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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 140 out of 6,867

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VAERS ID: 1667908 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-24
Onset:2021-08-14
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling of body temperature change, Musculoskeletal stiffness, Nasal congestion, Nausea, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Arm pain, almost like my arm wants to give out . Hurts to raise arm even a little bit. Burning sensation in arm
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: . One minute im freezing the next im hot, I can''t breath out my nose and now my body feel like I got rash that irritated all over and feel like im about to throw up. Arm stiffness


VAERS ID: 1668962 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-23
Onset:2021-08-14
   Days after vaccination:144
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Cough, Diarrhoea, Headache, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), 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), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ASA, atorvastatin, budesonide/fomoterol, carvedilol, vit d3, esomeprazole, ferrous sulfate, ipratropium/albuterol, lisinopril, trazodone
Current Illness:
Preexisting Conditions: diverticulitis, reflux, OSA, nocturnal hypoxemia, COPD, HTN, AAA,OA, obesity, ex-smoker, depression, RLS,
Allergies: azithromycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/19/21: presented to ED with cough, fever, body aches, HA and diarrhea for 5 days, COVID POS during stay started on steroids and remdesivir 8/20/21: discharged to home on night oxygen


VAERS ID: 1669667 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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

Write-up: headache; fever; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (fever) and HEADACHE (headache) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 14-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Aug-2021, the patient experienced PYREXIA (fever). On an unknown date, the patient experienced HEADACHE (headache). At the time of the report, PYREXIA (fever) and HEADACHE (headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant and treatment medications were reported. Reporter did not allow further contact


VAERS ID: 1670745 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-11
Onset:2021-08-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Pain in extremity, Tongue discolouration
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: coq-10, vitamin D3, curcumin, fish oil, carvedilol, lisinopril, sertaline, alprazolam
Current Illness: none
Preexisting Conditions: anxiety
Allergies: NKA
Diagnostic Lab Data: Ultrasound planned
CDC Split Type:

Write-up: gray spots on tongue day 3. Bilateral calf pain, alternating sides, starting day 6.


VAERS ID: 1670791 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0818 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dizziness, Gait disturbance, Rash, Rash pruritic, Vertigo
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: The day after the vaccination patient started having chest pain and dizziness/vertigo. The pain did not radiate down his arm or up his neck and he experienced no shortness of breath. At times he would have to hold onto something while walking due to the vertigo. This lasted from Saturday until Wednesday. He did contact his doctor but did not go in to be seen in person. Patient stated that he has not had any cardiac problems in the past nor has he experienced this with any other vaccines. He also had a bumpy itchy rash that formed on his left leg, it was quite itchy for a few days.


VAERS ID: 1670906 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-12
Onset:2021-08-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041021A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alopecia, Condition aggravated, Fatigue, 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? No
Hospitalized? No
Previous Vaccinations: My doctor believes my previous instance of Alopecia Areata may have been triggered by a flu vaccine.
Other Medications: Levothyroxine Vitamins A, B, D Vegan Omega Iron Low-Dose Naltrexone Niacinamide Carnatine Synergy DIM Zinc Riboflavin Multivitamin
Current Illness: Hashimotos (was under control) Previously diagnosed with Alopecia Areata , although hair was fully growing back with minimal to no additional hair loss as of late July/early August
Preexisting Conditions: See above
Allergies: Allergic to Compazine Sensitivities to Gluten and Dairy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within 1.5 weeks of getting the first dose of the vaccine, I lost about 70% of my hair. The hair loss was so bad that I shaved my head on August 25. Other symptoms were minor and expected: sore arm, extreme exhaustion/tiredness.


VAERS ID: 1670921 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: rash over abdomen, itchy, thus far treating with antihistamines and topical steroids


VAERS ID: 1671164 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-08-14
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dysgeusia
SMQs:, Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad)

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

Write-up: Patient stated that she had a metallic taste in her mouth and was dizzy


VAERS ID: 1671391 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D214 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abnormal loss of weight, Asthenia, Chills, Decreased appetite, Disturbance in attention, Ear discomfort, Ear pain, Ear swelling, Erythema, Feeding disorder, Headache, Impaired work ability, Laryngitis, Lethargy, Lymphadenopathy, Myalgia, Nausea, Oropharyngeal pain, Pain, Paraesthesia, Pharyngeal ulceration, Pyrexia, Rash, Somnolence, Swelling, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Agranulocytosis (broad), Angioedema (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none. Finding a doctor that thinks these events might be related DESPITE the timeline is laughable.
CDC Split Type:

Write-up: Here are the facts of the case: Friday, August 13, 2021: patient receives Moderna COVID Vaccine. Saturday, August 14th, 2021@1:00 AM: patient wakes up with fever, chills, body aches, nausea, and vomitting - Symptoms continue throughout the weekend. O2 sats drop to 92, lethargy and lack of appetite begin and continue through Sunday. Monday, August 16th, 2021: patient wakes up feeling a bit better and goes to work with only a headache, muscle soreness, and lethargy. Wednesday, August 18th, 2021: patient notices that the lymph nodes in his neck start to swell abnormally, complains of sore throat. Thursday, August 19th, 2021: Lymph node swelling continues, sore throat worsens, ear pain starts to become present. Leaves work at 11:00AM Friday, August 20th, 2021: All symptoms worsen, patient is unable to go to work. He works from home but is finding it increasingly hard to focus because of the pain. Takes Ibuprofen, Alieve D, and OTC ear pain drops. Patient finds it increasingly hard to consume solid food. Saturday, August 21, 2021: All symptoms continue to worsen. Patient stops eating and tries to sleep it off. Sunday, August 22nd, 2021: Patient drives himself to Urgent Care. Doctor prescribes OTC ear drops, Tylenol, and Augmentin. Monday, August 23rd, 2021: Patient''s pain continues to worsen, but knows that medicine takes time to work. He remains at home. Tuesday, August 24th, 2021: Patient''s pain in ear is unbearable. Symptoms of the previous weekend: Nausea, fever, body aches, chills, lethargy, throat pain are consistently worse. He is now on a fully liquid diet. He has a video calls with our GP, who says to continue the course of treatment that the Urgent Care has prescribed. Wednesday, August 25th, 2021: Patient wakes up to a ?cauliflower ear? (something akin to fighting) and realizes that something is really wrong. Our doctor told him to call if he got worse, so he called to no response. At 3:00 PM his wife, drives him to the doctors office on the off chance he will see him in person. He sees him, gives him a shot of Toradol for the pain and adds to the medicine that the Urgent Care has prescribed. He adds Bactrim, and Ciprofloxin ear drops with Dextamethazone. Patient starts the treatment. Thursday, August 26th, 2021: Swelling is worse, pain is worse, fever is worse, but patient continues the treatment. After consulting a doctor, he also starts a Medrol pack that we have in the cabinet to see if a course of full-body steroids don?t help with the swelling and pain as well. Patient reports tingling on the right side of his face and neck. Friday, August 27th, 2021: Patient''s spirits are up even though symptoms remain the same. The swelling starts to recede on Friday afternoon and patient feels well enough to try and venture out of the house. His energy level is extremely low because he is still on a liquid only diet, and he can only make it about 30 min outside of the house. Saturday, August 28th, 2021: The swelling in the ear has almost completely receded and leaves behind red skin and white bumps. He is continuing on all medications religiously. He still isn?t eating and continues to sleep most of the day. Moaning in pain during sleep. At this point, he has lost 15lbs? All symptoms continue to worsen or stay the same through... Tuesday, August 31st: At this point, patient has lost 22lbs and calls his doctor and his doctor directs him to ER. He calls ahead and gives instructions to admit him and give him pain meds (Morphine) and Unasyn (a very strong antibiotic) Orders bloodwork and CT scan. 2PM - patient arrives at the ER and checks in. 3:30PM - patient sees first ER doctor: she finds two perforations in his right ear. 5:30 PM - Nurse comes to draw blood, punctures left vein, draws blood from the right. 8:00 PM - The nurse inserts IV port to start fluids, and infiltrates his right arm (I have pics, but I?ll spare you). He almost passes out from the experience and gets chills after the IV was put into the other arm. Once hooked up to the fluids, he heads back to his chair in the hallway of the ER. 8:30 PM - Gets taken back to have a CT scan. 9:40 PM - Ear pain significantly worse and throat pain equally persistent 10:00 PM - CT results come back normal. Plan is still to get him taken back to start the antibiotics when there is a gurney available. Wednesday, September 1st: 2:30 AM - A place for him on a gurney in the hallway of the ER is found. He is able to lay down. 6:30 AM - Sees next ER doctor who starts Unasyn and offers Morphine. Patient starts the antibiotic by tries to avoid the morphine because it makes him itch. This doctor says the ear drum is a concern. The doctor says he is working on getting an ENT in the hospital to take him on, if not, they will refer him out. 7:00 AM - Bloodwork and labs have not come back yet. 9:30 AM - Patient first sees the doctor. Patient is starting to get frustrated because this is the 4th ER doctor he has seen. The doctor comes and asks all of the same questions the other doctor has and says, ?I do not see a reason to keep you here. You should probably try to see and ENT.? Patient has to walk him through the last week and a half and explain why he is there. After patient explains, the doctor says ?OK, well, we will keep you on these meds and see if it starts to help.? The doctor comes back and says there are no ENTs in the hospital to see him. 12:30 PM - Still no bloodwork back, the doctor calls to tell the hospital that he wants patient admitted for 3-7 Days, kept on the Unasyn and given pain meds as needed. The antibiotic is starting to work, patient is starting to enjoy jell and pudding. 3:30 PM - Ear pain is worse, patient finally asks for pain meds. 9:30 PM - Patient is finally given Dilaudid. Pain meds work within 20 min, providing relief and sleep for the first time in days. Thursday, September 2nd: 7:00 AM - Patient''s report is positive. He was finally able to sleep some and the pain meds are helping provide relief. The pressure in his ear sees to have lessened, but the throat pain remains consistent. Over night a new symptom seems to have emerged, tingling and aching at the base of his skull. Possibly muscle pain from the experience. Nurses tell him they are just monitoring him and waiting for him to take a turn. 8:00 AM - There is a shift change at the hospital. Patient eats his liquid diet and seems to be moving around more. He is finally feeling a little better. 9:30 AM - Patient has a second conversation with the doctor. He tells the patient that he is ready to go home, he says that he is giving him a spray for his throat and something to keep clearing up his ear. patient tries to explain that this course of action goes against what our primary care physician has set and the doctor doesn?t care. He is the same as before: short, cold, and corse. The doctor explains that he can?t see perforations on his ear drum, that he has an ulcer on his uvula and laryngitis that seems to be clearing up. 10:40 AM - Arguing with the doctor and trying to convince him to keep treating the patient with the antibiotics and pain meds he is on is getting exhausting. The Nurses and PA at the time talk with the patient and they agree with both doctors. They decided to try a hybrid. 11:00 AM - Patient eats an applesauce, pudding, one graham cracker and 4 saltines and a bit of a turkey sandwich - AFTER they spray his throat with Lidocaine as directed by the doctor. 12:30 PM- The charge nurse tells him he gets to go home, they bring him discharge papers and he is instructed to leave. 1:00 PM - Patient has walked from the ER to the center where his wife picks him up. The discharge instructions are as follows: Tylenol as needed, pseudoephedrine as needed, ciprofloxin with hydrocortisone bid. (This discontinues patient''s treatment of antibiotic and pain medication.) -The doctor also prescribes benzocaine nasal spray for the throat. Patient never sees the doctor after 9:30 AM. In total, he saw him for about 15 min. In that time, this doctor has ignored the patient''s concerns, disregarded his GP?s instructions, and overridden his care. He has also falsified patient improvement by first numbing his throat before he ate so that he could write on the chart that he ate. All of this is extremely disheartening, unprofessional, and negligent to the Hippocratic oath that he has sworn. 7:00 PM - All of the drugs that patient had in the ER have worn off and the infection symptoms and pain come back with a vengeance. We continue on the drops prescribed, because they are stronger than the ones the doctor prescribed and take OTC pain medication. Patient is glad to be home, but still unable to eat more than 2 solid bites of food and continues on the liquid diet. He sleeps well in his own bed after taking a shower. Friday, September 3rd: 8:30 AM - Patient wakes up with completely plugged ear and painful sharp pressure. The throat pain is exactly the same. He is feeling worse than he was in the hospital (which is to be expected because they took him off the right antibiotic and pain treatment!) 9:00 AM - Patient is able to get an appointment with an ENT on 9/9/21 at 2:20PM at ENT. We continue to use the ear drops prescribed. We sought help elsewhere and started Tylenol with Codeine and Cipro to try and continue (to a small degree) what was started in the hospital.


VAERS ID: 1671401 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Peripheral swelling, Rash, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asthma
Allergies: Pneumonia vaccine: anaphylaxis
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash/swelling in face/arms almost 24h after injection


VAERS ID: 1671588 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dizziness postural, Ear discomfort, Fatigue, Headache, Injection site erythema, Injection site pruritus, Injection site swelling, Lacrimation increased, Lymphadenopathy, Nodule, Respiratory tract congestion, Tinnitus, Upper respiratory tract infection
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Lacrimal disorders (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: Flu shot 2016 (approx year unknown)
Other Medications: Edarbyclor 40mg 12.5 Montelukast Mucinex B12 - monthly injection Vitamin D - 50,000 units 1 x week
Current Illness: Runny nose from allergies (allergic to grass, pollen, dust, mold, trees, dogs/cats)
Preexisting Conditions: Thalassemia Alopecia areata Hyper sensitive 10 year Mold exposure at work (sinus surgery 8/2019) Unable to take Flu shot after first shot produced allergic reaction
Allergies: Codeine Morphine Latex Honeydew Melon
Diagnostic Lab Data: 8/19/2021 Virtual doctor recommended I go to see doctors because of side effects 8/20/2021 Went back to Doctors office where injection was given. Diagnosed with URI and given 21 day tapper down prednisone. 8/27/2021 completed tapper down with no relief. 9/1/2021 Called primary doctors who stated I did not have a URI but was still experiencing side effects Added taking Zinc, B-12, Vitamin D, Vitamin C, Zyrtec 9/2/2021 Received 200 mg Venefor (infusion)/ 25mg Benedryl (premed) iron had dropped from Thalassemia. 9/3/2021 Congestion is still present, dizziness is still present when standing, nodule on collarbone (left side) present, lymph nodes still swollen.
CDC Split Type:

Write-up: Day 4 nodule in left collarbone Congestion Extreme fatigue Covid Arm - injection site swollen, itchy and red Dizziness Headache Ringing in the ears Days 4 - present Nodule in collarbone Lymph nodes swollen in neck, collarbone, breasts, bellow breast, chest, armpits (both sides) Runny eyes Congestion in chest, face and head Popping ears (full) Dizziness Extreme fatigue


VAERS ID: 1672410 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Blood pressure measurement, Cough, Dizziness, Headache, Heart rate, Nausea, Pyrexia, Throat irritation
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (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), Vestibular 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: AMLODIPINE; HCTZ; ROSUVASTATIN; ZYRTEC [CETIRIZINE HYDROCHLORIDE]
Current Illness: Cholesterol; Hypertension
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210814; Test Name: Blood pressure; Result Unstructured Data: blood pressure was elevated to 147/102; Test Date: 20210814; Test Name: Pulse rate; Result Unstructured Data: pulse rate was elevated to 105 as of the same evening; Test Date: 20210815; Test Name: Pulse rate; Result Unstructured Data: pulse rate was elevated to 105/pulse rate was 111
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Felt like she was going to pass out / dizziness; weakness; Itching in the back of her throat; Heavy cough; High temperature; Headache; Nausea; This spontaneous case was reported by a non-health professional and describes the occurrence of COUGH (Heavy cough), ASTHENIA (weakness), THROAT IRRITATION (Itching in the back of her throat), DIZZINESS (Felt like she was going to pass out / dizziness) and PYREXIA (High temperature) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 009C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Hypertension and Cholesterol. Concomitant products included ROSUVASTATIN for Cholesterol, AMLODIPINE and HCTZ for Hypertension, CETIRIZINE HYDROCHLORIDE (ZYRTEC [CETIRIZINE HYDROCHLORIDE]) for an unknown indication. On 13-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Aug-2021, the patient experienced COUGH (Heavy cough), PYREXIA (High temperature), HEADACHE (Headache) and NAUSEA (Nausea). On 15-Aug-2021, the patient experienced ASTHENIA (weakness) and THROAT IRRITATION (Itching in the back of her throat). On 16-Aug-2021, the patient experienced DIZZINESS (Felt like she was going to pass out / dizziness). The patient was treated with ACETAMINOPHEN for Adverse event, at an unspecified dose and frequency. At the time of the report, COUGH (Heavy cough), ASTHENIA (weakness), THROAT IRRITATION (Itching in the back of her throat), DIZZINESS (Felt like she was going to pass out / dizziness), PYREXIA (High temperature), HEADACHE (Headache) and NAUSEA (Nausea) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 14-Aug-2021, Blood pressure measurement: 147/102 (High) blood pressure was elevated to 147/102. On 14-Aug-2021, Heart rate: 105 (High) pulse rate was elevated to 105 as of the same evening. On 15-Aug-2021, Heart rate: 111 (High) pulse rate was elevated to 105/pulse rate was 111. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.


VAERS ID: 1672420 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Blood glucose, Chills, Constipation, Fatigue, Feeling abnormal, Headache, Infection, Pain, Palpitations, Stress, White blood cell count
SMQs:, Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: LISINOPRIL
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210816; Test Name: Glucose; Result Unstructured Data: WBC count as well as glucose was high; Test Date: 20210816; Test Name: WBC count; Result Unstructured Data: WBC count as well as glucose was high
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Slight infection; I was constipated; This morning I was kneeling over because of stomach pain; Pain was horrible; I was tired; Chills; Headache that would come and go in waves on Sunday; Brain fog; Stress induced because she was anxious in receiving the vaccine; I could feel my heart palpitating that night; This spontaneous case was reported by a consumer and describes the occurrence of PALPITATIONS (I could feel my heart palpitating that night), INFECTION (Slight infection), CONSTIPATION (I was constipated), ABDOMINAL PAIN UPPER (This morning I was kneeling over because of stomach pain) and FEELING ABNORMAL (Brain fog) in a 61-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. Previously administered products included for an unreported indication: GLUTATHIONE and Vitamin C. Concomitant products included LISINOPRIL for an unknown indication. On 14-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Aug-2021, the patient experienced PALPITATIONS (I could feel my heart palpitating that night) and STRESS (Stress induced because she was anxious in receiving the vaccine). On 15-Aug-2021, the patient experienced FEELING ABNORMAL (Brain fog), FATIGUE (I was tired), CHILLS (Chills) and HEADACHE (Headache that would come and go in waves on Sunday). On 16-Aug-2021, the patient experienced INFECTION (Slight infection), CONSTIPATION (I was constipated), ABDOMINAL PAIN UPPER (This morning I was kneeling over because of stomach pain) and PAIN (Pain was horrible). On 15-Aug-2021, CHILLS (Chills) had resolved. On 16-Aug-2021, ABDOMINAL PAIN UPPER (This morning I was kneeling over because of stomach pain), FEELING ABNORMAL (Brain fog) and HEADACHE (Headache that would come and go in waves on Sunday) had resolved. At the time of the report, PALPITATIONS (I could feel my heart palpitating that night), INFECTION (Slight infection), STRESS (Stress induced because she was anxious in receiving the vaccine), PAIN (Pain was horrible) and FATIGUE (I was tired) outcome was unknown and CONSTIPATION (I was constipated) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 16-Aug-2021, Blood glucose: high (High) WBC count as well as glucose was high. On 16-Aug-2021, White blood cell count: high (High) WBC count as well as glucose was high. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment medication included was Antibiotics for the increased WBC count.


VAERS ID: 1672497 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Body temperature, Contusion, Dizziness, Extra dose administered, Feeding disorder, Headache, Heart rate, Nausea, Pyrexia, Vaccination site bruising, Vaccination site erythema, Vaccination site pain, Vaccination site pruritus, Vaccination site swelling
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FAMOTIDINE; LOSARTAN; TOPROL; VITAMIN D [ERGOCALCIFEROL]; ZETIA; CELEBREX; KETAMINE; PLAVIX
Current Illness: Atrial fibrillation
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: 101; Test Date: 20210816; Test Name: Heart rate; Result Unstructured Data: Increased
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Extra dose administered; Started with bruise that now has become much larger; She is also feeling dizzy; She has headache; It is itchy.; On same day at night, she started with little fever; She had nausea.; Her left arm started hurting at injection site; Injection site is swollen; It is red; She had stomach cramps; She started with bruise that now has become much larger.; She hasn''t been eating much.; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (She is also feeling dizzy), EXTRA DOSE ADMINISTERED (Extra dose administered), ABDOMINAL PAIN UPPER (She had stomach cramps), CONTUSION (She started with bruise that now has become much larger.) and FEEDING DISORDER (She hasn''t been eating much.) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 051C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Atrial fibrillation. Concomitant products included FAMOTIDINE, LOSARTAN, METOPROLOL SUCCINATE (TOPROL), ERGOCALCIFEROL (VITAMIN D [ERGOCALCIFEROL]), EZETIMIBE (ZETIA), CELECOXIB (CELEBREX), KETAMINE and CLOPIDOGREL BISULFATE (PLAVIX) for an unknown indication. On 14-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 14-Aug-2021, the patient experienced ABDOMINAL PAIN UPPER (She had stomach cramps), CONTUSION (She started with bruise that now has become much larger.), FEEDING DISORDER (She hasn''t been eating much.), VACCINATION SITE PRURITUS (It is itchy.), PYREXIA (On same day at night, she started with little fever), NAUSEA (She had nausea.), VACCINATION SITE PAIN (Her left arm started hurting at injection site), VACCINATION SITE SWELLING (Injection site is swollen) and VACCINATION SITE ERYTHEMA (It is red). On 16-Aug-2021, the patient experienced DIZZINESS (She is also feeling dizzy), VACCINATION SITE BRUISING (Started with bruise that now has become much larger) and HEADACHE (She has headache). On an unknown date, the patient experienced EXTRA DOSE ADMINISTERED (Extra dose administered). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at an unspecified dose and frequency. At the time of the report, DIZZINESS (She is also feeling dizzy), ABDOMINAL PAIN UPPER (She had stomach cramps), CONTUSION (She started with bruise that now has become much larger.), FEEDING DISORDER (She hasn''t been eating much.), VACCINATION SITE BRUISING (Started with bruise that now has become much larger), VACCINATION SITE PRURITUS (It is itchy.), PYREXIA (On same day at night, she started with little fever), NAUSEA (She had nausea.), VACCINATION SITE PAIN (Her left arm started hurting at injection site), VACCINATION SITE SWELLING (Injection site is swollen), VACCINATION SITE ERYTHEMA (It is red) and HEADACHE (She has headache) outcome was unknown and EXTRA DOSE ADMINISTERED (Extra dose administered) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 16-Aug-2021, Heart rate: increased (High) Increased. On an unknown date, Body temperature: 101 (High) 101.


VAERS ID: 1672605 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-24
Onset:2021-08-14
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, COVID-19, Cough, Fatigue, Headache, Rhinorrhoea, SARS-CoV-1 test, Somnolence
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEXAPRO; ROSUVASTATIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cough (Had cough for year and half and didn''t think much of it.)
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: 99.6 degrees Fahrenheit; Test Date: 20210810; Test Name: COVID test; Test Result: Negative ; Result Unstructured Data: Negative; Test Date: 20210815; Test Name: COVID test; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Cough; want to take a nap; runny nose; headache; COVID-19; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (COVID-19), COUGH (Cough), SOMNOLENCE (want to take a nap), RHINORRHOEA (runny nose) and HEADACHE (headache) in a 47-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Cough (Had cough for year and half and didn''t think much of it.). Concomitant products included ESCITALOPRAM OXALATE (LEXAPRO) and ROSUVASTATIN for an unknown indication. On 24-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Aug-2021, the patient experienced FATIGUE (Fatigue). On 15-Aug-2021, the patient experienced COVID-19 (COVID-19). On an unknown date, the patient experienced COUGH (Cough), SOMNOLENCE (want to take a nap), RHINORRHOEA (runny nose) and HEADACHE (headache). At the time of the report, COVID-19 (COVID-19), COUGH (Cough), SOMNOLENCE (want to take a nap), RHINORRHOEA (runny nose), HEADACHE (headache) and FATIGUE (Fatigue) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 10-Aug-2021, SARS-CoV-1 test: negative (Negative) Negative. On 15-Aug-2021, SARS-CoV-1 test: positive (Positive) Positive. On an unknown date, Body temperature: normal (normal) 99.6 degrees Fahrenheit. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient mentioned that her pulse ox was 97 at the lowest and also states that her symptoms are mild. No treatment medications were provided. This case was linked to MOD-2021-132775 (Patient Link).


VAERS ID: 1672742 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-13
Onset:2021-08-14
   Days after vaccination:213
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: Chills, Extra dose administered, Feeling abnormal, Headache, Influenza, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Dementia (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Infective pneumonia (broad), Opportunistic infections (broad)

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

Write-up: Like I had the flu; Like I was hit by a brick; Terrible headache; Muscular aches and pains; Chills; After receiving the 3rd dose of the vaccine; This spontaneous case was reported by a physician and describes the occurrence of INFLUENZA (Like I had the flu), FEELING ABNORMAL (Like I was hit by a brick), HEADACHE (Terrible headache), MYALGIA (Muscular aches and pains) and CHILLS (Chills) in a 69-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 14-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 14-Aug-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXTRA DOSE ADMINISTERED (After receiving the 3rd dose of the vaccine). On 15-Aug-2021, the patient experienced INFLUENZA (Like I had the flu), FEELING ABNORMAL (Like I was hit by a brick), HEADACHE (Terrible headache), MYALGIA (Muscular aches and pains) and CHILLS (Chills). On 14-Aug-2021, EXTRA DOSE ADMINISTERED (After receiving the 3rd dose of the vaccine) had resolved. On 16-Aug-2021, INFLUENZA (Like I had the flu), FEELING ABNORMAL (Like I was hit by a brick), HEADACHE (Terrible headache), MYALGIA (Muscular aches and pains) and CHILLS (Chills) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Relevant concomitant medications were not provided. Patient was not taken any treatment medication.


VAERS ID: 1672857 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, Chills, Cough, Headache, Lacrimation increased, Nasal congestion, Oropharyngeal pain, Pyrexia, Rhinorrhoea, Vaccination site pain
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Lacrimal disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergy NOS; Asthma (Respiratory asthma); Vegetable allergy (Allergic to carrots)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Sore throat; Stuffy nose; Runny nose; watery eyes; coughing; lost taste; Lost smell; Chills; Fever; Headaches; Left arm pain/left arm pain went away after three days; This spontaneous case was reported by a consumer and describes the occurrence of OROPHARYNGEAL PAIN (Sore throat), NASAL CONGESTION (Stuffy nose), RHINORRHOEA (Runny nose), LACRIMATION INCREASED (watery eyes) and COUGH (coughing) in a 25-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 017E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Asthma (Respiratory asthma), Allergy NOS and Vegetable allergy (Allergic to carrots). On 14-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Aug-2021, the patient experienced OROPHARYNGEAL PAIN (Sore throat), NASAL CONGESTION (Stuffy nose), RHINORRHOEA (Runny nose), LACRIMATION INCREASED (watery eyes), COUGH (coughing), AGEUSIA (lost taste), ANOSMIA (Lost smell), CHILLS (Chills ), PYREXIA (Fever ), HEADACHE (Headaches) and VACCINATION SITE PAIN (Left arm pain/left arm pain went away after three days). The patient was treated with IBUPROFEN for Adverse event, at an unspecified dose and frequency; PARACETAMOL, PHENIRAMINE MALEATE, PHENYLEPHRINE HYDROCHLORIDE (THERAFLU COLD AND FLU) for Adverse event, at an unspecified dose and frequency and IBUPROFEN, PSEUDOEPHEDRINE HYDROCHLORIDE (VICKS ACTION) for Adverse event, at an unspecified dose and frequency. On 17-Aug-2021, VACCINATION SITE PAIN (Left arm pain/left arm pain went away after three days) had resolved. At the time of the report, OROPHARYNGEAL PAIN (Sore throat), NASAL CONGESTION (Stuffy nose), RHINORRHOEA (Runny nose), LACRIMATION INCREASED (watery eyes), COUGH (coughing), AGEUSIA (lost taste), ANOSMIA (Lost smell), CHILLS (Chills ), PYREXIA (Fever ) and HEADACHE (Headaches) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient stated that he experienced all symptoms and felt like a guinea pig. Patient occasionally uses an Asthma Inhaler (unknown name) as concomitant medication.


VAERS ID: 1672985 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-05
Onset:2021-08-14
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 MYALGIA (Body/muscle aches) and PYREXIA (Feverish feeling) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 05-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Aug-2021, the patient experienced MYALGIA (Body/muscle aches) and PYREXIA (Feverish feeling). At the time of the report, MYALGIA (Body/muscle aches) and PYREXIA (Feverish feeling) had not resolved. No concomitant medications were reported. No treatment information was provided.


VAERS ID: 1673119 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chills, Euphoric mood, Feeling abnormal, Nausea
SMQs:, Acute pancreatitis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: feels weak; nausea; wasn''t feeling right; chills; within 15 minutes of shot felt high for about an hour after; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (feels weak), EUPHORIC MOOD (within 15 minutes of shot felt high for about an hour after), NAUSEA (nausea), CHILLS (chills) and FEELING ABNORMAL (wasn''t feeling right) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002F21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Aug-2021, the patient experienced EUPHORIC MOOD (within 15 minutes of shot felt high for about an hour after). On 16-Aug-2021, the patient experienced ASTHENIA (feels weak), NAUSEA (nausea) and CHILLS (chills). 16-Aug-2021, the patient experienced FEELING ABNORMAL (wasn''t feeling right). On 14-Aug-2021, EUPHORIC MOOD (within 15 minutes of shot felt high for about an hour after) had resolved. At the time of the report, ASTHENIA (feels weak), NAUSEA (nausea), CHILLS (chills) and FEELING ABNORMAL (wasn''t feeling right) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product was not provided by the reporter. Treatment information was not provided.


VAERS ID: 1673138 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-01
Onset:2021-08-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 7481 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Acoustic stimulation tests abnormal, Blood test, Computerised tomogram, Deafness neurosensory, Deafness unilateral, Ear discomfort, Labyrinthitis, Magnetic resonance imaging, Sudden hearing loss
SMQs:, Hearing impairment (narrow)

Life Threatening? No
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: Warfarin, Simivastatin, sotolol, Lisinopril
Current Illness:
Preexisting Conditions: cardiovascular health
Allergies: Sulfa
Diagnostic Lab Data: MRI. CAT and blood work done at the hospital. Follow up included a hearing test. Was diagnosed with Sudden Idiopathic Soundineural Hearing Loss. Labyrinthitis
CDC Split Type:

Write-up: On 8/14/21 my ears felt like pressure was building up inside the canal. At 3:00 I exit my vehicle and while at home my left ear proceeded to get worse. Within 3 hours I lost complete hearing in that ear.


VAERS ID: 1673211 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site bruising, Vaccination site pain, Vaccination site swelling
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101052112

Write-up: I am looking in the mirror and its little bit kind of swollen in that area; Pain; almost like a deep bruise in my shoulder where the shot was; Pain; almost like a deep bruise in my shoulder where the shot was; This is a spontaneous report from a contactable consumer (patient). A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number was not reported), via an unspecified route of administration, administered in Arm on 14Aug2021 as dose 1, single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. On 14Aug2021 early, the patient got the Pfizer first shot (Covid-19 Vaccine) and patient got some pain, felt almost like a deep bruise in shoulder where the shot was. So, moved arm around and when woke up (15Aug2021) and arm was still sores feels like it got a little worse but looking in the mirror and its little bit kind of swollen in that area and the patient was calling to see if had any tips, advice or anything like that. The patient''s outcome of the event vaccination site pain was not recovered and other events was unknown. The lot number for the vaccine, [BNT162B2], was not provided and would be requested during follow up.


VAERS ID: 1673246 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Texas  
Vaccinated:2021-02-12
Onset:2021-08-14
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210814; Test Name: NAAT Covid test; Test Result: Positive.
CDC Split Type: USPFIZER INC202101076373

Write-up: Tested positive for Covid virus, after being fully vaccinated.; Tested positive for Covid virus, after being fully vaccinated.; This is a spontaneous report from a contactable consumer or other non-healthcare professional. This consumer reported similar events for 37 patients. This report is for 35th patient of 37 patients. An 81-years-old male patient received bnt162b2 (BNT162B2, PFIZER-BIONTECH COVID-19 VACCINE, Solution for Injection), dose 2 via an unspecified route of administration on 12Feb2021 (Batch/Lot Number: EL9266) as dose 2, single and dose 1 via an unspecified route of administration on 23Jan2021 (Batch/Lot Number: EN5318; Expiration Date: 31May2021) as dose 1, single for covid-19 immunization. The patient medical history and concomitant medications were not reported. On 14Aug2021, the patient experienced tested positive for covid virus, after being fully vaccinated. Laboratory tests on 14Aug2021 included NAAT Covid test: positive. Assistant Director of Health (non-HC) calling today from a (facility). She stated that they are monitoring and tracking the vaccine breakthrough cases in their area and she has some concerns regarding one specific lot number that 15% of their breakthrough cases had received. The lot number provided was EN5318. The caller at the time, did not have the NDC or expiration date, however, was going to work on pulling patient information so that she would be able to have this information available to provide. Further stated that she cannot provide some identifying details and that she would need to check with her legal department first. She can provide, age, gender, BMI, medical conditions, if reported, and date they tested positive for Covid, and the type of Covid test utilized. As part of the simplification process, the following Complaint Records were classified as Product Use. Attributes/Lack of Effect and have been moved to Closed (No Investigation) state referencing a previously completed investigation for the same product and lot as per the ''One and Done'' business process according to in Q1215 and/or Q1252. Refer to the below table for details. Product-Description (CR): COMPOUND BNT 162 COVID-19 VACCINE SUSPENSION FOR INTRAMUSCULAR 2ML MULTIPLE DOSE VIAL X 1. Lot (CR): EN5318. Conclusion of Previously Completed Investigation: The complaint for lack of effect of the PFIZER-BIONTECH COVID-19 VACCINE INJECTABLE lot EN5318 was investigated. The investigation included reviewing manufacturing and packaging batch records, deviation investigations, and an analysis of complaint history for the reported lot. The final scope was determined to be the reported finished goods lot EN5318, fill lot EN5317, and the formulated drug product lot EN5316. A complaint sample was not returned. No related quality issues were identified during the investigation. There was no impact on product quality. No root cause or CAPA were identified as the complaint was not confirmed. All release testing performed prior to the release of the reported batch was within specifications. When more than one investigation was found in the family, the Conclusion field could result in repeating rows for the CR in the table. If the Conclusion was blank in the table above, then the investigation record was likely an Offline Contractor Investigation and the conclusion must be obtained directly from the child investigation record(s) of the linked Complaint Record. The outcome of the events was unknown. Follow-up attempts are completed. No further information is expected.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101075254 Same reporter/drug/AE, different patients


VAERS ID: 1673283 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-28
Onset:2021-08-14
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Heart rate increased, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Latex allergy; Sulfonamide allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210816; Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC202101082349

Write-up: elevated heart rate; shortness of breath; chest pain; This is a spontaneous report from a contactable consumer (Patient) reported that. A 20-years-old female patient (Non-pregnant) received BNT162B2 PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection), dose 1 via an unspecified route of administration, administered in Arm Left on 28Jul2021 17:00 (Lot Number: FA7485) as dose 1, single for covid-19 immunization (Age at vaccination 20 years). The patient past Medical history included Known allergies: Latex, dairy and sulfa (Sulfonamide allergy) from an unknown date and unknown if ongoing. There were no concomitant medications. Facility type vaccine Pharmacy or Drug Store . Prior to the vaccination, the patient was not diagnosed with COVID-19. Patient was covid tested post vaccination. The patient did not receive any other vaccine within 4 weeks prior to covid-19 vaccination. The patient has not received other medications in two weeks. On 14Aug2021 20:00 the patient experienced elevated heart rate, shortness of breath and chest pain. The seriousness criteria are medically significant. Patient received treatment Propranolol 10mg. The events result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. The patient underwent lab tests and procedures which included sars-cov-2 test: Results: Negative on 16Aug2021. The event outcome was not recovered. Follow-Up (24Aug2021): Follow-up attempts are completed. No further information is expected.


VAERS ID: 1673400 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Blood test, Myalgia, Pain, Scan
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: Blood work; Result Unstructured Data: Test Result:Normal; Test Date: 2021; Test Name: Scan; Test Result: Negative ; Comments: they couldn''t see cyst on her ovary
CDC Split Type: USPFIZER INC202101104676

Write-up: pain kind of like her hip area may be kind like at ovaries and by her hip; pains in the muscles; She is getting lot of pain; it was so bad; This is a spontaneous report from a contactable consumer (patient''s mother). A 17-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot Number: Unknown, Expiration date: Unknown), via an unspecified route of administration on 14Aug2021 (at the age of 17-year-old) as dose 1, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. patient''s mother stated that her daughter got the first dose of the COVID Vaccine on not this Saturday, So about a week ago. A couple of hour after she got the COVID shot on the 14Aug2021, Saturday and couple of hour after on 14Aug2021 she started getting the pain kind of like her hip area may be kind like at ovaries and by her hip and just started like, some pains in the muscles whatever and anyways kind off and line and then by Friday a couple of days ago to the last Friday it was so bad. Patients mother actually took her up to the Emergency room and they done a bunch of test (further clarifications unknown) on her to see if she either had an UTI (further clarifications unknown), there was they did also scan on her. They did a bunch of test and everything all over blood work everything come back completely normal. They couldn''t find anything going on but the pain started like a said about 12 after she got a COVID vaccine. So were she was just trying to find out if this the pain. She took the emergency room that was the case she was had the shot and this pain came on a couple hour after and they thought maybe it was UTI or maybe there was a cyst on her ovary that everything came back negative they couldn''t see cyst on her ovary, all those things came back negative they can''t see cyst on her ovary, they can''t see her urine came back fine like everything was come back completely fine. So, we got to know what''s going on and she had not got any better at all, it was like worse and worse and so she doesn''t know this was a side effect of that vaccine or something that she can do as we checked but don''t know because everybody they done as scan on her, they done blood work on her, they given an IV, they given her pain meds, they done everything and everything shows no but she was getting lot of pain on 14Aug2021. The patient underwent lab tests which included blood test showed normal on an unknown date in 2021; scan was negative (they couldn''t see cyst on her ovary) on an unknown date in 2021. Therapeutic measures were taken as a result of pain kind of like her hip area may be kind like at ovaries and by her hip, pains in the muscles, she was getting lot of pain; it was so bad with IV and pain medications. The outcome of the events was mot recovered. The lot number for the vaccine BNT162B2 was not provided and will be requested during follow up.


VAERS ID: 1673432 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-01-08
Onset:2021-08-14
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210814; Test Name: COVID-19 PCR test; Test Result: Positive
CDC Split Type: USPFIZER INC202101117314

Write-up: COVID-19 PCR test positive; COVID-19 PCR test positive; This is a spontaneous report from a Pfizer Sponsored Program Covax US Support. A contactable consumer (patient) reported that a 68-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, solution for injection) (age at the time of vaccination was 68-year-old), on 08Jan2021 15:00 (Lot Number: EL3248) as dose 2, single and on 18Dec2020 15:00 (Lot Number: EK5730) as dose 1, single, both via an unspecified route of administration, administered in Arm for covid-19 immunization. Medical history included and concomitant medications were reported as none. Other vaccinations within four weeks prior to the first administration date of the suspect vaccine: None. It was reported that the patient COVID-19 PCR test was positive on 14Aug2021 and was treated with Regeneron antibody treatment via Subcutaneous injections. One injection in back of each arm, two injections in abdomen. All injections administered at one time. She was told that if she needs to get a 3rd/booster dose she would need to wait 90 days after the Regeneron treatment before doing so. She asked do we have information on this. It was unknown whether culture performed. There were predisposing factors (eg. immunosuppression, contact with other infected persons). Then patient went to an urgent care (Physician Office) for follow-up to see if she was progressing as expected). The outcome of event COVID-19 was unknown. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1674486 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-12
Onset:2021-08-14
   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 EW0173 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Baclofen Diazepam Levetiracetam Miralax Albuterol as needed
Current Illness:
Preexisting Conditions: Cerebral Palsy Hydrocephalus
Allergies: None known
Diagnostic Lab Data: Had yearly checkup at Hospital on 8/18/2021. Seizure was discussed.
CDC Split Type:

Write-up: Had a seizure. Only that one. Had not had a seizure in a very long time.


VAERS ID: 1674514 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-12
Onset:2021-08-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood glucose decreased, Blood test, Chest X-ray, Dizziness, Hunger, Hyperhidrosis, Hypertension, Hypoaesthesia, Palpitations, Tremor, Vision blurred
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Hypertension (narrow), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No illnesses
Preexisting Conditions: None
Allergies: Allergic to milk
Diagnostic Lab Data: I went to the ER and they checked for seizure, stroke, heart attack, blood clots and xray my chest. My blood sugar was a little low they gave me OJ and sent me home but the dizziness did not go away and sysmptons continued. Went to my primary 5 days later he did blood work and everything came back normal even my blood sugar but all the symptoms continued. It''s going on week 4 and most of what I was feeling is gone except the dizziness. I''m 40 years old, I workout and run at least 1 mile 5 days a week.
CDC Split Type:

Write-up: Dizziness lasting more than 3 weeks and lasting hours to days, heart palpitations, numbness in the arms and finger tips, sweating and shaking while eating, high blood pressure 150 sys that''s not normal for me, dizziness while walking short distances like 20 ft to my kitchen, at times exsesive hunger, blurry vision.


VAERS ID: 1674573 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-13
Onset:2021-08-14
   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 FC3181 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Lethargy, Migraine, Pain, Postmenopausal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothroxine; Lexapro; Vitamin D3 , Vitamin B12, Tylenol
Current Illness: N/A
Preexisting Conditions: Crohn''s Disease; hypothyroidism; anxiety
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Post Menopausal bleeding from date of injection to present (over 3 weeks); migraine; body aches; lethargy


VAERS ID: 1674675 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-09
Onset:2021-08-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

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

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

Write-up: Itchy rash on arms and legs


VAERS ID: 1674826 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-12
Onset:2021-08-14
   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 FA7485 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear pain, Mental impairment, Paraesthesia, Sleep disorder, Tinnitus
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (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: - Sumatriptan 50mg (as needed) - Estradiol patch 0.1mg (weekly) - Progresterone 100mg (daily)
Current Illness: None
Preexisting Conditions: Migraines
Allergies: - Benadryl (orally or via IV) - Alcohol/Ethanol (orally ingested)
Diagnostic Lab Data: I just had my vaccine 2 days ago. I''ve scheduled 3 different doctors appointments to see how I can stop this ringing and to get my hearing tested.
CDC Split Type:

Write-up: - Ringing in my ears started after 1st dose. - Ringing WORSE after 2nd dose. - The ringing in my ears is horrible. It''s very loud and piercing. - Painful ear ache on the 2nd night. - Tingling in feet. ***Ringing is my ears is sssssooooo bad that I can''t sleep. I have to keep the TV on to drown out the ringing. It''s absolutely horrible. I really hope this is not permanent. This is torture. I can''t even think straight. There should be more transparency on the side-effects, as this is life altering and psychologically damaging.***


VAERS ID: 1674935 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-14
   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 FD448 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A no medications being given to the child. No conditions to be aware of at this time
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: None at this time
CDC Split Type:

Write-up: No adverse reactions but patient was under the age of 12 at the time of he administration. No physiological alterations occurred to the patient as confirmed with questions answered by parents and review of observation report from on site dated 08/14/2021


VAERS ID: 1675009 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (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: no known
Current Illness: no known
Preexisting Conditions: no known
Allergies: no known
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient reports painful swelling in the armpit starting the day after vaccination and lasting for a total of 2 days


VAERS ID: 1675064 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-09
Onset:2021-08-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Scleral haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Scleral disorders (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: Armour Thyroid, Betaine Hcl, vitamins C, D3, zinc, Astragalus Root, B complex, Probiotics, collagen, magnesium glycinate, levocetitizine
Current Illness:
Preexisting Conditions: Hypothyroid
Allergies: Sulfa, gluten and dairy sensitivities
Diagnostic Lab Data: Doctor did not give me any treatment. He said it will just dissipate over time.
CDC Split Type:

Write-up: I got my first jab on 8/9/21. On 8/14/21, I had a severe hemorrhage on the sclera of my left eye. I went to Urgent Care, the doctor who attended to me denied it was a side effect of the vaccine. No treatment. My second jab was done on 8/31/21 and on 9/5/2021 had a hemorrhage again of the sclera, this time on the right eye. It is definitely a side effect of the Pfizer vaccine.


VAERS ID: 1675069 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Deep vein thrombosis, Erythema, Influenza like illness, Muscle spasms, Thrombophlebitis, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Dystonia (broad), Thrombophlebitis (narrow), Cardiomyopathy (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid and. Trandolapril
Current Illness:
Preexisting Conditions: Lupus
Allergies: Codeine
Diagnostic Lab Data: Scans on 08/31/2021 visual clots dvts
CDC Split Type:

Write-up: Had flulike symptoms for 4 days then cramping muscles Charlie horses in legs bout week later started getting red marks on legs and arm emergency room on 08/30/2021 had thrombophlebitis in leg and arm went for scan next morning and found multiple bloodclots started on Eliquis no history of clots before and no family history they couldn''t say what caused it


VAERS ID: 1675128 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-08
Onset:2021-08-14
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3181 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Eye contusion, Full blood count normal, Periorbital haemorrhage, Prothrombin level normal, Prothrombin time normal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Periorbital and eyelid disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multi-vitamin,
Current Illness: N/A
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: CBC and PT,PTT. All within normal limits drawn the day of the event.
CDC Split Type:

Write-up: Developed a spontaneous right side black eye or periorbital ecchymosis near the right tear duct and extending across the lower part of the right eye. There was no pain or tenderness noted. The ecchymosis was not present upon waking in the morning. No trauma causation.


VAERS ID: 1675548 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Nausea, Pyrexia
SMQs:, Acute pancreatitis (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: Plaquenil Zyrtec Singular Zarelto Cymbalta
Current Illness: None
Preexisting Conditions: Lupus
Allergies: Wheat Yeast Milk
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever 100.4 Headache Nausea Fatigue Joint pain


VAERS ID: 1676244 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Blood thyroid stimulating hormone normal, Diarrhoea, Feeling abnormal, Headache, Herpes zoster, Hypoaesthesia, Injection site pain, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (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: Allegra, fish oil, SAM-E, biotin, multi-vitamin, nasonex
Current Illness:
Preexisting Conditions: Asthma, allergies
Allergies: Aspirin, NSAIDS
Diagnostic Lab Data: Blood panel, hormone levels, thyroid - 8/16/21 results were normal Diagnosed with shingles 8/16/21
CDC Split Type:

Write-up: Shingles started 2 days after vaccine administration, still have them. Pain at injection site for 2 days after Numbness of left arm on and off for 3 days, occasionally still have this Foggy brain - ongoing Body aches and feverish (no fever) - ongoing Severe diarrhea- ongoing since injection Headache - slight one daily Nausea - daily since injection


VAERS ID: 1677203 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Pain in extremity
SMQs:, 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: pain in her arm to the wrist; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (pain in her arm to the wrist) in a 20-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 005C21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Aug-2021, the patient experienced PAIN IN EXTREMITY (pain in her arm to the wrist). At the time of the report, PAIN IN EXTREMITY (pain in her arm to the wrist) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. This case was linked to MOD21-134310 (Patient Link).


VAERS ID: 1677217 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Pain in extremity, Vaccination site mass
SMQs:, 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: he had a bump that was about size of a golf ball,It went away completely after about 3 days. Now 4 days later, it came back. It''s not as hard as before. The bump is at the injection site; He had a left sore arm.; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (He had a left sore arm.) and VACCINATION SITE MASS (he had a bump that was about size of a golf ball,It went away completely after about 3 days. Now 4 days later, it came back. It''s not as hard as before. The bump is at the injection site) in a 35-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939902) for COVID-19 vaccination. No Medical History information was reported. On 14-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Aug-2021, the patient experienced PAIN IN EXTREMITY (He had a left sore arm.). On 15-Aug-2021, the patient experienced VACCINATION SITE MASS (he had a bump that was about size of a golf ball,It went away completely after about 3 days. Now 4 days later, it came back. It''s not as hard as before. The bump is at the injection site). At the time of the report, PAIN IN EXTREMITY (He had a left sore arm.) outcome was unknown and VACCINATION SITE MASS (he had a bump that was about size of a golf ball,It went away completely after about 3 days. Now 4 days later, it came back. It''s not as hard as before. The bump is at the injection site) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication details were provided. No treatment information was mentioned.


VAERS ID: 1677453 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-12
Onset:2021-08-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Dyspnoea, Hypoaesthesia, Malaise, Pain in extremity, Palpitations, Paraesthesia, Vision blurred
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101082240

Write-up: Sore arm; blurry vision; numbness and tingling in hands and feet; numbness and tingling in hands and feet; shortness of breath; heart palpitation; anxiety; feeling of not being well; This is a spontaneous report from two contactable consumers. A 21-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: FC3181), via an unspecified route of administration, administered in Arm Left on 12Aug2021 at 16:30 (age at vaccination: 21 years) as dose number unknown single for covid-19 immunisation. Medical history was repoted as None. Patient had Pertussis vaccine allergy. There were no concomitant medications. Facility where the most recent COVID-19 vaccine was administered was Pharmacy or Drug Store. Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient did not receive any other medications within 2 weeks of vaccination. Patient was not diagnosed with COVID-19 prior vacccinations. Since the vaccination the patient was not tested for COVID-19. The patient experienced sore arm, blurry vision, numbness and tingling in hands and feet, shortness of breath, heart palpitation, anxiety, feeling of not being well on 14Aug2021.Patient received unspecified treatment for the events. The outcome of the events was no recovered. Device Date was 20Aug2021. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1678783 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-02-17
Onset:2021-08-14
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Malaise
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, atenolol, multivitamin, lisinopril, omeprazole, ondansetron, simvastatin
Current Illness:
Preexisting Conditions: RA
Allergies: Alterra, cephalosporins
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/14/2021 COVID pos and began feeling ill 8/19/2021 - present to ED with cough and SOB started on dexamethasone, remdesivir and O2 discharged on 8/27/2021 9/2/2021 returns to ED with SOB but no change in O2 needs - discharged on 9/3/2021 continued on O2


VAERS ID: 1678871 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-08
Onset:2021-08-14
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 49C21A / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sprintec
Current Illness: N/Al
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Doctors appointment, steroid treatment and neurologist appointment.
CDC Split Type:

Write-up: Arm numbness ongoing a month post first vaccination.


VAERS ID: 1679114 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E2CA / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Headache, Neck pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: At 11:15 am, I started to feel really tired and have body aches. Within the hour, I had a fever of 100.9, achier body, headache, no appetite, sore neck and very tired. This lasted until 2 am (when my fever broke through the night a couple of times). For the rest of the day on Sunday, I did not have a fever but was still tired. By Monday I had no aches, no fever and not tired anymore.


VAERS ID: 1679165 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Might be 11 years of age. Doing well. No issues per mom. Vital records has her as 11 years of age. Mom says he is 12 years of age. Mom seemed eager to get child vaccinated. Unsure of birth date or age. Noticed after vaccinated, when documenting in the KS Immunization Registry that vital records has the date of birth as 1 year later. Vital records = Mom reports =


VAERS ID: 1679409 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of personal independence in daily activities, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: raised rash in a shawl shape around my neck and shoulders after the flu vaccine. I was 42 years old. It was my first flu vaccine
Other Medications: Xiidra twice daily, Levothyroxine 25mg, castor oil (rubbed on eyelids)twice daily, systane ultra OTC drops PRN, loratidine 10mg once daily, turmeric, Fish oil 1200mg, flax seed oil 1000mg once daily Gummies: vitamin C, Vitamin D, Women''s m
Current Illness: none
Preexisting Conditions: Amblyopia and chronic dry eye due to meibomian gland dysfunction
Allergies: codeine, flu vaccine
Diagnostic Lab Data: I''m waiting to hear back from my PCP''s office, I spoke to the CDC (they directed me here), and I''m seeing my eye doctor tomorrow.
CDC Split Type:

Write-up: The morning after my 1st vaccination, I woke up with blurry vision. I wear progressives and just got the prescription renewed 4 months prior to the vaccine. I was very happy with my eyesight and was having no issues until after the vaccination. I have waited to see if it would clear up on its own but it has not. It''s making my job more difficult as reading/filling out forms and evaluating mammographic images for motion, etc. I''m on the computer off and on all day and that has become more difficult, as well as just trying to read a book at lunch time.


VAERS ID: 1681452 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-08-14
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Body temperature, Fatigue, Feeling cold, Muscle spasms, Pain in extremity, Pruritus, Pyrexia, Rash, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcoholic (Infrequently like a glass in social gatherings); Bronchitis; Non-smoker; Seasonal allergy
Preexisting Conditions: Medical History/Concurrent Conditions: Mosquito bite (Four quarter-size raised marking on her arms (two on each side) where she had the bug bites); Comments: The patient had no drug abuse or illicit drug usage
Allergies:
Diagnostic Lab Data: Test Date: 20210814; Test Name: Body temperature; Result Unstructured Data: 100 to 102 degrees F
CDC Split Type: USJNJFOC20210907553

Write-up: VERY ITCHY; RASH ALL OVER BODY (RAISED AT SOME POINTS); FOUR QUARTER-SIZE RAISED MARKING ON HER ARMS (TWO ON EACH SIDE) WHERE SHE HAD THE BUG BITES; SORENESS IN LEGS, HIPS AND SHOULDERS; TIRED; SHARP PAIN IN HER ANKLE AND WRISTS/JOINT PAIN IN KNEES WHEN SHE WALKS; CONVULSING (SPASMING) STARTED FROM TOE AND SPREAD TO HER HEAD (TOE TO HEAD) THAT WOULD BE OFF AND ON; FREEZING; FEVER BETWEEN 100 TO 102 DEGREES F; This spontaneous report received from a patient concerned a 61 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included: mosquito bite, and concurrent conditions included: seasonal allergies, seasonal bronchitis, alcoholic, and non smoker, and other pre-existing medical conditions included: The patient had no drug abuse or illicit drug usage. The patient experienced stomach issues (stomach ache) when treated with ciprofloxacin, and azithromycin. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 206A21A expiry: 21-SEP-2021) dose was not reported, administered on 13-AUG-2021 to Left Arm for prophylactic vaccination. No concomitant medications were reported. On 14-AUG-2021, the patient experienced sharp pain in her ankle and wrists/joint pain in knees when she walks. On 14-AUG-2021, the patient experienced convulsing (spasming) started from toe and spread to her head (toe to head) that would be off and on. On 14-AUG-2021, the patient experienced freezing. On 14-AUG-2021, the patient experienced fever between 100 to 102 degrees f. Laboratory data included: Body temperature (NR: not provided) 100 to 102 degrees F. On 16-AUG-2021, the patient experienced soreness in legs, hips and shoulders. On 16-AUG-2021, the patient experienced tired. On 25-AUG-2021, the patient experienced four quarter-size raised marking on her arms (two on each side) where she had the bug bites. On 02-SEP-2021, the patient experienced rash all over body (raised at some points). On 02-SEP-2021, the patient experienced very itchy. The action taken with covid-19 was not applicable. The patient recovered from convulsing (spasming) started from toe and spread to her head (toe to head) that would be off and on, freezing, and fever between 100 to 102 degrees f on 17-AUG-2021, was recovering from soreness in legs, hips and shoulders, and tired, and had not recovered from sharp pain in her ankle and wrists/joint pain in knees when she walks, rash all over body (raised at some points), very itchy, and four quarter-size raised marking on her arms (two on each side) where she had the bug bites. This report was non-serious.


VAERS ID: 1681597 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-01-05
Onset:2021-08-14
   Days after vaccination:221
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025120-2A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Bedridden, Body temperature, Cough, Fatigue, Feeling abnormal, Feeling hot, Headache, Illness, Myalgia, Oropharyngeal pain, Peripheral swelling, Pyrexia, Rhinorrhoea, Vaccination complication
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: INSULIN; PLAVIX; ZETIA; ATORVASTATIN
Current Illness: Blind; Drug allergy (allergic to most medications.); Immunocompromised
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210814; Test Name: Body temperature; Result Unstructured Data: Fever
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: a very bad reaction; was very very sick; bedridden for at least 3 days; coughing; sore throat; running nose; was deathly ill/She thought she was dying; arm became incredibly swollen, very swollen; arm became hot, very hot; very weak; lots of muscle ache/arm became sore; very tired; a mild headache; temperature got up to 101.7 or higher/very high temperature; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (a very bad reaction), ILLNESS (was very very sick), BEDRIDDEN (bedridden for at least 3 days), COUGH (coughing) and OROPHARYNGEAL PAIN (sore throat) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 088D21A, 025120-2A and 029L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Blind, Immunocompromised and Drug allergy (allergic to most medications.). Concomitant products included INSULIN, CLOPIDOGREL BISULFATE (PLAVIX), EZETIMIBE (ZETIA) and ATORVASTATIN for an unknown indication. On 05-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 02-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 13-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Aug-2021, the patient experienced PYREXIA (temperature got up to 101.7 or higher/very high temperature). On an unknown date, the patient experienced VACCINATION COMPLICATION (a very bad reaction), ILLNESS (was very very sick), BEDRIDDEN (bedridden for at least 3 days), COUGH (coughing), OROPHARYNGEAL PAIN (sore throat), RHINORRHOEA (running nose), FEELING ABNORMAL (was deathly ill/She thought she was dying), PERIPHERAL SWELLING (arm became incredibly swollen, very swollen), FEELING HOT (arm became hot, very hot), ASTHENIA (very weak), MYALGIA (lots of muscle ache/arm became sore), FATIGUE (very tired) and HEADACHE (a mild headache). At the time of the report, VACCINATION COMPLICATION (a very bad reaction), ILLNESS (was very very sick), BEDRIDDEN (bedridden for at least 3 days), COUGH (coughing), OROPHARYNGEAL PAIN (sore throat), RHINORRHOEA (running nose), FEELING ABNORMAL (was deathly ill/She thought she was dying), PERIPHERAL SWELLING (arm became incredibly swollen, very swollen), FEELING HOT (arm became hot, very hot), ASTHENIA (very weak), MYALGIA (lots of muscle ache/arm became sore), FATIGUE (very tired), PYREXIA (temperature got up to 101.7 or higher/very high temperature) and HEADACHE (a mild headache) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 14-Aug-2021, Body temperature: 101.7 (High) Fever. She said she had a very bad reaction to the booster shot. She said she''s immunocompromised and allergic to most medications. Patient was put on antibiotic for possible infection, although the follow up doctor didn''t think she had an infection. Patient used cold pack on the arm. Patient went to the urgent health and didn''t go to her primary care. She went to a skin doctor to look at her arm. This case was linked to MOD-2021-295425 (Patient Link).


VAERS ID: 1681901 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-05
Onset:2021-08-14
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Subcutaneous abscess
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101093343

Write-up: I have developed an abscess in my arm pit that requires draining; This is a spontaneous report from a contactable other healthcare professional (patient). A 46-year-old non-pregnant female patient received bnt162b2 (BNT162B2 PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Batch/Lot number: UNKNOWN), via an unspecified route of administration on 05Apr2021 (at the age of 46-years-old) as dose number unknown, single for COVID-19 immunisation. The medical history and concomitant medications of the patient were not reported. The patient was not pregnant at the time of vaccination. The patient did not receive any other vaccines within 4 weeks prior to the Covid vaccine. Prior to vaccination, the patient was not diagnosed with Covid-19. Since the vaccination, the patient not been tested with covid-19. The patient stated that she had developed an abscess in her arm pit that requires draining on 14Aug2021. The event led to the physician office visit. Therapeutic measures were taken as a result of event that included had to have it drained and now another apt drain. The outcome of the event was reported as not recovered. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.; Sender''s Comments: Based on the known safety profile of the vaccine BNT162B2, a temporal relation between the event Subcutaneous abscess and the administration of the vaccine cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1681907 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-10
Onset:2021-08-14
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Fatigue, Hyperhidrosis, Nasal congestion, Nasopharyngitis, Pain, Rhinorrhoea, SARS-CoV-2 test, Sinusitis, Sneezing, Vaccination failure
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SYNTHROID
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210820; Test Name: got tested with the PCR test and its positive for SARS Covid-2; Result Unstructured Data: Test Result:Positive
CDC Split Type: USPFIZER INC202101096387

Write-up: I had a break through; got tested with the PCR test and its positive for SARS Covid-2; I had a break through; got tested with the PCR test and its positive for SARS Covid-2; Cold/ I thought like I had a pretty bad cold coming on; Congestion; Runny nose; Sneezing; kind of feeling achy; Tired; sinus; bad cold sinus infection; Sweaty; This is a spontaneous report from a contactable consumer (patient). A 59-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported, Expiry date: unknown, at the age of 59 years), dose 1 via an unspecified route of administration on 18Feb2021 as dose 1, single, and dose 2 of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported, Expiry date: unknown, at the age of 59 years),via an unspecified route of administration on 10Mar2021 as dose 2, single for COVID-19 immunisation. The medical history was not reported. Concomitant medication(s) included levothyroxine sodium (SYNTHROID). The patient received first dose on 18Feb of this year and second dose on 10Mar of this year at the and she recently returned from travel exactly about a week ago on the 14th of August. She thought like she had a bad cold coming on you know sinus, congestion, runny nose often sneezing just kind of feeling achy and it just continued throughout the week and then on, when was that, about 5 days and with it persisting she went and got tested with the PCR test and its positive for SARS Covid-2. So, she was like it was very mild and concerns consistently most of that was 10 days before it was off. It just felt like a very bad, bad cold sinus infection, never any fever just sweaty, tired but she was symptoms free more or less for about 2 days now but it definitely a breakthrough case but mild in severity. The events started on 14Aug2021. The patient did not receive any treatment for the events. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 20Aug2021. The outcome of the events was unknown. No follow-up attempts are possible. Information about lot/batch number cannot be obtained, no further information is expected.


VAERS ID: 1681931 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-25
Onset:2021-08-14
   Days after vaccination:111
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Heart attack (dad-heart attack at age 41); Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None, Comment: Patient History: No
Allergies:
Diagnostic Lab Data: Test Date: 20210814; Test Name: Covid-19 Test; Test Result: Positive
CDC Split Type: USPFIZER INC202101098822

Write-up: She tested positive for Covid-19 after receiving the second dose in Apr2021; She tested positive for Covid-19 after receiving the second dose in Apr2021; This is a spontaneous report from Pfizer-sponsored program. This report was also received from Product Quality Complaint. A contactable consumer (patient) reported that a 56-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in left arm on 02Apr2021 (Batch/Lot Number: ER8732) as dose 1, single; then via an unspecified route of administration, administered in left arm on 25Apr2021 (Batch/Lot Number: EW0169) as dose 2, single for COVID-19 immunisation. The patient has no medical history and no concomitant medications. Family history included her dad had heart attack at age 41. There were no additional vaccines administered on the same date of the Pfizer vaccine. No other vaccines were given within four weeks prior to the first administration date of the suspect vaccine. The patient tested positive for COVID-19 on 14Aug2021 after receiving the second dose. She believes it is because of her grandkids. She is on her 10th day of quarantine. The events did not require a visit to emergency room and physician office. The outcome of the events was unknown. The Product Quality Complaints Group concluded that the complaint for lack of effect of the PFIZER-BIONTECH COVID-19 VACCINE lot EW0169 was investigated. The investigation included a review of manufacturing and packaging batch records, deviation investigations, and an analysis of complaint history for the reported lot and product type. The final scope included the reported finished goods lot EW0169, fill lot EP8700, and the bulk formulated drug product EP8602. A complaint sample was not returned. No related quality issues were identified during the investigation. There is no impact on product quality. No root cause or CAPA were identified as the complaint was not confirmed. All release testing performed prior to the release of the reported batch was within specifications.


VAERS ID: 1681934 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Myalgia, Pain, Pain in extremity, Vascular pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy; Sjogren''s; Sulfonamide allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101098920

Write-up: feeling small shock like pain in my thighs; feeling small shock like pain in my thighs. Ever since it''s moved to random places all over my body; Like piercing stabbing pain in muscles; feels sometimes like in my veins; This is a spontaneous report from a contactable consumer (the patient). A 52-year-old non-pregnant female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, (Batch/Lot number unknown due to unable to locate or read the details) via an unspecified route of administration, administered in Arm Left on 14Aug2021 15:45 at age of 52-year-old at single dose for COVID-19 immunisation. Medical history included Sjogrens, penicillin allergy and sulfa drugs allergy. The patient had no COVID-19 prior vaccination. No COVID tested post vaccination. Concomitant medications included unspecified drugs. It reported the patient received other medications within 2 weeks of vaccination. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. As she walked out she began feeling small shock like pain in her thighs. Ever since it''s moved to random places all over her body. Like piercing stabbing pain in muscles and felt sometimes like in her veins. The events onset date was reported as 14Aug2021 15:45. No treatment received for the events. The outcome of the events was not recovered. The lot number for BNT162B was not provided and will be requested during follow up.


VAERS ID: 1682858 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Maternal exposure during breast feeding
SMQs:, Neonatal exposures via breast milk (narrow)

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

Write-up: Breastfeeding baby developed a rash and hives to my breastmilk.


VAERS ID: 1682960 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered
SMQs:, Medication errors (narrow)

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

Write-up: Patient received his first and second dose in Jan and Feb. He scheduled this app as a "first dose" so was given a third dose in error.


VAERS ID: 1683119 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-11
Onset:2021-08-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest discomfort, Choking, Dyspepsia, Electrocardiogram, Gastrooesophageal reflux disease, Laboratory test, Taste disorder
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Taste and smell disorders (narrow), Gastrointestinal nonspecific dysfunction (narrow), Hypersensitivity (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: Losartan-hctz; vitamin D; women''s multivitamin multi-mineral pill; diclofenac; PEPCID
Current Illness: Tested positive for COVID-19 - On 07/22/2021
Preexisting Conditions: High blood pressure (manageable); anemic -not taking anything for it
Allergies: Shellfish- shrimp
Diagnostic Lab Data: EKG- looked good; 2 sets of blood work- to see if I had a heart attack- but results were normal regular lab to check everything in general- the anemia came up.
CDC Split Type: vsafe

Write-up: I tested positive for COVID-19 On 07/22/ mild heartburn I was taking TUMS for it and it subsided, and a little bit of dizziness, and coughing, I also had a bitter, acid taste in my mouth. About the 07/31/2021, all the COVID-19 symptoms subsided. My heartburn became manageable. On 08/11/2021- I had the Pfizer Dose 1-Within that hour of getting the vaccine. I had a strong taste in my mouth. I accepted that as maybe the heartburn coming back. I woke up the middle of the night, like I was choking. About the 3rd day, I was heavy on Tums, Pepcid and Prilosec and I was drinking a lot of water and chewing a lot of gum. Chewing a lot of gum gave me comfort. The Acid reflux got so bad I was sleeping up on the bed, I loaded up on Pepcid and started taking Prilosec, after 14 days it didn''t do anything for me. On 08/22/2021, I went to ER, because I was not getting any relief from the heartburn with everything I was taking. They checked me as if I was having something wrong with my heart. I had pressure in my chest. I am treating it like it was heartburn and my chest was tight. Treatment at the hospital: A GI cocktail and Mylanta and Pepcid, it''s supposed to numbing effect so I wouldn''t have the tightness in my chest. I felt a little relief because it numbed it. Once it wore out, I still had the tightness in my chest. The Pepcid, TUMS, and Prilosec caused my heart pressure to go high. I''m trying to stick to the TUMs and chew gum and drink plenty of water. This weekend will be a month that I have really, really bad heartburn. I am still having the heartburn 1st thing in the morning. I try to prop myself up at night and try not to sleep flat. At this point, when I started adding in the Mylanta and Pepcid, the heartburn has gotten better. I am 56 years old and I have never had heartburn before. I had mild heartburn after COVID-19 and it went away. It came 2 or 3 times worse with the Pfizer Dose 1 vaccine. I will be following up with my doctor and try to get a referral to a GI Doctor within the next week or so, because I am concerned about taking the Mylanta, TUMS and Pepcid and the whole mix for too long and it causes my blood pressure to rise.


VAERS ID: 1683220 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-02-25
Onset:2021-08-14
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 20 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Diagnosed and hospitalized with COVID 19.


VAERS ID: 1683244 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-09
Onset:2021-08-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / JET

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cardiomegaly, Chest X-ray, Chills, Cognitive disorder, Cough, Dyspnoea, Fatigue, Headache, Nasal disorder, Pyrexia, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, Therolictro, Losartan, Hydrocools, Trilepton, Reequip, Protonic, Zacapa, Letropril, Armdoasminl, magnesium, iron, vitamin D, baby aspirin
Current Illness:
Preexisting Conditions: diabetic, high blood pressure, Sjogren
Allergies: Erythromycin, Keslar
Diagnostic Lab Data: Chest x-ray, Covid-19 test
CDC Split Type: vsafe

Write-up: I had coughing, chills, fever, SOB, headache, cognitive, running noise, nose smell, and tried. I had a phone visit with my doctor and did a Covid-19 test, which was positive. I also went to the ER. They did a chest x-ray, which showed promontory vasal congestive with slightly enlarged heart.


VAERS ID: 1683314 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, 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), Accidents and injuries (narrow), 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: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None at this time
CDC Split Type:

Write-up: Patient was standing/leaning on a chair when they lost consciousness and fell from standing onto the floor. (syncope) Patient regained consciousness within a few minutes. Patient recovered after having some water within 15 or so minutes.


VAERS ID: 1683648 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-01-06
Onset:2021-08-14
   Days after vaccination:220
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210814; Test Name: COVID-19 Virus test; Test Result: Positive ; Result Unstructured Data: COVID-19 Virus test was positive
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: aching; runny nose; malaise; got tested positive for covid-19; Lack of drug effect; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (got tested positive for covid-19), DRUG INEFFECTIVE (Lack of drug effect), PAIN (aching), RHINORRHOEA (runny nose) and MALAISE (malaise) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 015M20H and 027L20A) for COVID-19 vaccination. No Medical History information was reported. On 06-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 05-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Aug-2021, the patient experienced COVID-19 (got tested positive for covid-19) and DRUG INEFFECTIVE (Lack of drug effect). On an unknown date, the patient experienced PAIN (aching), RHINORRHOEA (runny nose) and MALAISE (malaise). At the time of the report, COVID-19 (got tested positive for covid-19), DRUG INEFFECTIVE (Lack of drug effect), PAIN (aching), RHINORRHOEA (runny nose) and MALAISE (malaise) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 14-Aug-2021, SARS-CoV-2 test: positive (Positive) COVID-19 Virus test was positive. The concomitant medications information was not reported. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 02-Sep-2021: Follow up information included additional events.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. However, based on the mechanism of action of mRNA-1273, causal association between the event of COVID-19 infection and mRNA-1273 is assessed as not applicable.


VAERS ID: 1684857 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-13
Onset:2021-08-14
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Nausea, Pneumonia viral, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, atorvastatin, belatacept, cholecalciferol, clonidi, clonidine, docusate-senna, furosemide, hydralazine, insulin aspart, insulin detemir, levothyroxine, magnesium oxide, metoprolol tartrate, mycophenolic acid, prednisone, sodium
Current Illness:
Preexisting Conditions: Diabetes type 2, hypertension, hypothyroid, hyperlipidemia, GERD, hyperparathyroid, anemia, prior ESRD on HD now s/p, renal transplant on immunosuppressants
Allergies: Procardia
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/14/21: patient presents to ED with a chief complaint of dry cough, nausea, vomits since 7 days ago. admitted. Tested positive for covid 8/14/21. Note: patient previously vaccinated with Moderna vaccine: First dose: 03/16/21 Lot Number 030A21A;Second dose: 04/13/21 Lot Number 021B21A. Diagnosed with covid related viral pneumonia. Discharged 8/23/21.


VAERS ID: 1685452 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-13
Onset:2021-08-14
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 2 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Chronic obstructive pulmonary disease, Condition aggravated, Cough, Diarrhoea, Dyspnoea, Exposure to SARS-CoV-2, SARS-CoV-2 test positive, Viral infection
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), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), 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? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol, aspirin, atorvastatin, biotin, Calcium+D, vit B12, dicyclomine, folic acid, hydrocodone-acetaminophen, levothyroxine, lisinopril, omeprazole, umeclidinium-vilanterol, zonisamide
Current Illness:
Preexisting Conditions: HTN, Vit D deficiency, COPD, GERD
Allergies: no known allergies
Diagnostic Lab Data: COVID-19 positive test on 8/12/21 SARS CoV 2 PCR COVID19 detected on 8/15/21
CDC Split Type:

Write-up: 8/14/21: Patient recently exposed to someone with COVID, and developed shortness of breath, cough, and diarrhea for past 2 days. admitted. Diagnosed with COVID-19 pneumonia, acute hypoxic respiratory failure, acute COPD exacerbation secondary to acute viral infection 8/24/21: medically cleared to skilled nursing facility and discharged. Note: She stated she was vaccinated with Pfizer in Feb and March 2021. (However, record shows her vaccination was on 1/16/21 and 2/13/21. Unable to confirm as she did not have her vaccination card).


VAERS ID: 1685457 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-12
Onset:2021-08-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

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

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

Write-up: I had the feeling of numbness in my face legs and arms. It came in a wave. I continued to experience those system for up to three weeks after the vaccine. It did become less and less each day but still was experiencing them.


VAERS ID: 1685530 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-11
Onset:2021-08-14
   Days after vaccination:215
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Central venous catheterisation, Colitis, Diarrhoea, Dyspnoea, Hypotension, Intensive care, Nausea, Pneumonia viral, SARS-CoV-2 test positive, Septic shock, Viral infection, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Toxic-septic shock conditions (narrow), Pseudomembranous colitis (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad), Sepsis (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, aspirin, lisinopril, pantoprazole, rosuvastatin, trazodone
Current Illness:
Preexisting Conditions: diabetes
Allergies: seafood
Diagnostic Lab Data: tested positive for Covid on 8/14/21.
CDC Split Type:

Write-up: 8/14/21: presented to ED complaining of nausea vomiting diarrhea and shortness of breath patient is fully vaccinated against COVID with (Pfizer) 2nd dose was in January, he recently been traveling , has been experiencing nausea vomiting diarrhea that he contributed probably to food poisoning but and then he continue to have some shortness of breath last night he presented to ED and found to be hypotensive, given 2 L IV fluid with still no response so central venous catheter was placed the same time COVID- PCR test came back positive, patient was started on norepinephrine and will be admitted to ICU . Note: previously vaccinated with Covid-19 Pfizer vaccine on 12/22/20 & 1/11/21.Diagnosed and treated for acute distributive septic shock with multifocal viral PNA, acute colitis, and viral syndrome secondary to COVID-19 infection. Improved and was discharged 8/20/21


VAERS ID: 1685557 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, Cough, Fatigue, Migraine with aura, Nausea, Pain, Respiratory disorder, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Respiratory failure (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: 180 Mg Armor Thyroid
Current Illness: No other illness
Preexisting Conditions: Hashimoto''s Disease and Chronic Complicated Migraines with Aura
Allergies: Peanuts, Walnuts, Pecans, Gluten pseudoephedrine and Morphine
Diagnostic Lab Data: Not at this time
CDC Split Type:

Write-up: Body aches, Intense Migraine that lasted over a week (included aura and nausea), upper respiratory tightness and cough. I continue to have fatigue, body aches, and an upper respiratory cough that seems to be worsening. I am going to the urgent care 9/9 as I cannot get into my primary care physician until 9/24. I have continued to test weekly for covid and continue to come up negative.


VAERS ID: 1685569 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-12
Onset:2021-08-14
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Condition aggravated, Cough, Dyspnoea, Fatigue, Malaise, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), 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), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, benzonatate, chlorthalidone, losartan, rosuvastatin, ergocalciferol, albuterol, promethazine-dextromethorphan oral syrup
Current Illness:
Preexisting Conditions: Morbid obesity, HTN, HLD
Allergies: nkda
Diagnostic Lab Data: Tested positive for Covid on 8/14/21 prior to admission.
CDC Split Type:

Write-up: 8/18/21: History: patient had recent COVID-19 diagnosis on initial ER visit on 8/14. At that time he was experiencing general malaise, fatigue, fever, cough, and mild congestion. He had f/u ED visit on 8/16 w/ no hypoxia observed but then returned to the ED 8/18 w/ complains of worsening SOB and dyspnea. Admitted 8/18/21. Had J&J Covid-19 vaccine on 3/12/21. Diagnosed with COVID-19 viral pneumonia, acute hypoxic respiratory failure. 9/9/21: patient still admitted at the time of this report submission


VAERS ID: 1685674 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-05
Onset:2021-08-14
   Days after vaccination:70
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / N/A AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache
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: Flu shot 30 years ago was in bed sick for 2 days
Other Medications: hydroxychloroquine 200mg once daily, pilocarpine 5mg 4 times daily, omeprazole 40 mg once daily, xiidra 5% op solution. turmeric, DHA, vit B, vit D, calcium,
Current Illness:
Preexisting Conditions: RA, Sjogren''s syndrome, osteoporosis,
Allergies:
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: Daily headache it started mid August. over my left temple.


VAERS ID: 1685769 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-03
Onset:2021-08-14
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Immune-mediated adverse reaction, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Seasonal allergies
Allergies: Nickel, bacitracin, cats
Diagnostic Lab Data: Visited dermatologist 9/8/2021; diagnosed with immune response to vaccine
CDC Split Type:

Write-up: 10 days after first vaccination, itching, burning rash on forearms and hives/itching around knees, ankles, and hands. Lasted 7-10 days then cleared. Recurred in same areas within 24 hours of second vaccine dose.


VAERS ID: 1570780 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-12
Onset:2021-08-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD7204 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Epistaxis
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Magnesium Vitamin B (multi)
Current Illness: No
Preexisting Conditions: Thalassemia
Allergies: Hay fever
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Epistaxis 3x on the same day aug 14th 2021 lasting about 10 minutes originating from right nostril. Lasting sensitivity of right nostril till now at time of report (next day).


VAERS ID: 1578945 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary mass, Axillary pain, Breast pain, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Lipodystrophy (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: Lyrica Nucynta Metorprolol Bupropion Pantaloc Zoloft
Current Illness: None
Preexisting Conditions: Back pain Fibromyalgia
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Very painful left armpit only a couple hours after injection and it went down my left side a bit by left breast. The next day found a couple lumps in my armpits. Used ice packs and hot showers. Still very painful. On fourth day noticed that my left armpit was visibly swollen and still painful at this point. Have a call out to my doctor waiting to hear back.


VAERS ID: 1628644 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions: IBD - Ulcerative Colitis
Allergies: none known at this time
Diagnostic Lab Data: none.
CDC Split Type:

Write-up: Red rashes and hives all over the body. lots of itching and redness. Throat was stuck and could not breathe. Red bumps all over especially on the neck, stomach, hands, legs and breast.


VAERS ID: 1553696 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Glare, Paraesthesia oral, Throat irritation, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Ocular motility disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Magnesium supplement, L theanine
Current Illness: None known
Preexisting Conditions: None
Allergies: Amoxicillin, Sulfa drugs
Diagnostic Lab Data: none
CDC Split Type:

Write-up: About 7 minutes after vaccine began having tingling to tongue and lips; Scratchy throat sensation; Glare/ blurry vision. No shortness of breath or airway compromise Gave ice pack and cold water


VAERS ID: 1553726 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole, cetirizine, fish oil, probiotic, chlorthalidone, amlodipine, zinc, vitamin c, vitamin d
Current Illness: None
Preexisting Conditions: Migraines, HTN, Seasonal allergies, GERD, history of melanoma,
Allergies: Imitrex, atenolol, flunisolide
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives on legs, arms, hands, and face


VAERS ID: 1553749 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine Besylate 5mg/day for high blood pressure, Atorvastatin 40mg/day for Cholesterol
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Very bad headache and fever, 101.0 degrees.


VAERS ID: 1553817 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-03
Onset:2021-08-13
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
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: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: THE PATIENT WAS ADMINISTERED THE VACCINE AT THE AGE OF 12. NO ADVERSE REACTIONS REPORTED


VAERS ID: 1553837 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
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: PERICARDITIS
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT CAME IN AND FILLED OUT A VOUCHER CONFIRMING HE HAD NO PREVIOUS COVID VACCINES. UPON ENTERING JANSSEN VACCINE INTO COMPUTER, WE NOTICED THAT HE HAD ALREADY RECEIVED BOTH DOSES OF HIS PFIZER VACCINE.


VAERS ID: 1553842 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose normal, Eye movement disorder, Gait disturbance, Heart rate increased, Unresponsive to stimuli, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: All information was provided to me by the patient''s spouse. The patient awoke for the day at 6am (took fiber pill and daily aspirin) and by 6:05am had tripped and landed in a seated position on a living room recliner. His eyes were rolled back and he was unresponsive. Wife called 911. Meanwhile, he remained unresponsive for 4 minutes but still breathing. When he came to, he vomited and continued to vomit 6 times while waiting for EMS. It took 25 minutes for EMS to arrive due to a train. When EMS evaluated the patient they checked his blood pressure and heart rate (73) which were normal. Wife noted that his heart rate was elevated compared to his normal range. EMS offered to take the patient to the hospital for evaluation but he has no insurance and declined. His wife checked his blood fasting blood sugar which was 100 (normal). After the event, Wife contacted me at 9:48am to let me know what happened. She said at that time he was resting.


VAERS ID: 1553864 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-01
Onset:2021-08-13
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache
SMQs:

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

Write-up: Severe headaches on top of my head, I don''t think it had anything to do with the vaccine. Was prescribed 500 mg of Naproxen 2x a day for 1 week


VAERS ID: 1553867 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-07-21
Onset:2021-08-13
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram repolarisation abnormality, Pericarditis, Troponin increased
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (narrow), Conduction defects (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: HS troponin 7000. ECG with early repolarization
CDC Split Type:

Write-up: pericarditis 3 weeks after 2nd vaccine dose. Chest pain. HS troponin 7000. Further workup pending


VAERS ID: 1553870 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: The Moderna COVID-19 shot was given to a 16 year old. This is an adverse event because it is only approved for those 18 years and older right now.


VAERS ID: 1553878 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Patient vomited 5 minutes after vaccationation


VAERS ID: 1553888 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Headache
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: Magnesium, probiotics. Prenatal vitamins.
Current Illness: No illness.
Preexisting Conditions: None.
Allergies: No allergies.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, breastfeeding and baby?s poop is extremely dark green and mucusy.


VAERS ID: 1553891 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyskinesia, Refusal of treatment by patient, Snoring
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (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: VAERS reference number 593815
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: After immunization patient sat down and after a few minutes lay down on the floor on his side on his own. He began to snore for at most five seconds then his body jerked back and forth for at most five seconds then he became conscious. He lay down for ten minutes, and sat upright for thirty minutes. An ambulance was called but he refused to be taken to the hospital.


VAERS ID: 1553894 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Vaccine administered at 1000. Employee reported 1130 feeling redness, and "itchy throat". Evidence of redness on chest, neck, and face. Blood Pressure at 1130 was 144/85 Heart Rate was 60. BP at 1135 was 137/86 HR was 60. BP at 1140 was 126/93 HR was 56.


VAERS ID: 1553910 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Incorrect dose administered, Product preparation issue
SMQs:, Medication errors (narrow)

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

Write-up: After administering this first dose from the reconstituted vial, it was determined that the vial was reconstituted with 0.8ml normal saline rather than the required diluent quantity of 1.8ml. This vial was discarded, no further doses administered. per CDC guidance, patient informed and advised to observe for side effects. No further modifications indicated.


VAERS ID: 1553932 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Feeling abnormal, 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), Dementia (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: Amoxicillin, Ceftin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received his first Pfizer vaccine, and was being monitored in our hospital clinic. Nurse saw him bend over; he reported feeling awful, and then passed out for approximately 10 seconds. Vitals: B/P 126/71, HR 52, respirations 18, Pulse ox 99% on RA. Rapid response called, but not necessary to go to ER. Patient maintained in clinic for another 30 minutes. Alert & Oriented x 3. Given water & power bar and patient felt better. Second set of vitals: B/P 145/80, HR 61, respirations 20, Pulse ox 97%.


VAERS ID: 1553945 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / UNK - / IM

Administered by: Public       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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

Write-up: none


VAERS ID: 1553950 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-01-08
Onset:2021-08-13
   Days after vaccination:217
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 UN / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipne Besylate, Gabapentin, Trazodone, Aricept, Atorvastatin, Donepezil, Ketocanazol, Nitrofurantonin, Terbinafine
Current Illness: UTI
Preexisting Conditions: Dysphagia, Anemia, Hypertension, polyosteoarthritis, spinal stenosis, osteoporosis
Allergies: Ephedrine, penicillin
Diagnostic Lab Data: Abbott BinexNow rapid test
CDC Split Type:

Write-up: Asymptomatic, picked up on routine testing.


VAERS ID: 1553955 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-07
Onset:2021-08-13
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Incorrect dose administered
SMQs:, Medication errors (narrow)

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

Write-up: Patient received Pfizer COVID vaccine from a different Vendor on 1/26/2021 and 1/29/2021. Patient received 3rd dose Pfizer vaccine from us at Physicians on 8/7/2021 at Mall location. Investigation confirmed a regulatory authority had a different address listed for patient.


VAERS ID: 1553960 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / UNK RA / IM

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

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

Write-up: improper storage and handling of vaccine


VAERS ID: 1553963 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / UNK - / IM

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

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

Write-up: dose administered after improper temp storage. No outcome reported as of now


VAERS ID: 1553971 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / UNK - / IM

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

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

Write-up: improper storage and handing of vaccine


VAERS ID: 1553972 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / UNK - / IM

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

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

Write-up: dose administered after improper temp storage. No outcome reported as of now


VAERS ID: 1553975 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / UNK - / -

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

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

Write-up: Dose administered after improper temp storage. No outcome reported as of now.


VAERS ID: 1553977 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / UNK - / IM

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

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

Write-up: improper storage and handing of vaccine


VAERS ID: 1553981 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, 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? 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: no
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient passed out 10 minutes after the vaccination and lost consciousness for around 5 minutes. She regain consciousness around 5 minutes later, and didn''t know what had just happened. Patient mentioned that she passed out before when she had her blood drawn. Her only complained at that moment was she felt really hot


VAERS ID: 1553985 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / UNK - / IM

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

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

Write-up: improper storage and handing of vaccine


VAERS ID: 1553987 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / UNK - / IM

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

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

Write-up: dose administered after improper temp storage. No outcome reported as of now


VAERS ID: 1553997 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003B21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Basedow's disease, Blood test, Electrocardiogram, Heart rate increased, Hyperhidrosis, Hyperthyroidism, Ultrasound scan, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Optic nerve disorders (broad), Hyperthyroidism (narrow), Hypoglycaemia (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: lipitor 10 mg..hydrocodone 10 mg..enalapril 5 mg
Current Illness: herniated disc L5 S1
Preexisting Conditions: lower back pain
Allergies: none
Diagnostic Lab Data: ekg ..sonogram..07/28/2021 bloodwork
CDC Split Type:

Write-up: graves disease ...hyperthyroidism..rapid weight loss ..sweating profisely..rapid heart beat ...went to er and admitted to hospital with afib


VAERS ID: 1554001 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / UNK - / -

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

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

Write-up: improper storage and handing of vaccine


VAERS ID: 1554002 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / IM

Administered by: Public       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:
Other Medications: unknown
Current Illness: none
Preexisting Conditions: none
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt had a syncopal episode 5 minutes after dose administered. Pt states he has had similar episodes before d/t needles, blood, etc. Pt did not fall, pt recovered quickly.


VAERS ID: 1554007 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / UNK - / -

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

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

Write-up: dose administered after improper temp storage. No outcome reported as of now


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