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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 129 out of 6,867

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VAERS ID: 1670666 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 AR / IM

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

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

Write-up: Error, Improper Storage temperature.


VAERS ID: 1670765 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-15
Onset:2021-08-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Contusion
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 200mg Lyrica 2x daily.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: A few hours after the injection, Pt started complaining of pain under her arm. Not at the injection site. The next evening, we noticed a large bruise under her arm. It spread from under her arm down to her breast.


VAERS ID: 1670778 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-02-25
Onset:2021-08-16
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Dyspnoea, Fatigue, Headache, Heart rate decreased, Immediate post-injection reaction, Musculoskeletal discomfort, Oxygen saturation decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (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: Eliquis (Apixaban); Omeprazole; Atorvastatin; Diltiazem; Alopurinol; Metoprolol Succinate; Hydrocodone; Supplements: Iron; Vitamin D3; Daily Multi-Vitamin; Chromium; Ubiquinol; Glucosamine/Chondroitin; Tart cherry extract - natural anti-inf
Current Illness: No
Preexisting Conditions: A Fib; Idiopathic Peripheral Neuropathy; Episodic Gout; Chronic low back pain
Allergies: Augmentin - ankle rash
Diagnostic Lab Data: No
CDC Split Type: vsafe

Write-up: Immediately after vaccine, no significant ones other than I reported on v-safe permanent a fib - my heart rate/vitals changed dramatically; usually I''m stable 115/75 BP normal to 100-110 - Pulse rate; dropped to as low as 39 pulse rates. Average heart rate was 78 and BP 124/74. The lowest being as low as 39 for heart rate. I had a little shortness of breath and my O2 saturation dropped to 90 a nd that happened over a couple of day period. Normally I can''t even force it down to 94. I had general fatigue. Persistent headache - slight pulse rate is coming back up. At the beginning of the episode periodic discomfort at my left pec and shoulder. Increased anxiety levels with this - didn''t trust me to go out to get the mail. Spoke with a doctor - did not see a doctor - the facility is two hours away; did it via message service. They decreased the Metoprolol to 50 mg, and they are monitoring it now. And then we''ll examine it again. I am free to message them at any time. I have confirmed that I am feeling better as I am compliant with the decrease, and I will be getting back to them on Tuesday of next week. So, it''s an ongoing monitoring process. The average on the Pulse rate is 64 now. Anxiety has come down - but I do still have some recognized fatigue - I''m easily fatigued. We''re still maintaining self-quarantining - over this last year and a half. Not being very social at this time.


VAERS ID: 1670839 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-16
Onset:2021-08-16
   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 FD8448 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Gait inability, Neuralgia, Pain in extremity
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Azathioprine 75 mg Synthroid 0.05 mg Simvastatin 20 mg Fluoxetine 10mg Bupropion XL 150 mg Amlodipine besylate 5 mg Lubiprostone 24 mcg, twice daily Ozempic 0.5 mg/dose weekly Pantoprazole 40 mg FiberCon 625 tablets, twice daily Vitamin D3
Current Illness:
Preexisting Conditions: Autoimmune hepatitis Hypertension High cholesterol Chronic depression Hypothyroidism
Allergies: None
Diagnostic Lab Data: None Did not seek treatment because local facilities were overrun with Covid patients
CDC Split Type:

Write-up: Sharp nerve pain in right hip, dull pain in right thigh, sudden onset upon standing after sitting down, pain worsened over next 12 hours, became excruciating, could not sit up or walk unassisted, pain remained intense for 2 days before lessening, pain nearly gone after 5 days, still discomfort when lying on right side after 2 weeks. Treated at home with prescription pain killer for first 5 days, ibuprofen after that; used heat and elevation, bed rest. Would definitely have visited ER first night, but our local hospitals are overrun with Covid right now.


VAERS ID: 1672352 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-16
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 test, 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? No
Previous Vaccinations:
Other Medications:
Current Illness: Plaque psoriasis (MODERATE TO SEVERE)
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210816; Test Name: COVID-19 virus test; Result Unstructured Data: positive
CDC Split Type: USJNJFOC20210904763

Write-up: TESTED POSITIVE FOR COVID-19; This spontaneous report received from a patient concerned a 63 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: moderate to severe chronic plaque psoriasis. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: unknown) dose was not reported, administered on 2021, and dose was not reported, administered on 30-APR-2021 for prophylactic vaccination.The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. Non-company suspect drugs included: risankizumab (form of admin unknown, subcutaneous, batch number was not reported) dose, frequency, and therapy dates were not reported for moderate to severe chronic plaque psoriasis. No concomitant medications were reported. On 16-AUG-2021, the patient experienced tested positive for covid-19. Laboratory data included: COVID-19 virus test (NR: not provided) positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of tested positive for covid-19 was not reported. This report was non-serious.


VAERS ID: 1672432 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-10
Onset:2021-08-16
   Days after vaccination:6
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: Erythema, Muscle tightness
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Redness of the face; Tightness of the face; This spontaneous case was reported by a physician and describes the occurrence of ERYTHEMA (Redness of the face) and MUSCLE TIGHTNESS (Tightness of the face) in a 47-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included LOSARTAN for an unknown indication. On 10-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Aug-2021, the patient experienced ERYTHEMA (Redness of the face) and MUSCLE TIGHTNESS (Tightness of the face). At the time of the report, ERYTHEMA (Redness of the face) and MUSCLE TIGHTNESS (Tightness of the face) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The patient took a medication that causes angioedema (Losartan for more than a year). No treatment information was provided.


VAERS ID: 1672433 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, Product storage error
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: expired dose was given to a patient; vial was moved from the freezer to the refrigerator on 13Aug2021; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (expired dose was given to a patient) and PRODUCT STORAGE ERROR (vial was moved from the freezer to the refrigerator on 13Aug2021) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006D21A) for COVID-19 vaccination. No Medical History information was reported. On 16-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (expired dose was given to a patient) and PRODUCT STORAGE ERROR (vial was moved from the freezer to the refrigerator on 13Aug2021). On 16-Aug-2021, EXPIRED PRODUCT ADMINISTERED (expired dose was given to a patient) and PRODUCT STORAGE ERROR (vial was moved from the freezer to the refrigerator on 13Aug2021) 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. Concomitant product information was not provided. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 18-Aug-2021: Non significant Follow up


VAERS ID: 1672437 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Heart rate, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ADDERALL
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by reporter.
Allergies:
Diagnostic Lab Data: Test Date: 20210816; Test Name: Heart Rate; Result Unstructured Data: 110 BPM
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: heart rate has been elevated, heart rate was 110 BPM and has been over 100 most of the afternoon/evening; This spontaneous case was reported by a consumer and describes the occurrence of HEART RATE INCREASED (heart rate has been elevated, heart rate was 110 BPM and has been over 100 most of the afternoon/evening) in a 28-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) for COVID-19 vaccination. No medical history was provided by reporter. . Concomitant products included AMFETAMINE ASPARTATE, AMFETAMINE SULFATE, DEXAMFETAMINE SACCHARATE, DEXAMFETAMINE SULFATE (ADDERALL) for an unknown indication. On 16-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced HEART RATE INCREASED (heart rate has been elevated, heart rate was 110 BPM and has been over 100 most of the afternoon/evening). At the time of the report, HEART RATE INCREASED (heart rate has been elevated, heart rate was 110 BPM and has been over 100 most of the afternoon/evening) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 16-Aug-2021, Heart rate: 110 bpm (High) 110 BPM. No medical history was provided by reporter. Other concomitant includes blood pressure pills. No treatment medication reported.


VAERS ID: 1672476 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Texas  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose 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: CLARITIN [LORATADINE]
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 EXTRA DOSE ADMINISTERED (got the third dose of the Moderna COVID-19 vaccine) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included LORATADINE (CLARITIN [LORATADINE]) for an unknown indication. On 16-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced EXTRA DOSE ADMINISTERED (got the third dose of the Moderna COVID-19 vaccine). At the time of the report, EXTRA DOSE ADMINISTERED (got the third dose of the Moderna COVID-19 vaccine) had resolved. No treatment information was reported. The patient wanted to know if she could take an antihistamine she regularly took (claritin) and wanted to be sure it would not interfere with the vaccine.


VAERS ID: 1672487 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-16
Onset:2021-08-16
   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 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Myalgia, Pain, Vaccination site pain
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: left arm was hurting, where I got the shot; body aches; headaches; muscle pain; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (body aches), HEADACHE (headaches), MYALGIA (muscle pain) and VACCINATION SITE PAIN (left arm was hurting, where I got the shot) in a 51-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939902) 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 16-Aug-2021, the patient experienced PAIN (body aches), HEADACHE (headaches) and MYALGIA (muscle pain). On 17-Aug-2021, the patient experienced VACCINATION SITE PAIN (left arm was hurting, where I got the shot). At the time of the report, PAIN (body aches), HEADACHE (headaches), MYALGIA (muscle pain) and VACCINATION SITE PAIN (left arm was hurting, where I got the shot) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication of the patient was not reported. On 16-Aug-2021, the symptoms started a little, but it started again on 17-Aug-2021 after work. No treatment information was provided by the reporter.


VAERS ID: 1672526 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-09
Onset:2021-08-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E27A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination complication, Vaccination site erythema, Vaccination site pruritus, 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:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Experienced a hot; Covid arm; itchy; red spot/Rash; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Experienced a hot), VACCINATION COMPLICATION (Covid arm), VACCINATION SITE PRURITUS (itchy) and VACCINATION SITE ERYTHEMA (red spot/Rash) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E27A) for COVID-19 vaccination. No Medical History information was reported. On 09-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced VACCINATION SITE WARMTH (Experienced a hot), VACCINATION COMPLICATION (Covid arm), VACCINATION SITE PRURITUS (itchy) and VACCINATION SITE ERYTHEMA (red spot/Rash). At the time of the report, VACCINATION SITE WARMTH (Experienced a hot), VACCINATION COMPLICATION (Covid arm), VACCINATION SITE PRURITUS (itchy) and VACCINATION SITE ERYTHEMA (red spot/Rash) outcome was unknown. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged. No concomitant medications were reported. No Treatment medications were reported.


VAERS ID: 1672532 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-02
Onset:2021-08-16
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Menstrual disorder
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: LEXAPRO; TESTOSTERONE; ABILIFY
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by the reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: I did not have a period in over a year, and the day after the first and second vaccination I had my period; More than 35 days between first and second shot; This spontaneous case was reported by a consumer and describes the occurrence of MENSTRUAL DISORDER (I did not have a period in over a year, and the day after the first and second vaccination I had my period) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days between first and second shot) in a 21-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 05392114 and 041C21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included ESCITALOPRAM OXALATE (LEXAPRO), TESTOSTERONE and ARIPIPRAZOLE (ABILIFY) for an unknown indication. On 02-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 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 16-Aug-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days between first and second shot). On 17-Aug-2021, the patient experienced MENSTRUAL DISORDER (I did not have a period in over a year, and the day after the first and second vaccination I had my period). On 16-Aug-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days between first and second shot) had resolved. At the time of the report, MENSTRUAL DISORDER (I did not have a period in over a year, and the day after the first and second vaccination I had my period) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) and mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient says she takes testosterone as her body does not produce Estrogen and that she never has a period. treatment information was not provided This case was linked to MOD-2021-291006 (Patient Link).


VAERS ID: 1672550 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-19
Onset:2021-08-16
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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

Write-up: Headache after the second shot; Pain all over body after the second shot; Low Grade Fever after the second shot; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache after the second shot), MYALGIA (Pain all over body after the second shot) and PYREXIA (Low Grade Fever after the second shot) in a 56-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. Concurrent medical conditions included Amputee (Left leg above knee). On 19-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 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 16-Aug-2021, the patient experienced HEADACHE (Headache after the second shot), MYALGIA (Pain all over body after the second shot) and PYREXIA (Low Grade Fever after the second shot). On 18-Aug-2021, HEADACHE (Headache after the second shot), MYALGIA (Pain all over body after the second shot) and PYREXIA (Low Grade Fever after the second shot) had resolved. No Concomitant Medications were provided. No Treatment Medications were provided.


VAERS ID: 1672556 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-01-09
Onset:2021-08-16
   Days after vaccination:219
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Bedridden, Body temperature, Fatigue, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: 100F
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Sore arm; Fever 100F; Tired; A day in bed; This spontaneous case was reported by a consumer and describes the occurrence of BEDRIDDEN (A day in bed), PAIN IN EXTREMITY (Sore arm), PYREXIA (Fever 100F) and FATIGUE (Tired) in an 85-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 025J20A and 012M20A) for COVID-19 vaccination. No Medical History information was reported. On 09-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-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 16-Aug-2021, the patient experienced BEDRIDDEN (A day in bed). On an unknown date, the patient experienced PAIN IN EXTREMITY (Sore arm), PYREXIA (Fever 100F) and FATIGUE (Tired). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at a dose of 1 dosage form. On 17-Aug-2021, BEDRIDDEN (A day in bed) had resolved. At the time of the report, PAIN IN EXTREMITY (Sore arm), PYREXIA (Fever 100F) and FATIGUE (Tired) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 100f (High) 100F. Concomitant product use was not provided by the reporter. On 18 Aug 2021, the patient was feeling fine but not 100 percent. This case was linked to MOD-2021-290368, MOD-2021-290627 (Patient Link).


VAERS ID: 1672564 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-15
Onset:2021-08-16
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Headache, Hyperhidrosis, Inappropriate schedule of product administration, Myalgia, Pyrexia, Vaccination site erythema, Vaccination site swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Medication errors (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:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: first dose of the Moderna COVID-19 vaccine on 15Apr2021 and the second on 16Aug2021; pressure headache; swelling where the injection was given; Rash the size of an eye patch where the injection was given; sweats; fever; chills; body aches; This spontaneous case was reported by a consumer and describes the occurrence of HYPERHIDROSIS (sweats), PYREXIA (fever), CHILLS (chills), MYALGIA (body aches) and HEADACHE (pressure headache) in a 24-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 04C21A and 047A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 in December 2020. On 15-Apr-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 16-Aug-2021, the patient experienced HYPERHIDROSIS (sweats), PYREXIA (fever), CHILLS (chills) and MYALGIA (body aches). On 17-Aug-2021, the patient experienced HEADACHE (pressure headache), VACCINATION SITE SWELLING (swelling where the injection was given) and VACCINATION SITE ERYTHEMA (Rash the size of an eye patch where the injection was given). On an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (first dose of the Moderna COVID-19 vaccine on 15Apr2021 and the second on 16Aug2021). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) for Headache, at an unspecified dose and frequency. On 17-Aug-2021, HYPERHIDROSIS (sweats), PYREXIA (fever), CHILLS (chills) and MYALGIA (body aches) had resolved. At the time of the report, HEADACHE (pressure headache), VACCINATION SITE SWELLING (swelling where the injection was given) and VACCINATION SITE ERYTHEMA (Rash the size of an eye patch where the injection was given) had not resolved and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (first dose of the Moderna COVID-19 vaccine on 15Apr2021 and the second on 16Aug2021) had resolved. No concomitant medications were provided by reporter.


VAERS ID: 1672568 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-07-12
Onset:2021-08-16
   Days after vaccination:35
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: Arthralgia, Dyskinesia, Feeling hot, Flushing, Gait disturbance, Insomnia, Pain in extremity, Pruritus, Vaccination site pain, Vascular pain, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Feels warm; Could not sleep straight because every 2-3 hours he will wake up with his leg pain; flushed; pain on his legs but mostly on his right leg; Legs jerks and it will cause pain again; Pain round the ankle going up to the legs; right arm is very itchy; Right arm is painful; veins on his both legs looks swollen; Veins on his both legs very painful to touch,; Limping/can hardly stand on his feet at the time of the call; This spontaneous case was reported by a non-health professional and describes the occurrence of PRURITUS (right arm is very itchy), VACCINATION SITE PAIN (Right arm is painful), VASODILATATION (veins on his both legs looks swollen), VASCULAR PAIN (Veins on his both legs very painful to touch,) and GAIT DISTURBANCE (Limping/can hardly stand on his feet at the time of the call) in a 79-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Food allergy. Concomitant products included ATORVASTATIN CALCIUM (LIPITOR) for an unknown indication. On 12-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 16-Aug-2021, the patient experienced PRURITUS (right arm is very itchy), VACCINATION SITE PAIN (Right arm is painful), VASODILATATION (veins on his both legs looks swollen), VASCULAR PAIN (Veins on his both legs very painful to touch,), GAIT DISTURBANCE (Limping/can hardly stand on his feet at the time of the call), DYSKINESIA (Legs jerks and it will cause pain again) and ARTHRALGIA (Pain round the ankle going up to the legs). On 17-Aug-2021, the patient experienced FEELING HOT (Feels warm), INSOMNIA (Could not sleep straight because every 2-3 hours he will wake up with his leg pain), FLUSHING (flushed) and PAIN IN EXTREMITY (pain on his legs but mostly on his right leg). At the time of the report, PRURITUS (right arm is very itchy), VACCINATION SITE PAIN (Right arm is painful), VASODILATATION (veins on his both legs looks swollen), VASCULAR PAIN (Veins on his both legs very painful to touch,), GAIT DISTURBANCE (Limping/can hardly stand on his feet at the time of the call), FEELING HOT (Feels warm), INSOMNIA (Could not sleep straight because every 2-3 hours he will wake up with his leg pain), FLUSHING (flushed), PAIN IN EXTREMITY (pain on his legs but mostly on his right leg), DYSKINESIA (Legs jerks and it will cause pain again) and ARTHRALGIA (Pain round the ankle going up to the legs) outcome was unknown. patient took vitamin C as concomitant medication and also mentioned that took his first dose on 12-JUL-2021 and experienced some events. No treatment medications are provided by reporter. This case was linked to MOD-2021-291444 (Patient Link).


VAERS ID: 1672603 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Allergy to vaccine, Disturbance in attention, Dizziness, Eyelid irritation, Fatigue, Hypersomnia, Vaccination complication
SMQs:, Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug hypersensitivity (Sulfa); Food allergy (patient had other food allergies); Fruit allergy (watermelon); Fruit allergy (Apple); Latex allergy; Vegetable allergy (Carrots)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Still feels tired; Felt "in and out of it"; Felt like she feels when she has a sulfa allergy/she does have multiple allergies including Sulfa, latex, apples, watermelon, carrots, and other food allergies; Light headed; Couldn''t focus; Couldn''t keep her eyelids open; Slept for two days straight; This spontaneous case was reported by a consumer and describes the occurrence of ALLERGY TO VACCINE (Felt like she feels when she has a sulfa allergy/she does have multiple allergies including Sulfa, latex, apples, watermelon, carrots, and other food allergies), DIZZINESS (Light headed), DISTURBANCE IN ATTENTION (Couldn''t focus), EYELID IRRITATION (Couldn''t keep her eyelids open) and HYPERSOMNIA (Slept for two days straight) in a 47-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. Concurrent medical conditions included Drug hypersensitivity (Sulfa), Fruit allergy (Apple), Fruit allergy (watermelon), Vegetable allergy (Carrots), Latex allergy and Food allergy (patient had other food allergies). On 16-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Aug-2021, the patient experienced ALLERGY TO VACCINE (Felt like she feels when she has a sulfa allergy/she does have multiple allergies including Sulfa, latex, apples, watermelon, carrots, and other food allergies), DIZZINESS (Light headed), DISTURBANCE IN ATTENTION (Couldn''t focus), EYELID IRRITATION (Couldn''t keep her eyelids open) and HYPERSOMNIA (Slept for two days straight). On 17-Aug-2021, the patient experienced VACCINATION COMPLICATION (Felt "in and out of it"). On 19-Aug-2021, the patient experienced FATIGUE (Still feels tired). On 17-Aug-2021, EYELID IRRITATION (Couldn''t keep her eyelids open) and HYPERSOMNIA (Slept for two days straight) had resolved. On 19-Aug-2021, DIZZINESS (Light headed) and DISTURBANCE IN ATTENTION (Couldn''t focus) had resolved. At the time of the report, ALLERGY TO VACCINE (Felt like she feels when she has a sulfa allergy/she does have multiple allergies including Sulfa, latex, apples, watermelon, carrots, and other food allergies), VACCINATION COMPLICATION (Felt "in and out of it") and FATIGUE (Still feels tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided.


VAERS ID: 1672841 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Heart rate, Insomnia, Pain, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Heart rate; Result Unstructured Data: High (Rapid heart beat during day time); Test Date: 20210816; Test Name: Heart rate; Result Unstructured Data: Increased
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: breathing very hard; could not even go to sleep; arm was also hurting; It was very sore that night; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (breathing very hard), INSOMNIA (could not even go to sleep), PAIN IN EXTREMITY (arm was also hurting) and PAIN (It was very sore that night) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 035C21A) for COVID-19 vaccination. No Medical History information was reported. On 16-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Aug-2021, the patient experienced DYSPNOEA (breathing very hard), INSOMNIA (could not even go to sleep), PAIN IN EXTREMITY (arm was also hurting) and PAIN (It was very sore that night). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at a dose of 1 dosage form. At the time of the report, DYSPNOEA (breathing very hard), INSOMNIA (could not even go to sleep), PAIN IN EXTREMITY (arm was also hurting) and PAIN (It was very sore that night) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 16-Aug-2021, Heart rate: increased (High) Increased. On an unknown date, Heart rate: high (High) High (Rapid heart beat during day time). The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported. Patient felt heart beating was very fast and breathing very hard. It lasted for a while and patient could not even go to sleep. The next night was better. Previous day, patient had rapid heartbeat during the day. Patient never had any trouble with rapid heartbeat or breathing. It was very sore that night (same day of first vaccination), and for a couple of days it continued.


VAERS ID: 1672899 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-06
Onset:2021-08-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 1 - / OT

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

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

Write-up: tested positive for covid; This spontaneous case was reported by a pharmacist and describes the occurrence of COVID-19 (tested positive for covid) in a 35-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025C21A) for COVID-19 vaccination. No Medical History information was reported. On 06-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced COVID-19 (tested positive for covid). At the time of the report, COVID-19 (tested positive for covid) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was reported. The treatment information was unknown.


VAERS ID: 1673037 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blister, Erythema, Fatigue, Feeling abnormal, Oral herpes, Pain, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal infections (narrow), 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), Opportunistic infections (broad)

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

Write-up: Started not felling good; Blisters on face; Cold sores/Fever bilisters; Redness legs/Redness feet; Swelling legs/Swelling feet; Achy; Tired; Felt feverish, but no fever; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (Started not felling good), BLISTER (Blisters on face), ORAL HERPES (Cold sores/Fever bilisters), ERYTHEMA (Redness legs/Redness feet) and PERIPHERAL SWELLING (Swelling legs/Swelling feet) in a 40-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 information was reported. On 16-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Aug-2021, the patient experienced PAIN (Achy), FATIGUE (Tired) and PYREXIA (Felt feverish, but no fever). On 21-Aug-2021, the patient experienced FEELING ABNORMAL (Started not felling good), BLISTER (Blisters on face), ORAL HERPES (Cold sores/Fever bilisters), ERYTHEMA (Redness legs/Redness feet) and PERIPHERAL SWELLING (Swelling legs/Swelling feet). The patient was treated with IBUPROFEN (MOTRIN IB) at an unspecified dose and frequency. At the time of the report, FEELING ABNORMAL (Started not felling good), BLISTER (Blisters on face), ORAL HERPES (Cold sores/Fever bilisters), ERYTHEMA (Redness legs/Redness feet), PERIPHERAL SWELLING (Swelling legs/Swelling feet), PAIN (Achy), FATIGUE (Tired) and PYREXIA (Felt feverish, but no fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment medication include steroid and anti-viral medication. Concomitant medication was not provided.


VAERS ID: 1673092 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-15
Onset:2021-08-16
   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 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Asthenia, Back pain, Chest discomfort, Computerised tomogram, Feeling abnormal, Food aversion, Headache, Migraine, Musculoskeletal discomfort, Paraesthesia, Thirst, Weight decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210820; Test Name: CAT scan; Result Unstructured Data: normal.
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: anxiety state, unspecified; chest and neck feel intense which comes and goes; patient received intravenous migraine medication; not herself; lost 5 pounds; lower left back pain which feels internal; chest and neck feel intense which comes and goes; pressure tingly feeling in her head; weak; thirsty; food aversion, couldn''t eat, felt hungry, tasted disgusting; headache; This spontaneous case was reported by a consumer and describes the occurrence of MIGRAINE (patient received intravenous migraine medication) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088D21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 15-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-Aug-2021, the patient experienced ASTHENIA (weak), THIRST (thirsty), FOOD AVERSION (food aversion, couldn''t eat, felt hungry, tasted disgusting), PARAESTHESIA (pressure tingly feeling in her head) and HEADACHE (headache). On 18-Aug-2021, the patient experienced CHEST DISCOMFORT (chest and neck feel intense which comes and goes). On an unknown date, the patient experienced MIGRAINE (patient received intravenous migraine medication) (seriousness criterion medically significant), FEELING ABNORMAL (not herself), WEIGHT DECREASED (lost 5 pounds), BACK PAIN (lower left back pain which feels internal), MUSCULOSKELETAL DISCOMFORT (chest and neck feel intense which comes and goes) and ANXIETY (anxiety state, unspecified). The patient was treated with IBUPROFEN ongoing from 18-Aug-2021 for Head pressure, at a dose of 1 dosage form. At the time of the report, MIGRAINE (patient received intravenous migraine medication), ASTHENIA (weak), THIRST (thirsty), FOOD AVERSION (food aversion, couldn''t eat, felt hungry, tasted disgusting), FEELING ABNORMAL (not herself), PARAESTHESIA (pressure tingly feeling in her head), WEIGHT DECREASED (lost 5 pounds), BACK PAIN (lower left back pain which feels internal), CHEST DISCOMFORT (chest and neck feel intense which comes and goes), MUSCULOSKELETAL DISCOMFORT (chest and neck feel intense which comes and goes), ANXIETY (anxiety state, unspecified) and HEADACHE (headache) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 20-Aug-2021, Computerised tomogram: normal (normal) normal. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. no concomitant information was provided by reporter. They gave her an IV of a migraine medication. she thinks it was Toradol but was unsure. 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.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1673223 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-14
Onset:2021-08-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: IBUPROFEN; TYLENOL
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101058751

Write-up: Painful swollen lymph nodes under injection side arm; Hives/rash; Hives/rash; Sore arm; This is a spontaneous report from a non-contactable consumer (patient). A 14-years-old male patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration, administered in Arm Right on 14Aug2021 17:00 at age of 14-years-old (Lot Number: FD8448) as DOSE 1, SINGLE for covid-19 immunisation. The patient medical history was not reported. Concomitant medications included ibuprofen; paracetamol (TYLENOL). The patient experienced Painful swollen lymph nodes under injection side arm, hives, rash, sore arm on 16Aug2021 05:00 with outcome of recovering. The patient received Benadryl, hydrocortisone cream as treatment. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1673224 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Extra dose administered, Fatigue, Gait disturbance, Off label use, Somnolence
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Medication errors (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101063929

Write-up: difficulty staying awake; dizziness; difficulty walking/could hardly walk; received third dose; received third dose; tiredness; This is a spontaneous report from a contactable Consumer. A 76-years-old female patient received third dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported) via unspecified route of administration on 16Aug2021 at around 17:00 (age at the time of vaccination was 76-year-old) as a single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. Previously patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported) via unspecified route of administration in Jan2021 (age at the time of vaccination was 76-year-old) as a single dose, second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported) via unspecified route of administration on an unspecified date, as a single dose for COVID-19 immunization. On 16Aug2021, the patient experienced tiredness, difficulty walking/could hardly walk and received third dose. On 17Aug2021, the patient experienced dizziness. On an unspecified date, the patient experienced difficulty staying awake. Subsequently experienced dizziness, tiredness, difficulty walking, and difficulty staying awake. Caller states he and his wife both received booster doses (third doses) of the Pfizer BioNTech Covid-19 Vaccine yesterday at 5PM. Caller states his wife began experiencing side effects such as ty walking, and difficulty staying awake. Caller states his wife has been lying down since she can hardly walk. Caller states his wife was sitting up now but her eyes are closed. Caller states they both received their first doses of the vaccine in Jan. He''s calling about the Pfizer Covid 19 booster, clarified the third dose. He reports he and his wife both received their booster dose yesterday afternoon, 16Aug2021 around 5:00PM. In the last 10-15 minutes his wife got dizzy and could hardly walk, she had to lay down. He was asking if this could be a side effect. Outcome of all the events was unknown. Outcome of all the events was unknown. The lot no number of the vaccine [BNT162B2] was not provided and will be requested during follow up.


VAERS ID: 1673228 (history)  
Form: Version 2.0  
Age: 2.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Accidental exposure to product by child, Body temperature, Pyrexia, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic 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: Viral infection (fever and hives are some sort of viral infection which she has had in past, but not these kind).
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: fever; Result Unstructured Data: Test Result: low grade around 100 degrees F.
CDC Split Type: USPFIZER INC202101068628

Write-up: Got ahold of bandage and broke out in fever, hives and rash on arms and legs; Got ahold of bandage and broke out in fever, hives and rash on arms and legs; Got ahold of bandage and broke out in fever, hives and rash on arms and legs; Got ahold of bandage and broke out in fever, hives and rash on arms and legs; This is a spontaneous report from a contactable consumer. This consumer (patient mother) reported for a 2-year-old female patient. A 2-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection. Batch/Lot number was not reported), via an unspecified route of administration on 16Aug2021 (at the age of 2-yers-old) as DOSE NUMBER UNKNOWN, SINGLE for COVID-19 immunization. Medical history included viral infection (She saw where fever and hives are some sort of viral infection which she has had in past, but not these kind) from an unknown date and unknown if ongoing. There were no concomitant medications. Patient history and investigation assessment: No. It was reported that, consumer said she received the 2nd dose of the Pfizer-BioNTech COVID-19 Vaccine on 16Aug2021, Monday. She said her husband received his 1st dose on the same day, and they never had any reaction, however, her 2-year-old got ahold of bandages from vaccine and somehow a couple of hours later broke out in fever and hives. She was not sure if it was related. She just wonders if any trace amount of vaccine got on her skin. She had not been in contact with anyone else. She works from home and they are diligent and strict about restrictions. She would like to know if the fever, hives and rash that her daughter experienced after playing with the Band-Aids after she and her husband got vaccinated could be related to the Pfizer COVID vaccine. It was mentioned that, I also told the consumer that since their daughter has not received the vaccine yet, then Pfizer cannot assess whether the reaction she had caused by the Pfizer-BioNTech COVID-19 Vaccine. Then, I referred them to their daughter''s doctor as they would be in the best position to give them advice on the appropriate actions to be taken. She will wait a couple of days to see if it improves before she decides to go to the doctor. It has not gotten any worse as of yet. She came home and her daughter has a thing for band-aids. They set them on counter and she had them in her hand and was playing with them. The fever has persisted and it is low grade around 100. It gets better with Motrin. The hives go away with Benadryl, but they come back. She gave it yesterday morning and it was back by evening. By the evening, she gave more and they were back by morning. She saw where fever and hives are some sort of viral infection which she has had in past, but not these kind. They are going away with this antihistamine. She had been in the house all day. The rash on her daughter was on her arms and legs, but viral rashes are normally on her torso and this was not. No further details provided. Separate report completed to document his experience. The outcome of the event accidental exposure to product by child was unknown while other events were not recovered. The lot number was not provided. Information on lot number has been requested during follow up.


VAERS ID: 1673277 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-16
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, COVID-19, Cough, Fatigue, Pain, Pyrexia, SARS-CoV-2 test, Vaccination failure
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), 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: 20210816; Test Name: Fever; Result Unstructured Data: Test Result: 37.8 Centigrade; Test Date: 20210818; Test Name: PCR; Test Result: Positive; Comments: Nasal Swab.
CDC Split Type: USPFIZER INC202101082237

Write-up: Patient covid positive; Patient covid positive; feel body pains; fatigue; fever (37.8C); Cough; This is a spontaneous report from a contactable consumer (reported for himself). A 40-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: EN6205/Batch number was not reported), dose 1 via an unspecified route of administration, administered in arm left on an unspecified date (at the age of 40-years-old) as dose 1, single and dose 2 via an unspecified route of administration on an unspecified date (Lot Number: EW0158/Batch number was not reported) as dose 2, single for covid-19 immunisation at other. The patient medical history and concomitant medications were not reported. The patient did not receive any other vaccines within four weeks prior to the vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has been tested for COVID-19. The patient experienced feel body pains, fatigue, fever (37.8 Centigrade), cough on 16Aug2021 and patient covid positive on 18Aug2021. The event patient covid positive assessed as serious (medically significant). The patient underwent lab tests and procedures which included body temperature: 37.8 Centigrade on 16Aug2021 and sars-cov-2 test: positive on 18Aug2021 (nasal swab). The outcome of the events was not resolved. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1673289 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-16
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210818; Test Name: PCR/nasal Swab; Test Result: Positive ; Comments: PCR and 2 at home tests
CDC Split Type: USPFIZER INC202101082628

Write-up: I got covid 3 months after being fully vaccinated with the Pfizer Vaccine.; I got covid 3 months after being fully vaccinated with the Pfizer Vaccine.; This is a spontaneous report from a contactable consumer (patient). A 37-years-old male patient received first dose of bnt162b2 (Pfizer covid-19 vaccine, Solution for injection, Lot number: er8731), via an unspecified route of administration in the left arm on 14Apr2021 at 15:00 (age at vaccination: 37-year-old) and second dose of bnt162b2 (Pfizer covid-19 vaccine, Solution for injection, Lot number: Ew0173) via an unspecified route of administration in the left arm on an unspecified date, both as a single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, patient was not diagnosed with COVID-19. On 16Aug2021 at 17:00, patient got COVID 3 months after being fully vaccinated with the Pfizer Vaccine. Adverse event resulted in Doctor or other healthcare professional office/clinic visit. Patient did not receive any treatment for the events. The patient underwent lab test and procedure which included PCR covid test post vaccination, nasal Swab: positive on 18Aug2021 and 2 at home tests. The clinical outcome of COVID-19 was recovering. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1673296 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Colorado  
Vaccinated:0000-00-00
Onset:2021-08-16
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, Headache, Nasal congestion, SARS-CoV-2 test, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210816; Test Name: Covid-19 virus test; Result Unstructured Data: Test Result:Positive
CDC Split Type: USPFIZER INC202101082669

Write-up: mild headache; some nasal congestion; Unfortunately, I became infected last weekend, testing positive on 16Aug; I received both of my Pfizer vaccine shots in April. Unfortunately, I became infected last weekend; This is spontaneous report from a contactable consumer(patient). An unknown age and gender patient received bnt162b2 (BNT162B2, formulation: solution for injection, Batch/Lot number were not reported) dose 2 via an unspecified route of administration on an unspecified date as dose 2, single for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient past drug history included bnt162b2 (BNT162B2, formulation: solution for injection, Batch/Lot number were not reported) dose 1 via an unspecified route of administration on an unspecified date as dose 1, single for COVID-19 immunisation. The patient received both of my Pfizer vaccine shots in April. Unfortunately, patient became infected last weekend, testing positive on 16Aug2021. patient symptoms, which were a mild headache and some nasal congestion, would have likely been severe if not for your vaccine. The patient underwent lab tests and procedures which included Covid-19 virus test was positive on 16Aug2021. The outcome of the events was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1673370 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angioedema, Ear pruritus, Erythema, Eye pruritus, Hypersensitivity, Pruritus, Rash macular, Swelling face, Throat irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CONCERTA; CYMBALTA; ARMOUR THYROID
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypothyroidism; Latex allergy; Migraine headache; Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101092114

Write-up: Progressed to symptoms of angioedema.; Systemic " itching "- head, arms, upper anterior thighs bilaterally, vaguely within about 20-30 minutes.; Facial swelling; red face; blotchy red patches arms, back, legs face; severe itchy (10) inside of ears (deep), eyes; severe itchy (10) inside of ears (deep), eyes; scratchy throat; Next morning, allergic reaction covered by medication; This is a spontaneous report from a contactable Nurse (patient). A 58-year-old female patient not pregnant received first dose of bnt162b2 (BNT162B2), via an unspecified route of administration, administered in Arm Left on 16Aug2021 19:00 (Lot Number: fc3181) as single dose (at age of 58-year-old) for covid-19 immunisation. Medical history included migraine headache (h/a), hypothyroid, latex allergy, penicillin (PCN) allergy. Concomitant medications included methylphenidate hydrochloride (CONCERTA); duloxetine hydrochloride (CYMBALTA); thyroid (ARMOUR THYROID). Facility type vaccine: Pharmacy or Drug Store. It was unknown if patient had COVID prior vaccination and was not tested for COVID post vaccination. On 16Aug2021 patient experienced progressed to symptoms of angioedema, systemic " itching "- head, arms, upper anterior thighs bilaterally, vaguely within about 20-30 minutes, facial swelling, red face, blotchy red patches arms, back, legs face, severe itchy (10) inside of ears (deep), eyes, scratchy throat, next morning, allergic reaction covered by medication. Events resulted in Doctor or other healthcare professional office/clinic visit. Clinical course was reported as follows: Systemic "itching "- head, arms, upper anterior thighs bilaterally, vaguely within about 20-30 minutes. Progressed to symptoms of angioedema. Facial swelling, red face, blotchy red patches arms, back, legs face, although much more severe itchy (10) inside of ears (deep), eyes, and scratchy throat. Patient had no food or anything else but water after the vaccination. These symptoms evolved over two hours, increasing in intensity. Patient had Benadryl and prednisone in her medicine box and took 75 mg Benadryl, (liquid) 50 ng prednisone at 10:00 pm. Was up until 12:00 midnight; symptoms quelled 80% by 12:30 am. Next morning, allergic reaction covered by medication. General practitioner (GP), notified and was documented. Patient was treated for the events. Patient was recovering from all the events, at the time of the report.


VAERS ID: 1673412 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: New York  
Vaccinated:2021-02-24
Onset:2021-08-16
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 RA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma
Allergies:
Diagnostic Lab Data: Test Date: 20210825; Test Name: Rapid Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202101110265

Write-up: lack of efficacy- contracted COVID-19; lack of efficacy- contracted COVID-19; This is a spontaneous report from a contactable consumer (patient). A 40-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 intramuscular administered in Arm Right on 05Feb2021 (Lot Number: EM9810) at age of 39-year-old, dose 2 intramuscular administered in Arm Right on 24Feb2021 (Lot Number: EN6202) at age of 39-year-old, both at single dose for covid-19 immunisation. Medical history included asthma. No covid prior vaccination. There were no concomitant medications. The patient previously took cefaclor (CECLOR) and experienced drug hypersensitivity. No other vaccine in four weeks. The patient experienced lack of efficacy- contracted covid-19 on 16Aug2021. Events resulted in [Doctor or other healthcare professional office/clinic visit]. No treatment received. The patient underwent lab tests and procedures which included sars-cov-2 test (Rapid Nasal Swab): positive on 25Aug2021. The outcome of events was recovering. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1673416 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Fatigue, Headache, Pain, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101110549

Write-up: backaches; extreme fatigue; leg and body aches; leg and body aches; recurring headaches; This is a spontaneous report from a contactable consumer reporting for granddaughter (patient) via medical information team. A 14-year-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot Number: unknown, expiration date: unknown), via an unspecified route administered on 13Aug2021 (at the age of 14-year-old) as DOSE 2, SINGLE for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot Number: unknown, expiration date: unknown) administered via unknown route on an unknown date as DOSE 1, SINGLE for COVID-19 immunization. The patient had no history of adverse events with any previous vaccines. No additional Vaccines Administered on Same Date of the Pfizer Suspect. Reporter stated that patient received her second dose of the vaccine on 13Aug2021, after which she developed backaches on 26Aug2021, leg and body aches, recurring headaches, and extreme fatigue on 16Aug2021. The back ache was intermittent. Reporter stated that the extreme fatigue vary from tired to very tired and it is persistent with some extreme fatigue and that it goes up and down. It was reported that no medical treatment was given and patient just took Tylenol. No further details provided. The outcome of all the events was not recovered. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1673442 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-16
Onset:2021-08-16
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
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 test/Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202101119771

Write-up: I tested positive for a breakthrough infection of COVID-19; I tested positive for a breakthrough infection of COVID-19; This is a spontaneous report from a non-contactable consumer (patient). A 28-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: EW0185), via an unspecified route of administration on arm right on 16May2021(age at vaccination: 28 Years) as dose 2, single and received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: EW0171), via an unspecified route of administration on arm right on 25Apr2021 as dose 1, single for COVID-19 immunization at Pharmacy or Drug Store. The patient medical history was not reported. The patient has not received any other vaccines within 4 weeks prior to the COVID vaccine. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient Concomitant medications were not reported. On 16Aug2021, the patient tested positive for a breakthrough infection of COVID-19. The event resulted in Doctor or other healthcare professional office/clinic visit. Since the vaccination, the patient has tested for COVID-19. Treatment received was reported as no. The lab test included SARS-CoV-2 test(Nasal Swab): positive on 17Aug2021.The outcome of event was resolving. No follow up attempts are possible. No further information is expected.


VAERS ID: 1674862 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Induration, Nodule, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Swollen eyes and then hard, red, purple lumps in tear troughs . Still not resolved. GP prescribed corticosteroid.


VAERS ID: 1674869 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-21
Onset:2021-08-16
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Heart rate increased, Magnetic resonance imaging heart, Palpitations, Ventricular extrasystoles, X-ray
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multi-vitamin, protein supplement
Current Illness: Anxiety
Preexisting Conditions: None that I know
Allergies:
Diagnostic Lab Data: Blood work, x ray, cardiac mri
CDC Split Type:

Write-up: Rapid heart rate 2 weeks after 2nd dose; Palpitations/PVC 3weeks after 2nd dose.


VAERS ID: 1674938 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-01
Onset:2021-08-16
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstruation irregular
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amoxicillin 500mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: After receiving my first shot 2-3 weeks later I started having very heavy long period. I have a birth control implant for 2yrs now and it stops me from having regular periods. Now they come every 2-3 weeks and last 6 days I?ve never had that happen to me before.


VAERS ID: 1675041 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-07
Onset:2021-08-16
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Cough, Fatigue, Muscle fatigue, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fineasteride, omeprozale
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Multiple visits to urgent care. Negative Covid test 9/2/21
CDC Split Type:

Write-up: Severe fatigue, muscle fatigue, cough and chest pain developed 9 days later.


VAERS ID: 1675049 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphthous ulcer, Asthenia, Balance disorder, Diarrhoea, Dizziness, Electric shock sensation, Feeling abnormal, Flushing, Groin pain, Headache, Hyperhidrosis, Insomnia, Nausea, Pain, Rash, Skin warm, Temperature intolerance, Vertigo, Vision blurred
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Osteonecrosis (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Vitamin C, Zinc, Tizanidine, Maxalt, Fiorcet
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Complete blood work done 9/3/21.
CDC Split Type:

Write-up: 15 minutes after receiving first dose, got up to leave the pharmacy and the room started spinning and the floor felt like it was moving. I almost fell. Since then I have had headache, room spinning, dizziness, nausea, blurred vision, electrical shocks in legs and chest, diarrhea, sweating, heat intolerance, unsteady walking, flushed face, groin pain, body aches, insomnia, vertigo, weakness, canker sores, burning body rash, brain fog.


VAERS ID: 1675367 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-05
Onset:2021-08-16
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Cough, Dyspnoea, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levoxyl Flovent Adderal Zyrtec
Current Illness: None
Preexisting Conditions: Asthma Hypothyroidism
Allergies: Amoxicillin
Diagnostic Lab Data: Positive Covid test
CDC Split Type:

Write-up: Fever, chills, loss of smell/taste, cough, difficulty breathing


VAERS ID: 1675698 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
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: Arthralgia, Limb discomfort, Pain
SMQs:, Arthritis (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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: No Known Allergies
Diagnostic Lab Data: No testing
CDC Split Type:

Write-up: Patient reported a joint pain on the medial elbow that was not present before they shot, he states it feels like an "arthritic, joint pain" in the elbow. He states that it worsened during the week of his first shot but after that week seemed to get better but still has pain when lifting objects and when making a fist that he feels discomfort.


VAERS ID: 1675773 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discharge, Erythema, Induration, Lymphadenopathy, Pain, Skin irritation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: under left arm my lymph-nope became hard and swollen and tons of puss came out.. very painful. still red and irratated d as of today.


VAERS ID: 1676259 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-02-25
Onset:2021-08-16
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: Chest pressure, difficulty breathing (aug 16-present)


VAERS ID: 1677133 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-07-19
Onset:2021-08-16
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 LA / OT

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

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

Write-up: Administered today from a vial that was punctured more than 12 hours ago; This spontaneous case was reported by a consumer and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Administered today from a vial that was punctured more than 12 hours ago) in a 59-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 088D21A and 051C21A) 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) (Intramuscular) 1 dosage form. On 16-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 16-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Administered today from a vial that was punctured more than 12 hours ago). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Administered today from a vial that was punctured more than 12 hours ago) had resolved. No concomitant medications were reported. No treatment information was reported.


VAERS ID: 1677138 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Nausea, Presyncope, Vaccination site discomfort, Vaccination site pain
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MULTIVITAMIN [VITAMINS NOS]
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: During a meeting I was feeling really woozy and lightheaded I have never passed out but today I felt close to it; During a meeting I was feeling really woozy and lightheaded I have never passed out but today I felt close to it; I felt nausea Tuesday I was not feeling great and today the Lightheadedness was very significant; I received the injection in my left arm but it is uncomfortable and painful when I go to sleep on my left side; I received the injection in my left arm but it is uncomfortable and painful when I go to sleep on my left side; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE DISCOMFORT (I received the injection in my left arm but it is uncomfortable and painful when I go to sleep on my left side), DIZZINESS (During a meeting I was feeling really woozy and lightheaded I have never passed out but today I felt close to it), PRESYNCOPE (During a meeting I was feeling really woozy and lightheaded I have never passed out but today I felt close to it), VACCINATION SITE PAIN (I received the injection in my left arm but it is uncomfortable and painful when I go to sleep on my left side) and NAUSEA (I felt nausea Tuesday I was not feeling great and today the Lightheadedness was very significant) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 050C21A) for COVID-19 vaccination. Concomitant products included MULTIVITAMIN [VITAMINS NOS] for an unknown indication. On 16-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced VACCINATION SITE DISCOMFORT (I received the injection in my left arm but it is uncomfortable and painful when I go to sleep on my left side) and VACCINATION SITE PAIN (I received the injection in my left arm but it is uncomfortable and painful when I go to sleep on my left side). On 17-Aug-2021, the patient experienced NAUSEA (I felt nausea Tuesday I was not feeling great and today the Lightheadedness was very significant). On 19-Aug-2021, the patient experienced DIZZINESS (During a meeting I was feeling really woozy and lightheaded I have never passed out but today I felt close to it) and PRESYNCOPE (During a meeting I was feeling really woozy and lightheaded I have never passed out but today I felt close to it). At the time of the report, VACCINATION SITE DISCOMFORT (I received the injection in my left arm but it is uncomfortable and painful when I go to sleep on my left side), DIZZINESS (During a meeting I was feeling really woozy and lightheaded I have never passed out but today I felt close to it), PRESYNCOPE (During a meeting I was feeling really woozy and lightheaded I have never passed out but today I felt close to it), VACCINATION SITE PAIN (I received the injection in my left arm but it is uncomfortable and painful when I go to sleep on my left side) and NAUSEA (I felt nausea Tuesday I was not feeling great and today the Lightheadedness was very significant) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Other concomitant medications reported include thyroid medications unspecified. The patient experienced major lightheadedness and felt like was close to passing out and had an uncomfortable pain in injection site arm today the side effects were quite significant. The symptoms are still ongoing. Treatment information was not provided.


VAERS ID: 1677440 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   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 FA7484 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Pyrexia, Tenderness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 INC202101065376

Write-up: Her arm was tender today; got second shot yesterday 16Aug2021 and was a little tired and felt feverish; got second shot yesterday 16Aug2021 and was a little tired and felt feverish; This is a spontaneous report from a contactable other Health Care Professional.A female patient of an unspecified age received bnt162b2 (BNT162B2), dose 2 via an unspecified route of administration on 16Aug2021 (Batch/Lot Number: FA7484; Expiration Date: 01Sep2021) as DOSE 2, SINGLE for covid-19 immunization.The patient medical history was not reported.The patient''s concomitant medications were not reported.On 16Aug2021 the patient experienced got second shot yesterday 6aug2021 and was a little tired and felt feverish. The outcome of event was unknown.


VAERS ID: 1677553 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-16
Onset:2021-08-16
   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 EW0179 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (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: AMLODIPINE; LOSARTAN; LOVASTATIN; LEVOTHYROXINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure abnormal; Stroke (Verbatim: Stroke); Thyroidectomy (Verbatim: Thyroid removed)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101127606

Write-up: possibly been exposed to Covid; Sore arm; This is a spontaneous report from a contactable consumer (patient) received from Pfizer-sponsored program Support. A 56-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection, Lot Number: EW0179), via an unspecified route of administration in the upper left arm on 16Aug2021 (at the age of 56-years-old) as dose 1, single for COVID-19 immunization. Medical history stroke, blood pressure abnormal from an unknown date and unknown if ongoing and thyroidectomy, thyroid removed from 29May2020 to an unknown date. Concomitant medication(s) included amlodipine taken for blood pressure abnormal, been on this medication since had a stroke at age 46, losartan taken for blood pressure abnormal, been taking since age 46, stated blood pressure had improved with thyroidectomy and is on so much less blood pressure medicine, lovastatin taken for blood pressure abnormal, stated began taking at age 46, pretty much started taking all blood pressure medicines at the same time, levothyroxine taken for thyroid from 29May2020 and ongoing, began taking the moment the caller had thyroid removed on 29May2020. The patient did not receive any other vaccines within 4 weeks prior to the COVID-19 vaccine. The reporter stated that, she had possibly been exposed to Covid. The exposure to Covid occurred on 23Aug2021. The patient was asking if she was to be tested for Covid and the test was positive will the patient be able to receive the second dose Pfizer Covid Vaccine. The patient also experienced a sore arm (16Aug2021) for one day after receiving the first dose Pfizer Covid Vaccine. The patient further stated that began the day she received the first dose Pfizer Covid Vaccine on 16Aug2021, the arm soreness went away on 18Aug2021, she did not take Tylenol. The caller states she recovered completely from the sore arm. The reporter also reported that she still wears a mask and takes precautions. The patient autoimmune panel was completely gone, plus last parathyroid. The patient was really nervous about that, patient would love for the Pfizer Covid Vaccine to work and be a real thing. The events did not resulted in physician room or emergency room visit. Patient did not receive any treatment for sore arm. The clinical outcome for possibly been exposed to Covid was unknown and sore arm was recovered on 18Aug2021.


VAERS ID: 1679131 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: North Dakota  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Rash, Rash erythematous, Rash pruritic
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NSAID
Current Illness: Shoulder surgery 1.5 month ago
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Hundreds of little itchy red bumps all over hands and legs. Took loratadine and applied hydrocortisone 1% cream. Lasted for 10 days.


VAERS ID: 1679238 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-11
Onset:2021-08-16
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 1 RA / SYR

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tested postive on 08-16-2021 for Covid . Admitted to hospital on 08/23/2021. Stayed in Hospital until 09/05/2021 being treated for Covid. Released with Oxgen


VAERS ID: 1679545 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   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 EW0168 / 1 LA / IM

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

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

Write-up: Patient came to facility for 2nd dose of Pfizer. Patient reported she felt woozy one hour after her 1st dose. Patient reported she took Tylenol and symptom went away.


VAERS ID: 1679975 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-10
Onset:2021-08-16
   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 FA6780 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: School       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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Physician completed exam
CDC Split Type:

Write-up: Approximately 6 days after vaccination #1, my son developed a lump under his left armpit, same side as his injection. After receiving his 2nd dose, 21 days later, in the same arm, the condition worsened. It is now larger and painful to the touch. Physician completed exam and determined it to be Lymphadenopathy due to Covid vaccine.


VAERS ID: 1681445 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-08-16
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Medication error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BNT 162
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: Patient has no known drug allergies, healthy.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210905638

Write-up: RECEIVED PFIZER VACCINE AFTER BEING FULLY VACCINATED WITH JANSSEN COVID 19 VACCINE; This spontaneous report received from a patient concerned a 60 year old female. The patient''s weight was 203 pounds, and height was not reported. The patient''s concurrent conditions included: no alcohol use, and non smoker, and other pre-existing medical conditions included: Patient has no known drug allergies, healthy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1802068, expiry: 23-AUG-2021) dose was not reported, administered on 08-MAR-2021 for prophylactic vaccination. Concomitant medications included BNT 162 for prophylactic vaccination. On 16-AUG-2021, the patient experienced received Pfizer vaccine after being fully vaccinated with Janssen covid 19 vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of received Pfizer vaccine after being fully vaccinated with Janssen covid 19 vaccine was not reported. This report was non-serious. This case, from the same reporter is linked to 20210909424 and 20210909555.


VAERS ID: 1681557 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Feeling abnormal, Feeling cold, Heart rate, Nausea, Pain in extremity, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: No relevant medical history was provided.
Allergies:
Diagnostic Lab Data: Test Date: 20210821; Test Name: Heart rate; Result Unstructured Data: Abnormal
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: After 6 days later, his head had a funny feeling with weird sensation; He felt really cold; He was shaking really bad; He had nausea; He had chills.; He had a sore right arm on that day.; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (He had a sore right arm on that day.), FEELING ABNORMAL (After 6 days later, his head had a funny feeling with weird sensation), FEELING COLD (He felt really cold), TREMOR (He was shaking really bad) and NAUSEA (He had nausea) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No relevant medical history was provided. On 16-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced PAIN IN EXTREMITY (He had a sore right arm on that day.). On 21-Aug-2021, the patient experienced FEELING ABNORMAL (After 6 days later, his head had a funny feeling with weird sensation), FEELING COLD (He felt really cold), TREMOR (He was shaking really bad), NAUSEA (He had nausea) and CHILLS (He had chills.). At the time of the report, PAIN IN EXTREMITY (He had a sore right arm on that day.), FEELING ABNORMAL (After 6 days later, his head had a funny feeling with weird sensation), FEELING COLD (He felt really cold), TREMOR (He was shaking really bad), NAUSEA (He had nausea) and CHILLS (He had chills.) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 21-Aug-2021, Heart rate: increased (abnormal) Abnormal. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Pain medicines were taken as concomitant medication. Treatment medication was not provided.


VAERS ID: 1681791 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-16
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Work       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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Covid test; Result Unstructured Data: Test Result:COVID-19 diagnosis
CDC Split Type: USPFIZER INC202101069108

Write-up: Covid diagnosis; Covid diagnosis; This is a spontaneous report from a contactable consumer (parent). A 27-year-old male patient received an unknown dose number of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: unknown) via an unspecified route of administration on an unspecified date as single dose for COVID-19 immunization at workplace clinic. Medical history and concomitant medications were not reported. Patient previously received Psyllins on an unspecified date and experienced allergy. Patient did not receive any other vaccine within four weeks of COVID-19 vaccine. Patient was not tested for COVID prior vaccination. On 16Aug2021, patient was diagnosed with COVID-19. Patient was tested for COVID-19 post vaccination on an unspecified date [test type: unknown] and had diagnosis of COVID-19. AE resulted in Doctor or other healthcare professional office/clinic visit. Patient did not receive any treatment in response to the event. Outcome of the event was resolving. That information on the Lot/batch number has been requested.


VAERS ID: 1681792 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   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: Asthenia, Dizziness, Gait disturbance, Palpitations
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101069313

Write-up: extreme dizziness; weakness; heart was racing; had trouble walking; This is a spontaneous report from a contactable consumer. This 59-year-old female consumer (patient) reported for herself. A 59-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE Solution for injection Lot number was not reported) via an unspecified route of administration on 16Aug2021 as dose 1, single (age at vaccination: 59 years) for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. On 16Aug2021, she experienced extreme dizziness and weakness, my heart was racing immediately after receiving the shot. It was pretty bad for one hour, had trouble walking and with 2-3 hours it was completely gone and queried that she had a side effect after first dose and if she should get the 2nd Pfizer covid vaccine dose. The clinical outcome of the events was resolved. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1681793 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-14
Onset:2021-08-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Lymphadenopathy, Paraesthesia, Skin disorder
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101069327

Write-up: swollen lymph nodes in the groin area; she had bumps all over her body, painful to the touch, in her groin, collar bone, and arm; she had bumps all over her body, painful to the touch, in her groin, collar bone, and arm; This is a spontaneous report from a contactable pharmacist. A female patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN), dose 2 via an unspecified route of administration on 14Aug2021 as a single dose for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. Patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on an unspecified date as a single dose for covid-19 immunization. On 16Aug2021, two days after receiving the dose, the patient experienced swollen lymph nodes in the groin area, she had bumps all over her body, painful to the touch, in her groin, collar bone, and arm. The bumps are on the side of the body where she received the vaccine, the left side. The patient reports feeling the same today, according to the caller. Outcome of the event was unknown. Information about lot/batch number has been requested.


VAERS ID: 1681796 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   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: Dysgeusia, Extra dose administered, Off label use, Pain
SMQs:, Taste and smell disorders (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101069770

Write-up: received his third dose/booster dose of the Pfizer COVID 19 vaccine on 16Aug2021; received his third dose/booster dose of the Pfizer COVID 19 vaccine on 16Aug2021; achiness; metallic taste in his mouth; This is a spontaneous report from a contactable consumer (patient). A 48-year-old male patient received third dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot Number: Unknown, and Expiration date: Unknown), via an unspecified route of administration on 16Aug2021 as dose 3, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. Previously the patient received first and second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot Number: Unknown, and Expiration date: Unknown) on an unspecified date for COVID-19 immunization. It was reported that a 48 year male "received his third dose/booster dose of the Pfizer COVID 19 vaccine on 16Aug2021" and since then had "achiness, which has gone away", but "still has a metallic taste in his mouth". The patient had not seen this listed as a common side effect. He was wondering if this had been reported. "Because it is not getting any better". The outcome of the event achiness was reported as resolved on an unspecified date in 2021. The outcome of the event "metallic taste in his mouth" was reported as not resolved. Follow-up attempts have been completed. Batch/lot number not available for BNT162B2. No further information is expected.


VAERS ID: 1681821 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-09
Onset:2021-08-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / OT

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure measurement, Blood test, Glycosylated haemoglobin, Idiopathic pulmonary fibrosis, Joint dislocation, Platelet count decreased, Platelet disorder, SARS-CoV-2 test
SMQs:, Haematopoietic thrombocytopenia (narrow), Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune 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: OXYCONTIN; GABAPENTIN; OXYCODONE; VALIUM; ATENOLOL
Current Illness: Anxiety; Back pain; Neuropathy
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high; Fatty liver (Verbatim: Fatty liver); Gallbladder removal (Verbatim: gallbladder taken out); Herniated disc (Verbatim: Herniated disc Other conditions: from 2009 five herniated disc as of today)
Allergies:
Diagnostic Lab Data: Test Name: Blood pressure; Result Unstructured Data: Test Result:120/80; Test Date: 20210709; Test Name: Blood work; Result Unstructured Data: Test Result:Unknown results; Test Date: 20210816; Test Name: Blood work; Result Unstructured Data: Test Result:Unknown results; Test Name: A1C; Result Unstructured Data: Test Result:High; Test Name: IPF; Test Result: 12.2 %; Test Name: MPFL; Result Unstructured Data: Test Result:13.0; Test Date: 202011; Test Name: platelets; Result Unstructured Data: Test Result:83; Test Date: 20210709; Test Name: platelets; Result Unstructured Data: Test Result:117; Test Date: 20210816; Test Name: platelets; Result Unstructured Data: Test Result:88; Comments: platelets down to 88; Test Date: 202011; Test Name: COVID-19; Test Result: Negative
CDC Split Type: USPFIZER INC202101076871

Write-up: Platelets down to 88; This is a spontaneous report from a contactable consumer (patient). A 51-years-old male patient received bnt162b2 (Pfizer-BioNTech COVID-19 Vaccine, solution for injection), dose 1 intramuscular, administered in Arm Left on 09Aug2021 11:00 (at the age of 51-years-old) (Batch/Lot Number: EW0187) as DOSE 1, SINGLE for covid-19 immunisation. Medical history included gallbladder taken out from Nov2020 to an unknown date, intervertebral disc protrusion (herniated disc, other conditions: from 2009 five herniated disc as of today (on reporting date)) from an unknown date and unknown if ongoing, hepatic steatosis (fatty liver) from an unknown date and unknown if ongoing, high blood pressure from an unknown date and unknown if ongoing and ongoing anxiety, neuropathy and back pain. Patient was hospitalized in Nov2020 for gallbladder predating treatment with the Pfizer COVID 19 vaccine. Also before the vaccine, caller mentions in the past his A1C was high and he ask his doctor if he could just take Metformin and drink black tea. He was in the prediabetic stage and then it went to the normal stage. Mentions he also get examined by every year since 2016. They are the ones who first noticed his platelets were down to 148 and they have been monitoring it since. Concomitant medication included oxycodone hydrochloride (OXYCONTIN) and gabapentin both drugs taken for neuropathy and back pain from an unspecified start date and ongoing; oxycodone taken for an unspecified indication from an unspecified start date and ongoing; diazepam (VALIUM) taken for anxiety from an unspecified start date and ongoing; atenolol taken for blood pressure measurement from an unspecified start date and ongoing. The patients platelets down to 88 (platelet count decreased) on 16Aug2021. It was reported that a week later after vaccination he has an issue with his blood platelets; they have never been this low before except when he was in the hospital last year. The only time it was even close was when his platelets went down to 83 during that hospitalization; he was fine after that. He went back to normal. Adds he was in the hospital in Nov2020. He had a negative COVID test at that time. He had a bile duct that was blocked, and he was all yellow; after a bunch of tests they pulled out his gallbladder. The only thing was his liver enzymes were high so, he had blood work done on 09Jul2021. he had a full blood work and was just going back again in Oct2021. His platelets on 09Jul2021 were at 117; When he saw his doctor for the blood work last Monday, mentions his doctor was pleased with his weight loss and said his blood pressure was 120/80. After he got the first dose of the vaccine on 09Aug2021, he ask them to check his platelets again and they had dropped to 88. He noticed the IPF percentage which has to do with bone marrow and producing new platelets and also a section where they check MRNA. Patient; mentions he lost 27 pounds since 09Jul2021; states he has severe spine problems from herniated disc so he decided to lose weight on purpose. On 09Jul2021 before he got the shot; he gets blood work for liver, A1C (Glycosylated haemoglobin) (was high on unspecified date) and blood platelets. The blood platelets were a concern for him. This past Monday, 16Aug2021, he had new blood work done; found it in his My Chart, adds he understood what he was reading except the IPF (Idiopathic pulmonary fibrosis). His blood platelets were 88; IPF was 12.2%; MPFL (Joint dislocation) 13.0; adds those three work together. Blood platelets were 117 on 09Jul2021. For treatment he was going to see a doctor; a haematologist. Outcome of the event was unknown.


VAERS ID: 1681956 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-16
Onset:2021-08-16
   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 EWO168 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebrovascular accident, Chest pain, Fatigue, Headache, Pyrexia, SARS-CoV-2 test, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: FLUVOXAMINE; ESTRADIOL; TRAZODONE; ASPIRIN [ACETYLSALICYLIC ACID]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210821; Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC202101103005

Write-up: possible stroke; Seizure; Fever; chest pain; headache; extreme fatigue.; This is a spontaneous report from a contactable consumer. This 54-year-old non-pregnant female consumer (patient) reported that she received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: EWO168, Expiry Date: Unknown), via an unspecified route of administration, administered in left arm on 16Aug2021 at 10:15 AM (at the age of 54 years) as dose 2, single for covid-19 immunisation. Medical history included known allergies (unspecified). Concomitant medications in two weeks included Fluvoxamine, Estradiol, Trazadone, aspirin [acetylsalicylic acid] (ASPIRIN [ACETYLSALICYLIC ACID]). The patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: EWO168, Expiry Date: Unknown), via an unspecified route of administration, administered in left arm on 26Jul2021 at 12:15 PM (at the age of 54 years) as dose 1, single for covid-19 immunisation. No other vaccine in four weeks. No covid test prior vaccination. Facility type vaccine was public health clinic/veterans administration facility. Covid test performed post vaccination. The patient experienced fever, chest pain, headache. Seizure, possible stroke, extreme fatigue on 16Aug2021 at 13:00. Adverse event resulted in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. No treatment received. The patient underwent lab tests and procedures which included Nasal swab: negative on 21Aug2021. The outcome of event was not resolved. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1681972 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-14
Onset:2021-08-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Feeling abnormal, Hypersomnia, Memory impairment
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TRIAMTERENE; HCTZ
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101106233

Write-up: Short term memory; brain fog; sleeping a lot; out of breath; This is a spontaneous report from a non-contactable consumer reported for himself. This 79-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, NDC 59267-1000-01) via unspecified route of administration on 14Aug2021 01:00 AM at the age of 79 years old at single dose for COVID-19 immunization. Medical history included patient was diagnosed with COVID-19 prior to vaccination. No known allergies. Concomitant medications included triamterene, HCTZ. The patient experienced short term memory, brain fog, sleeping a lot, out of breath on 16Aug2021 with outcome of not recovered. Since the vaccination, the patient has not been tested for COVID-19. The lot number for BNT162B2, was not provided and will be requested during follow up.


VAERS ID: 1682064 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-30
Onset:2021-08-16
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paraesthesia, SARS-CoV-2 test, Vaccination site pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210817; Test Name: PCR test; Test Result: Negative ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101138604

Write-up: Localized pain in left arm where the injection was placed/mild throbbing pain in that area; Developing some tingling down arm to fingers; This is a spontaneous report from a contactable consumer, the patient. A 36-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 30Apr2021 at 10:30 (at the age of 36-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient did not receive any concomitant medications. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 02Apr2021 at 15:30 (at the age of 36-years-old) as a single dose for COVID-19 immunisation. On 16Aug2021, the patient started experiencing localized pain in the left arm where the injection was placed. The patient was experiencing mild throbbing pain in that area and developed some tingling down the arm to the fingers. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had been tested for COVID-19. On 17Aug2021, the patient underwent polymerase chain reaction (PCR) test for COVID- 19 and the result was negative. The clinical outcome of the events localized pain in left arm where the injection was placed/mild throbbing pain in that area and developing some tingling down arm to fingers were not resolved at the time of this report. The batch/lot numbers for, BNT162b2, were not provided and will be requested during follow up.


VAERS ID: 1682199 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052EZ1A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Amenorrhoea
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: No period


VAERS ID: 1682516 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Seizure like phenomena
SMQs:, Convulsions (narrow)

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

Write-up: The patient was vaccinated with his 1st dose of the Pfizer vaccine. Approximately 10 minutes after injection, it was witnessed that the patient was experiencing seizure like behavior that lasted for approximately 10 seconds. After this incident, the patient was instructed to recline his seat. The patient refused as he was more comfortable sitting up. 911 was called. The patient''s blood pressure was taken x 2 - 92/60. The patient was given a water and ice pack that the patient applied to his neck. The patient quickly recovered, within a few minutes of incident. He was alert and oriented. He was talking and joking with staff regarding the incident. The patient was assessed by EMS. The patient refused to be transported to the hospital..


VAERS ID: 1682603 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Night sweats, Oropharyngeal pain, Pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: fatigue, body aches, sore throat, night sweats fro 3 weeks


VAERS ID: 1682627 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-03
Onset:2021-08-16
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chest pain, Chills, Cough, Diarrhoea, Dyspnoea, Eye pain, Fatigue, Headache, Myalgia, Nasal discomfort, Pain, Pneumonia, Positive airway pressure therapy, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Tinnitus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), 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, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertension/High Blood Pressure, Obesity (BMI $g 40), Former smoker
Allergies:
Diagnostic Lab Data: 08/18/2021 Antigen + COVID-19 test at medical Practice; 08/23/2021 PCR+ COVID-19 test at Hospital
CDC Split Type:

Write-up: Fever $g100.4, Subjective fever (felt feverish), Chills, Muscle or body aches, New loss of taste or smell, Runny nose/Congestion, Cough (new onset or worsening of chronic cough), Shortness of breath or difficulty breathing, Chest pain, Fatigue or tiredness, Headache, Diarrhea ($g/=3 loose/looser stools in 24 hr period), eye pain, nostril burning, ear ringing. Bilateral Pneumonia. 9/1/2021 BiPAP machine at hospital. Scheduled to move to ICU


VAERS ID: 1682771 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-06
Onset:2021-08-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dyspnoea, Seizure, Speech disorder
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PATIENT DOES NOT HAVE ANY HEALTH ISSUES OR TREATMENTS
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: ALLERGY TO PENICILLIN FAMILY ANTIBIOTICS AND ORAL PREDNSONE (STOMACH SICKNESS)
Diagnostic Lab Data:
CDC Split Type:

Write-up: CONVULSIONS. DIFFICULTY SPEAKING. DIFFICULTY BREATHING. WEAKNESS


VAERS ID: 1682917 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       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:

Write-up: Patient was under the age of 18 and received JJ by accident. Both patient and provider were informed.


VAERS ID: 1683662 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Superficial vein thrombosis
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Superficial thrombosis; Redness in her leg 3 days after her second shot; This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (Redness in her leg 3 days after her second shot) and THROMBOPHLEBITIS SUPERFICIAL (Superficial thrombosis) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 13-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Aug-2021, the patient experienced ERYTHEMA (Redness in her leg 3 days after her second shot). On an unknown date, the patient experienced THROMBOPHLEBITIS SUPERFICIAL (Superficial thrombosis). At the time of the report, ERYTHEMA (Redness in her leg 3 days after her second shot) and THROMBOPHLEBITIS SUPERFICIAL (Superficial thrombosis) outcome was unknown. No relevant concomitant medications were reported. No treatment information was provided.


VAERS ID: 1683678 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Electrocardiogram normal, Troponin I normal
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Anxiety
Allergies: None
Diagnostic Lab Data: 8/21/21 -- Normal trop I, normal EKG
CDC Split Type:

Write-up: Dyspnea, chest pressure. ER evaluation 8/21/21 normal. Symptoms have been slowly improving..


VAERS ID: 1683717 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-02
Onset:2021-08-16
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood test, Computerised tomogram abdomen, Computerised tomogram head, Hepatic enzyme, Migraine
SMQs:, Liver related investigations, signs and symptoms (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: get flu vaccination every year for 25+ years. About 8 years ago, I got a rash from one of the flu vaccinations. Visited a der
Other Medications: only one prescription :levothyroxine sodium 50 MCG; other supplements include glucosamine, Vitamin D3 (50mcg), Iron, (65mcg), aspirin (81mg), super b-complex, B-12 (1000mcg) and Preservision (areds 2)
Current Illness: none
Preexisting Conditions: none - Kidney donor in 2008
Allergies: IV contrast and any drug with mercury in them as a preservative
Diagnostic Lab Data: Had Covid test on Aug 18, 2021. negative result Had CT scan of head and abdomen - without contrast due to allergy. Both normal. Repeated blood work on Sept 3, 2021: AST liver enzyme was normal and ALT had dropped by half but was still twice the normal range. Other blood tests back to normal range. Will follow up with another round of blood work in 6 weeks.
CDC Split Type:

Write-up: Massive migraine headache for 12 days starting Aug 16. Never had them before. Acetaminophen helped but then got migraine relief OTC and it knocked it back. Slight fever 1-2 degrees. Had full panel of blood work done on Aug 23, 2021. Liver enzymes (AST and ALT were 500 to 1000% over the normal range. Six other blood tests were out of normal range, HDL cholesterol, triglycerides, white blood count, red blood count, Hematocrit, and platelet count.


VAERS ID: 1684466 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA J88D21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstruation irregular
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 150mg Bupropion
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heavy menstrual bleeding starting a few days after date of vaccination. (Normal period ended just before vaccination) Heavy menstrual bleeding for almost 28 days straight and counting. Passing abnormally large clots everyday and soaking through both a super tampon and super pad together in about an hour.


VAERS ID: 1684781 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Exposure during pregnancy, Rash, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Pregnant (due 11/4/2021) no symptoms prior to vaccination, first dose of covid Pfizer vaccine 8/13/2021 shot in left arm. Skin rash/sores begin 8/15/2021 under arms, under breasts, upper thighs/groin, spreading to neck. Reported to community physicians 8/18/21, Obgyn on 8/19/2021. Asked about rash being vaccine side effect. They were both unsure of what is causing. Told to take OTC Benadryl and to contact primary care physician should rash spread. By the time of 2nd dose of Pfizer vaccine, some rash sores beginning to clear up. After 2nd dose was received as shot in left arm on 9/3/2021, rash became worse in groin, causing pain and also became worse under arms and across stomach and neck. New sore beginning on left eyelid. Scheduled appt with primary care physician who could not confirm cause of rash, even when I asked if related to vaccine, and prescribed me prednisone steroid to treat sores.


VAERS ID: 1684942 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-10
Onset:2021-08-16
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, Cough, Dialysis, Dyspnoea, Dyspnoea exertional, Food intolerance, Haemorrhoids, Nausea, Pneumonia viral, SARS-CoV-2 test positive, Vomiting
SMQs:, Acute renal failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Chronic kidney disease (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol, albuterol-ipratropium, allopurinol, ammonium lactate topical, aspirin, carvedilol, cinacalcet, diphenhydramine, fluticason-salmeterol, gabapentin, insulin regular, nitroglycerin, oxycodone-acetaminophen, rosuvastatin, zolpidem
Current Illness:
Preexisting Conditions: COPD, ESRD on HD, diabetes type 2, obesity, OSA, hypertension, CAD, hyperlipidemia, hx multiple myeloma, hemorrhoids, chronic opioid dependence
Allergies: shellfish
Diagnostic Lab Data: 8/17/2021: COVID-19 PCR positive
CDC Split Type:

Write-up: 8/16/2021: admitted. Chief Complaint: shortness of breath.3 days of shortness of breath, moderate, worse on exertion, associated with dry irritating cough, also nausea/vomiting, poor oral tolerance, feeling hemorrhoids are irritated. He had some mild cough on 8/11, was at dialysis at the time, underwent covid testing, apparently he was told it was positive just before he was about to go for dialysis on 8/13, was unable to get dialysis, so has missed a dialysis session as well. Diagnosed with Covid 19 viral pneumonia, acute hypoxic respiratory failure. Discharged 8/23/21. Note: previously received J&J COVID-19 vaccine on 03/10/21 Lot Number 1805029


VAERS ID: 1684964 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-18
Onset:2021-08-16
   Days after vaccination:59
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Confusional state, Cough, Dysarthria, Fatigue, SARS-CoV-2 test positive, Toxic encephalopathy
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: furosemide, gabapentin, glipizide, insulin NPH, lactulose, parparoxetine, rifaximin, spironolactone
Current Illness:
Preexisting Conditions: decompensated liver cirrhosis secondary to hepatitis-C and alcohol abuse, esophageal varices, hepatic encephalopathy, hyperbilirubinemia, ascites, chronic left lower extremity lymphedema, DM and portal hypertension
Allergies: nka
Diagnostic Lab Data: Tested positive for Covid via PCR on 8/16/21.
CDC Split Type:

Write-up: 8/16/2021: admitted. presents to ED with complaints of generalized weakness, slurred speech, mild confusion, nagging non productive cough and feels run down since last week. Wife (at bedside) thought his weakness and slurred speech were related to high ammonia level so patient has been taking lactulose daily. COVID 19 PCR was positive. Note: patient previously vaccinated with Pfizer COVID-19 vaccine: First dose: 05/29/21 Lot Number;EW0180; Second dose: 06/18/21 Lot Number EW0196 Diagnosed with: toxic metabolic encephalopathy, COVID-19 infection Discharged 8/22/21.


VAERS ID: 1684997 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
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: Public       Purchased by: ?
Symptoms: Herpes zoster, Induration, Inflammation, Skin warm
SMQs:, Extravasation events (injections, infusions and implants) (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Local inflammation with large, hot induration measering 4cmx9cm. Received second dose elsewhere on 09/03/2021 (Lot FA7485 Exp. 10/1/2021) and reports a similar reaction with the second dose. Resolved without treatment. Developed shingles a week after second dose.


VAERS ID: 1685038 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-23
Onset:2021-08-16
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 08/16/2021 PCR+ COVID-19 test at Hospital.
CDC Split Type:

Write-up: Breakthrough COVID-19 case


VAERS ID: 1685614 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-01
Onset:2021-08-16
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 10981 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Dyspnoea, Fatigue, Headache, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? No
Previous Vaccinations:
Other Medications: Xycal Prozac Singular Lorazepam Flonase Vitamins
Current Illness: None
Preexisting Conditions: Compromised immune system
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: I tested positive for covid 19 on aug, 19th 2021 Coughing Headache Chills Fever Body aches Shortness of breath Extreme fatigue Loss of smell and taste


VAERS ID: 1685775 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-12
Onset:2021-08-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW09191 / 2 AR / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Anion gap, Antinuclear antibody, Blood albumin decreased, Blood calcium decreased, Blood chloride normal, Blood creatine phosphokinase decreased, Blood creatinine normal, Blood glucose normal, Blood immunoglobulin G, Blood phosphorus, Blood potassium normal, Blood sodium decreased, Blood urea increased, C-reactive protein increased, Carbon dioxide normal, Glomerular filtration rate normal, Haematocrit decreased, Haemoglobin decreased, Inflammatory marker increased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume normal, Myalgia, Myoglobin blood, Platelet count increased, Polyarthritis, Red blood cell count decreased, Red blood cell sedimentation rate increased, Red cell distribution width normal, Troponin T normal, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Haematopoietic erythropenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Hyponatraemia/SIADH (narrow), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Arthritis (narrow), Tumour lysis syndrome (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, asa, symbicort, metoprolol, atorvastatin, nitroglycerin, clobidogrel , singulair
Current Illness: CAD, asthma, obesity
Preexisting Conditions: obesity, ACS with CAD, asthma
Allergies: nkda
Diagnostic Lab Data: Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 2 wk ago Troponin T 0.00 - 0.03 ng/mL <0.01 Encounter Summary Related to Troponin T Component 08/24/21 08/24/21 08/12/21 08/05/21 07/19/21 06/05/21 Troponin T <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 Contains abnormal data Sedimentation rate, automated Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 2 wk ago Sed Rate 0 - 25 mm/hr 31 High Encounter Summary Related to Sedimentation rate, automated Component 08/28/21 08/25/21 08/24/21 08/21/21 07/19/21 Sed Rate 121 High 96 High 31 High $g140 High 46 High Contains abnormal data C-Reactive Protein Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 2 wk ago CRP 0.00 - 0.74 mg/dL 5.38 High Encounter Summary Related to C-Reactive Protein Component 08/28/21 08/27/21 08/25/21 08/24/21 08/17/21 07/19/21 CRP 10.80 High 9.49 High 7.37 High 5.38 High 16.20 High 3.65 High Contains abnormal data RENAL FUNCTION PANEL Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 2 wk ago Sodium 135 - 147 mmol/L 135 Potassium 3.5 - 5.0 mmol/L 4.1 Chloride 96 - 108 mmol/L 102 CO2 22 - 32 mmol/L 23 Calcium 8.6 - 10.6 mg/dL 8.8 Glucose 82 - 115 mg/dl 102 Creatinine 0.7 - 1.2 mg/dL 0.7 BUN 8 - 20 mg/dL 21 High Albumin 3.5 - 4.8 g/dL 3.0 Low Phosphorus 2.4 - 4.7 mg/dL 3.3 Anion Gap 7.0 - 16.0 mmol/L 10.0 eGFR $g60 mL/min/1.73m? $g60 Encounter Summary Related to RENAL FUNCTION PANEL Component 08/31/21 08/28/21 08/25/21 08/24/21 08/22/21 08/21/21 Sodium 138 136 138 135 137 140 Potassium 3.9 3.8 4.4 4.1 4.3 4.0 Chloride 101 103 104 102 103 105 CO2 22 23 23 23 24 23 Calcium 9.1 8.6 8.9 8.8 8.9 8.9 Glucose 160 High 119 High 168 High 102 160 High 132 High Creatinine 0.8 0.7 0.8 0.7 0.6 Low 0.7 BUN 18 20 23 High 21 High 20 17 Albumin 3.4 Low 2.9 Low 3.2 Low 3.0 Low 2.9 Low ? Phosphorus ? ? ? 3.3 4.0 ? Anion Gap 15.0 10.0 11.0 10.0 10.0 12.0 eGFR $g60 $g60 $g60 $g60 $g60 $g60 View all related data Contains abnormal data Antinuclear Antibodies, HEp-2 Substrate, IgG, Serum Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 2 wk ago Comments Antinuclear Ab, HEp-2 Substrate, S <1:80 (Negative) Positive 1:160 Abnormal -------------------ADDITIONAL INFORMATION------------------- Method: Immunofluorescence using HEp-2 cellular substrate. ANA Titer 1:160 ANA Pattern Speckled Encounter Summary Contains abnormal data CBC (Hemogram) no Auto Diff Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 2 wk ago WBC Count 4.0 - 10.0 k/mcL 13.7 High RBC 3.90 - 5.80 M/mcL 3.76 Low HGB 13.0 - 17.3 g/dL 10.8 Low HCT 38.0 - 51.0 % 33.7 Low MCV 81.0 - 95.0 fl 89.6 MCH 26.5 - 34.0 pg 28.7 MCHC 32.0 - 36.0 g/dL 32.0 RDW 11.5 - 15.0 % 13.4 Platelets 140 - 450 k/mcL 479 High MPV 9.4 - 12.4 fl 8.4 Low Encounter Summary Related to CBC (Hemogram) no Auto Diff Component 08/31/21 08/28/21 08/25/21 08/21/21 08/20/21 08/17/21 WBC Count 12.8 High 11.9 High 13.7 High 12.8 High 12.0 High 12.2 High RBC 3.79 Low 3.73 Low 3.76 Low 3.67 Low 3.84 Low 3.99 HGB 10.6 Low 10.8 Low 10.8 Low 10.7 Low 11.1 Low 11.7 Low HCT 34.1 Low 33.2 Low 33.7 Low 33.0 Low 34.2 Low 34.6 Low MCV 90.0 89.0 89.6 89.9 89.1 86.7 MCH 28.0 29.0 28.7 29.2 28.9 29.3 MCHC 31.1 Low 32.5 32.0 32.4 32.5 33.8 RDW 13.9 13.9 13.4 13.4 13.2 12.9 Platelets 461 High 430 479 High 433 434 333 MPV 8.3 Low 8.3 Low 8.4 Low 8.7 Low 8.5 Low 8.6 Low View all related data Antibody to Extractable Nuclear Antigen (ENA) Evaluation, S Specimen: Blood - Venous blood specimen (specimen) Component Ref Range & Units 13 d ago Comments Jo 1 Ab, Igg, S <1.0 (Negative) U <0.2 Rnp Ab, Igg, S <1.0 (Negative) U <0.2 Sm Ab, Igg, S <1.0 (Negative) U <0.2 Scl 70 Ab, Igg, S <1.0 (Negative) U <0.2 Ss-B/La Ab, Igg, S <1.0 (Negative) U <0.2 SS-A/RO AB, IGG, S <1.0 (Negative) U <0.2 Encounter Summary Contains abnormal data Myoglobin -STAT Specimen: Blood - Blood specimen (specimen) Component Ref Range & Units 1 d ago Myoglobin 28 - 72 ng/mL <21 Low Encounter Summary Contains abnormal data CK (Creatine Kinase) -STAT Specimen: Blood - Blood specimen (specimen) Component Ref Range & Units 1 d ago CK (Creatine Kinase) 39 - 308 IU/L 16 Low
CDC Split Type:

Write-up: crippling polyarthritis and polymyalgia''s with elevated inflammatory markers.


VAERS ID: 1578994 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Fatigue, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: High temperature (around 40?C), headache, lightheadedness, and feeling tired hours after the vaccination. Paracetamol and rest. Drink plenty of water.


VAERS ID: 1636164 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-15
Onset:2021-08-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3004667 / UNK LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Chills, Injection site erythema, Malaise, 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: We have just received the news that some of the vaccines from Moderna that were distributed in were contaminated. My husband and I have received the second dose of the vaccine on August 15, 2021 in the city . Throughout the night of the following day, we felt unwell with fever, chills, and a red spot on the arm we received the vaccine. This symptoms lasted for almost a whole week. We both had the same symptoms. We had a flight on August 17, two days after the vaccination, and we didn?t have time to make na appointment with a doctor and report the symptoms. We would like to have clarified what tipe of contamination we were exposed to and what protection this contaminated doses of the vaccine offer. It is necessary that this information is clarified as soon as possible, since our health is priority. I am attaching to this email our record of vaccination so your company can give me the proper clarifications. We are currently in , and we are waiting for the company?s reply regarding the health risks and immunity as well as what should be done at this time.


VAERS ID: 1638891 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-08-16
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210835106

Write-up: STOMACH PAIN; This spontaneous report received from a consumer concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 16-AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 16-AUG-2021, the patient experienced stomach pain. The action taken with covid-19 vaccine was not applicable. The outcome of stomach pain was not reported. This report was non-serious.


VAERS ID: 1641338 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-08-15
Onset:2021-08-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3380 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Cough, Fatigue, Feeling abnormal, Headache, Influenza like illness, Malaise, Oropharyngeal pain, Pain in extremity, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Multivitamins; nac; vit c; vit d; zinc.
Current Illness:
Preexisting Conditions:
Allergies: None that I know of.
Diagnostic Lab Data: Had a negative COVID test on the 20th of August
CDC Split Type:

Write-up: First started with sore arm on the day of vaccine. Then the following day, I started to feel sick on the evening. Like the start of a flu/cold. 3rd day after the jab I had a piercing headache upon waking up, just above my left eye. Also started waking up with a painful sore throat that would come and go but was far worse in the morning. Also developed a cough that only comes at night before I go to sleep. However headache went away after 2 days. I''m now at 10 days after my first dose, and I''ve got massive brain fog, and fatigue. Too tired to exercise. Still have sore throat in the morning which feels kind of like mono/strep and a thickly cough that comes at night and is gone for the rest of the day.


VAERS ID: 1653714 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Monoplegia, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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: Lamaline
Current Illness: Fibromyalgia, Osteoarthritis
Preexisting Conditions: Fibromyalgia
Allergies:
Diagnostic Lab Data: I have not yet been able to contact my doctor, he is on vacation.
CDC Split Type:

Write-up: I have one leg with a beginning of paralysis since the vaccination and there I begin to have pain in the muscles of the other leg and arms.


VAERS ID: 1660243 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF3319 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic reaction, Cold sweat, Lip swelling, Paraesthesia oral, SARS-CoV-2 test, Tachycardia
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), COVID-19 (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: CETIRIZINE; FEXOFENADINE; HYOSCINE BUTYLBROMIDE; LACTULOSE; LEVOTHYROXINE; TRANEXAMIC ACID
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anaphylaxis (Patient has history of unknown anaphylaxis to unknown substance, known to hospital.); Coeliac disease; Immunodeficiency (Has an illness or condition, not listed above, which reduces the immune response (e.g. immunodef...)
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Negative ; Comments: No - Negative COVID-19 test
CDC Split Type: GBPFIZER INC202101075691

Write-up: Anaphylaxis; clammy; swollen lips; tingling lips; tachycardia; This is a spontaneous report from a contactable healthcare professional. This is a report received from the regulatory authority. Regulatory authority report number GB-MHRA-ADR 25817734. Safety Report Unique Identifier GB-MHRA-WEBCOVID-202108181345077990-HJ04U. A 15-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: FF3319), via an unspecified route of administration on 16Aug2021 (at the age of 15 years), as a single dose covid-19 immunisation. Medical history included immunodeficiency from an unknown date and unknown if ongoing (Has an illness or condition, not listed above, which reduces the immune response (e.g. immunodef ); coeliac disease, from an unknown date and unknown if ongoing; anaphylaxis (Patient has history of unknown anaphylaxis to unknown substance, known to Hospital), from an unknown date and unknown if ongoing. Patient had not had symptoms associated with COVID-19. Patient was not currently breastfeeding. Patient is not enrolled in clinical trial. Concomitant medication included cetirizine taken for hypersensitivity, start and stop date were not reported; fexofenadine taken for hypersensitivity, start and stop date were not reported; hyoscine butylbromide taken for irritable bowel syndrome, start and stop date were not reported; lactulose taken for constipation, start and stop date were not reported; levothyroxine taken for hyperthyroidism, start and stop date were not reported; tranexamic acid taken for heavy menstrual bleeding, start and stop date were not reported. GP agreed to give vaccine at surgery, on 16Aug2021, patient started with swollen lips after 21 mins of vaccination, tachycardia, tingling lips then shaky and clammy, as anaphylaxis. Monitored by GP/Nurses and given 10mg/1ml chlorphenamine, symptoms started to reduce after 10 minutes. The anaphylaxis was serious-medically significant, the rest of events were reported as non-serious. The patient underwent lab tests and procedures which included sars-cov-2 test: no, negative covid-19 test on unknown date. The outcome of the event anaphylaxis was recovered, and the other events were unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1560128 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-07
Onset:2021-08-15
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Formication, Pruritus, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Severe itching in my face. Makes it so I can?t sleep. Feels line sonething crawling under my skin as well. I never have seasonal allergies or any other condition that causes itching.


VAERS ID: 1562816 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Discomfort, Fatigue, Injection site reaction, Oropharyngeal pain, Pain, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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: Dulera
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Body aches, my right arm where I got the injection is feels heavy, swollen feet, sore throat and tiredness.


VAERS ID: 1569030 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-29
Onset:2021-08-15
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Lip swelling, Rash, Swelling face, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl to sleep; fresh ginger and fresh mint herbal tea
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: No tests. Just monitor and give Benadryl, prednisone and epinephrine.
CDC Split Type:

Write-up: Woke up at 4:30am with a horrible rash all over arms, legs, torso, head. Jaw started to stiffen with difficulty breathing. At emergency room face and lips started to swell terribly. Throat started to tighten. Emergency staff have given me prednisone, Benadryl and a shot of epinephrine. They are continuing to monitor me.


VAERS ID: 1569078 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939891 / 1 RA / IM

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

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

Write-up: PATIENT PRESENTED TO THE PHARMACY FOR A COVID VACCINE. PATIENT SAID IT WAS HIS FIRST DOSE. WHEN I SAW HE MARKED THAT HE WAS IMMUNOCOMPROMISED, I ASKED HIM AGAIN IF THIS WAS HIS FIRST DOSE OF A COVID VACCINE AND HE SAID YES. WHEN IMPACTSIS FOR WAS DONE TECH PUT NAME INSTEAD OF FULL NAME WHICH BROUGHT NOTHING UP. I THEN GAVE THE VACCINATION AND WHEN SPEAKING WITH HIM HE MENTIONED HOW HE DID FINE WITH ALL HIS OTHER SHOTS LIKE SHINGLES AND HEPATITIS SO I KNEW SOMETHING WASN''T ADDING UP. I DID IMPACTSIS MYSELF LATER WITH PT AS FIRST NAME WHICH BROUGHT UP HIS WHOLE VACCINATION HISTORY AND THAT HE HAD RECEIVED JANSSEN ON 3/6/2021.


VAERS ID: 1569082 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: Chest pain and shortness of breath after one hour of vaccination


VAERS ID: 1569119 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 1 - / IM

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

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

Write-up: Explosive diarrhea around 10am on 8/15/2021 (48 hrs post-shot) Vomiting around 11:30 am on 8/15/2021


VAERS ID: 1569120 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Extra dose administered
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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: After vaccine was administered at 1035, a completed series of Pfizer vaccine on 3/07/21 and 3/28/21 was shown. Patient denies having ever received any other covid vaccine. Patient was educated that he will not be able to receive 2nd dose of series until this is corrected.


VAERS ID: 1569121 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-08-12
Onset:2021-08-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pruritus, Injection site reaction, Injection site swelling
SMQs:, 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: tylenol
Current Illness:
Preexisting Conditions:
Allergies: ampecillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: red itchy and swollen at injection site


VAERS ID: 1569127 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Hypoaesthesia, Immediate post-injection reaction, Injection site pain, Injection site warmth, Muscular weakness, Pain in extremity, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin C, D3, calcium
Current Illness: Had Covid in November of 2020 and hysterectomy on April 23, 2021
Preexisting Conditions:
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: The shot was painful and I immediately felt my left arm get very warm from injection site down to my fingertips. My fingertips were also tingly and numb. About 5 minutes after my right arm starting feeling warm and fingertips numb and tingly as well. I also felt weakness in my right hand and dropped a bottle of water. About 40 minutes later my right arm/hand started to feel better. About 1 hour later left arm is still sore, but tingly feeling is better.


VAERS ID: 1569131 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), 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? 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: n/a
CDC Split Type:

Write-up: Approx 3 mins after vaccine admin, patient felt weak, sweaty and light headed. Patient states he "passed out" for about a minute but quickly regained full alertness. Patient reports feeling 100% better after drinking juice and resting. Patient reports not having any food today prior to vaccine. After 15mins obvs time done, patient reports feeling well enough to leave clinic with partner and go home.


VAERS ID: 1569135 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-26
Onset:2021-08-15
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Severally painful & extra heavy period.


VAERS ID: 1569137 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Dysstasia, Head injury, Malaise, Nausea, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Roughly 12 hours after receiving vaccination, I started to feel sick. I got up to get water from the kitchen as I was starting to feel nauseous and fainted. I hit my head as I passed out and shortly after regaining consciousness, I began to vomit. For about 10 to 15 minutes, I could not get myself off the ground. I also experienced severe abdominal pain. The reaction as a whole lasted about 2 hours.


VAERS ID: 1569144 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), 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: Patient received his Janssen COVID vaccine and was waiting his 15 minute wait. He stood and reported feeling light headed , faint, pale, and diaphoretic. Patient was lowered to the floor, feet elevated, ice pack applied to neck, and vitals taken. BP 126/72, O2 sat 98%, Pulse 70. Monitored patient for an extra 25 minutes. Vitals stable BP: 127/74, O2 sat 98%, and Pulse 71. Patient discharged to home and feeling back to normal. Patient states that he had gone out the night prior and had a few drinks and did not eat breakfast prior to coming for vaccine.


VAERS ID: 1569149 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Patient''s mother said that he had a seizure after a flu vaccination when he was 9 years old. But this is all the information I h
Other Medications: Unsure.
Current Illness: None stated on vaccine administration record questionnaire.
Preexisting Conditions: None stated on vaccine administration record questionnaire.
Allergies: None stated on vaccine administration record questionnaire. But patient''s mother said he had a seizure after a flu shot when he was approximately 9 years old. We were told this after the event occurred and not on the vaccine administration record.
Diagnostic Lab Data: I used our blood pressure machine while he was laying on his back supine shortly after the seizure and our machine read 137/71, 87 bpm. I wouldn''t rely on this reading though as we rarely use our blood pressure monitor and I don''t know when it has last been calibrated or the batteries have been replaced. Patient''s mother said he is not on treatment for seizures.
CDC Split Type:

Write-up: Approximately 3-5 minutes after vaccinated the patient collapsed and had what appeared to be a grand mal seizure. He was in the waiting area with his family. Pharmacy staff wasn''t there to witness the start of the seizure but it appears that his mother recognized the symptoms and helped him to the ground on his side and managed to protect his head and extremities. It probably lasted around 2-3 minutes before the patient regained consciousness and seemed relatively alert and oriented. EMS arrived shortly after and he was transported to the local hospital. He was able to stand up with some assistance to get into their stretcher. Patient''s mother mentioned afterwards that he had a seizure in the past when he was 9 years old after a flu immunization.


VAERS ID: 1569152 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-08-10
Onset:2021-08-15
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein normal, Chest X-ray normal, Chest discomfort, Chest pain, Echocardiogram, Electrocardiogram normal, Palpitations, Troponin normal
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: zyrtec, singular, methyl folate
Current Illness:
Preexisting Conditions: asthma, food sensitivities,
Allergies: sesame, wheat, peanuts, soy
Diagnostic Lab Data: CXR non acute Serial EKG''s on same day non ischemic. EKG 5 days later non-ischemic Trops day of and 5 days later neg CRP neg POC cardiac ultrasound neg for pericardial fluid
CDC Split Type:

Write-up: One hour after vaccine pt felt chest pressure and pain, heart pounding without racing.


VAERS ID: 1569163 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / UNK - / SYR

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

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

Write-up: Light headed


VAERS ID: 1569164 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Herpes zoster, Pain in extremity, Paraesthesia, Rash, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth Control (Sprintec), Echinacea, Zinc, Vitamin C, Flavonoids
Current Illness:
Preexisting Conditions: Joint pain, sprained ankle/tendinitis
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Symptom: sore arm and shingles Signs: long rash with blisters on left abdomen. Tingling and burning sensation mainly around hip, sometimes on upper abdomen, arms, neck and upper thigh. Time: Almost 48 hours after second shot. Treatment: Prescribed VALACYCLOVIR (1 gram tablet) Outcome: TBA


VAERS ID: 1569204 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood creatinine increased, C-reactive protein normal, Cardiac arrest, Cardiac telemetry abnormal, Dizziness, Electrocardiogram normal, Loss of consciousness, Malaise, N-terminal prohormone brain natriuretic peptide normal, Nausea, Pain in extremity, Presyncope, Red blood cell sedimentation rate normal, Sinus arrest, Sinus arrhythmia, Sinus rhythm, Supine position, Syncope, Troponin normal, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Disorders of sinus node function (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 34-year-old man who is otherwise healthy admitted following a syncopal episode at home. Yesterday afternoon, he received his first dose of the Moderna vaccine around 1pm. His arm felt sore afterwards, though otherwise he felt generally well. This morning when he awoke, he felt generally unwell with dizziness, lightheadedness, and presyncope. He attempted to walk to the bathroom to splash some cold water on his face. He then had a syncopal episode. When he awoke on the bathroom floor, he developed nausea and vomiting. His family was at his side and ultimately called emergency services. Shortly after arrival to the ER this morning, he then had another episode of loss of consciousness. He was laying supine in his stretcher at the time with no clear provoking factors. He then developed recurrent dizziness, lightheadedness, and presyncope followed by loss of consciousness. Review of his telemetry was notable for sinus rhythm with gradual slowing of his sinus rate followed by sinus arrest with an approximately 22 second pause/asystolic event. The team was at bedside preparing to start CPR. However, he subsequently regained consciousness with normal sinus rhythm on telemetry. His ECG on presentation was relatively unremarkable. His labs are notable for a mildly elevated creatinine of 1.3, otherwise unremarkable. His initial troponin, ESR, CRP, and NT-ProBNP were normal. He continues to feel unwell in general. He denies chest pain and chest tightness. He denies shortness of breath. He reports a remote history of syncope following a blood draw when he was a teenager. There is no known family history of sudden cardiac death. He denies any concerning symptoms prior to this morning.


VAERS ID: 1569223 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling jittery
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Plavixr, aspirin, prednisone, Olmesartan Medoxomil tables 20 mg., buspirone, magnesium oxide, tizanidine, metformin HLC, pantoprazole Sod DR, Wes-Tab max, vitamin c, Zinc, Resveratrol, ventolin inhaler.
Current Illness: Central nervous system/cerebral Vasculitis, stage three kidney disease, hyper active immune system, fibromyalgia, Raynaud?s phenomena, Hashimoto?s thyroiditis, adrenal insufficiency, asthma.
Preexisting Conditions: Central nervous system/cerebral Vasculitis, stage three kidney disease, hyper active immune system, fibromyalgia, Raynaud?s phenomena, Hashimoto?s thyroiditis, adrenal insufficiency, asthma.
Allergies: Anaphylactic shock to all chocolate and cocoa. I?m allergic to codeine, Demerol, Advair inhaler.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I just feel jittery like too much caffeine. Aside from that no issues.


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