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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 134 out of 6,867

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VAERS ID: 1670759 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Musculoskeletal stiffness, Pain, Tinnitus
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (narrow), 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: aspirin, Lipitor, otc omega fatty acids, flomax
Current Illness: none
Preexisting Conditions: hyperlipidemia, bph
Allergies: nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: left ear clicking, pain, stuffiness.


VAERS ID: 1670908 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-01
Onset:2021-08-15
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, Metoprolol, Aleve
Current Illness: None
Preexisting Conditions: Narcolepsy High Blood Pressure
Allergies: Vancomycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed redness, hot, swelling, itching, at injection site on 10th day after shot. Lasted about 5 days


VAERS ID: 1671384 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deep vein thrombosis, Injection site pain, Injection site reaction, Rash macular, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen; Adderall; Benadryl
Current Illness: Anaphylaxis due to shellfish
Preexisting Conditions: Migraines
Allergies: All Shellfish; Many allergies
Diagnostic Lab Data: Ultrasound was done at the hospital and confirmed a blood clot in my arm
CDC Split Type:

Write-up: Blood clot - cephalic vein thrombosis/DVT in left arm. On August 14, I began feeling soreness in my left arm, at the injection site. On August 15 I began feeling a pain below the injection site on my bicep area. It was very sore but my skin was not exhibiting any redness. August 16 and 17th the pain intensified and a large red Blotch in the area begin to appear and grow over the course of the two days. The pain intensified and I couldn?t even touch the area without it being incredibly painful. August 18 I went to the emergency room, and was diagnosed with Cephalic vein thrombosis.


VAERS ID: 1672422 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-06
Onset:2021-08-15
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Myalgia, Vaccination site erythema, Vaccination site inflammation, Vaccination site pain, Vaccination site pruritus
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: Arm was a little bit sore after the shot; Her arm where she got the shot in is red; Her arm where she got the shot in is inflamed; Her arm where she got the shot in is a little bit itchy; Her arm where she got the shot in was a little bit tender; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE INFLAMMATION (Her arm where she got the shot in is inflamed), VACCINATION SITE PRURITUS (Her arm where she got the shot in is a little bit itchy), VACCINATION SITE PAIN (Her arm where she got the shot in was a little bit tender), VACCINATION SITE ERYTHEMA (Her arm where she got the shot in is red) and MYALGIA (Arm was a little bit sore after the shot) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E21A) 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 15-Aug-2021, the patient experienced VACCINATION SITE PAIN (Her arm where she got the shot in was a little bit tender). On 16-Aug-2021, the patient experienced VACCINATION SITE INFLAMMATION (Her arm where she got the shot in is inflamed), VACCINATION SITE PRURITUS (Her arm where she got the shot in is a little bit itchy) and VACCINATION SITE ERYTHEMA (Her arm where she got the shot in is red). On an unknown date, the patient experienced MYALGIA (Arm was a little bit sore after the shot). At the time of the report, VACCINATION SITE INFLAMMATION (Her arm where she got the shot in is inflamed), VACCINATION SITE PRURITUS (Her arm where she got the shot in is a little bit itchy), VACCINATION SITE PAIN (Her arm where she got the shot in was a little bit tender), VACCINATION SITE ERYTHEMA (Her arm where she got the shot in is red) and MYALGIA (Arm was a little bit sore after the shot) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication reported. No treatment medication provided. Patient was concerned as her events started 8 days after the shot.


VAERS ID: 1672423 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
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: Myalgia, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: Aches and pains; Fever; Throwing up; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (Aches and pains), PYREXIA (Fever) and VOMITING (Throwing up) in a 22-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. 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 15-Aug-2021, the patient experienced MYALGIA (Aches and pains), PYREXIA (Fever) and VOMITING (Throwing up). At the time of the report, MYALGIA (Aches and pains), PYREXIA (Fever) and VOMITING (Throwing up) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Concomitant medications were reported. No Treatment information was reported.


VAERS ID: 1672442 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-12
Onset:2021-08-15
   Days after vaccination:3
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: Anxiety, Chills, Dyspnoea, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: Medical History/Concurrent Conditions: Heart rate increased; Shortness of breath (Patient used a CPAP machine for shortness of breath (prior to Moderna COVID-19 vaccination))
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 DYSPNOEA (shortness of breath), TACHYCARDIA (increased heart rate), ANXIETY (anxiety) and CHILLS (chills) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Shortness of breath (Patient used a CPAP machine for shortness of breath (prior to Moderna COVID-19 vaccination)) and Heart rate increased. On 12-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Aug-2021, the patient experienced DYSPNOEA (shortness of breath), TACHYCARDIA (increased heart rate), ANXIETY (anxiety) and CHILLS (chills). At the time of the report, DYSPNOEA (shortness of breath), TACHYCARDIA (increased heart rate), ANXIETY (anxiety) and CHILLS (chills) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment medications were reported.


VAERS ID: 1672446 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Bedridden, Body temperature, Feeling abnormal, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: GABAPENTIN; LEVETIRACETAM; TAMSULOSIN; TOPIRAMATE; CELECOXIB; CHLORZOXAZONE; IMITREX [SUMATRIPTAN]
Current Illness: Migraine
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210815; Test Name: I had 102.3?F; Result Unstructured Data: 102.3?F
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: I''ve been in bed for two days; It literally feels like my brain is splitting in two; I had 102.3?F; This spontaneous case was reported by a consumer and describes the occurrence of BEDRIDDEN (I''ve been in bed for two days), FEELING ABNORMAL (It literally feels like my brain is splitting in two) and PYREXIA (I had 102.3?F) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 049E21A) for COVID-19 vaccination. Concurrent medical conditions included Migraine. Concomitant products included SUMATRIPTAN (IMITREX [SUMATRIPTAN]) for Migraine, GABAPENTIN, LEVETIRACETAM, TAMSULOSIN, TOPIRAMATE, CELECOXIB and CHLORZOXAZONE for an unknown indication. On 13-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Aug-2021, the patient experienced BEDRIDDEN (I''ve been in bed for two days), FEELING ABNORMAL (It literally feels like my brain is splitting in two) and PYREXIA (I had 102.3?F). The patient was treated with ASPIRIN [ACETYLSALICYLIC ACID] for Adverse event, at an unspecified dose and frequency. On 17-Aug-2021, BEDRIDDEN (I''ve been in bed for two days) had resolved. At the time of the report, FEELING ABNORMAL (It literally feels like my brain is splitting in two) and PYREXIA (I had 102.3?F) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-Aug-2021, Body temperature: 102.3?f (High) 102.3?F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The reporter mentioned that he had seen to a neurologist.


VAERS ID: 1672449 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:2021-08-16
Onset:2021-08-15
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 - / 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: Another pharmacist used that vial to administer a single dose of the vaccine at 3pm.; The vial was left out at room temperature Sunday night into Monday (16Aug2021); 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 PRODUCT STORAGE ERROR (The vial was left out at room temperature Sunday night into Monday (16Aug2021)) and EXPIRED PRODUCT ADMINISTERED (Another pharmacist used that vial to administer a single dose of the vaccine at 3pm.) 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 first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Aug-2021, the patient experienced PRODUCT STORAGE ERROR (The vial was left out at room temperature Sunday night into Monday (16Aug2021)). On 16-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Another pharmacist used that vial to administer a single dose of the vaccine at 3pm.). At the time of the report, PRODUCT STORAGE ERROR (The vial was left out at room temperature Sunday night into Monday (16Aug2021)) and EXPIRED PRODUCT ADMINISTERED (Another pharmacist used that vial to administer a single dose of the vaccine at 3pm.) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medications were not provided. Treatment information was not provided. Suspect details included: Manufacture date: 21Apr2021 Original refrigeration date: 14Aug2021 (In freezer/frozen prior to that) Temperature stored in fridge: 38?F Stored at room temperature at 2:30p on 15Aug2021. 1st puncture: 15Aug2021 at 2:54pm. At room temp prior to her getting off work Left out at room temperature from 2:30pm 15Aug2021 through 3:00pm on Mon 16Aug2021.


VAERS ID: 1672470 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
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: Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

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

Write-up: This spontaneous case was reported by a consumer and describes the occurrence of DIARRHEA (Diarrhea) in a 42-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. 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 15-Aug-2021, the patient experienced DIARRHEA (Diarrhea). At the time of the report, DIARRHOEA (Diarrhea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Concomitant medications were reported. No Treatment information was reported.


VAERS ID: 1672539 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA #052E21A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Feeling abnormal, Heart rate increased, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Chills; A high heart rate, sitting still it was 125 bpm; Had cold chills; He was not feeling good,he felt bad all day; Had 102 fever which then went normal,102 fever,101.5 fever; Sore shoulder; This spontaneous case was reported by a consumer and describes the occurrence of HEART RATE INCREASED (A high heart rate, sitting still it was 125 bpm), FEELING ABNORMAL (He was not feeling good,he felt bad all day), CHILLS (Had cold chills), ARTHRALGIA (Sore shoulder) and PYREXIA (Had 102 fever which then went normal,102 fever,101.5 fever) in a 42-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. #052E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 15-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Aug-2021, the patient experienced ARTHRALGIA (Sore shoulder). On 16-Aug-2021, the patient experienced FEELING ABNORMAL (He was not feeling good,he felt bad all day) and PYREXIA (Had 102 fever which then went normal,102 fever,101.5 fever). On 17-Aug-2021, the patient experienced HEART RATE INCREASED (A high heart rate, sitting still it was 125 bpm) and CHILLS (Had cold chills). On 18-Aug-2021, the patient experienced CHILLS (Chills). At the time of the report, HEART RATE INCREASED (A high heart rate, sitting still it was 125 bpm), FEELING ABNORMAL (He was not feeling good,he felt bad all day), CHILLS (Had cold chills), ARTHRALGIA (Sore shoulder), PYREXIA (Had 102 fever which then went normal,102 fever,101.5 fever) and CHILLS (Chills) outcome was unknown. No concomitant medications were reported. No treatment medications were reported.


VAERS ID: 1672563 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-07-17
Onset:2021-08-15
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache, Vaccination site pain, Vaccination site pruritus, Vaccination site rash, Vascular injury
SMQs:, Accidents and injuries (narrow), Hypersensitivity (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: METOPROLOL; FLOVENT; AZELASTINE
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 VASCULAR INJURY (second one was definitely worse she thinks because the woman that gave her the shot hit a blood vessel), VACCINATION SITE PRURITUS (rash after the second shot started the day after the shot and it is way more of a rash, half of her upper arm has a rash. It is also very itchy), VACCINATION SITE PAIN (achy where she got the shot/burns a little), VACCINATION SITE RASH (rash near where she got the shot/rash after the second shot started the day after the shot and it is way more of a rash, half of her upper arm has a rash) and HEADACHE (headachy) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 048C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included FLUTICASONE PROPIONATE (FLOVENT) for Asthma, AZELASTINE for Rhinitis, METOPROLOL for an unknown indication. On 17-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 15-Aug-2021, the patient experienced VACCINATION SITE RASH (rash near where she got the shot/rash after the second shot started the day after the shot and it is way more of a rash, half of her upper arm has a rash). On an unknown date, the patient experienced VASCULAR INJURY (second one was definitely worse she thinks because the woman that gave her the shot hit a blood vessel), VACCINATION SITE PRURITUS (rash after the second shot started the day after the shot and it is way more of a rash, half of her upper arm has a rash. It is also very itchy), VACCINATION SITE PAIN (achy where she got the shot/burns a little), HEADACHE (headachy) and FATIGUE (extremely tired). At the time of the report, VASCULAR INJURY (second one was definitely worse she thinks because the woman that gave her the shot hit a blood vessel), VACCINATION SITE PRURITUS (rash after the second shot started the day after the shot and it is way more of a rash, half of her upper arm has a rash. It is also very itchy), VACCINATION SITE PAIN (achy where she got the shot/burns a little), VACCINATION SITE RASH (rash near where she got the shot/rash after the second shot started the day after the shot and it is way more of a rash, half of her upper arm has a rash), HEADACHE (headachy) and FATIGUE (extremely tired) outcome was unknown. No treatment medication were reported. This case was linked to MOD-2021-291193.


VAERS ID: 1672690 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-08-15
Onset:2021-08-15
   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: Fatigue, Myalgia, Slow speech
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (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: SULPHASALAZINE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Drawling; Pain in the arm; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of SLOW SPEECH (Drawling), MYALGIA (Pain in the arm) and FATIGUE (Fatigue) in a 58-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concomitant products included SULPHASALAZINE for an unknown indication. On 15-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 15-Aug-2021, the patient experienced SLOW SPEECH (Drawling), MYALGIA (Pain in the arm) and FATIGUE (Fatigue). On 15-Aug-2021, MYALGIA (Pain in the arm) had resolved. On 17-Aug-2021, SLOW SPEECH (Drawling) and FATIGUE (Fatigue) had resolved. Relevant concomitant medications were also included immunosuppressants. The treatment information was not provided. It was reported that patient was immunosuppressed.


VAERS ID: 1672911 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-15
Onset:2021-08-15
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C121A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Extra dose administered, Fatigue, Hyperhidrosis, Malaise, Migraine, Neck pain, Pyrexia, Tension headache, Vaccination complication
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: This spontaneous case was reported by a consumer and describes the occurrence of EXTRA DOSE ADMINISTERED (Extra dose), VACCINATION COMPLICATION (COVID arm/It was pretty bad, it looked bad, it felt bad), MIGRAINE (almost a migraine headache), NECK PAIN (pain went into my neck) and MALAISE (just didn''t feel well) in an 85-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 054C121A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 15-Jan-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Aug-2021, the patient experienced EXTRA DOSE ADMINISTERED (Extra dose). On 16-Aug-2021, the patient experienced VACCINATION COMPLICATION (COVID arm/It was pretty bad, it looked bad, it felt bad), MIGRAINE (almost a migraine headache), NECK PAIN (pain went into my neck) and ARTHRALGIA (pain went into my shoulder). On 17-Aug-2021, the patient experienced MALAISE (just didn''t feel well), TENSION HEADACHE (tightness in her head) and HYPERHIDROSIS (broke out in perspiration in my scalp and face). On 20-Aug-2021, the patient experienced FATIGUE (tired). On an unknown date, the patient experienced PYREXIA (a little fever). The patient was treated with LORATADINE (CLARITINE) on 19-Aug-2021 at an unspecified dose and frequency. On 15-Aug-2021, EXTRA DOSE ADMINISTERED (Extra dose) had resolved, FATIGUE (tired) had resolved. At the time of the report, VACCINATION COMPLICATION (COVID arm/It was pretty bad, it looked bad, it felt bad), MIGRAINE (almost a migraine headache), NECK PAIN (pain went into my neck), MALAISE (just didn''t feel well), TENSION HEADACHE (tightness in her head), HYPERHIDROSIS (broke out in perspiration in my scalp and face), ARTHRALGIA (pain went into my shoulder) and PYREXIA (a little fever) outcome was unknown. This case was linked to MOD-2021-293599 (Patient Link).


VAERS ID: 1673010 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose administered, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad), Medication errors (narrow)

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

Write-up: arm hurt like crazy; patient got the booster vaccine and is not immunocompromised; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (arm hurt like crazy) and EXTRA DOSE ADMINISTERED (patient got the booster vaccine and is not immunocompromised) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088D21A) for COVID-19 vaccination. No Medical History information was reported. On 15-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Aug-2021, the patient experienced PAIN IN EXTREMITY (arm hurt like crazy). 15-Aug-2021, the patient experienced EXTRA DOSE ADMINISTERED (patient got the booster vaccine and is not immunocompromised). On 15-Aug-2021, EXTRA DOSE ADMINISTERED (patient got the booster vaccine and is not immunocompromised) had resolved. At the time of the report, PAIN IN EXTREMITY (arm hurt like crazy) outcome was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided. Patient got the booster vaccine the same day they got the flu shot and less than 8 month after getting the second dose. This case was linked to MOD-2021-294085 (Patient Link).


VAERS ID: 1673227 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-15
   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 EW0183 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood urine present
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101065902

Write-up: I peed out blood; I haven''t had period in over a year; This is a spontaneous report received from a contactable consumer or other non-health care professional (patient). A patient of unspecified age and gender received 1st dose of bnt162b2 (Pfizer BioNTech COVID-19 Vaccine, Lot Number: EW0183; Expiration Date: 31Aug2021), via an unspecified route of administration on 13Aug2021 as Dose 1, Single for covid-19 immunization. The patient medical history and concomitant medications were not reported. The patient experienced peed out blood; not had period in over a year on 15Aug2021.Consumer was provided with the number of Pfizer Medical Information Department was requested to select option 3, timings as 8 am to 8 pm on Monday to Friday as per EST. When asked for reporter, it was stated as cardiac technician (Further not clarified hence captured as consumer or other non-health care professional in tab). Consumer was informed to file a safety report as the consumer experienced side effect after receiving the vaccine. Further probing could not be done as consumer was unwilling to share any further information. Hence, limited information was available over the call. The outcome of the event was unknown. No follow-up attempts are possible. No further information is expected


VAERS ID: 1673232 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-07-31
Onset:2021-08-15
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood urine present, Dizziness, Pain in extremity, Protein urine, Urine analysis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad), Proteinuria (narrow), 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: ATORVASTATIN; ISOSORBIDE; AMLODIPINE; BABY ASPIRIN; LISINOPRIL
Current Illness: Angina pectoris (Angina); Blood pressure high (states that the last 11 years it has gotten more extreme.)
Preexisting Conditions: Medical History/Concurrent Conditions: Cholesterol; Heart attack (Verbatim: Heart attack); Myocarditis (myocarditis that has been spoken about.); Renal failure (Father: third stage renal failure); Stent placement
Allergies:
Diagnostic Lab Data: Test Date: 20210817; Test Name: Urine test; Result Unstructured Data: Test Result:Extreme Blood; Protein
CDC Split Type: USPFIZER INC202101070232

Write-up: Blood in urine; Pain in their arms; Little bit dizzy; Urine test showed extreme blood and protein; This is a spontaneous report from a contactable consumer. This consumer reported for a 52-year-old male patient that. A 52-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection), dose 2 via an unspecified route of administration, administered in Arm Right on 31Jul2021 (Batch/Lot Number: FA7484) as DOSE 2, SINGLE for covid-19 immunization(Age at vaccination 52 years) The patient past Medical history included ongoing hypertension, myocardial infarction from 22Jun2021 to an unknown date Verbatim: Heart attack , stent placement from 22Jun2021 to an unknown date , renal failure from an unknown date and unknown if ongoing Father: third stage renal failure , blood cholesterol from an unknown date and unknown if ongoing Cholesterol , ongoing angina pectoris Angina , myocarditis from an unknown date and unknown if ongoing States she doesn''t know if it is from dye or if it has to do with myocarditis that has been spoken about. Concomitant medication(s) included atorvastatin (ATORVASTATIN) taken for blood cholesterol from an unspecified start date and ongoing; isosorbide (ISOSORBIDE) taken for angina pectoris, amlodipine (AMLODIPINE) taken for hypertension from an unspecified start date and ongoing; acetylsalicylic acid (BABY ASPIRIN) taken for an unspecified indication from an unspecified start date and ongoing and lisinopril (LISINOPRIL) taken for an unspecified indication from an unspecified start date and ongoing. The patient did not receive any other vaccine within 4 weeks prior to covid-19 vaccination. Caller states she is calling more about her boyfriend than herself. About 2 weeks after the second shot, he started having blood in his urine on 15Aug2021. States she doesn''t know if it is from dye or if it has to do with myocarditis that has been spoken about. States she does not know if the vaccine helped bring this about. Caller states they are testing her boyfriend for Glomerulonephritis and Hematuria. Caller states she doesn''t know if it is an interaction from the dye he had during his stent, or if it is an underlying condition coming up. Caller states that so far, she is doing good after her vaccines. States that her and her boyfriend had pain in their arms that lingered for days. Says so far that is the only side effect she knows of. States they were a little bit dizzy also after the second vaccine, but that only lasted about an hour or so. States otherwise they are doing good. The patient underwent lab tests and procedures which included urine analysis: extreme blood; protein on 17Aug2021. The event outcome was Not recovered for Blood in urine, Unknown for Pain in their arms and Urine test showed extreme blood and protein and recovered for Little bit dizzy on an unspecified date in 2021.


VAERS ID: 1673281 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-15
Onset:2021-08-15
   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 FD8448 / 3 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Antibody test, Antinuclear antibody, Blood cholesterol, Blood test, Blood thyroid stimulating hormone, Blood triglycerides, Blood uric acid, Creatinine renal clearance, Drug ineffective, Extra dose administered, High density lipoprotein, Laboratory test, Low density lipoprotein, Off label use, Vitamin D, Weight decreased
SMQs:, Lack of efficacy/effect (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ORENCIA; PREDNISONE; INDOCIN; RESTORIL; ETANERCEPT
Current Illness: Atrial tachycardia (I am having atrial tachycardia, that''s brand new)
Preexisting Conditions: Medical History/Concurrent Conditions: Addison''s disease; Ankylosing spondylitis; Crohn''s disease; Ehlers-Danlos syndrome; Fibromyalgia; Iron; Osteoporosis
Allergies:
Diagnostic Lab Data: Test Name: antibody test; Result Unstructured Data: Test Result:has less than 1% protection; Test Name: checking on my ANA; Result Unstructured Data: Test Result:Normal; Test Name: Cholesterol; Result Unstructured Data: Test Result:cholesterol was high; Test Name: blood draws and checking different testing; Result Unstructured Data: Test Result:Normal; Test Name: TSH; Result Unstructured Data: Test Result:Normal; Test Name: triglyceride; Result Unstructured Data: Test Result:Normal; Test Name: Uric acid; Result Unstructured Data: Test Result:Normal; Test Name: Creatinine clearance; Result Unstructured Data: Test Result:Normal; Test Name: HDL; Result Unstructured Data: Test Result:Normal; Test Name: CTK; Result Unstructured Data: Test Result:Normal; Test Name: LDL; Result Unstructured Data: Test Result:High; Test Name: Vitamin D; Result Unstructured Data: Test Result:Normal
CDC Split Type: USPFIZER INC202101082337

Write-up: I did not respond to the vaccine. When they took blood from me after the vaccine to see if I have developed antibody to the Covid the vaccine has not worked for me at all; My weight it is I am losing a bit of weight; I just had the booster before I get the antibodies test again; I just had the booster before I get the antibodies test again; This is a spontaneous report from a contactable consumer (patient herself) or other non hcp. A 70-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch Number/Lot Number: FD8448), via intramuscular route of administration, administered in Arm Left on 15Aug2021 (at the age of 70-Years-old) as dose 3, single for COVID-19 immunisation. Medical history included crohn''s disease, ankylosing spondylitis, fibromyalgia, blood iron, addison''s disease, ehlers-danlos syndrome, osteoporosis from unknown start and stop dates and ongoing atrial tachycardia (am having atrial tachycardia, that''s brand new). Concomitant medication(s) included abatacept (ORENCIA), prednisone, indometacin (INDOCIN), temazepam and etanercept taken for an unspecified indication, start and stop date were not reported. The patient previously took BNT162B2, via unspecified route of administration, administered on 02-Feb-2021 as dose 1, single (Lot Number: EL3248) and dose 2 on 23-Feb-2021 (Lot number: EM9810) for COVID-19 immunisation and no events were experienced by the patient (at the age of 70-Years-old). The patient did not respond to the vaccine. when they took blood from patient after the vaccine to see if developed antibody to the covid the vaccine has not worked for me at all, losing a bit of weight, patient just had the booster before and get the antibodies test again on 15Aug2021 on 15Aug2021. The patient underwent lab tests and procedures which included antibody test: has less than 1% protection, antinuclear antibody: normal, blood cholesterol: cholesterol was high, blood test: normal, blood thyroid stimulating hormone: normal, blood triglycerides: normal, blood uric acid: normal, creatinine renal clearance: normal, high density lipoprotein: normal, laboratory test: normal, low density lipoprotein: high and vitamin d: normal on an unspecified date. The outcome of the events was reported as unknown. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1673352 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-30
Onset:2021-08-15
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Back injury
SMQs:, Accidents and injuries (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 INC202101090847

Write-up: she injured her back; This is a spontaneous report from a Pfizer-sponsored Regulatory Authority Support. A contactable consumer (patient) reported that a female patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot Number: EW0164) dose 1 via an unspecified route of administration on 30Jul2021 as single dose for Covid-19 Immunisation. The patient medical history and concomitant medications were was not reported. On 15Aug2021, she injured her back and she was under different medication such as steroid (Intent: treatment), now she is supposed to get her second dose on 18Aug2021 however that needs to be canceled because she is still under medication (treatment) she was schedule for the second dose on 25Aug2021, this coming Wednesday however she thinks she is still unable to make it Wednesday. She was still worried about her condition (Clarification unknown). She was on a lot of medications she does not know if she could be on these medicines when she got the vaccine she was taking ''Mobic'' (Not clarified) now which is anti-inflammatory, she thinks and steroid ''Dosepak'', she finished steroid ''Dosepak'' today, she needed to move it (second dose) ahead a little bit because of the medication. She was seeking for advice. The outcome of event was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1674465 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-12
Onset:2021-08-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood urine present, Diarrhoea, Fatigue, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Fever, fatigue, blood in urine, diarrhea


VAERS ID: 1674736 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA 7485 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FW 0191 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Culture stool negative, Diarrhoea, Fatigue, Full blood count, Hiccups, Metabolic function test abnormal, Nausea, Pain, Red blood cell count increased
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bicktarvy, tylenol, jardiance, clonopin, gabapentin, remeron, multi vitamin, naproxen dextrostat, vit D
Current Illness: Runny nose, scratchy throat, head cold
Preexisting Conditions: Hiv + chronic 25 years
Allergies: Dust, grass pollen
Diagnostic Lab Data: Cmp, cbc, stool culture . Cmp abnormalities including 550 rbc count Stool culture returned neg. 8/26/21
CDC Split Type:

Write-up: Developed uncontollable diarrhea on 3 thru 5 days, body aches, hiccups, nausea, extreme fatigue . 8/15 thru 8/20 then dialy diarrhea, body aches, hiccups, nausea 6 more days to around 8/27


VAERS ID: 1674803 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-07
Onset:2021-08-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metoprolol 25 mg. daily.vitamin D3 1000. vitamin B12.sodium bicarbonate
Current Illness: CKD patient for last five years
Preexisting Conditions: bladder cancer (resolved) and kidney condition ,wearing a Foley catheter.
Allergies: lovaquin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: One week after second injection started itching in upper torso.back of neck shoulders and both arms up to wrist. the itching is more violent at night scratching myself almost to bleeding. Tacking Tylenol almost nightly and using ointment for calming effect.it is almost three weeks and no let up.


VAERS ID: 1674900 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Fatigue, Headache, Hypoaesthesia, Immediate post-injection reaction, Injection site pain, Lethargy, Nausea, Nervous system disorder, Pain, Paraesthesia, Sensory disturbance, Sleep disorder, Tremor, Visual impairment
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: Site: Pain at Injection Site-Severe, Systemic: Body Aches Generalized-Medium, Systemic: Chills-Medium, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Headache-Severe, Systemic: Nausea-Medium, Systemic: Numbness (specify: facial area, extremities)-Severe, Systemic: Shakiness-Medium, Systemic: Tingling (specify: facial area, extemities)-Severe, Systemic: Unable to Sleep-Medium, Systemic: Visual Changes/Disturbances-Medium, Systemic: Weakness-Severe, Additional Details: After receiving their second dose patient immediately started to experience what she said was tingling sensation of her arm and stated that it has got worse over time. Currently patient is stating that they are suffering from what feels like "nerve damaging issue". The current symptoms are the following that have been reported: Tingling sensation down both arm and legs, legs/arms feel like they are falling asleep and she is dragging them along, tightening sensation around her fingers


VAERS ID: 1675393 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-12
Onset:2021-08-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Carbuncle, Eye swelling, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Mouth swelling, Rash, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Systemic: Allergic: Rash (specify: facial area, extremeties)-Severe, Systemic: Allergic: Rash Generalized-Severe, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Severe, Additional Details: Patient reported developing carbuncles and followed up with urgent care, and then PCP - both prescribed antibiotics and prednisone.


VAERS ID: 1676247 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-28
Onset:2021-08-15
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Burning sensation, Dizziness, Headache, Hypoaesthesia, Hypoaesthesia oral, Malaise, Nausea, Paraesthesia, Paraesthesia oral, Peripheral coldness
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Diovan, Metoprolol, Avorstatin
Current Illness: Some problem with total knee replacement but that has been ongoing for a year.
Preexisting Conditions: Asthma, Cardiac stents.
Allergies: Ace inhibitors, Calcium channel blockers, penicillin
Diagnostic Lab Data: I have contacted my doctor but what tests could possibly be done? I have only a minor fever of 99.5. He is scheduling me for circulation tests of my legs. What on Earth would you test regarding a complaint of a numb and tingly feeling all over the body? My BP is high but it is always high.
CDC Split Type:

Write-up: After 1st dose in April about 2-1/2 weeks later these exact same symptoms described below started. It took May and June for them to fade away. It was clear that my doctor thought I might have a brain tumor since he suggested an MRI of my head. That was my same thoughts. After being told that there was no way what I experienced could be vaccine side effect I took the 2nd shot. After 2-1/2 weeks My front teeth got numb, My upper lip was numb and tingly. My nose is numb and tingly and all the skin around my nose similar. A bad headache that was different from anything I''ve ever had. It''s like there is a numb and tingly spot inside my brain. My stomach has a numb and tingly feeling which also creates slight nausea and dizziness. There is a numb tingly feeling across my chest. My fingers and toes are cold. And even though my toes are cold my feet feel like they are burning. It took two months for the effects to fade away for the first shot. These are debilitating effects. I spend a lot of time in bed moaning. My doctor has no idea how to treat this since he is being told that side effects are only mild and go away after a couple of days. I have searched the internet for numb and tingly side effects. I couldn''t find anything at all until August. Then suddenly I started finding others that were using the words numb and tingly the same words I had used to my doctor in May. And then I found Dr. He described almost precisely the exact symptoms I have. I found lots of people describing numb and tingly nose and lips. These side effects make me so sick that I have had to put off important surgery on my knee. If this second dose goes like the first dose then I don''t expect to feel better until end of October at the earliest.


VAERS ID: 1677168 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-02-01
Onset:2021-08-15
   Days after vaccination:195
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Myalgia, Off label use
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: arm hurt like crazy; patient got the booster vaccine and is not if are considered immunocompromised; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (arm hurt like crazy) and OFF LABEL USE (patient got the booster vaccine and is not if are considered immunocompromised) in an 82-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 088D21A, 010A21A and 030L20A) for COVID-19 vaccination. No Medical History information was reported. On 01-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 02-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 15-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 15-Aug-2021, the patient experienced MYALGIA (arm hurt like crazy) and OFF LABEL USE (patient got the booster vaccine and is not if are considered immunocompromised). At the time of the report, MYALGIA (arm hurt like crazy) and OFF LABEL USE (patient got the booster vaccine and is not if are considered immunocompromised) outcome was unknown. No concomitant medications were reported. No treatment information was provided. patient 1 informs that the Patient 2 is in a high risk patient due to having diabetes, asthma, a heart condition and had kidney cancer, but they are not sure if patient 2 is immunocompromised. This case was linked to MOD-2021-294284 (Patient Link).


VAERS ID: 1677188 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026021A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Axillary mass, Bone pain, Cough, Fatigue, Formication, Joint swelling, Limb mass, Pain in extremity, Pruritus
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Joints in their left hand are swollen, red, and painful; bones hurt; a lot of pain in both legs; left underarm a lump; a lump on inner left thigh; cough that doesn''t go away; joints in their left hand are swollen, red, and painful; felt exhausted; crawling sensation in their legs; itch; This spontaneous case was reported by a consumer and describes the occurrence of FORMICATION (crawling sensation in their legs), PRURITUS (itch), JOINT SWELLING (Joints in their left hand are swollen, red, and painful), BONE PAIN (bones hurt) and PAIN IN EXTREMITY (a lot of pain in both legs) in a 37-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026021A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided. Concomitant products included ONE A DAY WOMEN''S. On 15-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Aug-2021, the patient experienced FORMICATION (crawling sensation in their legs) and PRURITUS (itch). On an unknown date, the patient experienced JOINT SWELLING (Joints in their left hand are swollen, red, and painful), BONE PAIN (bones hurt), PAIN IN EXTREMITY (a lot of pain in both legs), AXILLARY MASS (left underarm a lump), LIMB MASS (a lump on inner left thigh), COUGH (cough that doesn''t go away), ARTHRALGIA (joints in their left hand are swollen, red, and painful) and FATIGUE (felt exhausted). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL A) at an unspecified dose and frequency and PARACETAMOL (TYLENOL) at an unspecified dose and frequency. On 16-Aug-2021, FORMICATION (crawling sensation in their legs) and PRURITUS (itch) had resolved. At the time of the report, JOINT SWELLING (Joints in their left hand are swollen, red, and painful), BONE PAIN (bones hurt), PAIN IN EXTREMITY (a lot of pain in both legs), AXILLARY MASS (left underarm a lump), LIMB MASS (a lump on inner left thigh), COUGH (cough that doesn''t go away), ARTHRALGIA (joints in their left hand are swollen, red, and painful) and FATIGUE (felt exhausted) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The patient is taking is a women''s one-a-day multivitamin as concomitant drug


VAERS ID: 1677245 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Back pain, Dysstasia, Hypoaesthesia, Insomnia, Loss of personal independence in daily activities, Malaise, Mobility decreased, Neck pain, Pain, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Complex regional pain syndrome (since 17 year)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: not doing well at all; fingers are numb; can''t sleep; can''t do anything; can barely move the shoulder; can barely stand because of the pain in the back; Pain is spreading across her back and into her left shoulder and arm; Pain is spreading across her back and into her left shoulder and arm; She can barely move shoulder; The pain travelled from the right arm/shoulder, across the back, to the top of the left shoulder and also to the neck.; it became beyond the pain she knows, this is totally different/It gets everyday more severe; woke up with severe arm pain, entire upper arm/ the pain is spreading across her back and into her left shoulder and arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (woke up with severe arm pain, entire upper arm/ the pain is spreading across her back and into her left shoulder and arm), MALAISE (not doing well at all), HYPOAESTHESIA (fingers are numb), INSOMNIA (can''t sleep) and LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (can''t do anything) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939902) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Complex regional pain syndrome (since 17 year). On 14-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Aug-2021, the patient experienced PAIN IN EXTREMITY (woke up with severe arm pain, entire upper arm/ the pain is spreading across her back and into her left shoulder and arm). On 17-Aug-2021, the patient experienced PAIN (it became beyond the pain she knows, this is totally different/It gets everyday more severe). On an unknown date, the patient experienced MALAISE (not doing well at all), HYPOAESTHESIA (fingers are numb), INSOMNIA (can''t sleep), LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (can''t do anything), MOBILITY DECREASED (can barely move the shoulder), DYSSTASIA (can barely stand because of the pain in the back), BACK PAIN (Pain is spreading across her back and into her left shoulder and arm), ARTHRALGIA (Pain is spreading across her back and into her left shoulder and arm), MOBILITY DECREASED (She can barely move shoulder) and NECK PAIN (The pain travelled from the right arm/shoulder, across the back, to the top of the left shoulder and also to the neck.). The patient was treated with NAPROXEN SODIUM (ALEVE) at a dose of 6 a day. At the time of the report, PAIN IN EXTREMITY (woke up with severe arm pain, entire upper arm/ the pain is spreading across her back and into her left shoulder and arm), MALAISE (not doing well at all), HYPOAESTHESIA (fingers are numb), INSOMNIA (can''t sleep), LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (can''t do anything), MOBILITY DECREASED (can barely move the shoulder), DYSSTASIA (can barely stand because of the pain in the back), BACK PAIN (Pain is spreading across her back and into her left shoulder and arm), ARTHRALGIA (Pain is spreading across her back and into her left shoulder and arm), MOBILITY DECREASED (She can barely move shoulder), NECK PAIN (The pain travelled from the right arm/shoulder, across the back, to the top of the left shoulder and also to the neck.) and PAIN (it became beyond the pain she knows, this is totally different/It gets everyday more severe) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment medications were reported.


VAERS ID: 1677446 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-05
Onset:2021-08-15
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Blood pressure high; High cholesterol; Hypothyroidism; Rheumatoid arthritis; Stroke
Allergies:
Diagnostic Lab Data: Test Date: 20210815; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC202101069680

Write-up: Tested positive for COVID-19 infection on 15Aug2021; This is a spontaneous report received from a contactable consumer or other non-health care professional (patient) reported for herself. A 54-years-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot Number: FC3180), via an unspecified route of administration, administered in Arm Left on 05Aug2021 in afternoon (at the age of 54-years-old) as dose 1, single for COVID-19 immunisation and tofacitinib citrate (XELJANZ XR), oral from an unspecified date (Batch/Lot number was not reported) to an unspecified date, at 11 mg, 1x/day for an unspecified indication. Caller does not recall when she started it. States she had taken Xeljanz before and tried a different one Rinvoq, and apparently she was allergic to it, she took it about a week and it was horrible body aches and everything. States she felt really bad like she had the flu so she stopped that and went back on Xeljanz and almost right away she started to feel better. States she was allergic to Rinvoq or something in it. she threw it away. States it was the one the doctor prescribed. Caller state her doctor just called and said she can get the 2nd Covid vaccine 14 days after she tests negative and has no symptoms and to stop taking the Xeljanz XR 11mg until after all of this. Medical history included high blood pressure, high cholesterol, hypothyroid, rheumatoid arthritis from an unknown date and unknown if ongoing, stroke from 2005 to an unknown date. The patient concomitant medications were not reported. Prior Vaccinations (within 4 weeks): no just the regular, she was not taking methotrexate already had taken it for a couple weeks before she got Covid and was not supposed to take it after and she has not taken it in about month a half, she was supposed to be taking it before but she just did not had any so she had run out and was trying to get her prescription. Patient does not took anything or pain pills, she takes probiotic, multivitamins all that stuff. Patient states she has a lot of arthritis in her right shoulder, she tore her rotator cuff and said alright use the left arm. The consumer reports she had stopped taking methotrexate, per her physician instructions, 2 weeks before the first injection of the Pfizer covid-19 vaccine and was told she could resume taking methotrexate 2 weeks after getting the second injection of the Pfizer covid-19 vaccine. The consumer reports she was told she could receive the second injection of the Pfizer covid-19 vaccine two weeks after she tested negative and was free of symptoms of COVID-19 injection. Caller stated she called for assistance with the Xeljanz and she had asked her doctor and her rheumatologist told her if she was taking methotrexate to stop it for 2 weeks and start it again and go get more blood work and then when she goes to get the 2nd shot to do the same thing. Caller stated she got 1 shot already and then tested positive for COVID-19 infection on 15Aug2021 and everyone else in the house was negative. States she was quarantined to her room. Caller states she was taking Xeljanz but not Methotrexate Caller was asking if she was still supposed to not take Methotrexate. States she did not tell her rheumatologist yet, she told her regular doctor and was told that after 10 days and she tests negative she could go 90 days after and get the 2nd vaccine. Caller stated she was due for the 2nd dose 26Aug2021 and that is her last day of the 10 days and could be tested and if negative she could after 90 days of tested positive she could schedule for the 2nd Covid vaccine. States her doctor told her to stop the methotrexate for 2 weeks if she gets the shot and then go on it for 2-3 weeks and then stop for the 2nd shot. Caller stated she did not tell him she was positive yet. Stated he told her to stop it for 2 weeks after she got the vaccine. Caller stated she stopped the methotrexate and is feeling a little sore. Caller is asking if they are covering Xeljanz for her, did they do that already and get all her information. Caller states they said that while doing that they were going to transfer her to DSU. States she gave them all her information about how many people and how much her husband makes, that she doesn''t work. Caller stated she got her 1st Pfizer Covid vaccine 5Aug2021. Stated her daughter was a nurse and said that was the best one she can find and did not like any of the other ones. Stated her daughter has not gotten it yet and they were home with it. Caller stated she herself does not had any symptoms, she has a headache and was tired but they had cough, stuffy nose and everything. Caller stated she got her shot and has to stay there for 10 days and her daughter was worried because of all her medical stuff. Caller states she was thinking she got at least 1 shot and was praying that was what has gotten her through this. Because everybody was starting to get sick and it was spreading in her area so she spoke to her rheumatologist and he encouraged her to have it and her daughter recommended it for everybody. Caller stated she tried to get it a couple of months ago and her daughter said to check with all her doctors and she just went and got it and did not tell her. Stated she has a 4 year old at home that was not allowed to get it and she convinced her husband to do it, he did not want to either. Caller states she had blood drawn before for her doctor and rheumatologist to make sure her liver and thyroid and everything was ok since she takes medication for that too. Caller stated she stopped taking Methotrexate injection about 3-4 weeks before getting the 1st dose of the Covid vaccine. The outcome of the events was reported as recovered on Aug2021.


VAERS ID: 1678155 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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

Write-up: Sweats; Chills; Fever; This spontaneous case was reported by a consumer and describes the occurrence of HYPERHIDROSIS (Sweats), CHILLS (Chills) and PYREXIA (Fever) in a 41-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Relapsing multiple sclerosis. Concomitant products included OCRELIZUMAB (OCREVUS) for an unknown indication. On 15-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Aug-2021, the patient experienced HYPERHIDROSIS (Sweats), CHILLS (Chills) and PYREXIA (Fever). At the time of the report, HYPERHIDROSIS (Sweats), CHILLS (Chills) and PYREXIA (Fever) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Treatment medications were not reported.


VAERS ID: 1678319 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray, Computerised tomogram thorax, Immediate post-injection reaction, Laboratory test, Pneumonia bacterial, Respiratory failure, Sepsis
SMQs:, Anaphylactic reaction (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), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Respiratory failure (narrow), Infective pneumonia (narrow), Hypokalaemia (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: HTN MEDICINES, ASPIRIN
Current Illness: NOTHING ACUTE
Preexisting Conditions: HTN, PACEMAKER
Allergies: NKDA
Diagnostic Lab Data: SEPSIS WORKUP, CHEST X RAY, CT SCAN OF CHEST.
CDC Split Type:

Write-up: PATIENT DEVELOPED COVID-19 IMMEDIATELY AFTER RECEIVING THE J&J VACCINE, HE THEN DEVELOPED HYPOXIC RESPIRATORY FAILURE DUE TO COVID AND THEN 2.5 WEEKS LATER HAS DEVELOPED SEVERE HYPOXIC RESPIRATORY FAILURE DUE TO EXTENSIVE BILATERAL BACTERIAL PNEUMONIA WITH SEPSIS.


VAERS ID: 1678701 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-09
Onset:2021-08-15
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: lorazepam, venlafaxine, tamsulosin
Current Illness:
Preexisting Conditions: depression and anxiety
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID pos on 8/18/2021 hospitalized 8/20/2021and put on oxygen, remdesivir and dexamethasone then discharged 8/29/2021


VAERS ID: 1678801 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-07-29
Onset:2021-08-15
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO196 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bacterial test negative, Blood creatine phosphokinase normal, Blood immunoglobulin G, Blood immunoglobulin M, Blood lactate dehydrogenase increased, Blood magnesium normal, Blood phosphorus increased, Blood thyroid stimulating hormone decreased, Blood uric acid normal, C-reactive protein decreased, Differential white blood cell count, Electric shock sensation, Feeling hot, Full blood count normal, Metabolic function test, Metabolic function test normal, Nerve conduction studies normal, Pain, Pain in extremity, Parvovirus B19 test negative, Porphyrins urine normal, Red blood cell sedimentation rate normal, Renal function test normal, SARS-CoV-2 test negative, Sensory disturbance, Serum ferritin normal, Urine analysis, Varicella virus test negative, Vitamin B12 normal, Vitamin B6, X-ray normal
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Pre-Teen Mulitvitamin, Probitoics, L-lysine, Vitamin C
Current Illness: Phyto-photodermatitis on primarily on Right Hand, some of Left fingers - occured from exposure to citrus juice on June 18 - lasted for nearly 7 weeks. Cold Sore
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: 8/17 8/19 Xrays - nothing significant 8/25 Nerve EMG study - negative 8/26 1SARS COV-2 - negative 8/22 CBC with DIFF - nothing significant 8/22 Comp Metabolic Panel - nothing significant 8/22 CK/Creatine Kinase - 72 8/22 LDH total - 620 8/22 Uric Acid - 6.3 8/22 TSH - 1.04 8/22 C-Reactive Protein <0.5 8/22 SED RATE - 5 8/22 Phosphorus - 5.49 8/22 Magnesium - 2.1 8/26 Lyme - NEGATIVE 8/26 Ferritin - 28.60 8/26 B12 - 649 8/26 B6 Profile - Pyridoxal - 11 / Pyridoxic Acid - 3 8/27 Microscopic UA - nothing 8/27 Urinalysis with Microscopic - NOTHING 8/27 Porphyrins, QN, 22 to 26, HR Collection Only, U - NOTHING 8/28 Parvovirus - NOTHING 9/3 CBC with DIFF - Nothing significant 9/3 Renal Function Panel - nothing 9/3 Varicella - Zoster AB, IGG, S - Equivocal 9/3 Varicella-Zoster, AB, IGM - Negative Awaiting Genetic testing for Fabrys Disease and Erythtromelalgia
CDC Split Type:

Write-up: Woke up on 8/15 with significant pain in both hands - from wrists to fingers. No medication, treatment has relieved the pain in any manner - except ice. Pain intensity has increased signficantly and spread to both feet (mid-foot to toes) as well. Pain sensation began as "achy", then progressed to "sharp stabbing" and now includes "shocking" in addition to the "stabbing" pain. Both hands and feet are warm to the touch despite being iced nearly non-stop. (3) ED visits on 8/22, 8/24 and 8/26 with admittance to Hospital on 8/27 and discharged on 9/5. Most recently, she has shared the sensation of all fingers being "jammed".


VAERS ID: 1679162 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-15
Onset:2021-08-15
   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 FC3182 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Fatigue, Feeling cold, Hypoaesthesia, Muscle tightness, Sleep disorder, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: The night of the first dose, I woke from my sleep due to tightening of my muscles all over my body. I tried to bush it off. I went to use to bathroom. When I sat in the toilet I felt ill, like something was wrong. I rushed to get up to wash my hands and get to bed. When I pumped the soap, I went numb and my arms started to tremor. I felt like I was going to faint, so I rushed back to my room to wake my spouse. I laid down and couldn''t shake the feeling. My arms kept shaking and then my chest began to feel cold inside. After a while I started to feel a bit better so I tried to sleep. As soon as I would drift into sleep the same thing would happen. The tightening of my muscles and arms shaking and cold chest. This lasted until about 2 am. The next day I was extremely fatigued. My body felt weak. I tried to do my part and get the vaccine for myself and those around me. I can honestly say getting the second dose worries me.


VAERS ID: 1681517 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053B21A / 1 LA / -

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

Write-up: Soreness; I have a headache; On the second day I had face warm arm; Arm pain; 30 minutes after I received the vaccine I started feeling dizzy and after I got home the dizziness got worse; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (30 minutes after I received the vaccine I started feeling dizzy and after I got home the dizziness got worse), PAIN (Soreness), VACCINATION SITE WARMTH (On the second day I had face warm arm), VACCINATION SITE PAIN (Arm pain) and HEADACHE (I have a headache) in a 43-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 053B21A) for COVID-19 vaccination. Concomitant products included ASCORBIC ACID (VITAMIN C ACID) for an unknown indication. On 15-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Aug-2021, the patient experienced DIZZINESS (30 minutes after I received the vaccine I started feeling dizzy and after I got home the dizziness got worse). On 16-Aug-2021, the patient experienced VACCINATION SITE WARMTH (On the second day I had face warm arm) and VACCINATION SITE PAIN (Arm pain). On 19-Aug-2021, the patient experienced PAIN (Soreness) and HEADACHE (I have a headache). At the time of the report, DIZZINESS (30 minutes after I received the vaccine I started feeling dizzy and after I got home the dizziness got worse), PAIN (Soreness), VACCINATION SITE WARMTH (On the second day I had face warm arm), VACCINATION SITE PAIN (Arm pain) and HEADACHE (I have a headache) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. Treatment information not provided by reporter. Patient received her first dose of the Moderna COVID-19 vaccine on 15AUG2021 in the left nondominant arm lot number 053B21A expiration date unknown. The patient reports that after receiving the vaccine she started to experience dizziness, headache, arm pain and soreness. The symptoms are currently ongoing.


VAERS ID: 1681555 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Palpitations, Vaccination site erythema, Vaccination site pain, Vaccination site swelling, Vaccination site warmth
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (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: Depression
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: very hot in the area of the injection; weal appeared in the injection site; weal appeared in the injection site that was a little swollen; palpitations; pain in the injection arm to the middle of her elbow; This spontaneous case was reported by a consumer and describes the occurrence of PALPITATIONS (palpitations), VACCINATION SITE WARMTH (very hot in the area of the injection), VACCINATION SITE ERYTHEMA (weal appeared in the injection site), VACCINATION SITE PAIN (pain in the injection arm to the middle of her elbow) and VACCINATION SITE SWELLING (weal appeared in the injection site that was a little swollen) in a 41-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 005C21A) for COVID-19 vaccination. Concurrent medical conditions included Depression. On 14-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Aug-2021, the patient experienced PALPITATIONS (palpitations) and VACCINATION SITE PAIN (pain in the injection arm to the middle of her elbow). On 22-Aug-2021, the patient experienced VACCINATION SITE ERYTHEMA (weal appeared in the injection site) and VACCINATION SITE SWELLING (weal appeared in the injection site that was a little swollen). On 23-Aug-2021, the patient experienced VACCINATION SITE WARMTH (very hot in the area of the injection). On 15-Aug-2021, PALPITATIONS (palpitations) had resolved. On 17-Aug-2021, VACCINATION SITE PAIN (pain in the injection arm to the middle of her elbow) had resolved. At the time of the report, VACCINATION SITE WARMTH (very hot in the area of the injection), VACCINATION SITE ERYTHEMA (weal appeared in the injection site) and VACCINATION SITE SWELLING (weal appeared in the injection site that was a little swollen) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications include Pill for depression to help sleep. No treatment information was mentioned.


VAERS ID: 1681790 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-15
Onset:2021-08-15
   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 FC3180 / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature, Burning sensation, Ear discomfort, Extra dose administered, Fatigue, Headache, Hyperhidrosis, Malaise, Neuralgia, Poor quality sleep, Pyrexia, Vaccination site erythema, Vaccination site mass, Vaccination site pruritus, Vaccination site swelling
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Depression (excl suicide and self injury) (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: ATENOLOL; BENICAR; OMEPRAZOLE; LIPITOR; FLECAINIDE
Current Illness: Arrhythmia
Preexisting Conditions: Medical History/Concurrent Conditions: Cholesterol (cholesterol family history); GERD; Sulfonamide allergy (mentions she is allergic to Sulfa)
Allergies:
Diagnostic Lab Data: Test Date: 20210817; Test Name: fever/today her temperature is normal; Result Unstructured Data: Test Result:fever of 101; Comments: yesterday; had a fever of 101; Test Date: 20210818; Test Name: fever/today her temperature is normal; Result Unstructured Data: Test Result:normal; Comments: today her temperature is normal
CDC Split Type: USPFIZER INC202101068970

Write-up: woke up with sweats; couldn''t sleep; even her earlobe felt like it was pinching; Fatigue; feeling sick; headache; fever of 101/ Fever; aching like her nerves are high pitched; injection site redness, swelling, and itching; injection site redness, swelling, and itching; injection site redness, swelling, and itching; aching burning sensation; Injection site lump; her third, or booster dose; This is a spontaneous report from a contactable consumer or other non hcp. A 66-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation solution for injection) via an unspecified route of administration, administered in Arm Left on 15Aug2021 at 15:00 (Batch/Lot Number: FC3180) as dose 3, single for covid-19 immunization (at the age of 66-years-old). Medical history included allergic to Sulfa and gastrooesophageal reflux disease (GERD) from an unknown date and unknown if ongoing and ongoing arrhythmia from an unknown date and had family history of cholesterol from an unknown date. Concomitant medication(s) included atenolol taken for arrhythmia; olmesartan medoxomil (BENICAR) taken for prophylaxis; omeprazole taken for gastrooesophageal reflux disease; atorvastatin calcium (LIPITOR) taken for blood cholesterol and flecainide (FLECAINIDE) taken for arrhythmia, start and stop date were not reported for all. The patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot Number: EL3249) on 30Jan2021 early morning in the left arm and received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot Number: EL9265) on 20Feb2021 at 09:00 as single dose for COVID-19 immunization and had no side effects. The patient previously also received flu shot last year for immunization and experienced frozen shoulder from the flu shot (mentions she got frozen shoulder from the flu shot last year; but she has no product information, no NDC, lot or expiration for that flu shot). Patient had not received any other vaccine within 4 weeks of vaccination. It was reported that patient received her third, or booster dose of vaccine on 15Aug2021 and stated that the next day on 16Aug2021 she was feeling sick, had headache, fever of 101/ fever, aching like her nerves are high pitched, injection site redness, swelling, and itching, aching burning sensation and injection site lump. On 17Aug2021 she couldn''t sleep, even her earlobe felt like it was pinching and had fatigue. On 18Aug2021 she woke up with sweats. The patient stated that "After the booster on 15Aug2021, the next day she reports she got a headache, felt really sick the next day and yesterday; had a fever of 101 and felt an aching burning sensation, even her earlobe felt like it was pinching then at the site of the injection she has a four inch by two inches red red area and it had a lump that may have gone down some; and it is itchy. Adds she also felt fatigue. Adds the ache she would guess it was some kind of vagal response, anytime she felt pain she could feel it projecting to another part of her body, like ants running in her body and her nerves were so high pitched she couldn''t sleep. Today her arm maybe is a little less lumpy; and she doesn''t feel nearly as bad as Sunday; and today her temperature is normal. Mentions there is no sign of blood so the lump on her arm is not like a hematoma. Adds the worst was on Sunday; she woke up with sweats like menopause. Today she reports all of her symptoms have gone away, except the lump on her arm and it is improved. Adds she would not have called except for the arm. She is asking is this normal or is it something she should be concerned about?. Treatment: Mentions she would have gone to the emergency room if it had not gotten better. Caller confirmed she did not contact her doctor and did not report any treatment". Patient had not visited emergency room or physician office for the events. The patient underwent lab tests and procedures which included body temperature which showed fever of 101 on 17Aug2021 (yesterday) and was normal on 18Aug2021. The outcome of the event vaccination site lump was recovering at the time of report and patient had recovered from the event feeling sick and headache on 17Aug2021 and from event fever on 18Aug2021and was recovered from rest of the other events on an unspecified date in 2021.The outcome was unknown for the event extra dose administered. The lot number for the vaccine [BNT162B2], was not provided and will be requested during follow-up.


VAERS ID: 1681856 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Nasal congestion
SMQs:, Anaphylactic reaction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Fruit allergy; Sulfonamide allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101090287

Write-up: Having a cough and some stuffiness; Having a cough and some stuffiness; This is a spontaneous report from a non-contactable consumer (patient). This 33-year-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 14Aug2021, at the age of 33 years, as the first single dose, in right arm, for COVID-19 immunisation. No other vaccine was administered in 4 weeks. Medical history included sulfa drugs and strawberries allergy. The patient did not have COVID prior vaccination. Concomitant medications were not reported. On 15Aug2021 the patient experienced having a cough and some stuffiness. COVID was not tested after vaccination. The events were resolving. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1681948 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cystitis, Haematuria, Thrombosis, Ultrasound bladder, Ultrasound kidney, Urinary tract infection
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Tubulointerstitial diseases (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hematuria microscopic (Verbatim: microhematuria); Keloid
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: Kidney and Bladder Ultrasound; Result Unstructured Data: Test Result:normal; Test Date: 202108; Test Name: Kidney and Bladder Ultrasound; Result Unstructured Data: Test Result:normal; Comments: no hydro nephrosis or shadowing renal stones. The bilateral ureter jets were visualized. The kidneys are normal in echo texture. No evidence of hydro nephrosis or shadowing calculus
CDC Split Type: USPFIZER INC202101100791

Write-up: urinating blood. It progressed to clots; Hematuria; urinary tract infection; acute cystitis with hematuria; This is a spontaneous report from a contactable consumer (patient). A 51-year-old female patient received BNT162B2, via an unspecified route of administration, administered in Arm Left on 14Aug2021 11:30 (Batch/Lot number was not reported) as dose 1, single for COVID-19 immunization/Covid Prevention. Medical history included microhematuria from an unknown date and unknown if ongoing and developed a keloid from getting the small pox vaccine on an unknown date. There were no concomitant medications. On 15Aug2021, the patient experienced urinating blood. it progressed to clots, hematuria, urinary tract infection and acute cystitis with hematuria. The events were assessed as serious (medically significant). The events resulted in Emergency Room visit and Physician Office visit. There were no prior vaccinations (within 4 weeks). The clinical course was reported as follows: Patient went to the emergency room. She was told her she had a urinary tract infection and was put on an antibiotic. She was convinced it was caused by the vaccine. She will be seeing a urologist for testing. She asked if she should get she get the second dose. The urologist told her to wait until she was scoped to see if anything was going on in bladder. Patient''s height as 5 feet 2 and 7/8th inches. She had the shot on Saturday 14Aug2021 at 1130 am. The following morning she woke up feeling like she had a urinary tract infection. She started urinating blood. It progressed to clots. She went to the urgent care. They saw that the level was significant. After 36 hours she went to the urgent care. She was told to contact the doctors office. The office told her to go to the emergency room. She went to the hospital. They did the same test as the urgent care and had the same conclusion. Since age 21 she has had microhematuria. She sees a urologist every 6 months for testing. At the urgent care and hospital she had a kidney and bladder ultrasound. At the hospital they said she had acute cystitis with hematuria. The impression from the Kidney Renal Ultrasound was no hydro nephrosis or shadowing renal stones. The bilateral ureter jets were visualized. The kidneys are normal in echo texture. No evidence of hydro nephrosis or shadowing calculus. She was unable to find any information about someone having gross hematuria and if they should get the second dose. Her doctor will see if there is an underlying cause. This is not a normal reaction and should not have happened. The patient is apprehensive about getting the second dose. She found reports of other people having it from a creditable website. She does not have any details to provide. The patient underwent lab tests and procedures which included Kidney and Bladder Ultrasound: both normal in Aug2021. Therapeutic measures were taken as a result of urinary tract infection. The outcome of the event ''hematuria'' was recovered in Aug2021 and outcome of the other events was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1682458 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-06
Onset:2021-08-15
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Alopecia, Haemorrhage, Laboratory test
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Pneumovax
Other Medications: Vitamin E; D; C; multivitamin; benazepril; Farxiga; pioglitazone; progesterone
Current Illness: None
Preexisting Conditions: Diabetes; High Blood Pressure
Allergies: Pneumonia vaccine
Diagnostic Lab Data: 09/03/2021 Dilation and curettage done and tissues sent to lab but haven''t received results
CDC Split Type: vsafe

Write-up: 03/01/2021 Hair starting falling out and had to seek care from a dermatologist. 08/05/2021 Starting having extreme bleeding.


VAERS ID: 1682709 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-13
Onset:2021-08-15
   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 EW0164 / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Erythema, Pyrexia, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aciphex, xyzal, Zofran, Meclizine, Scopolamine, Ambien, proair, Nucynta, Conopid, lexapro, aspirin, magnesium, biotin, zinc, hair growth supplement, elderberry, motrin
Current Illness:
Preexisting Conditions: Spinal cord, asthma, lupus, Antiphospholipid Syndrome, anxiety and depression, heartburn
Allergies: azithromycin, penicillin, sulfa, Levaquin, oxycodone, acetaminophen,
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I started having Fever and chills, by Sunday morning I was mess I was over hydrating. The first place I notice when I''m having allergic reaction is my inner arms, started pink, then went to a rash to hives, and it spread like wildfire went to both arms, my stomach, my back just progressively started going all over my body. I went to Well Now Urgent Care, they gave me benadryl sent you home. I was worried about my airway so I went to my doctor 2 days later, High prednisone for 14 days. It helped, every once in a while the pink comes back on my arms. Dr. recommended to get the booster.


VAERS ID: 1683018 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-02-10
Onset:2021-08-15
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012W120A / 1 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002A21A / 2 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Clopidogrel, metoprolol, benazepril-hctz, asa
Current Illness: None
Preexisting Conditions: DM2, NSTEMI w/ stent, CKD stage 3
Allergies: gabapentin
Diagnostic Lab Data: HOSPITALIZED 8/19/21; NOW ONLIFELONG ANTICOAGULATION
CDC Split Type:

Write-up: SEVERE UNPROVOKED SADDLE PULMONARY EMBOLISM


VAERS ID: 1683075 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymph node pain, Lymphadenopathy, Pain in extremity
SMQs:, 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: no
Current Illness: no
Preexisting Conditions: high blood pressure
Allergies: soma, cipro, hydrocodone, fish oil
Diagnostic Lab Data: no
CDC Split Type:

Write-up: top of arm was hurting went all the way down to her hands, lymph node under arm is swollen and painful


VAERS ID: 1683152 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Analgesic therapy, Pain in extremity
SMQs:, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: IBUPROFEN
Current Illness:
Preexisting Conditions:
Allergies: CODEINE
Diagnostic Lab Data:
CDC Split Type:

Write-up: THE PATIENT COMPLAINED OF PAIN IN THE ARM THE FOLLOWING DAY OF RECEIVING THE VACCINE. THE PATIENT WAS SELF-TREATING THE SYMPTOMS USING IBUPROFEN AND ICE BUT IT GRADUALLY BECAME WORSE. THE PAIN SPREADED TOWARDS THE RIGHT HAND THE FOLLOWING WEEK. THE PATIENT WAS SEEN AT THE ER IN THE MORNING OF 9/8/21 AFTER THE PAIN BECAME UNBARERABLE.


VAERS ID: 1683906 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-15
   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 FA7485 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Chest pain, Dizziness, Feeling abnormal, Pain in extremity, Palpitations, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Vestibular disorders (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: Approximately 2 days after first vaccine Initial feeling of heart pounding, the heart flutters, and heart feeling like a gurgling in the center of my chest, but no pain. On 8/18/21 while driving experienced stabbing pains in the center of m
Current Illness: None.
Preexisting Conditions: None.
Allergies: Erythromycin
Diagnostic Lab Data: In Progress have to work test around my work schedule and caring for my child who has a disability, and her drop off pick up school schedule.
CDC Split Type:

Write-up: Approximately 2 days after first vaccine Initial feeling of heart pounding, the heart flutters, and heart feeling like a gurgling in the center of my chest, but no pain. On 8/18/21 while driving experienced stabbing pains in the center of my chest on way home. Stuck in heavy traffic. Made it home to care for my disabled child, then called my managed care agency. Could not get into my managed care agency as they wanted to hospitalize me and I had no one to take care of my child (I''m a single parent). Pain subsided, after 45 minutes time, but heart fluttering, pounding and gurgling continued off and on for weeks, along with stabbing pains from time to time but briefly in center of chest..happens sometimes daily, sometimes skips a day. Goes away after 30 seconds to a minute. No prior health issues or history of health conditions. Never experienced chest pains, and heart palpitations. before or heart fluttering. Swelling in feet, feel dizzy/light headed. Brain Fog, can''t remember simple things all of a sudden. One day had severe leg pain all day then it vanished. Prior to vaccine, would run 4-5 days a week 1 - 1.5 miles a day with no pain or heart problems. Been running for 2-3 years with no issues, and no injuries. But the severe pain in chest happened while relaxed in traffic sitting in my car driving home. Makes absolutely no sense why it came on out of nowhere.


VAERS ID: 1685027 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH E08448 / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Aspiration pleural cavity, Dyspnoea, Pulmonary oedema, X-ray abnormal
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Taste and smell disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allopurinol; Dolcet; Prograf; Aspirin; Centrum silver; Cholecalciferol; Flomax; folic acid; Synthroid; Xanax; Lomadol; whey protein in the morning of dialysis
Current Illness: None
Preexisting Conditions: Liver transplant UAB 01/29/2007, currently on dialysis, diagnosed with bronchiectasis because I had pneumonia in 2008
Allergies: Lisinopril makes me cough; Rapamune
Diagnostic Lab Data: X-ray- fluid on lungs
CDC Split Type: vsafe

Write-up: Almost immediately after getting the vaccine, I could hardly breathe, I lost my smell and taste. They recommended I had an x-ray done. I had the x-ray done and it came back with some fluid. I set up an appointment to have a Thoracentesis done. My doctor did it and they retrieved 250CCS. It did not help. The original x-ray showed that I might have developed pneumonia. They finally gave me a prescription for Levaquin and that helped more than anything. I take that after dialysis. I have seen the most effects and results for the better from that medication. I check my oxygen saturation every morning and it is usually at 96-98. But since I got the shot it has not been better than 93. Right now it is 95 and my temperature is 97.8. After the vaccine my temperature did go up to 98.7. They ran a teste for the fluid they took out of my lungs and it came back normal.


VAERS ID: 1685482 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-30
Onset:2021-08-15
   Days after vaccination:197
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029K20A / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Blood creatinine increased, Blood potassium increased, Blood sodium decreased, Blood urea increased, COVID-19, COVID-19 pneumonia, Fatigue, Hyperkalaemia, Infusion, Presyncope
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Hyponatraemia/SIADH (narrow), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Tumour lysis syndrome (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, azithromycin, bisacodyl, diazepam, evolocumab, hydralazine, insulin aspart, insulin degludec-liraglutide, labetalol, lamotrigine, nystatin topical, ranolazine, tadalafil PRN, thyroid desiccated
Current Illness:
Preexisting Conditions: hypertension, diabetes, coronary artery disease, hyperlipidemia
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/15/21: presented to the emergency room with complaints of generalized weakness. He tested positive for COVID-19 five days ago; Earlier today, he was at the infusion center having a Regeneron infusion, got tired and legs gave up and he almost had a near syncopal episode and he was brought to the emergency room. In the ER, patient had a potassium of 5.9. He was given Lokelma and sodium was 129 and BUN was 51, creatinine was 4.06, and he is admitted to the hospital with acute hyperkalemia, presyncope, COVID infection. Diagnosed and treated for Covid-19 pneumonia. Improved and discharged on 8/24/21. Note: previously vaccinated with Moderna COVID-19 vaccine: on 1/2/21 and 1/30/21.


VAERS ID: 1685515 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-09
Onset:2021-08-15
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Dizziness, Dyspnoea, Nausea, Parosmia, Pneumonia viral, SARS-CoV-2 test positive, Taste disorder
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Respiratory failure (narrow), 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, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol, budesonide-formoterol, montelukast, multivitamin
Current Illness:
Preexisting Conditions: COPD
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/15/21: Patient presented secondary to shortness of breath. history of COPD maintained on inhalers and no oxygen who states he has been short of breath "for a while". He did report being dizzy with increased shortness of breath since waking up today. Patient has had nausea and difficulty with taste and smell more recently, reporting that food just does not taste right. Patient tested positive for COVID-19 in the ER. Note: patient previously vaccinated with Moderna Covid-19 vaccine on 6/11/21 & 7/9/21. Diagnosed with Covid viral pneumonia and acute hypoxic respiratory insufficiency. 8/28/21: discharged Covid vaccine on 7/9/21. Diagnosed with Covid viral pneumonia and acute hypoxic respiratory insufficiency. Remain in hospital as of 8/26/21.


VAERS ID: 1624069 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-27
Onset:2021-08-15
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD7207 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bipolar I disorder, Dysmenorrhoea, Impaired work ability, Menstruation irregular, Nausea, Suicidal ideation, Thrombosis
SMQs:, Acute pancreatitis (broad), Suicide/self-injury (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Psychosis and psychotic disorders (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), 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: Topirimate, Clonazepam, marvelon birth control
Current Illness:
Preexisting Conditions: Epilepsy, Migraines, IBS
Allergies: Oral allergy syndrome
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe irregular menstruation almost one month after receiving the second dose of Pfizer vaccine, started the 15th of August with unrelenting bleeding, cramps so bad I wanted to throw up, could barely function at work and had to leave early many times, and it is the 23rd of August I am still experiencing shooting pains, cramping, and fullness in the uterus area and brown clotty bleeding. I also have been experiencing extreme maniacal/depressive issues much more severe than normal around periods, I almost killed myself. This kind of period has never happened as I''ve been on the birth control pill for almost 9 years now which kept them steady and relatively minor never lasting more than 4 days.


VAERS ID: 1657146 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Unknown  
Location: Foreign  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Myalgia, Pain in extremity, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210814; Test Name: COVID-19 virus test; Test Result: Negative
CDC Split Type: GBPFIZER INC202101056869

Write-up: pain in whole upper arm, extremely painful to move or lift arm, too painful to sleep; Muscle soreness; This is a spontaneous report from a contactable consumer received from the regulatory authority. Regulatory authority report number is GB-MHRA-WEBCOVID-202108160038517600-EDYU6, Safety Report Unique is GB-MHRA-ADR 25802224. A 16-year-old patient of an unspecified gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 15Aug2021 (Lot number and expiry date were not reported) , at the 16 years old of vaccination as DOSE 1, single for COVID-19 immunisation. Medical history and concomitant medications were not reported. Patient had not had symptoms associated with COVID-19. Patient was not enrolled in clinical trial. The patient experienced muscle soreness on 15Aug2021 with outcome of not recovered, and pain in whole upper arm, extremely painful to move or lift arm, too painful to sleep on an unspecified date with outcome of unknown. The patient underwent lab tests and procedures which included sars-cov-2 test: negative on 14Aug2021. Patient had not tested positive for COVID-19 since having the vaccine. The events were reported as serious, medically significant by the health authority. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1659484 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Hypersensitivity, Nasal pruritus, Rhinorrhoea
SMQs:, Angioedema (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: Snot itchy nose and allergy. 21 years, August 13, 2021 COVID-19 vaccine MODERNA.
Other Medications: Oral contraceptive: levonorgestrel / ethinyl estradiol (generic). Asthma inhaler: formulated (2timesper day, every day). Antihistamine: Cetirizine (1-4 times per week). Dog epithelium vaccine to combat allergy (once a month)
Current Illness: No
Preexisting Conditions: No
Allergies: Food: walnut, bananas, melon and watermelon (all to a small amounts) Others: pollen and dog epithelium
Diagnostic Lab Data:
CDC Split Type:

Write-up: Snot, itchy nose and allergy.


VAERS ID: 1660414 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-15
Onset:2021-08-15
   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 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Pain in extremity, SARS-CoV-2 test, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: OMEPRAZOLE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Clinical trial participant (college trial)
Allergies:
Diagnostic Lab Data: Test Date: 20210812; Test Name: COVID-19 virus test; Test Result: Negative
CDC Split Type: GBPFIZER INC202101064666

Write-up: Vomiting; Pain in arm; This is a solicited report from the regulatory authority program from a contactable consumer . This is a report received from the regulatory authority. The regulatory authority report number is GB-MHRA-YCVM-202108141916301290-9RDGK. Safety Report Unique Identifier GB-MHRA-ADR 25803149. A 17-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 15Aug2021 (lot number: FF3319), at the age of 17 years old, dose number unknown ,single for COVID-19 immunisation. Last menstrual period date was on 11Aug2021. Medical history included clinical trial participant (college trial). Patient was not pregnant at the time of vaccination. Concomitant medication included omeprazole. The patient experienced pain in arm on 15Aug2021 and vomiting on 17Aug2021. The events were considered medically significant. Patient has not tested positive for COVID-19 since having the vaccine. The patient underwent lab tests and procedures which included COVID-19 virus test: negative on 12Aug2021. The patient has recovered from the event vomiting on 18Aug2021 and was recovering from the event, pain in arm. The reporter''s assessment of the causal relationship of the pain in arm and vomiting with the suspect product was not provided at the time of this report. Since no determination has been received, the case is managed based on the company causality assessment. . No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Based on available information and the drug temporal relationship, the causality between the event "pain in extremity", "vomiting" and the suspect drug "BNT162B2" cannot be completely excluded.


VAERS ID: 1554480 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

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

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

Write-up: pATIENT SAID THAT HE GOT A SMALL RASH ON BOTH ARMS STARTING THE DAY AFTER HIS SHOT. IT DID NOT APPEAR TO BE VACCINE RELATED TO ME BUT FELT THAT I SHOULD REPORT IT. SEEMED MORE LIKE CONTACT DERMATITIS. PATIENT SAID THAT HE IS OUTSIDE A LOT BUT THAT IS WAS NOT POISON IVY BUT IT LOOKED SIMILIAR TO ME. THE RASH HAD IMPROVED AND WAS ALMOST GONE WHEN HE CAME IN. HE SAID HE DIDN''T KNOW IF IT WAS RELATED BUT THOUGHT HE SHOULD SHARE IT.


VAERS ID: 1555596 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-06
Onset:2021-08-14
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Nodule, Pruritus, Rash macular, Skin mass, Skin warm, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec-D Digestive Enzymes with a probiotic Omeprazole Multi-vitamin Vitamin D3 Collagen Fish oil
Current Illness:
Preexisting Conditions:
Allergies: Latex and kiwi
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid arm, 1 week later. My arm starting itching and was blotchy with red marks that were hot. It felt like there were little bumps under my skin. I almost thought I had been bit my mosquitos or spider; however the knots were bigger and under the skin.


VAERS ID: 1558091 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Ear congestion, Head discomfort, Headache, Nausea, Pain, Pyrexia, Renal pain
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pharmapress 20mg / Wellbutrin / BCal DM / Ecotrin / Slowmag / Circadin / Glolucophage / Qlaira / Trustan
Current Illness:
Preexisting Conditions: Hypertension and insulin resistant
Allergies: Penicillin and Cephalosporins
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe headache, severe fever, nausea, severe burning in sinuses, pressure in head and ears, pain in kidneys, sore body and joints


VAERS ID: 1558104 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Headache, Hypoacusis, Otorrhoea
SMQs:, Hearing impairment (narrow)

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

Write-up: Fluid coming out of ears hearing is muffled. Headache in back of head


VAERS ID: 1558114 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-06
Onset:2021-08-14
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, 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: OCP, 150mg synthroid, 150mg magnesium oxide, 250mg armadaphonil
Current Illness:
Preexisting Conditions: Hashimotos
Allergies: Rocephin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe pain and mild swelling at injection site 8 days after injection


VAERS ID: 1558124 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029D21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Peripheral swelling, Swelling face
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Swelling in hands, feet, and face


VAERS ID: 1558134 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / UNK RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal, Paraesthesia oral
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Compazine PRN Med for Migraine 2 weeks ago
Current Illness:
Preexisting Conditions: Migraines
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was waiting in her car, came back into clinic approximately 17 minutes after vaccination, complained of "lips-tingling". She sat down and nurse started assessment. Complained of tongue feeling strange and had to focus on swallowing. 911 called. BP 132/88, Pulse: 89, O2sat: 95. Feeling faint. single dose adult Epinephrine administered at 9:37 am. BP: 130/67, pulse:102, O2sat: 98. 940- reports improving. Emergency squad arrived, transported patient to Hospital ER at 950 AM. Patient alert and oriented throughout visit.


VAERS ID: 1558165 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Diarrhoea, Dizziness, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Diarrhea and some dizziness, soreness in arm


VAERS ID: 1558168 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: PATIENT MENTIONED SHE ALWAYS FEEL SAME KIND OF SYMPTOMS DURING ANY VACCINATION OR BLOOD WORK
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT WAS GIVEN JANSEEN COVID 19 VACCINE ON 08/14/21 @ 10:20AM AND PATIENT WAS WAITING IN WAITING AREA AND START COMPLAINING ABOUT DIZZINESS , SWEATING AND NAUSEATED. CALLED EMERGENCY SERVICES AND EMS TEAM CAME IN FEW MINUTES AND MONITORED HER . EMS ASKED IF PATIENT WANTS TO GO TO HOSPITAL BUT PATIENT REFUSED AND MENTIONED SHE IS FEELING BETTER AND SHE IS FINE. PATIENT WAS ALSO ADVISED TO REPORT IN VAERS AND PROVIDED THE FACT SHEET ABOUT THE VACCINE.


VAERS ID: 1558171 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Malaise
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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: PT SAID SHE WOKE UP WITH EXTREME DIZZINESS AND FELT LIKE SHE WAS HUNGOVER BUT THE DIZZINESS WAS THE WORRISOME PART FOR HER. NOT ABLE TO OPEN EYES WITHOUT HAVING EXTREME DIZZINESS


VAERS ID: 1558173 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / IM

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

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

Write-up: Patient developed nausea within 15 minutes of receiving a dose of this vaccine. She feels bloated, stomach pain and has difficulty breathing. Previously she received the mRNA vaccine and developed nausea, diarrhea for a couple of days and stomach pain.


VAERS ID: 1558174 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (broad)

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

Write-up: Patient received Janssen COVID-19 vaccine on March 5, 2021. She had reported she never received a COVID-19 vaccine in the past and the dose was given. Patient had no reaction in 15 minute wait period.


VAERS ID: 1558178 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA 7485 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: About 1 minute after vaccination, patient told me verbally she felt like she was going to pass out. Patient leaned forward in chair and her mother and I caught her and leaned her back in chair. Patient was breathing but non-responsive for 30-45 seconds. I was about to administer an Epi pen and patient regained responsiveness. Patient was alert and responding verbally and drinking water. Patients pulse was 62 and appeared to be breathing normally. Parents declined 911, after 30-45 minutes of rest under my and parents supervision. Patient appeared normal and left store with parents without assistance.


VAERS ID: 1558189 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 started to feel shortness of breath 10 minutes after receiving vaccine. Patient suffers from anxiety. Vitals were taken: BP 141/93, Pulse 116, O2 98%, PR 28 Breathing technique was used to calm patient along with therapeutic talk. Patient waited 15 minutes and felt well; she was cleared.


VAERS ID: 1558206 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Blood glucose normal, Loss of consciousness, Malaise, Paraesthesia, Paraesthesia oral, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (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: None
Current Illness: UTI
Preexisting Conditions: Information unavailable
Allergies: None
Diagnostic Lab Data: 8/14: blood pressure normal (95/55 and then 117/96), blood glucose level normal (unavailable level since it was taken by EMT)
CDC Split Type:

Write-up: About 1-2 minutes after the patient received the vaccine, she reported she wasn''t feeling well and then fainted while sitting in chair. Her husband and I proceeded to transfer her to the floor and elevate her legs. Patient resumed consciousness after 1 minute and had no recollection of what happened. Blood pressure was taken after 5 minutes (95/55) and again after 10 minutes (117/96). EMS was called because patient was still not feeling improvement after 10 minutes (reported shakiness, tingling feeling in hands and tongue). EMS cleared her as BP was normal and blood glucose level was normal.


VAERS ID: 1558208 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product container seal issue, 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: none reported
Current Illness: none reported
Preexisting Conditions: none reported
Allergies: none reported
Diagnostic Lab Data:
CDC Split Type:

Write-up: I believe the vaccine may have been expired. The vaccine was in the fridge when I pulled it out to withdraw the dose. After giving the dose I realized I had not pulled the top off myself, and that it may have been opened yesterday. After calling the manufacturer they recommended not revaccinating and having the patient receive a second dose in 28 days as normal.


VAERS ID: 1558216 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Polymenorrhoea
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: Zolpidem 10mg, Sudafed 30mg, Claritin 10mg, Macrobid
Current Illness: UTI
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Vaginal bleeding. My menstruation ended 3 days ago. Today, about 24 hours after receiving my first dose, I started bleeding again.


VAERS ID: 1558221 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Discomfort, Dizziness, Head discomfort, Headache, Injection site pain, Pain, Pallor
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)

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

Write-up: Site: Pain at Injection Site-Medium, Systemic: Dizziness / Lightheadness-Severe, Systemic: Heavy head and body and burning pain in back and very pale-Severe, Systemic: Headache-Severe


VAERS ID: 1558224 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
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: Booster Given Too Early-


VAERS ID: 1558226 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Inappropriate schedule of product administration, Pyrexia, Sleep disorder, Tremor, Vaccination site pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CBD flower
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Received 2nd dose of Moderna 3 months after first dose. Fell asleep around 11 pm, woke up at midnight with severe headache, shaking with fever of 103, vaccination site hurt. Unable to sleep the rest of the night. Just thought it was interesting because of the interval from the first to second dose and the intensity of the reaction. Fever and headache still happening at around 1 pm right now, but not so bad.


VAERS ID: 1558230 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 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: Yellow Fever, 2020, 27 years old
Other Medications: Vitamins and pre workout supplements
Current Illness: Reaction to Yellow Fever vaccine
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Client was vaccinated with Pfizer''s 1st dose at 1020. At 1025, the client stated he was light headed. RN on staff began taking his vitals: BP was 168/82 at 1030, 138/72 at 1039, 134/68 at 1051, and 128/72 at 1108. The PulseOx reading was 107 to 180 at 1035, 72 to 74 at 1042. Within this time, RN and client walked around the vaccination area. His mobility was good, as he described himself as a "runner." At 1110, he was cleared by RN and he stated he was feeling good.


VAERS ID: 1558231 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-26
Onset:2021-08-14
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Heart rate increased, Pain
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 as of yet
CDC Split Type:

Write-up: Patient went home, and shortly after arriving at home sat down. While resting, he felt sharp, needle-like pain for a couple of minutes. These were sudden, and dissipated shortly thereafter. Then he noticed his resting HR to be increased by about 20 bpm. He experienced this a few times after this, but none since the second day after the shot. After the second day post vaccine, he started to feel pressure in chest, as if he exited a room temp building and walked out on a hot, humid, summer day. He has experienced this a few times since then.


VAERS ID: 1558232 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphagia, Dyspnoea, Flushing, Hyperhidrosis, Malaise, Oropharyngeal discomfort, Throat tightness, Tremor
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Shakiness-Medium, Additional Details: patient received her second dose of pfizer vaccine. After sitting for about 5-10 minutes, she said she was not feeling well. she said she was having a difficulty breathing and her throad feeling "weird", sweating and flushed. she asked to call 911. diapatcher over the phone said paramedics are on the was and do not give her anything. Patient looked stable and left with paramedics


VAERS ID: 1558233 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site swelling
SMQs:, Haemorrhage terms (excl laboratory terms) (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Bruising at Injection Site-Mild, Site: Swelling at Injection Site-Mild


VAERS ID: 1558236 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 - / -

Administered by: Public       Purchased by: ?
Symptoms: Fall, Hyperhidrosis, Limb injury
SMQs:, Neuroleptic malignant syndrome (broad), Accidents and injuries (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: No reported illness.
Preexisting Conditions: No reported long standing health conditions
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt was ambulating to car with mom who states he fell into wall hitting right shoulder, did not fall to ground, she accompanied him back to observation area and Pt was assisted to gurney area with legs elevated slightly. Pt had received First Pfizer vaccine approx 20 min before. Pt states he feels dizzy, reports he ate a croissant this am and a few sips of water this morning. Denies and mom confirms no prior reactions with vaccines, allergies or medical problems. 10:12 am VS 90/50, p 93, 02 sat 99%, mild diaphoresis noted. Drank apple juice slowly and ate a few animal crackers when feeling well enough to. VS 10:17 90/50 p 91 and 02 sat 100%. 10:20 90/50 p 92 O2 sat 99%. Consumed additional juice, skin color improved, no diaphoresis noted and denies dizziness. Able to move shoulder without difficulty. Pt stated he was feeling well enough to walk to car where his father is waiting and will sit in back seat with Pt. Given additional juice and snack to consume as needed. Given protocols for contacting provider/EMS if does not continue to improve. Ambulated to car with mom with steady gait. Advised father by phone to relay history of this vaccination and request Pt be vaccinated lying down. Father states Pt is currently eating breakfast and is feeling back to normal.


VAERS ID: 1558237 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal, Muscle spasms
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Vestibular disorders (broad)

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

Write-up: ~5 minutes after pt received her vaccine she stated she felt light headed and was having severe lower back spasms. She was sitting down, refused water. A few minutes later her son summoned me stating she wasn''t doing better. Pt said she was feeling like she did when she had a heart attack a few years ago, but denied having chest pain. We immediately called 911 and a ''code white'' per facility protocol. I took her BP which was 167/103. EMS arrived and transported to local hospital. Pt did not loose consciousness during this episode, nor did she appear short of breath.


VAERS ID: 1558238 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-12
Onset:2021-08-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

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

Write-up: Part of my right thigh is numb.


VAERS ID: 1558252 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Asthenia, Confusional state, Heart rate increased, Hyperhidrosis, Hypotension, Visual impairment
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: The patient received the vaccination at 1212pm and did not complain or show any signs of distress. He then waited in the room as his wife received her vaccinated approximately 3 minutes later. The patient sat upright in the chair and did not display any signs of a reaction. He talked and joked while his wife received her vaccination and while I filled out their vaccination cards. He exited the exam room walking and talking with his wife around 1219. He and his wife walked about 10 feet from the clinic when the wife called out for help. The patient was found extremely diaphoretic, confused, weak and very anxious. He then stated that he could not see and that everything was black. EMS was called and it was discovered his heart rate was elevated at 200 and his blood pressure was low at 100/90. The wife did state that he has a fear of needles but stated that he would normally pass out at the sight of the need, not minutes after the administration. The patient was taken from the clinic via EMS services.


VAERS ID: 1558253 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-06
Onset:2021-08-14
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0880214 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Injection site rash
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (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: Slynd BC
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Large red rash at injection site occurring 8 days after injection. Slight burning sensation around rash.


VAERS ID: 1558259 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

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

Write-up: Patient''s father reported that patient had fainted. Patient was found sitting on the floor and was pale. After sitting for a little while and drinking some water, patient was fine and left the pharmacy with her father. Patient''s color also returned.


VAERS ID: 1558261 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

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

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

Write-up: Patient received vaccine, was sitting in waiting area and passed out not even 5 minutes after receiving the vaccine. Patient was sitting down at the time so he slid down his chair but mother caught him before he fell out of chair. Patient was out for a few moments then came to again. Patient was given water to help him. Mother and patient sat in waiting area until he felt better and communicated to her he was okay to leave and then they left to go shopping in the store.


VAERS ID: 1558264 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: fainted per father
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: Patient fainted within 5 minutes of receiving COVID vaccine


VAERS ID: 1558265 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-11
Onset:2021-08-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
SMQs:, Medication errors (narrow)

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

Write-up: Patient was inadvertently administered her 2nd COVID shot 8 days early


VAERS ID: 1558268 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Palpitations
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

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

Write-up: Patient felt hot, heart racing, dizziness and lightheadedness approximately 5 minutes after the receiving the vaccine. Patient drank some water and felt fine after 25 minutes.


VAERS ID: 1558271 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bystolic 40mg qd Losartan Nexium Norvasc Vitamin D
Current Illness: none
Preexisting Conditions: Cutaneous Lupus, Hypertension,
Allergies: Sulfa
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Vaccine given in left arm... now fingers on left hand are numb.


VAERS ID: 1558274 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache, Injection site pain, Injection site swelling, Muscle spasms, Pain, Palpitations, Poor quality sleep
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Pseudomembranous colitis (broad), Dystonia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Noninfectious diarrhoea (narrow)

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

Write-up: Constant Muscle spasms in leg, thunderstorm like rumblings in stomach, diarrhea, severe frontal headache, heart racing, fever, chills, body aches, restless sleep, fatigue , swelling at sight injection, sever muscle pain in injected arm, brain fog. Every symptom I had when I had Covid-with the exception of muscle spasms, that is new. The symptoms have the same severity.


VAERS ID: 1558285 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fainted after Tetanus Vaccine
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: BP 124/85 HR 80 resp 16
CDC Split Type:

Write-up: 10 min after shot was administered patient started feeling light headed and throat was closing. Pharmacist got an epi-pen and sat with patient. Patient said the breathing issue was coming and going. Staff called 911 while patient was observed. Patient then stated she felt it was closing again. Pharmacist asked if she was ready for the EpiPen and she nodded yes. Pharmacist administered EpiPen in left anterior thigh. Patient stated she could breath again shortly after. EMS arrived and checked vitals. Patient said she felt better and refused ambulance transport. Patient waited 30min after the vaccine and then purchased Benadryl and walked around the store to make sure she still felt ok. Patient said she would go to the ER if she felt an additional symptoms and would follow up with her MD$g


VAERS ID: 1558288 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling hot, Lethargy, Pallor
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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 felt hot and I got him water and an ice pack. He then turned white and started to become lethargic. He laid down on the floor to cool off and put his knees up. I got him two more ice packs and the color returned to his face. After about 20 minutes he got back up into the chair and felt better.


VAERS ID: 1558292 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Head injury, Malaise, Pallor, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Less than 5 minutes after receiving the Pfizer Covid 19 vaccine, the patient slumped to the side hitting his head on the wall. He started to seize. His father moved him down to the ground. He came to and opened his eyes. His lips were pale and he said he didn''t feel well. His father kept talking to him to keep him awake. The father stated he had seizures in the past. 911 was called and an EpiPen was given. Paramedics arrived. The patient was able to walk to the gurney. Paramedics took him away.


VAERS ID: 1558301 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dry eye, Dry mouth, Limb discomfort, Musculoskeletal discomfort, Nasal dryness
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Corneal disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Magnesium, iron, Zyrtec
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Latex sensitivity, mustard allergy
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Dry eyes, mouth and nose almost immediately after vaccination was given. Slight sensation in left side of neck and arm


VAERS ID: 1558302 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphasia, Pharyngeal swelling, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient reported throat swelling about 30 minutes after the vaccine was given. The patient had normal vital signs and was given 50 mg of Benadryl, and said that her throat felt tighter and it was more difficult to speak. Called 911 and EMS monitored the patient. The patient said they were starting to feel better, so EMS let the patient go home.


VAERS ID: 1558305 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / UNK LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE AS REPORTED BY PATIENT
Current Illness: NONE AS REPORTED BY PATIENT
Preexisting Conditions: NONE OR REPORTED BY PATIENT
Allergies: NONE AS REPORTED BY PATIENT
Diagnostic Lab Data: DIASTOLIC BP 103 SYSTOLIC BP 71. PULSE 67 AND SO2 98
CDC Split Type:

Write-up: AT APPROXIMATELY 10:37 AM PATIENT REPORTED SWELLING IN HIS RIGHT HAND AND FELT SOME DIZZINESS. PATIENT WAS CHECKED FOR BLOOD PRESSURE AND OXYGEN LEVEL. PATIENT WAS ALSO GIVEN A DOSE OF DIPHENHYDRAMINE 25 MG AND PREDNISONE 10 MG. AT 10:50 AM PATIENT WAS RECHECKED AND SWELLING OF HANDS AND DIZZINESS SYMPTOMS HAD RESOLVED.


VAERS ID: 1558306 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Incorrect dose administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Patient previously received Pfizer (08/05/2021) and Astra zeneca . Patient presented today (08/14/21 )and received Janssen . Patient was monitored for 15 minutes. No adverse effects noted.


VAERS ID: 1558307 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Fall, Head injury, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Chronic bladder disease, depression, celiac
Allergies: NKA
Diagnostic Lab Data: Patient transported to nearby hospital for further evaluation.
CDC Split Type:

Write-up: Syncopal episode occurred 4 minutes after receiving first dose of Pfizer vaccine. Patient was seated in observation area and fell out of chair, sustaining minor head laceration. Medical team responded immediately and activated emergency medical response. Patient''s vital signs were taken immediately after incident was identified (BP 86/52, HR 83), and again after 2 minutes (BP 92/70, HR 88). Gauze was applied to head laceration. Patient regained consciousness and responded appropriately to medical team. EMS arrived 5 minutes after initial incident and took over patient care.


VAERS ID: 1558322 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthma, Condition aggravated, Dyspnoea, Fatigue, Pain
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

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

Write-up: The day after my vaccine I experienced normal side effects of fatigue and body aches. Later in the afternoon I also started having breathing/asthma issues. My asthma is very controlled and typically I only have flare ups with sickness. The breathing problems I have experienced are very similar to the issues I had when I was sick with Covid-19 in December of 2020.


VAERS ID: 1558323 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 1821286 / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Somnolence, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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:
CDC Split Type:

Write-up: Patient became unconscious while waiting the 15-20 minute period after vaccination. His parents tried to wake him but no response. Was asked to call ambulance. While on phone with dispatcher, the parents threw water on him and he woke up. Parents said to cancel ambulance. Patient remained in pharmacy for another half hour while drinking water and eating candy. He felt back to normal and left with his parents.


VAERS ID: 1558325 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperventilation, Immediate post-injection reaction, Immunisation anxiety related reaction, Nausea, Stress, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Very short-term syncope, probably caused more by anxiety/stress from receiving a vaccine as patient was nervous when actually receiving a shot. Patient reported nausea and appeared to be hyperventilating right after incident occurred so mother took him to the restroom together with member of pharmacy staff. Patient returned after a few minutes reporting he was feeling much better. Was able to walk and converse freely. Kept patient for 30 minutes observation period.


VAERS ID: 1558335 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Dizziness
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: patient''s family member called after couple hours after receiving the vaccine,mentioning that the patient was feeling dizzy which might be also due to his upset stomach for which he had taken immidium. Pharmacist called the patient in a few hours and patient was feeling ok.


VAERS ID: 1558338 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-12
Onset:2021-08-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (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: Amlodepine Lisinopril
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itchy, burning hives and rashes on left arm, armpit, upper chest and neck


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