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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 122 out of 6,867

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VAERS ID: 1668489 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-23
Onset:2021-08-17
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 30A21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Cough, Pain, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (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, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, ascorbic acid, vit d, rose hips, ASA, B12, insulin, Xalatan, levothyroxine, lisinopril, multivitamin, fexofenadine, sertraline
Current Illness: shoulder pain
Preexisting Conditions: anxiety, CAD, chronic pain, Depression, DM, hypertension, hypothyroidism
Allergies: Tramadol
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/17/21: presents to ED with body aches, cough, congestion COVID POS in hospital started on dexametasone, remdesivir, zinc and baricitinib 8/25/21: discharged home


VAERS ID: 1669571 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-08-17
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Seasonal allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210858519

Write-up: RASH AROUND BOTH ANKLES, LEFT ANKLE HAD A SLIGHTLY ITCHY RASH THAT WENT ALMOST COMPLETELY AROUND HIS ANKLE AND THE RIGHT ANKLE HAS A PATCH OF THE SAME RASH; HIP AND KNEE PAIN; CHEMICAL FEELING; This spontaneous report received from a patient concerned a 60 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: seasonal pollen allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported and batch number: 203A21A, expiry: UNKNOWN) dose was not reported, administered on 17-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 17-AUG-2021, the patient experienced chemical feeling. On 17-AUG-2021, the patient experienced hip and knee pain. On 28-AUG-2021, the patient experienced rash around both ankles, left ankle had a slightly itchy rash that went almost completely around his ankle and the right ankle has a patch of the same rash. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chemical feeling, and hip and knee pain on AUG-2021, and had not recovered from rash around both ankles, left ankle had a slightly itchy rash that went almost completely around his ankle and the right ankle has a patch of the same rash. This report was non-serious.


VAERS ID: 1669580 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-08-17
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies, drug abuse or illicit drug use. No prior medical history.
Allergies:
Diagnostic Lab Data: Test Date: 20210817; Test Name: SARS-CoV-2 IgG antibody test; Result Unstructured Data: (-)1.00 negative antibody result; Test Date: 20210825; Test Name: SARS-CoV-2 IgG antibody test; Result Unstructured Data: (-)1.00 negative antibody result
CDC Split Type: USJNJFOC20210900296

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient concerned a 59 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non-alcohol user, and non smoker. The patient had no known allergies, and drug abuse or illicit drug use. Patient had no prior medical history. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 1805018, expiry: 23-AUG-2021) dose was not reported, 1 total, administered on 11-MAR-2021 to left arm for prophylactic vaccination. No concomitant medications were reported. On 17-AUG-2021 and 25-AUG-2021, Patient tested for SARS-COV-2 IgG spike semi quantitative blood test two times and both the results were negative (-)1.00 for antibodies (coded to confirmed immunological vaccine failure). As per the test procedure, a result of 1.00 or more (positive) meant that antibodies to SARS-CoV-2 get detected in the blood sample by the test, and result less than 1.00 (negative) meant that antibodies do not get detected in the blood sample by the test. The patient was anxious about not being immune from the vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with a product quality complaint.; Sender''s Comments: V0: 20210900296-Covid-19 vaccine ad26.cov2.s-Confirmed immunological vaccine failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1669854 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Presyncope
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Mild, Additional Details: vasovagal symptoms post injection


VAERS ID: 1670266 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-08-16
Onset:2021-08-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 AR / IM

Administered by: Military       Purchased by: ?
Symptoms: Blood creatine phosphokinase normal, Blood thyroid stimulating hormone normal, Dizziness, Fatigue, Full blood count normal, Headache, Metabolic function test normal, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Seasonal allergies
Allergies: N/A
Diagnostic Lab Data: CBC, TSH, BMP and CK all normal 8/23
CDC Split Type:

Write-up: Severe fatigue, HA, nausea and dizziness since 8/17, pt received vaccine 8/16


VAERS ID: 1670290 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Chest discomfort, Dysgeusia, Dysphagia, Dyspnoea, Injection site irritation, Injection site urticaria, Mouth swelling, Pain in extremity, Peripheral swelling, Pharyngeal swelling, Swollen tongue
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lo Loestrin FE Zyrtec
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: metronidazole gel
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Within a few minutes experienced tightness in my chest, difficulty swallowing and catching my breath and then feeling like my throat and tongue were swollen and a metallic taste in my mouth that lingered for over an hour. Elevated blood pressure, but oxygen levels were ok. Was monitored for 30 minutes until blood pressure returned normal and i could swallow. Returned home and took 4 benadryl over the course of 4 hours, throat, mouth and tongue remained swollen through Thursday, 19 AUG - PCP ordered prednisone which was taken starting Wednesday. Upon removing bandaid from injection site - there were hives and irritation, arm was swollen and painful for over 4 days.


VAERS ID: 1670419 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-26
Onset:2021-08-17
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH O23D21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abortion spontaneous, Blood test abnormal, Erythema, Exposure during pregnancy, Tenderness
SMQs:, Anaphylactic reaction (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Redness in arm and tenderness in arm for 2 weeks after - Miscarriage happened in pregnancy.


VAERS ID: 1670456 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Dyspnoea, Heart rate increased, Hypertension, Laboratory test, Mast cell activation syndrome, Peripheral swelling, Pollakiuria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: synthroid, xyzal, metropolol, pepcid, zinc, vitamin c, multi vitamin, welchol, quercetin, atarax, singulair,potassium, advair, coQ10, atorvastatitn
Current Illness: none
Preexisting Conditions: Ehlers-danlos syndrome, mast cell disorder, hypertension, POTS dysautonomia
Allergies: shellfish, penicillin, demerol, codeine, morphine
Diagnostic Lab Data: 9/3/2021 awaiting results
CDC Split Type:

Write-up: developed mast cell symptoms of reactions, leg swelling, trouble breathing, high heart rate and blood pressure, urinating a lot and developing severe hypertension 230/120 HR 100-140 within days and requiring IV saline treatments several times since this day and added mast cell blockers like atarax


VAERS ID: 1670591 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-08-03
Onset:2021-08-17
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Decreased appetite, Diarrhoea, Dizziness, Faeces discoloured, Neck pain, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (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: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None yet.
CDC Split Type:

Write-up: First 3 days, Left arm Hurt. That has gone away. Second week through presently, Pain in back of neck on left side, running down along left shoulder blade. Beginning third week, feeling dizzy and week, loss of appetite, dark / black color stool. Beginning 9/3/2021 stomach growling and diarrhea.


VAERS ID: 1670596 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1670653 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1670670 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1670738 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1671400 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-27
Onset:2021-08-17
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059ELIA / 1 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dizziness, Echocardiogram, Electrocardiogram, Fatigue, Nausea, Pericarditis
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Centrum Multivitamin Venlafaxine 75 mg daily
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: EKG 8/18/21, Echocardiogram 8/19/21; Repeat EKG 8/24/21
CDC Split Type:

Write-up: Pericarditis (symptoms included dizziness, chest pain, nausea, extreme fatigue); Treated with Colchicine; resolved adequately after approximately one week


VAERS ID: 1671907 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Allergy to vaccine, Arthralgia, Blood test, Chest X-ray, Decreased appetite, Fatigue, Headache, Hypersensitivity, Injection site pain, Injection site warmth, Malaise, Mobility decreased, Myalgia, Night sweats, Peripheral swelling, Pyrexia, Rash, SARS-CoV-2 test, Screaming, X-ray limb
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nil
Current Illness: Psoriasis
Preexisting Conditions: Psoriasis
Allergies: Nil
Diagnostic Lab Data: Chest, shoulder, hand x-rays. Blood tests, COVID-19 tests. No idea of results.
CDC Split Type:

Write-up: Injection ASTRAZENECA received Monday 16th August 4:30pm. Tuesday afternoon 17th August (24hrs post-vaccination): headache, malaise, pain at the injection site, injection site warm to touch Wednesday afternoon 18th August (48hrs post-vaccination): malaise, tiredness, muscular and joint pain, rash, pain at the injection site, fever, night sweats, loss of appetite Thursday afternoon 19th August (72hrs post-vaccination): malaise, extreme muscular and joint pain, swelling of extremities (hands/feet/wrists/ankles), unable to lift both arms, extreme pain in hip, pain at injection site, fever, night sweats, loss of appetite - these symptoms continued until escalation of pain approximately 11:30pm Saturday night. Saturday 21st August 11pm: Patient screaming in pain. Extreme pain in all joints and muscles. Rash present on lower legs, inside thighs, abdomen (front and back), upper arms, underarms. Patient still unable to lift arms. Called health advice line. Transferred to ambulance line. Ambulance transported patient to hospital just before 1am Sunday morning. Hospital advised extreme allergic reaction to ASTRAZENECA vaccination. Held for observation until just after 7am Sunday morning. Discharged and advised to rest for a week and to make appointment with immunology clinic to assess if should receive another vaccine. Slight improvement of condition Wednesday 01st September - able to lift left arm but still unable to lift right arm. Thursday 02nd September patient relapse with re-emergence of all symptoms previously indicated - cannot lift either arm, cannot close hands, swelling of extremities. Friday 03rd September 8am: Patient started screaming in pain shortly after waking up. Extreme joint and muscle pain. Admitted to hospital. Receiving Endone (unknown dosage) and prednisone(?). Some subsidence of pain and swelling symptoms at 3:30pm Saturday 04th September.


VAERS ID: 1671911 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-16
Onset:2021-08-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Blood test, Chest pain, Condition aggravated, Dyspnoea, Feeling abnormal, Insomnia, Panic attack
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: Flu vaccine several years ago resulted in vomiting, chills, bowel issues
Other Medications: none
Current Illness: none
Preexisting Conditions: generalized anxiety
Allergies: possible shellfish possible buspar
Diagnostic Lab Data: Blood work to rule out pericarditis (chest pain). Blood pressure checked. Pulse/O2 levels with fingertip scanner.
CDC Split Type:

Write-up: Short-lived sharp chest pain across lung area, entire width of chest 12 hours after injection. Panic attack at 7 days with chest pains that varied in location and sensation. Insomnia began at about 10 days. Shortness of breath for hours at a time began around 12 days with Insomnia. Heavy anxiety since the 7 day mark, just don''t feel normal, never felt this way in my life.


VAERS ID: 1672450 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 - / OT

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

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

Write-up: Hives; This spontaneous case was reported by a pharmacist and describes the occurrence of URTICARIA (Hives) in an 18-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 051C21A) 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 17-Aug-2021, the patient experienced URTICARIA (Hives). At the time of the report, URTICARIA (Hives) 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. Concomitant medication was not provided. Treatment information was not reported. Patient who received the Moderna vaccine 30 minute ago and now has hives, but not all over the body.


VAERS ID: 1672451 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2020-12-01
Onset:2021-08-17
   Days after vaccination:259
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: Product dose omission 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: first dose of Moderna Covid-19 vaccine in December 2020; waited 8 months after 1st dose can I still receive 2nd dose; This spontaneous case was reported by an other health care professional and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (first dose of Moderna Covid-19 vaccine in December 2020; waited 8 months after 1st dose can I still receive 2nd dose) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In December 2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Aug-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (first dose of Moderna Covid-19 vaccine in December 2020; waited 8 months after 1st dose can I still receive 2nd dose). At the time of the report, PRODUCT DOSE OMISSION ISSUE (first dose of Moderna Covid-19 vaccine in December 2020; waited 8 months after 1st dose can I still receive 2nd dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication were provided No treatment information was provided.


VAERS ID: 1672452 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-16
Onset:2021-08-17
   Days after vaccination:1
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: Body temperature decreased, Feeling cold, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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: Test Date: 20210817; Test Name: BODY TEMPERATURE; Result Unstructured Data: -0 degree temperature
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: his body started shaking so much; His whole body was "very very cold" and "extremely cold."; He said his body is in -0 degree temperature; This spontaneous case was reported by a consumer and describes the occurrence of TREMOR (his body started shaking so much), FEELING COLD (His whole body was "very very cold" and "extremely cold.") and BODY TEMPERATURE DECREASED (He said his body is in -0 degree temperature) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 16-Aug-2021 at 6:15 PM, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Aug-2021, the patient experienced TREMOR (his body started shaking so much) and FEELING COLD (His whole body was "very very cold" and "extremely cold."). 17-Aug-2021, the patient experienced BODY TEMPERATURE DECREASED (He said his body is in -0 degree temperature). At the time of the report, TREMOR (his body started shaking so much), FEELING COLD (His whole body was "very very cold" and "extremely cold.") and BODY TEMPERATURE DECREASED (He said his body is in -0 degree temperature) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 17-Aug-2021, Body temperature decreased: decreased (Low) -0 degree temperature. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication information was provided. No treatment medication information was provided. Reporter did not allow further contact


VAERS ID: 1672464 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 1 - / 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: Inadvertently gave a 1st Moderna dose to a 13 year old today; This spontaneous case was reported by a nurse and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Inadvertently gave a 1st Moderna dose to a 13 year old today) in a 13-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040B21A) 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 17-Aug-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Inadvertently gave a 1st Moderna dose to a 13 year old today). On 17-Aug-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Inadvertently gave a 1st Moderna dose to a 13 year old today) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. Treatment information was not provided by the reporter.


VAERS ID: 1672477 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 - / OT
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH END187 / 1 - / OT

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? 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 the Pfizer vaccine first dose 21 days ago and today, 17Aug2021, got a dose of the Moderna vaccine as a second dose; This spontaneous case was reported by a pharmacist and describes the occurrence of INTERCHANGE OF VACCINE PRODUCTS (got the Pfizer vaccine first dose 21 days ago and today, 17Aug2021, got a dose of the Moderna vaccine as a second dose) in an 18-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 053E21A) for COVID-19 vaccination. Co-suspect product included non-company product TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) 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) (unknown route) 1 dosage form. On an unknown date, the patient received first dose of TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) (unknown route) 1 dosage form. On 17-Aug-2021, the patient experienced INTERCHANGE OF VACCINE PRODUCTS (got the Pfizer vaccine first dose 21 days ago and today, 17Aug2021, got a dose of the Moderna vaccine as a second dose). On 17-Aug-2021, INTERCHANGE OF VACCINE PRODUCTS (got the Pfizer vaccine first dose 21 days ago and today, 17Aug2021, got a dose of the Moderna vaccine as a second dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Treatment medication were not reported. Patient takes some medication but nothing long term.


VAERS ID: 1672489 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 1 - / 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: 1 dose of Moderna COVID 19 vaccine given to a patient who is 17 years old; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (1 dose of Moderna COVID 19 vaccine given to a patient who is 17 years old) in a 17-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026C21A) 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) (unknown route) 1 dosage form. On 17-Aug-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (1 dose of Moderna COVID 19 vaccine given to a patient who is 17 years old). On 17-Aug-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (1 dose of Moderna COVID 19 vaccine given to a patient who is 17 years old) 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.


VAERS ID: 1672490 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Heart rate, Heart rate increased, Myalgia, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BIOTIN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Heart beat; Result Unstructured Data: 75-80 beats per minute; Test Date: 20210817; Test Name: Heart beat; Result Unstructured Data: Fast heart beat around 6-7 PM 80-100 beats per minute
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Soreness of arm; Fever; Body aches; Headache; Heart beat increased to 80-100 beats per minute; This spontaneous case was reported by a nurse and describes the occurrence of PAIN IN EXTREMITY (Soreness of arm), HEART RATE INCREASED (Heart beat increased to 80-100 beats per minute), PYREXIA (Fever), MYALGIA (Body aches) and HEADACHE (Headache) in a 19-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939902) for COVID-19 vaccination. Concomitant products included BIOTIN for an unknown indication. On 17-Aug-2021 at 11:30 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Aug-2021, the patient experienced HEART RATE INCREASED (Heart beat increased to 80-100 beats per minute). On 18-Aug-2021, the patient experienced PAIN IN EXTREMITY (Soreness of arm), PYREXIA (Fever), MYALGIA (Body aches) and HEADACHE (Headache). At the time of the report, PAIN IN EXTREMITY (Soreness of arm), HEART RATE INCREASED (Heart beat increased to 80-100 beats per minute), PYREXIA (Fever), MYALGIA (Body aches) and HEADACHE (Headache) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 17-Aug-2021, Heart rate: 80-100 (High) Fast heart beat around 6-7 PM 80-100 beats per minute. On an unknown date, Heart rate: 75-80 (normal) 75-80 beats per minute. 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. Concomitant drugs includes Birth Control No Treatment information was reported.


VAERS ID: 1672515 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:2021-07-20
Onset:2021-08-17
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006021A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Myalgia, Pain in extremity
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: METFORMIN; ASPIRIN 1000; ATORVASTATIN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: arm pain; muscle pain; Headache; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (arm pain), MYALGIA (muscle pain) and HEADACHE (Headache) in a 57-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 053E21A and 006021A) for COVID-19 vaccination. Concomitant products included METFORMIN, ACETYLSALICYLIC ACID (ASPIRIN 1000) and ATORVASTATIN for an unknown indication. On 20-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 17-Aug-2021, the patient experienced PAIN IN EXTREMITY (arm pain), MYALGIA (muscle pain) and HEADACHE (Headache). At the time of the report, PAIN IN EXTREMITY (arm pain), MYALGIA (muscle pain) and HEADACHE (Headache) outcome was unknown. Treatment medications were not provided by the reporter.


VAERS ID: 1672533 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-13
Onset:2021-08-17
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Extra dose administered, Fatigue, 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:
Other Medications:
Current Illness: Multiple sclerosis (diagnosed 6 years ago)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Horrible severe fatigue; Multiple joint worse than what she normally experiences with her multiple sclerosis; Muscle pain worse than what she normally experiences with her multiple sclerosis; Extra dose administered; This spontaneous case was reported by a consumer and describes the occurrence of EXTRA DOSE ADMINISTERED (Extra dose administered), FATIGUE (Horrible severe fatigue), ARTHRALGIA (Multiple joint worse than what she normally experiences with her multiple sclerosis) and MYALGIA (Muscle pain worse than what she normally experiences with her multiple sclerosis) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 017E21A, 012M20A and 012L20A) for COVID-19 vaccination. Concurrent medical conditions included Multiple sclerosis (diagnosed 6 years ago). On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Feb-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 17-Aug-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXTRA DOSE ADMINISTERED (Extra dose administered). On 18-Aug-2021, the patient experienced FATIGUE (Horrible severe fatigue), ARTHRALGIA (Multiple joint worse than what she normally experiences with her multiple sclerosis) and MYALGIA (Muscle pain worse than what she normally experiences with her multiple sclerosis). The patient was treated with PARACETAMOL (TYLENOL) ongoing since an unknown date for Adverse event, at an unspecified dose and frequency. On 17-Aug-2021, EXTRA DOSE ADMINISTERED (Extra dose administered) had resolved. At the time of the report, FATIGUE (Horrible severe fatigue), ARTHRALGIA (Multiple joint worse than what she normally experiences with her multiple sclerosis) and MYALGIA (Muscle pain worse than what she normally experiences with her multiple sclerosis) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient stated that about 24 hours after getting the booster shot, she had horrible severe fatigue, multiple joint and muscle pain; worse than what she normally experiences with her multiple sclerosis. She also used Medical Marijuana gummies; but she was still having the symptoms. Her husband stated that she takes lots of other medication but did not provide them.


VAERS ID: 1672541 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-19
Onset:2021-08-17
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027D21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Vaccination site erythema, Vaccination site swelling, Vaccination site warmth
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210817; Test Name: Body temperature; Result Unstructured Data: Running high temperature, two lines over 102
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Very hot to the touch; Very red around injection site; Swollen at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Very hot to the touch), VACCINATION SITE ERYTHEMA (Very red around injection site) and VACCINATION SITE SWELLING (Swollen at the injection site) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 088D21A and 027D21A) for COVID-19 vaccination. No Medical History information was reported. On 19-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 17-Aug-2021, the patient experienced VACCINATION SITE WARMTH (Very hot to the touch), VACCINATION SITE ERYTHEMA (Very red around injection site) and VACCINATION SITE SWELLING (Swollen at the injection site). At the time of the report, VACCINATION SITE WARMTH (Very hot to the touch), VACCINATION SITE ERYTHEMA (Very red around injection site) and VACCINATION SITE SWELLING (Swollen at the injection site) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 17-Aug-2021, Body temperature: high (High) Running high temperature, two lines over 102. No concomitant medications were reported. The patient kept ice on vaccination site as her Pharmacist recommended to do.


VAERS ID: 1672546 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:2021-02-02
Onset:2021-08-17
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose administered, Vaccination site pain
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: USMODERNATX, INC.MOD20212

Write-up: Received her booster dose of the Moderna Covid-19 vaccine; her injection site arm was sore; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (her injection site arm was sore) and EXTRA DOSE ADMINISTERED (Received her booster dose of the Moderna Covid-19 vaccine) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 939901, 001B21A and 013M20A) for COVID-19 vaccination. No Medical History information was reported. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-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 17-Aug-2021, the patient experienced VACCINATION SITE PAIN (her injection site arm was sore). On an unknown date, the patient experienced EXTRA DOSE ADMINISTERED (Received her booster dose of the Moderna Covid-19 vaccine). At the time of the report, VACCINATION SITE PAIN (her injection site arm was sore) and EXTRA DOSE ADMINISTERED (Received her booster dose of the Moderna Covid-19 vaccine) outcome was unknown. Patient Date of Birth was mentioned as 13May (declined yr) Concomitant product use was not provided by the reporter. Treatment information was not provided. This case was linked to MOD-2021-291045.


VAERS ID: 1672634 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-10
Onset:2021-08-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Hot flush, Peripheral swelling, Post-acute COVID-19 syndrome, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (narrow)

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

Write-up: She is referring it as a covid arm.; A week later, her left arm was very itchy; It was red; It was hot to touch; It was swollen; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (A week later, her left arm was very itchy), ERYTHEMA (It was red), HOT FLUSH (It was hot to touch), PERIPHERAL SWELLING (It was swollen) and POST-ACUTE COVID-19 SYNDROME (She is referring it as a covid arm.) in a 23-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 078C21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Aug-2021, the patient experienced PRURITUS (A week later, her left arm was very itchy), ERYTHEMA (It was red), HOT FLUSH (It was hot to touch) and PERIPHERAL SWELLING (It was swollen). On an unknown date, the patient experienced POST-ACUTE COVID-19 SYNDROME (She is referring it as a covid arm.). At the time of the report, PRURITUS (A week later, her left arm was very itchy), ERYTHEMA (It was red), HOT FLUSH (It was hot to touch), PERIPHERAL SWELLING (It was swollen) and POST-ACUTE COVID-19 SYNDROME (She is referring it as a covid arm.) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided. Anti-histamine was used for treatment. Reporter did not allow further contact


VAERS ID: 1672670 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-01
Onset:2021-08-17
   Days after vaccination:197
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: Mass
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Little lumps inside his forearms, calf muscle, and veins,some are small and some are the size of little socket holes; This spontaneous case was reported by a consumer and describes the occurrence of MASS (Little lumps inside his forearms, calf muscle, and veins,some are small and some are the size of little socket holes) in a 48-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In February 2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In February 2021, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 17-Aug-2021, the patient experienced MASS (Little lumps inside his forearms, calf muscle, and veins,some are small and some are the size of little socket holes). At the time of the report, MASS (Little lumps inside his forearms, calf muscle, and veins,some are small and some are the size of little socket holes) had not resolved. Concomitant medications were not provided by the reporter. Treatment information was not provided. Patient was slim and could see the veins easily, he had seen 20-30 or more small lumps and he had never seen them there before. He noticed these small lumps look like blood clots. Some are small, and some are the size of little socket holes, or like filling bubble on the floor. It has been 6 months now since his vaccination. He''s concerned whether these are blood clots.


VAERS ID: 1672676 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-16
Onset:2021-08-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Myalgia, Pyrexia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: a rash on her neck,rash on her chest ,rash on her stomach; a fever; a headache; Body aches; This spontaneous case was reported by a consumer and describes the occurrence of RASH (a rash on her neck,rash on her chest ,rash on her stomach), PYREXIA (a fever), HEADACHE (a headache) and MYALGIA (Body aches) in a 20-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088D21A) 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) (unknown route) 1 dosage form. On 17-Aug-2021, the patient experienced PYREXIA (a fever), HEADACHE (a headache) and MYALGIA (Body aches). On 18-Aug-2021, the patient experienced RASH (a rash on her neck,rash on her chest ,rash on her stomach). On 18-Aug-2021, PYREXIA (a fever), HEADACHE (a headache) and MYALGIA (Body aches) had resolved. At the time of the report, RASH (a rash on her neck,rash on her chest ,rash on her stomach) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication were not reported. Treatment medication were not reported.


VAERS ID: 1672699 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-07-23
Onset:2021-08-17
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Nasal congestion
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:
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 NASAL CONGESTION (Stuffy nose couple days ago) in a sixty-four-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (Batch no. 051C21A) for COVID-19 vaccination. No Medical History information was reported. On 23-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Aug-2021, the patient experienced NASAL CONGESTION (Stuffy nose couple days ago). At the time of the report, NASAL CONGESTION (Stuffy nose couple days ago) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication of the patient was not reported. No treatment information was provided by the reporter. The patient was scheduled to take his second shot vaccine.


VAERS ID: 1672713 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Erythema, Feeling hot, Peripheral swelling, Pyrexia, Vaccination site erythema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: chills; fever; arm is red; arm is swollen; arm is warm to the touch; I continue to have redness around my injection site and down my arm.; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (arm is red), PERIPHERAL SWELLING (arm is swollen), FEELING HOT (arm is warm to the touch), VACCINATION SITE ERYTHEMA (I continue to have redness around my injection site and down my arm.) and CHILLS (chills) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was reported. Concomitant products included PARACETAMOL (TYLENOL) for an unknown indication. On 17-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Aug-2021, the patient experienced ERYTHEMA (arm is red), PERIPHERAL SWELLING (arm is swollen), FEELING HOT (arm is warm to the touch) and VACCINATION SITE ERYTHEMA (I continue to have redness around my injection site and down my arm.). On 18-Aug-2021, the patient experienced CHILLS (chills) and PYREXIA (fever). On 18-Aug-2021, CHILLS (chills) and PYREXIA (fever) had resolved. At the time of the report, ERYTHEMA (arm is red), PERIPHERAL SWELLING (arm is swollen), FEELING HOT (arm is warm to the touch) and VACCINATION SITE ERYTHEMA (I continue to have redness around my injection site and down my arm.) outcome was unknown. It was reported that the patient had received a booster dose on 17-AUG-2021. patient received first dose on 08-FEB-2021 and second dose on 08-MAR-2021. No treatment information was provided. This case was linked to MOD-2021-292485 (Patient Link).


VAERS ID: 1672727 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-17
Onset:2021-08-17
   Days after vaccination:122
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051E21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cold sweat, Fatigue, Headache, Hyperhidrosis, Illness, Pyrexia, Vaccination site pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: feels like I''m sweating right now; a little bit clammy; yucky; a bit tired; had a fever; really bad headache; arm got quite sore for about a day and a half; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (arm got quite sore for about a day and a half), HYPERHIDROSIS (feels like I''m sweating right now), COLD SWEAT (a little bit clammy), ILLNESS (yucky) and FATIGUE (a bit tired) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 051E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 17-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Aug-2021, the patient experienced VACCINATION SITE PAIN (arm got quite sore for about a day and a half). On 20-Aug-2021, the patient experienced HYPERHIDROSIS (feels like I''m sweating right now), COLD SWEAT (a little bit clammy), ILLNESS (yucky), FATIGUE (a bit tired), PYREXIA (had a fever) and HEADACHE (really bad headache). The patient was treated with PARACETAMOL (TYLENOL) for Adverse reaction, at an unspecified dose and frequency. On 18-Aug-2021, VACCINATION SITE PAIN (arm got quite sore for about a day and a half) had resolved. At the time of the report, HYPERHIDROSIS (feels like I''m sweating right now), COLD SWEAT (a little bit clammy), ILLNESS (yucky), FATIGUE (a bit tired), PYREXIA (had a fever) and HEADACHE (really bad headache) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosing remained unchanged. No concomitant medications provided. Patient does not have a spleen.


VAERS ID: 1672765 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-04
Onset:2021-08-17
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Pyrexia, Vaccination site erythema, Vaccination site pruritus, Vaccination site warmth
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CRESTOR; OMEPRAZOLE; MULTIVITAMINS [VITAMINS NOS]; PROBIOTICS NOS
Current Illness:
Preexisting Conditions: Comments: No medical history information was reported.
Allergies:
Diagnostic Lab Data: Test Date: 20210817; Test Name: body temperature; Result Unstructured Data: low grade fever, under 100 degrees Fahrenheit
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: she started to develop itching in the arm a little bit right at the injection site, it was hot, red around it.; she started to develop itching in the arm a little bit right at the injection site, it was hot, red around it.; she started to develop itching in the arm a little bit right at the injection site, it was hot, red around it.; low grade fever, under 100 degrees Fahrenheit; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (she started to develop itching in the arm a little bit right at the injection site, it was hot, red around it.), VACCINATION SITE PRURITUS (she started to develop itching in the arm a little bit right at the injection site, it was hot, red around it.), VACCINATION SITE ERYTHEMA (she started to develop itching in the arm a little bit right at the injection site, it was hot, red around it.) and PYREXIA (low grade fever, under 100 degrees Fahrenheit) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006D21A) for COVID-19 vaccination. No medical history information was reported. Concomitant products included ROSUVASTATIN CALCIUM (CRESTOR), OMEPRAZOLE, MULTIVITAMINS [VITAMINS NOS] and PROBIOTICS NOS for an unknown indication. On 04-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Aug-2021, the patient experienced VACCINATION SITE WARMTH (she started to develop itching in the arm a little bit right at the injection site, it was hot, red around it.), VACCINATION SITE PRURITUS (she started to develop itching in the arm a little bit right at the injection site, it was hot, red around it.), VACCINATION SITE ERYTHEMA (she started to develop itching in the arm a little bit right at the injection site, it was hot, red around it.) and PYREXIA (low grade fever, under 100 degrees Fahrenheit). On 21-Aug-2021, VACCINATION SITE ERYTHEMA (she started to develop itching in the arm a little bit right at the injection site, it was hot, red around it.) had resolved. At the time of the report, VACCINATION SITE WARMTH (she started to develop itching in the arm a little bit right at the injection site, it was hot, red around it.), VACCINATION SITE PRURITUS (she started to develop itching in the arm a little bit right at the injection site, it was hot, red around it.) and PYREXIA (low grade fever, under 100 degrees Fahrenheit) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 17-Aug-2021, Body temperature: under 100 degrees fahrenheit (High) low grade fever, under 100 degrees Fahrenheit. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment information were not provided by the reporter. It was reported that the pinkness had gone. Most recent FOLLOW-UP information incorporated above includes: On 23-Aug-2021: Follow up information received included event outcome updated (Resolved) .


VAERS ID: 1672771 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-03
Onset:2021-08-17
   Days after vaccination:14
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: Diarrhoea, Hypoaesthesia oral, Lip swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (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: USMODERNATX, INC.MOD20212

Write-up: Swollen Lips; Numb Lips; Diarrhea; This spontaneous case was reported by a consumer and describes the occurrence of LIP SWELLING (Swollen Lips), HYPOAESTHESIA ORAL (Numb Lips) and DIARRHOEA (Diarrhea) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Aug-2021, the patient experienced LIP SWELLING (Swollen Lips), HYPOAESTHESIA ORAL (Numb Lips) and DIARRHOEA (Diarrhea). At the time of the report, LIP SWELLING (Swollen Lips), HYPOAESTHESIA ORAL (Numb Lips) and DIARRHOEA (Diarrhea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications was not reported. Treatment information was not provided.


VAERS ID: 1672817 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-04
Onset:2021-08-17
   Days after vaccination:225
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Body temperature, Decreased appetite, Erythema, Feeling abnormal, Incorrect dose administered, Pruritus, Pyrexia, Rash macular, Vaccination site vesicles
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cancer
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: high
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: no appetite; huge red blotch under vaccination site the size of a mango; which blistered and peeled; left breast red/part of right breast were all red; breasts were real itchy; 2nd dose 08Feb2021/3rd on16Aug; has no energy; On the day after her 3rd shot she woke up with a mild 99.3 fever; felt like freight train ran over her; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (felt like freight train ran over her), DECREASED APPETITE (no appetite), RASH MACULAR (huge red blotch under vaccination site the size of a mango), VACCINATION SITE VESICLES (which blistered and peeled) and ERYTHEMA (left breast red/part of right breast were all red) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 002F21A, 010M20A and 012L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Cancer. On 04-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 17-Aug-2021, the patient experienced FEELING ABNORMAL (felt like freight train ran over her) and PYREXIA (On the day after her 3rd shot she woke up with a mild 99.3 fever). On 20-Aug-2021, the patient experienced ASTHENIA (has no energy). On an unknown date, the patient experienced DECREASED APPETITE (no appetite), RASH MACULAR (huge red blotch under vaccination site the size of a mango), VACCINATION SITE VESICLES (which blistered and peeled), ERYTHEMA (left breast red/part of right breast were all red), PRURITUS (breasts were real itchy) and INCORRECT DOSE ADMINISTERED (2nd dose 08Feb2021/3rd on16Aug). At the time of the report, FEELING ABNORMAL (felt like freight train ran over her), DECREASED APPETITE (no appetite), RASH MACULAR (huge red blotch under vaccination site the size of a mango), VACCINATION SITE VESICLES (which blistered and peeled), ERYTHEMA (left breast red/part of right breast were all red), PRURITUS (breasts were real itchy) and PYREXIA (On the day after her 3rd shot she woke up with a mild 99.3 fever) was resolving and ASTHENIA (has no energy) and INCORRECT DOSE ADMINISTERED (2nd dose 08Feb2021/3rd on16Aug) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 99.3 (High) high. Concomitant medication were not reported. Treatment medication were not reported. Patent was a cancer survivor This case was linked to MOD-2021-293260 (Patient Link).


VAERS ID: 1672970 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-08
Onset:2021-08-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Pyrexia, SARS-CoV-2 test
SMQs:, 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? 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: 20210819; Test Name: SARS-CoV-2 test; Test Result: Positive; Result Unstructured Data: tested positive for COVID
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Tested positive for COVID after first dose; started to feel a fever; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (started to feel a fever) and COVID-19 (Tested positive for COVID after first dose) in an 18-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 062E21A) for COVID-19 vaccination. No Medical History information was reported. On 08-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Aug-2021, the patient experienced PYREXIA (started to feel a fever). On 19-Aug-2021, the patient experienced COVID-19 (Tested positive for COVID after first dose). At the time of the report, PYREXIA (started to feel a fever) and COVID-19 (Tested positive for COVID after first dose) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 19-Aug-2021, SARS-CoV-2 test: tested positive for covid (Positive) tested positive for COVID. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Their first symptoms were 16 Aug 2021, started to feel a fever on 17 Aug 2021 and they got the positive result for COVID on 19 Aug 2021. Concomitant product use was not provided by the reporter. Treatment information was not provided. This case was linked to MOD-2021-293904 (Patient Link).


VAERS ID: 1672975 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-16
Onset:2021-08-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A OR 602F / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Dizziness, Fatigue, Headache, Pyrexia, Rash pruritic, Varicella
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (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: KEPPRA [LEVETIRACETAM]; EPINEPHRINE
Current Illness: Allergy (reacting weird to a lot of stuff); Allergy to arthropod sting; Epilepsy
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Dizzy; Dry cough; Little bit of fever; Bumps on her left front side, like if it was chickenpox/Bumps on inner thigh/One bump got "really agitated"/Bum was getting quite large; Super itchy; Pinchy Headache; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of VARICELLA (Bumps on her left front side, like if it was chickenpox/Bumps on inner thigh/One bump got "really agitated"/Bum was getting quite large), RASH PRURITIC (Super itchy), DIZZINESS (Dizzy), COUGH (Dry cough) and PYREXIA (Little bit of fever) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002F21A or 602F21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19. Previously administered products included for an unreported indication: FLU VACCINE VII in 2013. Concurrent medical conditions included Epilepsy, Allergy (reacting weird to a lot of stuff) and Allergy to arthropod sting. Concomitant products included EPINEPHRINE for Anaphylactic reaction, LEVETIRACETAM (KEPPRA [LEVETIRACETAM]) for Epilepsy. On 16-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Aug-2021, the patient experienced HEADACHE (Pinchy Headache) and FATIGUE (Fatigue). On 19-Aug-2021, the patient experienced VARICELLA (Bumps on her left front side, like if it was chickenpox/Bumps on inner thigh/One bump got "really agitated"/Bum was getting quite large) and RASH PRURITIC (Super itchy). On 23-Aug-2021, the patient experienced DIZZINESS (Dizzy), COUGH (Dry cough) and PYREXIA (Little bit of fever). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL ITCH) (topical) for Itch, at an unspecified dose and frequency. On 19-Aug-2021, FATIGUE (Fatigue) had resolved. At the time of the report, VARICELLA (Bumps on her left front side, like if it was chickenpox/Bumps on inner thigh/One bump got "really agitated"/Bum was getting quite large), RASH PRURITIC (Super itchy), DIZZINESS (Dizzy), COUGH (Dry cough), PYREXIA (Little bit of fever) and HEADACHE (Pinchy Headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.


VAERS ID: 1673032 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Muscle spasms, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (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: ATORVASTATIN; LEVOTHYROXINE; OLMESARTAN
Current Illness:
Preexisting Conditions: Comments: No medical history provided by the reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: muscle cramps in her both feet/left leg had horrible cramp up to her calf which lasted almost 5 minutes; left arm was very sore for a day; This spontaneous case was reported by a consumer and describes the occurrence of MUSCLE SPASMS (muscle cramps in her both feet/left leg had horrible cramp up to her calf which lasted almost 5 minutes) and MYALGIA (left arm was very sore for a day) in an 80-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 053E21A) for COVID-19 vaccination. No medical history provided by the reporter. Concomitant products included ATORVASTATIN, LEVOTHYROXINE and OLMESARTAN for an unknown indication. On 17-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Aug-2021, the patient experienced MUSCLE SPASMS (muscle cramps in her both feet/left leg had horrible cramp up to her calf which lasted almost 5 minutes) and MYALGIA (left arm was very sore for a day). At the time of the report, MUSCLE SPASMS (muscle cramps in her both feet/left leg had horrible cramp up to her calf which lasted almost 5 minutes) and MYALGIA (left arm was very sore for a day) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No treatment medication were provided by the reporter


VAERS ID: 1673034 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-12
Onset:2021-08-17
   Days after vaccination:186
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: Hypersensitivity, Inappropriate schedule of product administration, Influenza like illness
SMQs:, Angioedema (broad), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Allergic reaction; Received his booster, third shot; Feels like he is "sick with the flu"; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (Feels like he is "sick with the flu"), HYPERSENSITIVITY (Allergic reaction) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received his booster, third shot) in a 68-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 12-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-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 17-Aug-2021, the patient experienced INFLUENZA LIKE ILLNESS (Feels like he is "sick with the flu"). 17-Aug-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received his booster, third shot). On an unknown date, the patient experienced HYPERSENSITIVITY (Allergic reaction). At the time of the report, INFLUENZA LIKE ILLNESS (Feels like he is "sick with the flu"), HYPERSENSITIVITY (Allergic reaction) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Received his booster, third shot) outcome was unknown. No concomitant medications were given by the reporter. No Treatment information were provided by the reporter.


VAERS ID: 1673093 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-01-19
Onset:2021-08-17
   Days after vaccination:210
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Balance disorder, Diarrhoea, Headache, Inflammation, Paralysis, Peripheral swelling, Transient ischaemic attack, Vomiting
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Pseudomembranous colitis (broad), Embolic and thrombotic events, arterial (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: a TIA/thought it was a mini stroke; feel like you are paralized; ended up with a large feeling in her body and right hand, elbow to her right hand/it started growing up for a hour or a half.; losing body control/she couldn''t even hold her body up/her friend had to hold her up to throw up,; diarrhea; under her armpit she felt like if she had inflammation in that area.; still having headaches from time to time/she had terrible headaches even in the hospital; She threw up all the food; This spontaneous case was reported by an other health care professional and describes the occurrence of TRANSIENT ISCHAEMIC ATTACK (a TIA/thought it was a mini stroke), PARALYSIS (feel like you are paralized), PERIPHERAL SWELLING (ended up with a large feeling in her body and right hand, elbow to her right hand/it started growing up for a hour or a half.), BALANCE DISORDER (losing body control/she couldn''t even hold her body up/her friend had to hold her up to throw up,), DIARRHOEA (diarrhea), INFLAMMATION (under her armpit she felt like if she had inflammation in that area.), HEADACHE (still having headaches from time to time/she had terrible headaches even in the hospital) and VOMITING (She threw up all the food) in an 84-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 19-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 17-Aug-2021, the patient experienced TRANSIENT ISCHAEMIC ATTACK (a TIA/thought it was a mini stroke) (seriousness criteria hospitalization and medically significant), PARALYSIS (feel like you are paralized) (seriousness criteria hospitalization and medically significant), PERIPHERAL SWELLING (ended up with a large feeling in her body and right hand, elbow to her right hand/it started growing up for a hour or a half.) (seriousness criterion hospitalization), BALANCE DISORDER (losing body control/she couldn''t even hold her body up/her friend had to hold her up to throw up,) (seriousness criterion hospitalization), DIARRHOEA (diarrhea) (seriousness criterion hospitalization), INFLAMMATION (under her armpit she felt like if she had inflammation in that area.) (seriousness criterion hospitalization), HEADACHE (still having headaches from time to time/she had terrible headaches even in the hospital) (seriousness criterion hospitalization) and VOMITING (She threw up all the food) (seriousness criterion hospitalization). The patient was hospitalized from 17-Aug-2021 to 18-Aug-2021 due to BALANCE DISORDER, DIARRHOEA, HEADACHE, INFLAMMATION, PARALYSIS, PERIPHERAL SWELLING, TRANSIENT ISCHAEMIC ATTACK and VOMITING. The patient was treated with PARACETAMOL (TYLENOL) for Headache, at an unspecified dose and frequency and FEXOFENADINE HYDROCHLORIDE (ALLEGRA) at an unspecified dose and frequency. At the time of the report, TRANSIENT ISCHAEMIC ATTACK (a TIA/thought it was a mini stroke), PARALYSIS (feel like you are paralized), PERIPHERAL SWELLING (ended up with a large feeling in her body and right hand, elbow to her right hand/it started growing up for a hour or a half.), BALANCE DISORDER (losing body control/she couldn''t even hold her body up/her friend had to hold her up to throw up,), DIARRHOEA (diarrhea), INFLAMMATION (under her armpit she felt like if she had inflammation in that area.) and VOMITING (She threw up all the food) outcome was unknown and HEADACHE (still having headaches from time to time/she had terrible headaches even in the hospital) had not resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. They did every test, ecography, EKG, blood work, and they were not sure on what it was, but thought it was a mini stroke, a TIA. Relevant concomitant medications were reported blood pressure medications, and cholesterol medications. Treatment included oxygen, and an IV which she thought was saline solution but was not sure. She was given some medication for the headache, one that had caffein, but it did not help her much. Company Comment : Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. However, concomitant medication with blood pressure and cholesterol medications, which could be suggestive of hypertension and dyslipidemia, and patient?s age could be confounding factors for the event transient ischaemic attack.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. However, concomitant medication with blood pressure and cholesterol medications, which could be suggestive of hypertension and dyslipidemia, and patient?s age could be confounding factors for the event transient ischaemic attack.


VAERS ID: 1673299 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Connecticut  
Vaccinated:0000-00-00
Onset:2021-08-17
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210820; Test Name: COVID-19; Test Result: Positive
CDC Split Type: USPFIZER INC202101082739

Write-up: COVID-19 infection - positive test on 20Aug2021; COVID-19 infection - positive test on 20Aug2021; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 50-years-old non pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE solution for injection), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as dose number unknown, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. If other vaccine in four weeks was reported as unknown. The patient had been tested for COVID-19 since the vaccination. It was unknown if patient had covid prior vaccination. On 17Aug2021, after receiving the vaccine the patient experienced covid-19 infection - positive test on 20aug2021. The events were serious medically significant. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 20Aug2021. Treatment received for the events was reported was unknown. The outcome of the events was not recovered. Information on the lot/batch number has been requested.


VAERS ID: 1673338 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Vermont  
Vaccinated:2021-06-01
Onset:2021-08-17
   Days after vaccination:77
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210817; Test Name: COVID-19 antigen test; Test Result: Positive ; Test Date: 202107; Test Name: COVID-19 PCR test; Test Result: Negative ; Test Date: 20210817; Test Name: COVID-19 PCR test; Test Result: Positive
CDC Split Type: USPFIZER INC202101090107

Write-up: Tested positive to COVID 19 on both an antigen and PCR test; Tested positive to COVID 19 on both an antigen and PCR test; This is a spontaneous report from a contactable consumer. A 13-year-old female patient received BNT162B2 (COMIRNATY; solution for injection), via an unspecified route of administration in Jun2021 (lot number was not reported) as dose 2, single for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient previously received BNT162B2 (COMIRNATY) on an unspecified date (lot number was not reported) as dose 1, single for COVID-19 immunization. The patient received her 2nd dose of BNT162B2 in mid Jun2021 and she tested positive on both an antigen and PCR test on 17Aug2021 while traveling in Ireland. The patient was asymptomatic. She had a previous PCR test in Jul2021 that was negative. The outcome of the event was unknown. Event occurred in a country different from that of the reporter. This may be a duplicate if the reporter also submitted directly to his/her local agency. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1674595 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-26
Onset:2021-08-17
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Biopsy, Dehydration, Dysphagia, Dysuria, Endoscopy, Headache, Herpes simplex, Mouth ulceration, Pyrexia
SMQs:, Severe cutaneous adverse reactions (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow), Opportunistic infections (broad)

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

Write-up: disseminated HSV1, symptoms started 8/17 with fever, HA. Developed CP, dysphagia, oral ulcers, dysuria. ER visits x 2 for symptom management, dehydration. Endoscopy with biopsy on 8/23/2021. Confirmed HSV1- started Acyclovir on 8/26/2021


VAERS ID: 1674894 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect product formulation 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:

Write-up: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1674922 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-02-20
Onset:2021-08-17
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Menstruation delayed, Pregnancy test negative
SMQs:, Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine 75mcg OD, Vit D 1000 IU BID
Current Illness: none
Preexisting Conditions: hypothyroidism vitamin d insufficiency
Allergies: benzoyl peroxide
Diagnostic Lab Data: pregnancy test: negative (8/29/2021)
CDC Split Type:

Write-up: delayed menstrual period x 18days


VAERS ID: 1674925 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

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

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

Write-up: Beginning the evening of the same day when vaccine was administered, patient developed swelling in his armpit. The swollen lump measured about 4-5 inches in length and 2-3 inches in width, about 0.5-.75 inch raised from normal tissue. The swelling persisted for four days and then resolved.


VAERS ID: 1674989 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-08-15
Onset:2021-08-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Electrocardiogram, Fibrin D dimer, Pain in extremity, Troponin
SMQs:, 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: Tdap, 4 years ago.
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Seen in the Emergency room on 8/25/2021. D dimer, Troponin, EKG - normal
CDC Split Type:

Write-up: Constant pain in the left arm, pain in the elbow, and wrist


VAERS ID: 1675370 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-16
Onset:2021-08-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood creatine phosphokinase, Blood homocysteine, Blood insulin, Blood thyroid stimulating hormone, Blood triglycerides increased, Bradycardia, C-reactive protein increased, Choking, Concussion, Cyanosis, Electrocardiogram, Full blood count, Glycosylated haemoglobin, Hypotension, Loss of consciousness, Metabolic function test, Muscle rigidity, Nausea, SARS-CoV-2 antibody test, Troponin I, Urine analysis
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Lipodystrophy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nortriptyline Blisovi FE
Current Illness:
Preexisting Conditions: Sports induced asthma Headaches/migraines
Allergies: Seasonal allergies Latex
Diagnostic Lab Data: On 8/17/2021 EKG 12-lead (borderline abnormal - normal sinus rhythm with sinus arrhythmia, low voltage QRS ), CBC (low abs lymphocytes), metabolic panel, creatine kinase (CK), protime-INR, troponin I On 8/21/2021 POCT urinalysis, SARS COV 2 AB (IGG) spike semi QN (positive, 10.32), C-reactive protein (elevated, 1.4), glycohemoglobin A1C, homocysteine, insulin level, TSH ultrasensitive, lipid profile (elevated triglycerides)
CDC Split Type:

Write-up: 17 hours after first dose of vaccine, nausea, loss of consciousness, cyanosis, possible seizure with muscle rigidity and choking, hypotension, bradycardia, mild concussion, liter of fluid


VAERS ID: 1675589 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-01
Onset:2021-08-17
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood bilirubin increased, Blood test abnormal, Chest pain, Computerised tomogram normal, Dizziness, Dyspnoea, Echocardiogram normal, Electrocardiogram normal, Hypertension, Lymph node pain, Lymphadenopathy, Migraine, Scan with contrast, Tremor
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (narrow), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu shot in 2019- swollen lymph nodes.
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 09/01/2021 ER: EKG, echocardiogram, CT scan with contrast, blood work. EKG, Echocardiogram, CT scan all showed everything is ok. Blood work shows my bilirubin is high and my blood pressure was high. I normally have no issues with either of those things. Blood pressure is usually 110/70. That day it was all over the place 155/92 to 138/92.
CDC Split Type:

Write-up: Lymph nodes right arm pit swollen huge and painful 8/17-8/29, went down but still slightly swollen 9/6. 8/29 started having chest pain, high blood pressure, dizziness, shortness of breath, migraines, shaking. Went into the ER 9/1 to make sure my heart was ok.


VAERS ID: 1675757 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-20
Onset:2021-08-17
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Decreased appetite, Fatigue, Oropharyngeal pain, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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: not known
Current Illness: not known
Preexisting Conditions: not known
Allergies: not known
Diagnostic Lab Data: PCR + for Covid 8/24/2021
CDC Split Type:

Write-up: Client was vaccinated for Covid with Pfizer vaccines on 4//20 and 5/11/2021. Covid symptoms started around 8/17: extreme fatigue, loss of appetite, sore throat. Hospitalized on 8/24 and on admission tested positive for Covid. Reported as a breakthrough Covid case in a fully vaccinated person.


VAERS ID: 1676633 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-03
Onset:2021-08-17
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Erythema, Peripheral swelling, Pruritus, Vision blurred
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (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:

Write-up: Started having blurred vision and dizziness approximately 3-4 days after I had Covid arm (redness, swelling, itchy) Some days worse than others..still ongoing but lessened the amount of days.


VAERS ID: 1677198 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-20
Onset:2021-08-17
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain upper, Chills, Lymphadenopathy, Myalgia, Nausea, Pain, Pain in extremity, Pelvic pain, Renal pain, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Swollen left groin lymph node after second shot; Vomiting after second shot; Muscle Ache after second shot; Chills after second shot; Nausea; Stabbing pain left kidney and pelvis area after second shot; Radiating stabbing pain down the left leg and left foot after second shot; Radiating stabbing pain down the left leg and left foot after second shot; Can not hold anything in her stomach after second shot; Pelvis pain/Body Pain after second shot; Stomach ache after second shot; This spontaneous case was reported by a consumer and describes the occurrence of RENAL PAIN (Stabbing pain left kidney and pelvis area after second shot), PAIN (Radiating stabbing pain down the left leg and left foot after second shot), PAIN IN EXTREMITY (Radiating stabbing pain down the left leg and left foot after second shot), ABDOMINAL DISCOMFORT (Can not hold anything in her stomach after second shot) and PELVIC PAIN (Pelvis pain/Body Pain after second shot) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 002F21A and 040C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 20-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 17-Aug-2021, the patient experienced RENAL PAIN (Stabbing pain left kidney and pelvis area after second shot), PAIN (Radiating stabbing pain down the left leg and left foot after second shot), PAIN IN EXTREMITY (Radiating stabbing pain down the left leg and left foot after second shot), ABDOMINAL DISCOMFORT (Can not hold anything in her stomach after second shot), PELVIC PAIN (Pelvis pain/Body Pain after second shot), ABDOMINAL PAIN UPPER (Stomach ache after second shot), VOMITING (Vomiting after second shot), MYALGIA (Muscle Ache after second shot), CHILLS (Chills after second shot) and NAUSEA (Nausea). On 18-Aug-2021, the patient experienced LYMPHADENOPATHY (Swollen left groin lymph node after second shot). At the time of the report, RENAL PAIN (Stabbing pain left kidney and pelvis area after second shot), PAIN (Radiating stabbing pain down the left leg and left foot after second shot), PAIN IN EXTREMITY (Radiating stabbing pain down the left leg and left foot after second shot), ABDOMINAL DISCOMFORT (Can not hold anything in her stomach after second shot), PELVIC PAIN (Pelvis pain/Body Pain after second shot), ABDOMINAL PAIN UPPER (Stomach ache after second shot), LYMPHADENOPATHY (Swollen left groin lymph node after second shot), VOMITING (Vomiting after second shot), MYALGIA (Muscle Ache after second shot), CHILLS (Chills after second shot) and NAUSEA (Nausea) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) and mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Nurse stated she needs to go to the urgent care if symptoms do not go away. No concomitant medications reported. No treatment information was reported by reporter This case was linked to MOD-2021-294325 (Patient Link).


VAERS ID: 1677210 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-02-18
Onset:2021-08-17
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Inappropriate schedule of product administration, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), 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: HIZENTRA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Swollen Left Arm after the third shot; Red Left Arm after the third shot; Booster dose was taken outside the window period; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Swollen Left Arm after the third shot), ERYTHEMA (Red Left Arm after the third shot) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Booster dose was taken outside the window period) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 017E21A) for COVID-19 vaccination. Concomitant products included IMMUNOGLOBULIN HUMAN NORMAL (HIZENTRA) for an unknown indication. On 18-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-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 17-Aug-2021, the patient experienced PERIPHERAL SWELLING (Swollen Left Arm after the third shot), ERYTHEMA (Red Left Arm after the third shot) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Booster dose was taken outside the window period). On 17-Aug-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Booster dose was taken outside the window period) had resolved. On 19-Aug-2021, PERIPHERAL SWELLING (Swollen Left Arm after the third shot) and ERYTHEMA (Red Left Arm after the third shot) had resolved. Treatment information was not provided. Patient had no side effects after first and second doses of vaccine. She stated to have a colonoscopy done(outine and not related to vaccine).


VAERS ID: 1677439 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-17
Onset:2021-08-17
   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 EW0198 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vaccination site haemorrhage, Vaccination site pain
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: Medical History/Concurrent Conditions: Allergy; Mite allergy (Verbatim: allergic to mites and crabs)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101065230

Write-up: bleeding on her shoulder where she received the shot/have bleeding at site of injection; His daughter said ouch, so it hurt; This is a spontaneous report from a contactable consumer (patient''s father). A 19-years-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EW0198), via an unspecified route of administration, administered in left arm on 17Aug2021 at 02:43 (at the age of 19-years-old) as DOSE 2, SINGLE for covid-19 immunisation. The patient medical history allergic to mites and crabs. There were no concomitant medications. The patient had received MMRV when she was 3 months old and after that vaccine she developed high fever and crying because of the high fever. The patient had received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EW0196), via an unspecified route of administration, administered on 24Jul2021 (at the age of 19-years-old) as DOSE 1, SINGLE for covid-19 immunisation. The reporter stated that the patient went through bloodwork and analysis for one of the components in Pfizer and she showed fine and was not allergic to it. Patient had no vaccines 4 weeks prior to receiving COVID vaccines. The reporter reported that on 17Aug2021 at 02:43, patient had bleeding on her shoulder where she received the shot. She had not any adverse symptoms for the time being, but she did had bleeding at site of injection. When the Pharmacist injected the vaccine my daughter said ''Ouch, it hurts'' and the Pharmacist took out the needle and caused bleeding in my daughter''s left shoulder, I was shocked because the Pharmacist made a movement that was kind of strange and it caused the rupture of a cavity, she then proceeded to clean the bleeding, put pressure on it and put a band-aid on it (as treatment). Patient did not any AE(s) require a visit to emergency room and physician office. The outcome of the event was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1677444 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-17
Onset:2021-08-17
   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 EW0164 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 INC202101067753

Write-up: Numbness in my legs and hands and arms; This is a spontaneous report from a contactable consumer (patient). A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection, Lot Number: EW0164), via an unspecified route of administration on 17Aug2021 at 10:00 as dose 2, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. Historical vaccine included first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection, Lot Number: unspecified), via an unspecified route of administration on an unspecified date as dose 1, single for COVID-19 immunization. The patient stated that patient got second Pfizer vaccine today (17Aug2021) and patient guessed after 20 minutes (10:20) patient got the vaccine, patient had like numbness in the legs and hands and arms and patient just wanted to know if that was normal. The clinical outcome for the event was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1677449 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-11
Onset:2021-08-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature, Ear pruritus, Epistaxis, Gait disturbance, Headache, Lacrimation increased, Limb discomfort, Muscle contractions involuntary, Muscle spasms, Pyrexia, Rash, Rhinorrhoea, Sinus disorder, Sinusitis, Skin discolouration, Sneezing, Swollen tongue, Throat irritation, Thrombosis
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Lacrimal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Paralysis (Full paralysis in 2006 with Guillen Barre Syndrome symptoms and possible Multiple Sclerosis).
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy to intravenous contrast media (Known Allergies: MRI dye galidinium); Fish allergy; Food allergy; Guillain Barre syndrome; Multiple sclerosis (possible Multiple Sclerosis); Peanut allergy.
Allergies:
Diagnostic Lab Data: Test Name: Body Temperature; Result Unstructured Data: Test Result: 98.6 F.
CDC Split Type: USPFIZER INC202101076260

Write-up: Thrombus started getting swollen and it''s keeps went going down slowly; I couldn''t moved my leg like less then a minute; Headache; nose bleed; sinus was very dry; her face was purple colored; was not able to walk; Muscle spasms entire legs and back/muscle spasms came back from her knees to her feet; Swollen tongue; Itchy throat, ears; Itchy throat, ears; Runny nose; Sneezing; Watery eyes; Fascicullation around left knee; low grade fever/body temperature: 98.6; Itchy sinus; Rash right side torso, below armpit; The initial safety information received was reporting only non-serious adverse drug reactions. Upon receipt of follow-up information on 23Aug2021, this case now contains serious adverse reactions. Information processed together. This is a spontaneous report from a contactable consumer (patient). A 45-years-old female patient received bnt162b2 (BNT162B2), via an unspecified route of administration, administered in Arm Left on 11Aug2021 18:30 at 45-years-old (Batch/Lot Number: FC3181) as dose 1, single for COVID-19 immunization. Patient is not pregnant. Medical history included Full paralysis in 2006 (ongoing) with Guillan Barre Syndrome symptoms and possible Multiple Sclerosis. Allergies: Peanuts, Walnuts, Hazelnuts, Catfish, MRI dye galidinium. Facility type vaccine: Pharmacy or Drug Store. Patient did not have other vaccine in four weeks. Patient did not have other medications in two weeks. Patient did not have covid prior vaccination. Patient has not tested for covid post vaccination. Patient had no concomitant medications. The patient previously took keflex [cefalexin] and experienced allergies. Consumer stated, last Saturday her face was purple colored for a few hours and in then in the afternoon she couldn''t moved her leg like she didn''t know may be less than a minute. She was going to consult her doctor but she didn''t know what he can do? she meant (Incomplete Sentence). Consumer stated, Yes, it was hopeful of 21st her face was kind of purple in the morning and then her leg stops the movement for a minutes in the afternoon.She was beginning to have the reaction on Tuesday she was beginning to have reactions on the 17th. then her thrombus started getting swollen and then she have her thrombus area swollen on Wednesday the 18th then it keep went going down slowly, it was really swollen on wednseday18th. This happened on Saturday this is new. Her face got purple and she couldn''t walk for like a minutes, and it''s started happen before Saturday. Well, she had the runny nose, it was really bad she took it a night time a cold for cold that she have some kind of steam into it and that helped her runny nose has stopped now and she didn''t have a runny nose she took the pill it was the Friday night when she took it and yesterday stopped running, she didn''t have runny nose anymore. That''s the part all she took it, she was having a headache yesterday then she took a acetaminophen (Further clarification unknown) She didn''t have headache anymore these symptoms reactions to it. they seem to be fading away but she have been them. When probed for any further assistance: consumer stated well, she was just really concerned about what happen in Saturday afternoon she was not able to walk that''s really scared her a lot because she really had a hard time regarding her paralyses back in 2006 that was in a really scare for me. Muscle spasms entire legs and back, no treatment given. It stopped in her legs and back on Wednesday. Yesterday, the muscle spasms came back from her knees to her feet. Her tongue also started swelling again. Tongue started swelling again: Not as severe as last week. Still swollen on Wednesday, and Thursday. Started going back to normal and then started swelling again last night, re- occurring. When she started filing online for the first time she had a runny nose, sinus was very dry, and had a nose bleed. Fascicullations (spelling as provided by caller) around her left knee. She has a question, she has an appointment with her doctor this morning. She went to the website. If she is going to have her doctor to look into this they require two lab test and she has to wait until the reactions are gone or wait until her body goes back to normal. Does she have to wait in order to have her doctor look into this. The patient experienced thrombus started getting swollen and it''s keeps going down slowly on an unspecified date with outcome of unknown, swollen tongue on 17Aug2021 09:00 with outcome of not recovered, itchy throat, ears on 17Aug2021 09:00 with outcome of not recovered, runny nose on 17Aug2021 09:00 with outcome of not recovered, sneezing on 17Aug2021 09:00 with outcome of not recovered, watery eyes on 17Aug2021 09:00 with outcome of not recovered, fascicullation around left knee on 17Aug2021 09:00 with outcome of not recovered, low grade fever on 17Aug2021 with outcome of unknown, itchy sinus on 17Aug2021 with outcome of unknown, couldn''t moved leg like less then a minute on an unspecified date with outcome of unknown, headache on an unspecified date with outcome of unknown, muscle spasms entire legs and back/muscle spasms came back from her knees to her feet on 24Aug2021 with outcome of recovering, nose bleed on an unspecified date with outcome of unknown, sinus was very dry on an unspecified date with outcome of unknown, rash right side torso, below armpit on 17Aug2021 with outcome of recovered on 18Aug2021, her face was purple colored on an unspecified date with outcome of unknown, was not able to walk on an unspecified date with outcome of unknown. The patient underwent lab tests and procedures which included body temperature: 98.6 on an unspecified date. Caller stated that she is hesitant to take the second shot. Caller stated she is scheduled to take the second shot on 01Sep2021.


VAERS ID: 1678909 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-17
Onset:2021-08-17
   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 FC3181 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Exposure during pregnancy, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), 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: Numbness in the left arm.
Other Medications: Patient is on prenatal medication plus iron at the time of vaccination
Current Illness: Patient reports not having any disease at this time.
Preexisting Conditions: Patient reports not having any disease at this time.
Allergies: Patient reports not having any allergy to medicine or food products.
Diagnostic Lab Data: No test was performed at the time of the reaction.
CDC Split Type:

Write-up: Patient refers with numbness in the left arm then it manifested to the right arm it continues after the first dose since day 17/08/21. Patient with 5 months of pregnancy is recommended to visit her medical doctor to tell him a her symptoms.


VAERS ID: 1679025 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-17
Onset:2021-08-17
   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 FC3181 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arrhythmia, Confusional state, Crying, Dizziness, Electrocardiogram, Electrocardiogram ambulatory, Euphoric mood, Malaise, Palpitations, Panic attack, Somnolence, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Depression (excl suicide and self injury) (broad), Vestibular 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: None
Current Illness: None
Preexisting Conditions: Heart murmur
Allergies: None that I''m aware of.
Diagnostic Lab Data: None yet. I had an EKG that said I had some arrhythmia so I currently have a heart monitor on for 7 days. I''m 5 days in as of right now.
CDC Split Type:

Write-up: For the first three days after the shot I felt like I was on an adrenaline high. After that I started have frequent panic attacks where I wouldn''t be able to do anything besides shake and cry. As that let up I noticed I would get light headed, my heart would race, I would feel very sick, the world would move around me, I couldn''t think at all, and the simplest things like looking at a TV would make me very sick. I went to my doctor who said I was fine and it was just nerves but if I wanted I could get an EKG. So I did and she said that I had arrhythmia and I would need a heart monitor put on. I''ve had it on for 5 days now and it''s to come off after 7. But a lot of things set it off mainly affecting my heart rate. Example I''m a smoker and i smoked about a pack a day. Now if I so much as smoke half a cigarette it shoots my blood pressure up to around 150/100 with a pulse around 120. This makes me feel horribly sick and last for about 20 to 30 mins. Afterwards I feel like I ran a marathon and it''s extremely hard for me to stay awake.


VAERS ID: 1679076 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-02-04
Onset:2021-08-17
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, Chest discomfort, Dyspnoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, ASA, atorvastatin, CoQ10, glucosamine-chondroitin, losartan, metformin, metoprolol, naproxen, omega3 FA/fish oil, KCl, saw palmetto, zolpidem
Current Illness: none
Preexisting Conditions: anxiety, DM, HTN, OSA
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/17/2021: pos for COVID 19 8/23/2021: admitted to hospital with SOB and chest discomfort dexamethasone and remdesivir in hospital, and O2 8/27/2021: discharged on oxygen 9/7/2021: f/u with pt better but "improvement is slow"


VAERS ID: 1679112 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-16
Onset:2021-08-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad)

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

Write-up: a day after covid pfizer vaccination, patient started experiencing a cough that she has never had before as well as a runny nose. it is still there at her 2nd dose appointment


VAERS ID: 1679158 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-17
   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 - / 3 - / -

Administered by: Other       Purchased by: ?
Symptoms: Extra dose administered, No adverse event
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: Client was scheduled for his second vaccine of Pfizer when it was discovered in the immunization history that he had already received two doses of Pfizer on 01/14/2021 and 02/04/2021. The client was transferred to Post-acute SNF after bein
Current Illness: Spina Bifida, Scoliosis, Decubitus Ulcer to Rt hip
Preexisting Conditions: Spina Bifida
Allergies: Latex
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Client was scheduled for his second vaccine of Pfizer when it was discovered in the immunization history that he had already received two doses of Pfizer on 01/14/2021 and 02/04/2021. The client was transferred to Post-acute SNF after being hospitalized. The charge nurse at the facility was made aware and there were no reported adverse reactions.


VAERS ID: 1679332 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-04
Onset:2021-08-17
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: "BLOOD PRESSURE MED, POTASSIUM, WATER PILL"- NAMES OF DRUGS KNOWN
Current Illness: NONE
Preexisting Conditions: HIGH BLOOD PRESSURE. DENIES OTHERS
Allergies: NONE
Diagnostic Lab Data: CLIENT DID NOT SEEK MEDICAL ATTENTION AND FELT THERE WAS NO CONCERN TO SEE A PROVIDER.
CDC Split Type:

Write-up: CLIENT REPORTS 13 DAYS FROM VACCINE DATE, HE BROKE OUT WITH CLEAR FILLED BLISTERS ON HIS LEGS. HE REOPRTS THEY TRAVELED FORM HIS CALVES, TO HIS THIGHS, AND THEN TO HIS ARMS. BLISTERS IMPROVED AND WENT AWAY AFTER 3-4 DAYS. BLISTERS WERE EXTREMLY ITCHY AND PAINFUL. CLIENT STILL HAS HEALING AREAS BUT OTHERWISE NO OTHER CONCERNS. CLIENT REPORTS NO CHANGE IN ACTIVITIES, DOES NOT WEAR SHORTS, NO CHANGE IN HIS HEALTH OR DIET AND NO HISTORY OF A REACTION OF THIS NATURE IN THE PAST. CLIENTS WIFE SAID IT LOOKE DLIKE CHICKEN POX. CLIENT NOTES HIS FAMILY WAS ILL IN JANUARY OF 2020 AND THEY FELT IT MAY HAVE BEEN COVID.


VAERS ID: 1681446 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-17
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Pain in extremity, SARS-CoV-2 antibody test, Therapy non-responder
SMQs:, Lack of efficacy/effect (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210817; Test Name: SARS-CoV-2 IgG antibody test; Result Unstructured Data: negative
CDC Split Type: USJNJFOC20210905663

Write-up: LITTLE PAIN IN THE ARM; CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a consumer concerned an 80 year white and Hispanic or Latino old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805022, and expiry: Unknown) dose was not reported, 1 total, administered on 11-MAR-2021 for prophylactic vaccination into right arm. No concomitant medications were reported. On an unspecified date, the patient experienced little pain in the arm and that was it. On 17-AUG-2021, the patient''s health care professional (HCP) ordered a blood test, an antibodies test (Severe acute respiratory syndrome coronavirus 2 Antibody Immunoglobulin G, Spike, Semi-Quantitative, reported as "SARS COV2 AB IGG SPIKE SEMI QN") which came negative (confirmed immunological vaccine failure). Reporter was concerned that patient was protected against Covid-19 infection or not. The HCP provider recommended taking another dose of COVID-19 vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the confirmed immunological vaccine failure and pain in the arm was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000192053. This case, from the same reporter is linked to 20210905692.; Sender''s Comments: V0.20210905663-covid-19 vaccine ad26.cov2.s -Confirmed immunological vaccine failure . This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1681787 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-17
Onset:2021-08-17
   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 - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Fatigue
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: USPFIZER INC202101065924

Write-up: dizzy and really light headed; Tired; dizzy and really light headed; This is a spontaneous report from a contactable consumer or other non hcp (patient''s mother). A 13-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for Injection, Batch/Lot number was not reported), via an unspecified route of administration on 17Aug2021 (at the age of 13-year-old) as dose 1, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On 17Aug2021, the patient experienced dizzy and really lightheaded, tired. Reporter stated, my 13-year-old got her first shot today (Confirmed Pfizer COVID 19 vaccine) and she is like really dizzy and really lightheaded, Is that normal. Reporter stated, tired she said. 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: 1681798 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-17
Onset:2021-08-17
   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, Influenza like illness, Malaise, Nodule, Pain in extremity, Pyrexia, Rash erythematous, Vaccination site pain
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), 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? 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: Kidney transplant (start date : (??-???-1998))
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101069823

Write-up: her arm hurt more and she could feel a lump/nodule and the muscle feels hard; her arm hurt more and she could feel a lump/nodule and the muscle feels hard; low grade fever of 100.5 degrees Fahrenheit; red rash; flu like symptoms; Extra dose administered; the injection site became tender; malaise; injection site soreness in right arm; This is a spontaneous report from a contactable consumer or other non hcp. A 50-years-old female patient received third dose bnt162b2 (BNT162B2, Solution for injection, Batch/Lot number was not reported) via an unspecified route of administration on 17Aug2021 08:30 (age at vaccination:50 Years) as DOSE 3, SINGLE for covid-19 immunisation. Patient didn''t received other vaccines within 4 weeks prior to vaccination. Medical history included renal transplant from 1998 to an unknown date. The patient''s concomitant medications were not reported. Patient previously received first dose bnt162b2(BNT162B2, solution for injection, Batch/Lot Number: not reported) via unspecified route of administration on 09Mar2021 as DOSE 1, SINGLE for covid-19 immunisation. Patient previously received second dose bnt162b2(BNT162B2, solution for injection, Batch/Lot Number: not reported) via unspecified route of administration on 30Mar2021 as DOSE 2, SINGLE for covid-19 immunisation. The patient experienced the injection site became tender on 17Aug2021, malaise on 17Aug2021, her arm hurt more and she could feel a lump/nodule and the muscle feels hard on 18Aug2021, her arm hurt more and she could feel a lump/nodule and the muscle feels hard on 18Aug2021, low grade fever of 100.5 degrees fahrenheit on 18Aug2021, red rash on 18Aug2021, flu like symptoms on 18Aug2021, injection site soreness in right arm on 17Aug2021 , extra dose administered on 17Aug2021 08:30. No relevant tests were reported. The outcome of the events vaccination site pain recovering, the outcome of the event malaise was recovered, the outcome of the events vaccination site pain, pain in extremity, nodule, pyrexia, rash erythematous, Influenza like illness, Extra dose administered was unknown. PSCC Communication: She declined report number and phone number prior to attempted transfer to USMI. Caller agreed to be placed in the queue to hold for next available agent. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1681818 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-17
Onset:2021-08-17
   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 FC3182 / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Lymphadenopathy, Oropharyngeal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Immunocompromised; Type 2 diabetes mellitus (Type 2 Diabetic (this is under control))
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (received the antibody infusion/husband had an infusion when he had Covid 19); Prostate cancer (Prostate Cancer with radiation treatment States this was 2 years ago); Radiation therapy (Prostate Cancer with radiation treatment States this was 2 years ago)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101076042

Write-up: sore throat; swollen lymph nodes; This is a spontaneous report from a contactable consumer. This consumer (patient''s wife) reported for a 67-year-old male patient (reporter''s husband). A 67-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), dose 1 via an unspecified route of administration, administered in Arm Left on 17Aug2021 (Batch/Lot Number: FC3182; Expiration Date: 31Oct2021) as DOSE 1, SINGLE for covid-19 immunisation at Health Department. Medical history included covid-19 from Feb2021 to an unknown date (received the antibody infusion/husband had an infusion when he had Covid 19), ongoing type 2 diabetes mellitus Type 2 Diabetic (this is under control), prostate cancer from 2018 to an unknown date (Prostate Cancer with radiation treatment States this was 2 years ago), radiation treatment from 2018 to 2018 (Prostate Cancer with radiation treatment States this was 2 years ago), ongoing immunodeficiency. There were no concomitant medications. Wife called on behalf of husband, male, aged 67, DOB: (withheld), received first dose of the Pfizer BioNTech Covid 19 vaccine on 17Aug2021 around 10am. That afternoon he developed a sore throat and swollen lymph nodes. He was still having these symptoms today. He has tried gargling with Chloraseptic and with coffee. If these symptoms were too bad guess, he just won''t take the second dose? (made this comment in passing and did not specifically address during call, just stated in general that she needed to talk to her husbands HCP). Therapeutic measures were taken as a result of sore throat. The clinical outcome of the events was not recovered at the time of report. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1681828 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-17
Onset:2021-08-17
   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 - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Headache, Hot flush, Musculoskeletal stiffness, Neck pain, Pain in jaw, SARS-CoV-2 antibody test, Vaccination site pain, Vaccination site warmth
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Osteonecrosis (broad), Arthritis (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: EFFEXOR SR; TRAMADOL; LISINOPRIL; HYDROCHLOROTHIAZIDE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure raised (other medical history: Fibromyalgia, high blood pressure); Fibromyalgia (other medical history: Fibromyalgia, high blood pressure); Shellfish allergy (known allergies: Levaquin and shellfish)
Allergies:
Diagnostic Lab Data: Test Name: covid- 19; Result Unstructured Data: Test Result:Positive
CDC Split Type: USPFIZER INC202101082840

Write-up: Pain at injection site; stiffness; slightly warm; pain moved up my shoulder/neck area; pain moved up my shoulder/neck area; There were some hot flashes; Slight headache on rigth side; very small amount of right jaw pain that only laste a few hours; This is a spontaneous report received from a contactable consumer (patient). A 55-year-old female not pregnant patient received first dose of bnt162b2 (COMIRNATY, PFIZER-BIONTECH covid-19 vaccine, formulation: solution for injection and batch no: not reported/lot number: not reported) via an unspecified route of administration, in right arm on last Tuesday 17Aug2021 17:30 (at the age of 55-years-old) as dose 1, single for COVID-19 immunization. The patient medical history was reported as Fibromyalgia, high blood pressure and allergic to shellfish. Concomitant medications included the patient received medications within 2 weeks of vaccination included venlafaxine hydrochloride (EFFEXOR SR), tramadol, lisinopril and hydrochlorothiazide and all from an unknown date for an unspecified indication. The patient previously took levofloxacin (LEVAQUIN) and allergic to it. The patient had not received any other vaccines within 4 weeks prior to the covid vaccine. Prior to vaccination, the patient was diagnosed with covid-19 and since the vaccination, the patient has not been tested for covid-19. On 17Aug2021 at 17:45, patient reported that pain at injection site, stiffness and slightly warm, later in the day, that same pain moved up my shoulder/neck area and lasted for about 4 days. Also, it was reported that, some hot flashes that were not her regular kind and slight headache on right side, very small amount of right haw pain that only lasted a few hours. Patient underwent lab test and procedure which included SARS-CoV-2 antibody test Positive on unspecified date. The outcome of the events was recovering. Information on the lot/batch number has been requested.


VAERS ID: 1681923 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-17
   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 FC3182 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Asthenia, Cold sweat, Confusional state, Dizziness, Feeling abnormal, Feeling cold, Heart rate, Heart rate increased, Hyperhidrosis, Nervousness, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ADDERALL; CLARITON; VITAMINS NOS
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data: Test Date: 20210817; Test Name: heart rate; Result Unstructured Data: Test Result:increased
CDC Split Type: USPFIZER INC202101098046

Write-up: could feel I was about to faint any second/lightheaded; felt a wave of uneasiness come over me; felt confused & scared,everything sounded far away; felt confused & scared,everything sounded far away; my heart was beating rapidly & was sweating; my heart was beating rapidly & was sweating; began to feel terrified; got cold & clammy; got cold & clammy; face was pale; I was too weak; This is a spontaneous report from a contactable consumer (patient). A 33-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in arm left on 17Aug2021 14:45 (Batch/Lot Number: FC3182) as single dose for COVID-19 immunisation. Patient age at vaccination was 33-year-old. Medical history was none. Patient did not experienced COVID prior vaccination. Concomitant medications included amfetamine aspartate, amfetamine sulfate, dexamfetamine saccharate, dexamfetamine sulfate (ADDERALL), clarithromycin (CLARITON) and women''s daily vitamins (VITAMINS NOS), all taken for an unspecified indication, start and stop date were not reported. Historical vaccine included Tetanus Vaccine for immunization and experienced allergic to the Tetanus Vaccine. Patient got her vaccine and was feeling completely fine at first. While patient wait the"15 minutes," all of a sudden, she felt a wave of uneasiness come over her. It felt like slow motion and patient felt as if something just hit her body into shock. SHE felt confused & scared, everything sounded far away and she was too weak to yell for help. She was lightheaded and knew something was wrong. Her heart was beating rapidly and was sweating. She could feel she was about to faint any second and was fighting it as hard as she could not to faint b.c. She began to feel terrified. Her husband ran to her and then ran yelled to pharm for help. He said her body felt like lava when he reached to her and her body was covered in sweat. Patient then got cold and clammy. Her face was pale. The events onset on 17Aug2021 at 14:45. The events resulted in doctor or other healthcare professional office/clinic visit. The pharmacist gave her treatment which included cold rags, water, laid down. Outcome of the events was resolved in Aug2021. Patient did not test COVID post vaccination. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1682606 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-05
Onset:2021-08-17
   Days after vaccination:165
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 2 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Ageusia, Anosmia, Blister, COVID-19, Chills, Cough, Dyspnoea, Headache, Malaise, Myalgia, Nausea, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (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:
Current Illness:
Preexisting Conditions: Past medical history of anxiety, bulging lumbar disc, kidney stones, Chronic Lung Disease (asthma/emphysema/COPD), Current smoker, endometriosis
Allergies:
Diagnostic Lab Data: 08/24/2021 PCR+ COVID-19 test at medical facility
CDC Split Type:

Write-up: Fever $g100.4, Chills, Muscle or body aches, New loss of taste or smell, Runny nose/Congestion, Cough (new onset or worsening of chronic cough), Shortness of breath or difficulty breathing, Nausea or vomiting, Headache, Abdominal pain, Hospitalized, "She also said the CDC called her because she was a rare case that had a bad reaction to the Pfizer -One symptoms she had from the vaccine was that her hands developed blisters -PUI is now uses a oxygen machine at home and still feels she''s a rare case because she''s vaccinated but has been severely sick -"


VAERS ID: 1682635 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-17
Onset:2021-08-17
   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 EW0172 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Stomatitis, Urticaria
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Hives on abdomin . next dat sores in mouth


VAERS ID: 1682719 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-17
Onset:2021-08-17
   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 FC3181 / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood calcium increased, Blood creatinine increased, Blood test, Blood urea increased, Dizziness, Dyspnoea, Renal impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations: 1st COVID Pfizer vaccine and 2nd COVID Pfizer - Tiredness/blah feeling right after each of them
Other Medications: Diltiazem 30 mg twice a day; Myrbetriq - 50 mg once a day; Mag Oxide 400 mg - once a day; Simvastatin 10 mg once a day; Finasteride - 5 mg a day; Sertraline HCL - 50 mg once a day; Flecainide Acetate 50 mg twice a day; Eliquis - 5 mg twice
Current Illness: Struggling with kidney failure in the last month before the vaccine
Preexisting Conditions: Struggling with kidney failure in the last month and it''s also been an ongoing condition that has been going on for awhile. I have small b cell lymphoma - it''s in remission; Prostrate cancer - August 2020 - so far that''s gone; June 2020 - did surgery for a Appendiceal Mucocele
Allergies: Chempath - A kind of chemo - allergic to it - an injectable - Alemtuzumab - hives and couldn''t get warm and was shaking; Some kind of tree pollen; Fish - reaction to bad fish once
Diagnostic Lab Data: Blood tests at the Urgent care; ER - a lot of blood draws - I don''t recall if they did a CT scan or x-ray - I don''t think they did. - My calcium were high; my BUN and Creatine were high and my kidney function was low - all these came up by the end of my hospital stay.
CDC Split Type: vsafe

Write-up: On the 22nd, I was hiking with my wife and I couldn''t catch my breath and I had to sit down and rest for a bit. And I was getting faint the day that I got my vaccine when I was going up the stairs. On the 22nd, I went to Urgent care - they did a blood test and they sent me home. I had had a couple of blood tests before in the week. I decided to send them to my Urologist. And she told me to go to ER and that was on Monday, the 23rd. They admitted me and kept me for two days. Kept me hydrated and gave me an IV of saline for two days. I got out on the 25th. The doctors are trying different levels of Calcitriol - to see what''s best.


VAERS ID: 1682844 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-01
Onset:2021-08-17
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Angiocardiogram, Catheterisation cardiac, Coronary artery aneurysm, Electrocardiogram ST segment elevation, Myocardial infarction, Thrombosis, Troponin increased
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Newly diagnosed Diabetes, previous COVID-19 infection
Allergies: No known allergies
Diagnostic Lab Data: Left heart catheterization and coronary angiography (8/18/2021), elevated troponin
CDC Split Type:

Write-up: Right coronary artery aneurysm and thrombosis, ST elevation myocardial infarction


VAERS ID: 1682931 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-08-14
Onset:2021-08-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Intense Pain from hips to toes for 2 days . Now continue to ache . Also had dizziness that comes and goes .


VAERS ID: 1683296 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-17
Onset:2021-08-17
   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 FC3183 / 1 LA / IM

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

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

Write-up: Patient states that her menstrual cycle has been affected. She started her period on the morning she received the vaccine. She reports active bleeding for 13 days and then had a 4 day break in bleeding and then started bleeding again. This is unusual for her.


VAERS ID: 1683461 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-14
Onset:2021-08-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Hypoaesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, calcium, vitamin d
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Left arm numbness, chest pain and dyspnea x 6 days


VAERS ID: 1684793 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-17
Onset:2021-08-17
   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 FC3181 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: Sulfa
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: After receiving the vaccine in my left arm I had pins and needles in the left side of my face for about 1.5 hours. I was able to move my face and it was symmetrical, but I could feel the pins and needles like the left side of my face was asleep.


VAERS ID: 1685281 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-10
Onset:2021-08-17
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, COVID-19 pneumonia, Cough, Respiratory tract congestion, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Guillain-Barre 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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Allopurinol, cetirizine, finasteride, fish oil, furosemide, hydrochlorothiazide-triamterene, levothyroxine, lisinopril, omeprazole, KCL, ASA, meloxicam, metformin
Current Illness:
Preexisting Conditions: CHF, GERD, HTN, Hypercholesterolemia, sleep apnea, diabetes (adult onset), arthritis of knee, gout, abdominal aortic aneurysm (repaired)
Allergies: no known
Diagnostic Lab Data: COVID-19 PCR test positive on 8/17/2021
CDC Split Type:

Write-up: 8/18/2021 Admit hospital with COVID Breakthrough .Generalized weakness, cough and chest congestion for the last few days. His wife is also positive. Diagnosed with: minor COVID-19 symptoms, COVID-19 pneumonia Note: patient previously vaccinated with Pfizer COVID-19 vaccine, 2nd dose on 2/10/21. 8/19/21: Discharged


VAERS ID: 1685324 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-05
Onset:2021-08-17
   Days after vaccination:165
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Cough, Headache, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ephesior; Vitamin
Current Illness: No
Preexisting Conditions: No
Allergies: Erythromycin
Diagnostic Lab Data:
CDC Split Type: Vsafe

Write-up: Positive Covid Test, headache, cough, sore throat.


VAERS ID: 1685341 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-16
Onset:2021-08-17
   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 FC3181 / 7+ LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute coronary syndrome, Acute myocardial infarction, Akinesia, Catheterisation cardiac abnormal, Coronary artery stenosis, Ejection fraction decreased, Myocardial infarction
SMQs:, Cardiac failure (narrow), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Parkinson-like events (narrow), Cardiomyopathy (narrow), Other ischaemic heart disease (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Losartan/HCTZ 100/25 mg 1X/d; Spironolactone 25 mg 1X/d
Current Illness: Chronic Kidney Disease
Preexisting Conditions: Chronic Kidney Disease; High Blood Pressure; Lymphedema
Allergies: none
Diagnostic Lab Data: NSTEMI; Prox LAD Lesion 100 stenosed; OST LAD lesion is 90% stenosed; Cath with EF 30% with anterior apical akinesis; acute coronary syndrome
CDC Split Type:

Write-up: heart attack 12 hours after shot


VAERS ID: 1685351 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: California  
Vaccinated:2021-02-14
Onset:2021-08-17
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 8/17/21, COVID-19, POSITIVE
CDC Split Type:

Write-up: Patient received the COVID vaccines on 2/14/21 and 3/9/21. He was admitted to the hospital on 8/17/2021 with a Dx of COVID-19


VAERS ID: 1685368 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-17
Onset:2021-08-17
   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 FC3180 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Malaise, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: Nausea Dizzy Vomiting Treatment was just to get out of heat, into air-conditioning and sleep. Outcome, after about 6 hours, no more Nausea but did not feel well for a few days.


VAERS ID: 1686004 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blister, Fatigue, Myalgia, Oral herpes, Pain, Pruritus, Pyrexia, Rash, Skin exfoliation, Skin haemorrhage
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Iron, Calcium, Vitamin D3, Alendronate Sodium, Meloxicam, Oxybutinin; Zolpidiem, amlodipine
Current Illness: None
Preexisting Conditions: Insomnia;, overactive bladder; High blood pressure
Allergies: Erythromyacin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Full body rash, severe itching, joint and muscle pain, body aches, fever, blistering on my toes, very sore peeling and bleeding on my ears, fatigue, fever blister on my tongue


VAERS ID: 1686454 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-17
Onset:2021-08-17
   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 EW0196 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Nausea, Neuropathy peripheral, Peripheral swelling
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Immune-mediated/autoimmune 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: Singular.
Current Illness: NA
Preexisting Conditions: NA
Allergies: Penicilllin
Diagnostic Lab Data: Nothing at this point. I am still paying off other medical bills.
CDC Split Type:

Write-up: Within 15 minutes of the shot I was very lightheaded, nauseous and felt faint. I sat for an additional 15 minutes at pharmacy. I left because the Pharmacist told me to leave. I continued to be lightheaded, felt faint and nauseous the rest of the day. Within about 2 days of the first shot, my neuropathy in my neck and arm started to get worse. It has been three weeks and the neuropathy is still bad. I have not changed my normal routine. I am also having some swelling in my right hand as well that has not subsided. NOTE* the pharmacist noted that the injection was done in my left arm, which is incorrect. It was done in my right arm.


VAERS ID: 1664781 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-08-16
Onset:2021-08-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG0978 / 1 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Myocarditis
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Growth hormone hyposecretion
Allergies:
Diagnostic Lab Data:
CDC Split Type: JPPFIZER INC202101073672

Write-up: suspected myocarditis; This is a spontaneous report from a contactable physician received via COVID-19 regulatory authority. This 17-year-old male patient received the first dose of BNT162B2 (COMIRNATY, solution for injection, Lot number FG0978 with Expiration Date 30Nov2021), via intramuscular administered in the left arm, on 16Aug2021 12:00 (at the age of 17-year-old) at single dose for COVID-19 immunisation. Prior to vaccination, it was unknown whether the patient was diagnosed with COVID-19. Relevant medical history included growth hormone hyposecretion. The patient had no allergies to medications, food, or other products. No relevant concomitant medications were provided. On 17Aug2021 (1 day after the vaccination), the patient experienced suspected myocarditis, serious as medically significant. The event resulted in doctor or other healthcare professional office/clinic visit. The patient was treated with antipyretic analgesic. Since the vaccination, it was unknown whether the patient has been tested for COVID-19. The patient had recovered from the event on unknown date in 2021.; Sender''s Comments: Based on close temporal relationship and known drug safety profile the causal association between the event myocarditis and the vaccine BNT162B2 is assessed as probably related. 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 RAs, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1571217 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever- 101.9 Chills Injection site pain and soreness Headache


VAERS ID: 1573587 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-15
Onset:2021-08-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Fatigue, Feeling cold, Injection site pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: None
Current Illness: The common cold a few weeks ago
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe chills, fatigue, body ache, chest ache, fever, pain in the injection site


VAERS ID: 1573637 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-14
Onset:2021-08-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: swelling underneath my right underarm Pfizer-BioNTech COVID-19 Vaccine EUA


VAERS ID: 1573803 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-07
Onset:2021-08-16
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028D21A / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Conjunctival haemorrhage, Migraine
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Conjunctival disorders (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: NP Thyroid, Vitamin D, Dim-Plus
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Call virtual teledoc -. Doctor was not able to provide any care and referred me to my primary care provider.
CDC Split Type:

Write-up: Woke up with sever lower back pain. Migraine headaches. conjunctival hemorrhage in left eye.


VAERS ID: 1573866 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-15
Onset:2021-08-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Muscle tightness, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), 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: Clomid 10mg/day, Vit B6 100mg/day, Vit D2 50,000 IU 2x/week, Cetirizine 10mg/day
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tinging in left hand/arm, small tingling in left calf. Muscles on left side of body feel tight, along with general soreness at the injection site. Noticed when I woke up this morning around 8am on 8/16/2021 the tingling. It has been persistent through the morning so far.


VAERS ID: 1573893 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-08-14
Onset:2021-08-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 59267-1000-01 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymph node pain, Lymphadenopathy
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: Omeprazole, Calcium, D3, K2, Vitamin C, Joint Support, Magnesium, Omega 3
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling of the underarm lymph node and tenderness on left side


VAERS ID: 1573916 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-01-17
Onset:2021-08-16
   Days after vaccination:211
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamins
Current Illness: None
Preexisting Conditions: Allergies to meds.
Allergies: All meds except penicillin
Diagnostic Lab Data: All tests prescribed by dermatologist and internist reported at recorded by internist.
CDC Split Type:

Write-up: Full body breakout for 3 and 1/2 months.


VAERS ID: 1573933 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-08-16
   Days after vaccination:130
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Exposure to SARS-CoV-2, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), COVID-19 (narrow)

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

Write-up: Patient reports to the ED with complaints of sudden onset abdominal pain with nausea and vomiting. Patient''s daughter reports that she had Covid the 2nd of this month (August) and lives with the patient. She reports she quarantined within the home after being diagnosed. She stated that her and the patient are fully vaccinated. Patient''s daughter reports her quarantining is over.. Patient received first dose 03/11/2021 and second dose 04/08/2021.


VAERS ID: 1574013 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram, Hypoaesthesia, Tachycardia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Dehydration (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Coreg; Elavil, Lisinopril-hctz, omeprazole
Current Illness: none
Preexisting Conditions: HTN, Pt is currently on a cardiac monitor for a possible TIA a few weeks ago that was ruled out negative
Allergies: none
Diagnostic Lab Data: ekg-08-16-2021
CDC Split Type:

Write-up: Pt became tachycardia and htn 15 minutes after vaccine. Pt complained of numbness all over. Pt was placed on oxygen, Benadryl 25mg po, and Pepcid 10mg po. Heart rate came down to 90-110 at 15 min after reaction and 30 min after back up to 130s. Pt was sent to Emergency room for further eval.


VAERS ID: 1574021 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Presyncope, Tilt table test
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol 25mg, Levothyroxine 75mcg, Atorvastatin 20mg, Bupropion 150mg, Phentermine 37.5mg
Current Illness: New Rx for phentermine 8/9/21. Dose was not taken the time of the incident.
Preexisting Conditions: Hypertenion, elevated cholesterol, hypothyroid
Allergies: NKDA
Diagnostic Lab Data: n/a, orthostatic tilt test
CDC Split Type:

Write-up: Onset of acute dizziness and near syncope 8/16/21 requiring in clinic evaluation.


VAERS ID: 1574068 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: prostate cancer, CHF, gerd
Allergies: pcn, codeine, ibu, sulfa, blue dys
Diagnostic Lab Data:
CDC Split Type:

Write-up: tested positive for covid


VAERS ID: 1574088 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose normal, Dizziness, Loss of consciousness, Unresponsive to stimuli, Urinary incontinence
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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Dizziness/Lightheaded - vaccines/blood draws
Other Medications: blood pressure medication
Current Illness:
Preexisting Conditions: HTN
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient came for first Monderna vaccine. Pharmacist reviewed VAR with patient and discussed. Patient had felt lightheaded in past following vaccinations. Patient attributed it to anxiety with needles. Vaccine was administered in Left deltoid. Pharmacist stayed with patient to monitor. Patient was responsive in small talk, said he felt lightheaded. Pharmacist was about to ask pt to lie down, but patient was sitting upright and suddenly unresponsive for approximately 10 seconds, which is when technician was instructed to call 911. Patient regained consciousness, while asking patient how he felt (alert and responsive for approx. 30 seconds), he returned to unresponsive state for 10-15 seconds. Patient lost bladder control during this time. Medics were in route to pharmacy. Patient unaware of lost responsiveness. Medics checked BP/HR and blood glucose; all within normal limits per EMTs. Patient refused additional medical support.


VAERS ID: 1574154 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
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: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: UNKNOWN
Diagnostic Lab Data:
CDC Split Type:

Write-up: NO ADVERSE REACTIONS. The patient made an appointment via myTurn.com on 8/16/21. He wanted to get moderna vaccine on 8/16/21. He did not say anything that he already got other COVID 19 vaccines. After Moderna 1 dose administration, this office documented CAIR2 and found that he already got Pfizer on 3/3/21 and 3/24/21 and J&J on 5/19/21. He stated that he did not feel safe, and he got Moderna today. We observed him for 15 mins. No adverse events were noted.


VAERS ID: 1574166 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Underdose
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Error: Wrong Dose of Vaccine - Too Low-


VAERS ID: 1574169 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

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

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

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


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