concomitant medication was not provided This case was linked to MOD-2021-292142 (Patient Link).


VAERS ID: 1681596 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-09
Onset:2021-08-18
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure measurement, Headache, Incorrect dose administered, Tinnitus
SMQs:, Hearing impairment (narrow), 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: ZETIA; CRESTOR; OMEPRAZOLE; CENTRUM SILVER [ASCORBIC ACID;BETACAROTENE;BIOTIN;CALCIUM;CHROMIUM;COLECALCIFEROL;COPPER;FOLIC ACID;; GARLIC [ALLIUM SATIVUM]; VITAMIN C [ASCORBIC ACID]; RED YEAST RICE; ZOCOR; BYSTOLIC; ZONISAMIDE; MELOXICAM; FO
Current Illness: Lymphocytic colitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210818; Test Name: blood pressure; Result Unstructured Data: elevated
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: intense ringing in the ears; headache; 1st dose on 09Feb2021,2nd dose on 09Mar2021,3rd dose on 18Aug2021; This spontaneous case was reported by a pharmacist and describes the occurrence of TINNITUS (intense ringing in the ears), HEADACHE (headache) and INCORRECT DOSE ADMINISTERED (1st dose on 09Feb2021,2nd dose on 09Mar2021,3rd dose on 18Aug2021) in a 79-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 052E21A, 032M20A and 024M20A) for COVID-19 vaccination. Concurrent medical conditions included Lymphocytic colitis. Concomitant products included EZETIMIBE (ZETIA), ROSUVASTATIN CALCIUM (CRESTOR), OMEPRAZOLE, CENTRUM SILVER [ASCORBIC ACID;BETACAROTENE;BIOTIN;CALCIUM;CHROMIUM;COLECALCIFEROL;COPPER;FOLIC ACID;IODINE;IRON;LYCOPENE;MAGNESIUM;MANGANESE;NICOTINAMIDE;PANTOTHENIC ACID;PHOSPHORUS;PHYTOMENADIONE;POTASSIUM;PYRIDOXINE HYDROCHLORIDE;RETINOL;RIBOFLAVIN, GARLIC [ALLIUM SATIVUM], VITAMIN C [ASCORBIC ACID], MONASCUS PURPUREUS (RED YEAST RICE), SIMVASTATIN (ZOCOR), NEBIVOLOL HYDROCHLORIDE (BYSTOLIC), ZONISAMIDE, MELOXICAM, FOLIC ACID, ASPIRIN [ACETYLSALICYLIC ACID], MELATONIN, PYRIDOXINE HYDROCHLORIDE (MELATONIN [MELATONIN;PYRIDOXINE HYDROCHLORIDE]), FISH OIL, UBIDECARENONE (COQ10 [UBIDECARENONE]), MAGNESIUM, BUDESONIDE, CUCURBITA PEPO OIL, SERENOA REPENS, ZINC GLUCONATE (SAW PALMETTO [CUCURBITA PEPO OIL;SERENOA REPENS;ZINC GLUCONATE]) and PROBIOTICS [UMBRELLA TERM] for an unknown indication. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, the patient experienced TINNITUS (intense ringing in the ears), HEADACHE (headache) and INCORRECT DOSE ADMINISTERED (1st dose on 09Feb2021,2nd dose on 09Mar2021,3rd dose on 18Aug2021). On 18-Aug-2021, INCORRECT DOSE ADMINISTERED (1st dose on 09Feb2021,2nd dose on 09Mar2021,3rd dose on 18Aug2021) had resolved. At the time of the report, TINNITUS (intense ringing in the ears) and HEADACHE (headache) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 18-Aug-2021, Blood pressure measurement: high mmHg (High) elevated. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No treatment drug details were reported. Patient did not experience any adverse events after 1st and 2nd dose. Patient experienced adverse events after 3rd dose, which was authorized by his HCP due to his conditions/medications. Patient has a condition called lymphatic colitis, and the medication for it makes him immunocompromised.


VAERS ID: 1681607 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-22
Onset:2021-08-18
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Influenza like illness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: flu like symptoms; severe headache; terrible body aches; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (flu like symptoms), HEADACHE (severe headache) and MYALGIA (terrible body aches) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 040C21A, 024M20A and 029L20A) for COVID-19 vaccination. Concurrent medical conditions included Immunocompromised, Heart disorder and Lung disease. Concomitant products included PARACETAMOL (TYLENOL) for an unknown indication. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 18-Aug-2021, the patient experienced INFLUENZA LIKE ILLNESS (flu like symptoms), HEADACHE (severe headache) and MYALGIA (terrible body aches). At the time of the report, INFLUENZA LIKE ILLNESS (flu like symptoms), HEADACHE (severe headache) and MYALGIA (terrible body aches) outcome was unknown. Treatment medication was not reported. This case was linked to MOD-2021-295648 (Patient Link).


VAERS ID: 1681636 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004D21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site erythema, Vaccination site pain, Vaccination site pruritus, Vaccination site reaction
SMQs:

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

Write-up: Arm got a big thing on it, on hands. It hurt a little bit and it itched./It came back again. It''s pink and itchy; arm got a big thing on it; Arm got a big thing on it, on hands. It hurt a little bit and it itched; Arm got a big thing on it, on hands. It hurt a little bit and it itched./It came back again. It''s pink and itchy; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE REACTION (arm got a big thing on it), VACCINATION SITE PAIN (Arm got a big thing on it, on hands. It hurt a little bit and it itched), VACCINATION SITE PRURITUS (Arm got a big thing on it, on hands. It hurt a little bit and it itched./It came back again. It''s pink and itchy) and VACCINATION SITE ERYTHEMA (Arm got a big thing on it, on hands. It hurt a little bit and it itched./It came back again. It''s pink and itchy) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004D21A) for COVID-19 vaccination. No Medical History information was reported. On 16-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 VACCINATION SITE REACTION (arm got a big thing on it), VACCINATION SITE PAIN (Arm got a big thing on it, on hands. It hurt a little bit and it itched) and VACCINATION SITE PRURITUS (Arm got a big thing on it, on hands. It hurt a little bit and it itched./It came back again. It''s pink and itchy). On 24-Aug-2021, the patient experienced VACCINATION SITE ERYTHEMA (Arm got a big thing on it, on hands. It hurt a little bit and it itched./It came back again. It''s pink and itchy). On 20-Aug-2021, VACCINATION SITE REACTION (arm got a big thing on it), VACCINATION SITE PAIN (Arm got a big thing on it, on hands. It hurt a little bit and it itched) and VACCINATION SITE PRURITUS (Arm got a big thing on it, on hands. It hurt a little bit and it itched./It came back again. It''s pink and itchy) had resolved. At the time of the report, VACCINATION SITE ERYTHEMA (Arm got a big thing on it, on hands. It hurt a little bit and it itched./It came back again. It''s pink and itchy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment medications were reported


VAERS ID: 1681658 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: New York  
Vaccinated:2021-01-23
Onset:2021-08-18
   Days after vaccination:207
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Headache, Nasal congestion, Pyrexia, SARS-CoV-2 test positive, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (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? 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: Test Date: 20210818; Test Name: SARS-CoV-2 test; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: coughing; congestion; , sneezing; headache; Fever; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (headache), COUGH (coughing), NASAL CONGESTION (congestion), SNEEZING (, sneezing) and PYREXIA (Fever) in a 68-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 029L20A and 039K20A) for COVID-19 vaccination. No Medical History information was reported. On 23-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Feb-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 HEADACHE (headache) and COUGH (coughing). 18-Aug-2021, the patient experienced NASAL CONGESTION (congestion), SNEEZING (, sneezing) and PYREXIA (Fever). On 26-Aug-2021, HEADACHE (headache), COUGH (coughing), NASAL CONGESTION (congestion), SNEEZING (, sneezing) and PYREXIA (Fever) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 18-Aug-2021, SARS-CoV-2 test positive: Positive. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medication was not provided. Treatment information was not provided. This case was linked to MOD-2021-296717 (Patient Link).


VAERS ID: 1681665 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Exposure during pregnancy, Headache, Nasal congestion, Nasopharyngitis, Vaccination site erythema, Vaccination site pain, Vaccination site papule, Vaccination site reaction, Vaccination site swelling
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: Patient has a cold; Congestion; The injection site is magnetized, I can stick a magnet to the injection site; Injection site is the size of a dime; Injection site is red; Injection site is swollen; Headache; Patient is 31 weeks pregnant; Injection site left arm was sore.; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of NASOPHARYNGITIS (Patient has a cold), NASAL CONGESTION (Congestion), VACCINATION SITE REACTION (The injection site is magnetized, I can stick a magnet to the injection site), VACCINATION SITE PAPULE (Injection site is the size of a dime) and EXPOSURE DURING PREGNANCY (Patient is 31 weeks pregnant) in a 35-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088D21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. 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. The patient''s last menstrual period was on 21-Jan-2021 and the estimated date of delivery was 28-Oct-2021. On 18-Aug-2021, the patient experienced EXPOSURE DURING PREGNANCY (Patient is 31 weeks pregnant) and VACCINATION SITE PAIN (Injection site left arm was sore.). On 26-Aug-2021, the patient experienced NASOPHARYNGITIS (Patient has a cold), NASAL CONGESTION (Congestion), VACCINATION SITE REACTION (The injection site is magnetized, I can stick a magnet to the injection site), VACCINATION SITE PAPULE (Injection site is the size of a dime), VACCINATION SITE ERYTHEMA (Injection site is red), VACCINATION SITE SWELLING (Injection site is swollen) and HEADACHE (Headache). The patient received mRNA-1273 (Moderna COVID-19 Vaccine) beginning around the twenty-ninth week of the pregnancy. On 18-Aug-2021, EXPOSURE DURING PREGNANCY (Patient is 31 weeks pregnant) had resolved. At the time of the report, NASOPHARYNGITIS (Patient has a cold), NASAL CONGESTION (Congestion), VACCINATION SITE REACTION (The injection site is magnetized, I can stick a magnet to the injection site), VACCINATION SITE PAPULE (Injection site is the size of a dime), VACCINATION SITE PAIN (Injection site left arm was sore.), VACCINATION SITE ERYTHEMA (Injection site is red), VACCINATION SITE SWELLING (Injection site is swollen) and HEADACHE (Headache) outcome was unknown. 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. The patient stated that she is 31 weeks pregnant currently, with a due date of 28 October 2021. No concomitant product use was provided by the reporter. No treatment medications were reported. Most recent FOLLOW-UP information incorporated above includes: On 26-Aug-2021: Significant follow-up. Pregnancy details updated. New event-vaccination exposure during pregnancy added.; Sender''s Comments: This is a case of product exposure during pregnancy with associated AEs for this 3 5-year old female. Patient will not be contacted for further monitoring of AEs during the pregnancy.


VAERS ID: 1681803 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101070023

Write-up: Developed a rash today 18Aug2021 on his left arm that has spread to the back of his neck; Swollen lymph nodes; This is a spontaneous report received from a contactable pharmacist. A 15-years-old male patient received unknow dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot Number: Unknown), via an unspecified route of administration on 16Aug2021 as dose number unknown, single for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. Reporter called about a patient who received the Pfizer Covid-19 vaccine on 16Aug2021 and developed a rash today 18Aug2021 on his left arm that has spread to the back of his neck and has developed swollen lymph nodes as well. Health care professional was asking how long will it be before the above rash will disappear and if there are treatment recommendations for the rash. The outcome of the events was reported as unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1681812 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Extra dose administered, Off label use
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: USPFIZER INC202101075206

Write-up: armpit is aching; She had her 3rd dose yesterday; She had her 3rd dose yesterday; This is a spontaneous report from a contactable consumer or other non-health care professional (patient). A female patient of an unspecified age received third dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration, administered in arm on 18Aug2021 as dose 3, single for COVID-19 immunization. The patient medical history was not reported. There were no concomitant medications. The patient historical vaccine included first dose of BNT162B2 as dose 1, single and second dose of BNT162B2 as dose 2, single for COVID-19 immunization. On 18Aug2021, the patient experienced armpit is aching, she had her 3rd dose yesterday. It was further stated that, caller stated that she was calling about the Covid Vaccine, specifically the 3rd vaccine. She has a question about a concern. She has had no real problems with the first and 2nd dose. She had her 3rd dose yesterday and with her armpit, on the side where she got the shot, the armpit is aching. Caller wants to know if this is a normal side effect. Caller consents to safety report, but when this call handler attempts to start the safety report caller said before she answered questions she wanted to just know is this a normal side effect. The clinical outcome for all the events was reported as unknown. Information on the lot/batch number has been requested.


VAERS ID: 1681881 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose administered, Off label use, Oropharyngeal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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: USPFIZER INC202101091061

Write-up: Third dose last Wednesday on 18Aug2021; sore throat; Third dose last Wednesday on 18Aug2021; This is a spontaneous report from a contactable consumer (patient herself) via Pfizer Sponsored. This female patient (age unknown) received the third dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number unknown), via an unknown route, on 18Aug2021 at single dose for COVID-19 immunisation. No relevant medical history and concomitant medications were provided. The patient stated that she received her third dose last Wednesday on 18Aug2021 and has a sore throat. The patient had an appointment to get swabbed for COVID and wanted to know if this will affect the result of the COVID test because her Pharmacist explained that she may test positive because she just had the booster. The outcome of the events was unknown. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up


VAERS ID: 1681906 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-18
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Extra dose administered, Fatigue, Illness, Malaise, Weight, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), 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: Test Name: Weight; Result Unstructured Data: Test Result:Decreased
CDC Split Type: USPFIZER INC202101096306

Write-up: lost weight; I am exhausted/I am very tired; I was really sick; not feeling great; extra dose administered; This is a spontaneous report from a contactable consumer (patient, self-reported). A patient of unspecified age and gender received third dose of BNT162B2 (PFIZER-BIONTEC COVID-19 mRNA VACCINE, Solution for injection, lot number and expiry date were not reported), via an unspecified route of administration, on 18Aug2021, as a single dose for COVID-19 immunization, second dose of BNT162B2 (PFIZER-BIONTEC COVID-19 mRNA VACCINE, Solution for injection, lot number and expiry date were not reported), via an un-specified route of administration, on an unspecified date, as a single dose for COVID-19 immunization and after second shot had a reaction and you know it felt, flu like symptoms, and first dose of BNT162B2 (PFIZER-BIONTEC COVID-19 mRNA VACCINE, Solution for injection, lot number and expiry date were not reported), via an unspecified route of administration, on an unspecified date, as a single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient reported that the patient had third shot (further clarification unknown hence not captured in tab) and after second shot the patient had a reaction and you know it felt, flu like symptoms whatever and the patient was anticipating the same type of thing when the patient had the shot last Wednesday and today on Monday was the first day actually feel somewhat decent and other than fact that the patient was exhausted, lost weight, everything on 23Aug2021. The patient wanted to know like has this happened before the people the patient like felt like the patient was really sick and had it for so long, was that something that has happened before. The patient stated that the patient was concerned the patient mean it was possible to get sick at same time that seems strange and was perfectly fine you know when got it and right now the patient felt like the patient didn''t have fever today (further not clarified hence not captured in tab), it was the first time the patient was very tired and all wanted to know was if you supposed to documenting this all but I also wanted to know the patient was sure you have heard many thousands of peoples and the patient wanted to know if this was that something unusual obviously it was not the usual thing ok you wanna connect me to with them. The patient stated that the patient was not feeling great so did not feel like doing that. The patient underwent lab test and procedure included weight which was decreased on an unspecified date. Outcome of the events was unknown. The lot number for the vaccine, BNT162B2 was not provided and will be re-quested during follow up.


VAERS ID: 1681969 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anaphylactic reaction, Dizziness, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy; Cancer
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101105069

Write-up: Anaphylactic reaction; light-headed; her throat started to get tight and close on her; This is a spontaneous report from a contactable consumer (patient). This non-pregnant 62-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Left on 18Aug2021 10:15 (Lot Number: EW0217) at age of 62-years-old as dose 1, single for COVID-19 immunisation. Medical history included Asymmetric and Cancer on face, known allergies: yes. No other vaccine in four weeks. There were other medications in two weeks. The patient felt light-headed, and then her throat started to get tight and close on her, had an Anaphylactic reaction on 18Aug2021 10:45 AM. The event resulted in emergency room/department or urgent care. Therapeutic measures were taken as a result of the events included Epinephrine injection, Benadryl and Prednisone. The outcome of the events was recovered in Aug2021. There was no COVID prior vaccination. No COVID tested post vaccination. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1682156 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-11
Onset:2021-08-18
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Goitre, Lymphadenopathy
SMQs:, Hypothyroidism (broad), Hyperthyroidism (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: SYNTHROID
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypothyroidism
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101154390

Write-up: Swollen thyroid; Swollen thyroid and lymph nodes; This is a spontaneous report from a contactable consumer, the patient. A 34-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3180) via an unspecified route of administration in the left arm on 11Aug2021 at 11:30 (at the age of 34-years-old), as a single dose for COVID-19 immunisation. Medical history included hypothyroidism. The patient did not have any known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID-19 vaccine. Concomitant medications included levothyroxine sodium (SYNTHROID) for an unknown indication from an unknown date and unknown if ongoing. On 18Aug2021 at 12:00, the patient experienced swollen thyroid and lymph nodes. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Since the vaccination, the patient had not been tested for COVID-19. Therapeutic measures were not taken as a result of the events. The clinical outcome of the events swollen thyroid and lymph nodes were not resolved at the time of this report. The patient received second dose of BNT162b2 (COMIRNATY; Lot number: FC3183), via an unspecified route of administration in the left arm on 01Sep2021 at 11:15 (at the age of 34-years-old), as a single dose for COVID-19 immunisation.


VAERS ID: 1682399 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-06
Onset:2021-08-18
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO 180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vertigo
SMQs:, Vestibular 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shortly after vaccine (1-2 weeks?) extreme vertigo noted. 0 illness or other contributing factors noted. 0 changes in lifestyle habits, personal or professional activities, etc. Vertigo is present daily to varying degrees. Will seek professional medical attention if condition persists.


VAERS ID: 1682943 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (broad)

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

Write-up: Patient was charted on incorrectly for first dose. It stated she got Pfizer but really received Moderna. Upon arrival for her second vaccine she did not have her CDC card so the nurse wrote her a new chart based on the Pfizer vaccine in chart and then gave her a second Pfizer vaccine.


VAERS ID: 1683178 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Hypoaesthesia, Lethargy, Musculoskeletal stiffness, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Hypoglycaemia (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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2 days after dose 2 COVID vaccine, patient started to experience HA, stiff neck/shoulders, lethargy, left arm/hand numbness and tingling. HA improved on 9/2/21. Lethargy improved 9/4/21. All other symptoms resolved.


VAERS ID: 1683223 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram abdomen abnormal, Mesenteric vein thrombosis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ASA, astepro, atovatatin, azathioprine, ezetimibe, famotidine, fluticasone, lantus, levothyroxine, losartan, Novolin, omeprazole, promethazine, propranolol, vitamin C, vitamin D
Current Illness: immune hepatitis
Preexisting Conditions: Diabetes, immune hepatitis
Allergies: NKDA
Diagnostic Lab Data: CT abd - SMV clot
CDC Split Type:

Write-up: started with abd pain day after shot, seen in clinic on 8/24/21 with extreme pain and CT showed SMV blood clot


VAERS ID: 1683257 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site hypoaesthesia, Joint swelling, 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), Tendinopathies and ligament disorders (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:
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient experienced numbness in left arm (site of administration) on first day, which resolved after 3 days. However, she then experienced numbness and swelling in her left leg/knee. Patient was seen in urgent care and then referred to emergency room and patient was given medication for swelling/fluids, which has resolved after treatment. Patient reported all symptoms have resolved.


VAERS ID: 1683264 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-04
Onset:2021-08-18
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 2 AR / SYR

Administered by: Other       Purchased by: ?
Symptoms: Cough, Dysphagia, Oropharyngeal discomfort, Throat tightness, Tonsillar disorder
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (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: ADDERALL XR
Current Illness: In between first and 2nd vaccine - I had a really bad double ear infection. Antibiotics for that - I had postponed my vaccine (2nd one) back a week for me to get better.
Preexisting Conditions: Tietze Syndrome
Allergies: Penicillin and amoxicillin
Diagnostic Lab Data: No testing
CDC Split Type: vsafe

Write-up: It felt pretty similar to Strep Throat - had white patches on my tonsils but I did not have a sore throat. I kind of ignored them. I had them for about a week and then one day I woke up was feeling pain while swallowing and I developed a little bit of a cough. I did go to Urgent Care - that first week of just seeing the white patches and that was two Fridays ago (two weeks ago) in person - the doctor just recommended salt water gargling and tea. Three days after that visit, I looked in the mirror and I looked at my throat and it had spread to both of my tonsils (the white patches)- and the next morning I woke up and felt like my throat was going to close and it was painful swallowing. I called the Dr -(free video visit). He did not recommend I get a COVID test. I had Azithromycin for the symptoms. I completed course about six days later - last Friday.


VAERS ID: 1683478 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: California  
Vaccinated:2021-02-24
Onset:2021-08-18
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chest discomfort, Cough, Nasal congestion, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine, Hydrochloride, Baby Aspirin, Folic Acid Atorvastatin
Current Illness: N/A
Preexisting Conditions: Hypertension
Allergies: Mollusks
Diagnostic Lab Data: Covid-19 Positive
CDC Split Type: vsafe

Write-up: I tested positive for Covid-19 on 08-16/2021. Mild fever for about four days. I had a mild fever and a stuffy head I was prescribed Regeneron and I got the infusion on the fourth day. I also felt very tight in the chest and I had low energy. I had a dry cough but no sore throat. I started to feel better after a couple of weeks but after three weeks I still have low energy and some congestion. I started to get negative tests after two and a half weeks.


VAERS ID: 1683507 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-14
Onset:2021-08-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E214 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood test normal, Chest X-ray, Chest pain, Computerised tomogram thorax abnormal, Decreased appetite, Dehydration, Dizziness postural, Dysphagia, Electrocardiogram normal, Fatigue, Feeding disorder, Heavy menstrual bleeding, Menstruation irregular, Pain in extremity, Pulmonary thrombosis, Respiratory tract congestion, Urine analysis normal, Weight decreased
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), 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), Cardiomyopathy (broad), Fertility disorders (broad), Tendinopathies and ligament disorders (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hormonal Birth Control Pills
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Sulfur
Diagnostic Lab Data: Blood work, urine sample, and EKG (August 19, 2021) at my family doctors office. Blood work, urine sample, IV drip, EKG, Chest X-Ray, and Cat Scan (August 20, 2021) at the ER.
CDC Split Type:

Write-up: The first 2 days I experience congestion and severe arm pain. The following 2 days I experienced fatigue, dizziness when standing up, and the inability to eat. The following day (Wednesday, August 18) I woke up with severe chest pain. The chest pain made it extremely painful to eat or drink anything. I experienced no pain in my esophagus, it was as though the effort to eat or drink intensified the pain I was feeling in my chest. On Thursday I went to my doctors office where an EKG, urine sample, and blood work were done on me, both came back within normal range but I was severely dehydrated. They couldn?t figure out what was wrong, but said if the pain got worse to go to the ER. I woke up on Friday and the pain was worse. I hadn?t eaten in several days and had lost 15 lbs in one week. I went to the ER where they did blood work, a urine sample, an EKG, gave me a IV drip for my dehydration, and X-ray on my chest, and a CAT scan. The CAT scan relieved I had a blood clot in my lung. I was immediately told to stop taking birth control and I was put on blood thinners, nausea medicine, ulcer medicine (although I didn?t have issues with my through, they just didn?t know what else to do to help with my eating/drinking complications) and blood thinners. I was worried because my current birth control kept me from having my period, so as soon as I was told to stop and put on blood thinners I had my period. Normally I have period that last 7 days and are heavy, but due to the blood thinners my period was extremely heavy flow. Even more than usual.


VAERS ID: 1683694 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Blood test normal, Electric shock sensation, Magnetic resonance imaging normal, Mobility decreased, Pain in extremity, Spinal pain, Vaccine positive rechallenge
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: 37 at Time of second Moderna vaccination had similar adverse reaction to the third except the pain was not as severe as the thir
Other Medications: Prednisone Plaquenil IVIG (monthly but had been 4 weeks since last infusion)
Current Illness: None
Preexisting Conditions: SLE AUTONOMIC DYSFUNCTION
Allergies: NSAID GABAPENTIN MINOCYCLINE
Diagnostic Lab Data: MRI and blood tests Or performed at ER all blood tests were negative or normal as was the MRI
CDC Split Type:

Write-up: Severe pain in Spine and lower back into both legs and feet. Pain feels like lightening bolts, sharp shooting quality. Pain so severe I could not lay on back nor could I sit or bend over. Started 48 hours after vaccine #2 and # 3. Pain more severe after vaccine number three so severe it required a trip to the ER. Pain No increasing and still present on September 8 2021.


VAERS ID: 1683719 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (broad)

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

Write-up: received pfizer as 2nd dose, 1st dose was moderna


VAERS ID: 1684123 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Fibrin D dimer normal, Full blood count normal, Hypoaesthesia, Muscle twitching, Paraesthesia, Troponin normal
SMQs:, Peripheral neuropathy (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: probiotic, sertraline
Current Illness: none
Preexisting Conditions:
Allergies: N/A
Diagnostic Lab Data: Went to ED on 8/21. D dimer, CBC, trop, CXR. All neg.
CDC Split Type:

Write-up: The night of my shot I developed chest pain, left arm, forearm and hand/finger numbness and tingling along with twitching in my left forearm. I continues to have chest pain and numbness and tingling in my left arm. Twitching has moved all throughout my body.


VAERS ID: 1685236 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-06
Onset:2021-08-18
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Cough, Dyspnoea, Pyrexia, SARS-CoV-2 test positive, Sinus pain, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Budesonide inhalation, polymyxin B-trimethoprim opthalmic, lis HCTZ, levothyroxine, rosuvastatin, Tylenol, ibuprofen, Vit C, zinc, Vitamin D3, probiotic oral, tessalon Perles, albuterol inhalation, mucinex, dexamethasone
Current Illness:
Preexisting Conditions: Hypothyroidism, Hyperlipidemia, hypertension, melanoma
Allergies: sulfadiazine
Diagnostic Lab Data: COVID + 8/15/2021 with at-home test
CDC Split Type:

Write-up: 8/18/2021: admitted with a COVID breakthrough presenting with cough, SOB, and covid-19 viral pneumonia. Pt states her husband was unvaccinated and contracted covid in July. She states symptoms began as sinus pain and she was receiving treatment from her pcp for sinus infection but continued to have higher and higher fevers so she tested herself at home and was covid19+ 3 days ago. Note: previously vaccinated with Pfizer COVID-19 vaccines, 2nd dose in April 2021. Discharged 8/21/2021


VAERS ID: 1685286 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-16
Onset:2021-08-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Faeces discoloured, Haemorrhage, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Phenergan
Diagnostic Lab Data: No studies or laboratory test have done yet.
CDC Split Type:

Write-up: Heavy bleeding with the presence of clots, Dark stools.


VAERS ID: 1685319 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site swelling, Joint swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Site: Swelling at Injection Site-Severe, Additional Details: Patient had swelling at the elbow on the same arm she received the vaccine about 12 hours later. Her elbow had to be drained by healthcare professional and she received and unknown injection to help dry it out. Since her 1st shot patient states she feels like she is and more reactive to allergens around her.


VAERS ID: 1685323 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-14
Onset:2021-08-18
   Days after vaccination:126
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, COVID-19 pneumonia, SARS-CoV-2 test positive
SMQs:, Retroperitoneal fibrosis (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? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: furosemide, gabapentin, lactulose, metoprolol tartrate, potassium chloride, rifaximin, spironolactone, venlafaxine
Current Illness:
Preexisting Conditions: ASH cirrhosis of the liver, hepatic encephalopathy, chronic pain syndrome, irritable bowel syndrome, asthma
Allergies: tetracyclines, penicillin, papaya
Diagnostic Lab Data: Tested positive for Covid on 8/18/21.
CDC Split Type:

Write-up: 8/18/21: The patient has been states that he brought her into the emergency room primarily due to her complaints of progressive back pain over the past 30 days. He was concerned that she had some symptoms that were consistent with COVID-19 and requested that she be tested. She tested positive for COVID-19 in the ER. Note: patient had Moderna Covid-19 vaccine on 3/17/21 and 4/14/21. Diagnosed with viral pneumonia related to Covid 19. Discharged on 8/24/21.


VAERS ID: 1685349 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC 3181 / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Asthenia, Chest X-ray, Computerised tomogram head normal, Ear pain, Feeling of body temperature change, Headache, Hypoaesthesia, Loss of personal independence in daily activities, Neck pain, Nerve compression, Pain, Pain in extremity, Paraesthesia, Spinal pain
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Accidents and injuries (broad), Hypersensitivity (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No other illnesses
Preexisting Conditions: No long standing chronic health conditions
Allergies: Avelox Dexilant IV contrast shellfish nespresso coffee pods
Diagnostic Lab Data: CT scan Up head Chest X-ray
CDC Split Type:

Write-up: Start it with anaflatic response. Requiring an emergency room visit straight from is it straight from the pharmacy. I was given Solumedral and Benadryl. Monitor the hospital for a few hours and sent home. Upon arriving home rested in bed started started feeling tingling in my legs hot and cold patches. Feeling weakness numbness in my spine and lower extremities. Pain progressed to burning In neck ears spine head. I went er to where they performed A CT scan of head Because the burning pain in my head was so bad.they said was negative sent me home with prednisone. Finish the course of prednisone which did nothing and proceeded back to the ER with burning spine pain pain deropathy down my left arm left side of body. Again no real answers told me to see neurologist which I am following up with on Monday the 15th of September. They gave me a shot of tordol is bored all and sent me home with some prescription medications for basically a pinch nerve. I''ve never experienced pain like this and it has been progressively getting worse ever since I received the covid vaccine. I really would appreciate answers and help in this matter it has been 3 weeks and I have had 0 good days and unable to fulfill my duties in my life because of the pain I am experiencing


VAERS ID: 1685497 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-15
Onset:2021-08-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D20K / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Heart rate increased, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

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

Write-up: 8/18, 19, 20, 23, 26, 31/2021 - my heart began racing - beating fast - some chest pain - but mostly heart racing. This has never happened before. I felt I should''ve called 911 - but did not bc concerned about covid in ambulance, hospital.


VAERS ID: 1685580 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-04
Onset:2021-08-18
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Paraesthesia, SARS-CoV-2 test positive
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol, norgestimate-ethinyl estradiol (Sprintec)
Current Illness:
Preexisting Conditions: none
Allergies: nka
Diagnostic Lab Data: Tested positive for Covid on 8/18/21
CDC Split Type:

Write-up: 8/18/21: presents to the ED with tingling of left extremities since 10 am this morning. Per the patient, she tested positive for Covid-19 this weekend, but is currently feeling better. She adds that she is fully vaccinated (4/16/21 & 6/4/21). However, this morning she developed tingling in her left fingers and toes that has now started to progress to her mid arm and shin on her left side. The patient denies fever, loss of sensation, loss of movement, or any further complaints. the course/duration of symptoms is worsening. Location: Left upper extremity lower extremity. The character of symptoms is tingling. Was treated for r/o CVA. No covid related diagnosis or treatment. Discharged to home 8/19/21.


VAERS ID: 1685681 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-01
Onset:2021-08-18
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest X-ray abnormal, Confusional state, Fatigue, Rhinorrhoea, SARS-CoV-2 test positive, Sleep disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (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? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: Unknown
Preexisting Conditions: HTN, Cardiac disease
Allergies: unknown
Diagnostic Lab Data: 8/22/2021 Covid 19 RNA positive 8/22/2021 abnormal CXR (no details available)
CDC Split Type:

Write-up: Admitted 8/22/2021 with Covid symptoms: runny nose, fatigue, new confusion or inability to be woken. Onset of symptoms 8/18/2021. Not in ICU or intubated. Submitter does not have access to further details or medical records.


VAERS ID: 1686220 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Bowel movement irregularity, Diarrhoea, Feeling abnormal, Feeling cold, Headache, Hyperhidrosis, Nausea, Pain in extremity, Paraesthesia, Vomiting, Weight decreased
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Shellfish allergy, nuts allergy
Diagnostic Lab Data: I did not seek medical attention
CDC Split Type:

Write-up: 3pm arm started to hurt. Body felt tingly and started feeling cold. 3:15pm started feeling nauseous and needed to move bowels. 3:35 started violently vomiting. Then diarrhea took place. Continued to vomit and lose control of my bowels until 1am. During this time I was freezing and sweating. I never took my temperature due to the fact I could not tolerate anything in my mouth due to nausea. A severe headache took over at 1:20am. At 2:30 am I took 800mg motion. I finally fell asleep around 3 am. When I awoke at 9am I felt beat up. Later that day I forced down a half of English muffin Then around dinner time I had a small bowl of Raman noodles. It took me 3 days to recover and I lost 5 lbs.


VAERS ID: 1584220 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH BNT162B2 / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Severe pounding Headache, muscle ache all over, fatigue


VAERS ID: 1586585 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-09
Onset:2021-08-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 057D21A / 1 - / IM

Administered by: School       Purchased by: ?
Symptoms: Vaccination site erythema
SMQs:

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: Multivitamins
Current Illness: None
Preexisting Conditions: Polycystic ovary syndrome
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Covid Arm red rash local to vaccination site no medications taken for it.


VAERS ID: 1602939 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-05
Onset:2021-08-18
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 300-4729 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Chest pain, Dizziness, Dyspnoea, Headache, Hypoaesthesia, Musculoskeletal discomfort, Palpitations, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (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:
CDC Split Type:

Write-up: Shortness of breath, heart palpitation, lightheadedness, sharp pain in the left (almost at the center) of the chest, fainting, mild numbness on my left part of my body (left arm and left leg), pressure on my back neck, pain on my left back (left wing), headache at the back of my head every time I put exertion or it feels like pulsating.


VAERS ID: 1651272 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-01
Onset:2021-08-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Back pain, C-reactive protein increased, Dizziness, Fatigue, Haematology test normal, Nausea, Pain in extremity, SARS-CoV-2 test negative
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Chlorpheniramine 30 minutes before application.
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: August 26, 2021 Ultrasensitive CRP, 3.65 high risk results PCR COVID, NEGATIVE NORMAL HEMATOLOGY
CDC Split Type:

Write-up: 12 hours post inoculation, severe pain in right arm, axilla, back muscles. Following days extreme fatigue, nausea, dizziness. Symptoms continue for 10 days.


VAERS ID: 1575624 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-08-07
Onset:2021-08-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline, Norethindrone acetate and ethinyl estradiol
Current Illness: None
Preexisting Conditions: Anxiety, depression
Allergies: Penicillin
Diagnostic Lab Data: Have not gone to seek testing yet.
CDC Split Type:

Write-up: 12 hours to 3 days post vaccination I did have fever unresponsive to Tylenol and Ibuprofen, body aches, and nausea. Starting 8/17/21 I have been experiencing a heavier menstrual cycle than I''ve ever experienced with thick quarter sized clots or larger. Currently monitoring.


VAERS ID: 1577846 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-01
Onset:2021-08-17
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dysmenorrhoea, Intermenstrual bleeding, Postmenopausal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Metformin, Glipizide, Metropolol Tartrate
Current Illness: None
Preexisting Conditions: Diabetes, High Blood Pressure
Allergies: None
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Break through menstruation bleeding and cramping. I have been Port-Menopausal for 11 years!


VAERS ID: 1577906 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-16
Onset:2021-08-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site coldness, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Junel FE 24 birth control
Current Illness: None
Preexisting Conditions: Anxiety
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received vaccine 3 PM on 8/16/21. Arm soreness persists, 12:15 AM 8/17/21 cold/numb/pins & needles starts in upper right arm and goes all the way down to fingertips on right arm. Went to ER around 1:30 AM 8/17/21. Doctor rules out allergic reaction. Doctor says likely injection pressing on nerve. 3:30 AM 8/17/21 leaves emergency room. 10:42 AM 8/17/21 arm soreness persists and numb/cold feeling as well.


VAERS ID: 1577928 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-04
Onset:2021-08-17
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / UNK RA / 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? 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: Postive for Covid-19 after being fully vaccinated.


VAERS ID: 1577944 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Abdominal discomfort, Blindness, Dyspnoea, Pruritus
SMQs:, Anaphylactic reaction (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Loratadine 10mg tablet PO PRN,
Current Illness: no illnesses at time of vaccination.
Preexisting Conditions: no chronic health conditions; Mother of patient is Hemophilia positive. Patient shows signs of hemophilia from frequent nose bleeds as well as bleeding more than normal during menstruation.
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient reported to the vaccination clinic to receive the 2nd dose of the Pfizer vaccine. after vaccination patient reported first symptom of having an upset stomach and began to lose vision while remaining conscious. The patient was moved from the vaccination chair onto a patient bed with head elevated and given an ice pack. after patient was placed on bed the patient still had loss of vision and the complained of itching on lower back area as well as difficulty breathing. Patient was given 0.3mL Adrenalin brand Epinephrine vial dose 1:1000 on L deltoid approximately 2 inches below vaccination site approximately 4 minutes after onset of symptoms. Vitals were monitored after Epinephrine administration and became stable. Emergency Department at the hospital was notified and reported to the room for transfer.


VAERS ID: 1577959 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-16
Onset:2021-08-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Oral herpes
SMQs:, Oropharyngeal infections (narrow), Opportunistic infections (broad)

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

Write-up: Herpes simplex 1 (cold sore) outbreak on lip started 22 hours after 2nd vaccine. No signs or symptoms prior to vaccine. I have not had a cold sore in 2+ years prior to getting vaccine.


VAERS ID: 1577984 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-19
Onset:2021-08-17
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest pain, Dyspnoea, Peripheral swelling, Pleural effusion, SARS-CoV-2 test positive
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: APRESOLINE, BREO ELLIPTA, BUMEX, COMPAZINE, COREG, CYMBALTA, GLUCOTROL, HCl, injection, iron, ISOVUE-370, LIDODERM, LIPITOR, HumaLOG, Magnesium, IMDUR, NITROSTAT, PERIDEX, PLAVIX, Propanediol, TEMOVATE, PROVENTIL, VENTOLIN, PROAIR, ROBITUSS
Current Illness:
Preexisting Conditions: Coronary artery disease , Mixed hyperlipidemia, Essential hypertension, Type 2 diabetes mellitus, Bilateral carotid artery stenosis, Anxiety and depression, S/P CABG x 3, History of left-sided carotid endarterectomy, Mitral valve insufficiency, H/O mitral valve repair, Ischemic cardiomyopathy, Chronic combined systolic and diastolic congestive heart failure, Nonrheumatic aortic valve insufficiency, Ejection fraction < 50%, PAH (pulmonary artery hypertension), Dyspnea on exertion, Arthritis, Chronic kidney disease due to hypertension, Disorder of carotid artery, Gastroesophageal reflux disease, Otheaortocoronary bypass graft, Pseudophakia of both eyes, Former smoker, Thoracic spine pain, Lung cancer metastatic to brain, Iron deficiency anemia
Allergies: Asprin
Diagnostic Lab Data: COVID Positive Result on 8/16/2021
CDC Split Type:

Write-up: Pt received both Pfizer vaccines. On August 16th, 2021, pt tested positive for COVID-19. Presented to ED with complaint of chest pain, SOB, leg swelling, and difficulty breathing, and was diagnosed with plural effusion.


VAERS ID: 1578055 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-16
Onset:2021-08-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Hot flush, Muscle spasms, Oropharyngeal pain, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: birth control
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: woke up with bad hot flashes, cramping in legs and whole body, chest is heavy, sore throat


VAERS ID: 1578058 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Hyperhidrosis, Immediate post-injection reaction, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: vital signs (o2, bp, pulse) wnl
CDC Split Type:

Write-up: Pt felt dizzy, clammy, sweaty immediately after receiving Janssen vaccine. EMS was called and pharmacist and store managers waited with her until they arrived. Pharmacist suspected she had fainted. She was responsive and aware, vitals wnl. After about 15-20min with EMS, patient felt better and was encouraged to eat and drink something before leaving.


VAERS ID: 1578093 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-01
Onset:2021-08-17
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 9C 3180 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Diplopia, Dizziness, Hypoaesthesia, Muscular weakness, Nausea, Paraesthesia, Syncope, Vertigo
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (narrow), Ocular motility disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (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: Birth control
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Vertigo, dizziness, fingers numb/tingly, while walking legs collapsed/weak, double vision, nausea


VAERS ID: 1578109 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-07-27
Onset:2021-08-17
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (broad)

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

Write-up: Patient had got J&J COVID vaccine in April. Patient registered to the website and did not disclose that he had a COVID vaccine already and was given first dose of Pfizer in July. Patient came today to get the second Pfizer vaccine and it was noted on his Regulatory Authority chart that he had J&J already and one dose of Pfizer. Patient did not receive 2nd Pfizer vaccine.


VAERS ID: 1578125 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Felt dizzy after vaccine. Gave patient water and took blood pressure. Patient said they were nervous leading up tot he vaccine but felt better not long after. Had patient wait an additional 15 mintues


VAERS ID: 1578157 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Discomfort, Electrocardiogram
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu vaccine Also Gave him tightness ion the chest and made it hard for him to breathe.
Other Medications: Vitamin D Fluoxetine.
Current Illness:
Preexisting Conditions:
Allergies: Flu shot Morphine
Diagnostic Lab Data: EKG CHEST X RAY
CDC Split Type:

Write-up: Patient stated that within the 15 min time frame he started having chest pains. He waited for about another 3o mins. He was still felling discomfort so he went to the emergency room. They ran some test and sent him home. He was advise to follow up with PCP.


VAERS ID: 1578172 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Needle issue
SMQs:, Medication errors (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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: Iodine
Diagnostic Lab Data:
CDC Split Type:

Write-up: during injection needle became detached from syringe while still in the patients arm. It is unknown the amount of vaccine administered to patient.


VAERS ID: 1578176 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-16
Onset:2021-08-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER FA7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Gait inability, Joint swelling, Musculoskeletal stiffness, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: The day after my first dose I could not walk. My left knee and left calf is very swollen. I cannot straighten my left leg or walk on it. It?s bent and I am in excruciating pain. All of my joints feel bruised and hurt.


VAERS ID: 1578200 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-11
Onset:2021-08-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A-1 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Oropharyngeal pain, Pyrexia, Swelling of eyelid
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Periorbital and eyelid disorders (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: Acetaminophen 500mg
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: The symptoms listed just started. Will require continued tracking for resolve. Low grade temp (99.0-100.4) Sore throat Swollen eyelids


VAERS ID: 1578239 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-16
Onset:2021-08-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Lethargy, Pain
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

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

Write-up: Headache, body ache, soreness, lethargic


VAERS ID: 1578294 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Computerised tomogram head normal, Crying, Dysarthria, Laboratory test, Nausea, Retching, Tremor, Unresponsive to stimuli, Ventilation/perfusion scan
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (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:
Allergies:
Diagnostic Lab Data: CT scan of lungs/head results Normal, waiting on lab results
CDC Split Type:

Write-up: Initially, crying shaking, able to verbally respond. 5 minutes later unresponsive for few seconds, able to verbally arouse. Progressed in a few minutes to nauseated, dry heaves, intervals of unresponsiveness, to awake, speech became slurred. Help called immediately. Blood pressure 170/100. Pulse rapid 100. Transferred to the emergency department. IV started Benadryl and Ativan administered, O2 via nasal cannula 3 liters.


VAERS ID: 1578299 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

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

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

Write-up: PATIENT PASSED OUT IMMEDIATELY AFTER RECEIVING VACCINATION. HE WAS ONLY OUT FOR LESS THAN 10 SECONDS AND THEN CAME TO. WE CALLED EMS TO CHECK HIM OUT. THEY WERE TO OUR STORE IN LESS THAN 5 MINUTES , CHECKED HIS VITALS, AND CLEARED HIM. HE IS FULLY RECOVERED NOW.


VAERS ID: 1578307 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Productive cough, Pruritus
SMQs:, Anaphylactic reaction (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: Inhaler for asthma
Current Illness: Asthma
Preexisting Conditions: Unknown other than asthma
Allergies: Unknown
Diagnostic Lab Data: Transported to ED
CDC Split Type:

Write-up: 32 minutes noted facial itching, mid sternal chest tightness. Started coughing and expectorating with cough. Informed staff she had used her inhaler prior to coming to the clinic for vaccination. BP 157/80 HR 80 Pulse oxy 100% on RA.


VAERS ID: 1578311 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (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: UNKNOWN
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE LISTED
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: PATIENT RECEIVED VACCINATION AND SAT DOWN FOR HER 15 MINUTE WAIT. WITHIN 5 MINUTES PT WAS VERY LIGHT HEADED, HAVING TROUBLE BREATHING (NOT DUE TO SWELLING), AND PINS AND NEEDLES IN HER HANDS


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