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From the 6/11/2021 release of VAERS data:

Found 352,386 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 141 out of 3,524

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VAERS ID: 1366325 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Breast induration, Breast mass, Breast pain, Lactation disorder
SMQs:, Lipodystrophy (broad), Functional lactation 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: Pre natal
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Around 4pm my left breast developed a very hard and painful lump about 6? in diameter on my upper breast. As a result, my breastfed baby was having a very hard time latching correctly and extracting milk. Additionally, my breast had been leaking milk throughout the day (normal) and it stopped once the lump developed. This persisted for more than 24 hours and started to resolve the following evening. The lump took about 2-3 days to fully go away, but the milk started flowing within 24 hours of first developing the lump. It resolved itself without treatment, but did effect my milk supply.


VAERS ID: 1366328 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-01
Onset:2021-05-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (broad)

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

Write-up: Bell''s Palsy started on 5/18/21. He was then started on prednisone and antiviral medication.


VAERS ID: 1366351 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Immediate post-injection reaction, Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Immediately weak and light headed after shot. Next morning had red itchy bumps all over both legs. Almost 3 weeks later has not gone away


VAERS ID: 1367286 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Chills, Headache, Heart rate, Heart rate increased, Pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ARMOUR THYROID
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: hypothyroidism (Verbatim: Hypothyroidism, Additional Information for Other Conditions: I am only taking Armour Thyroid for my Hypothyroidism, 90 mg, once a day).
Allergies:
Diagnostic Lab Data: Test Name: heart rate is up; Result Unstructured Data: Test Result: Up.
CDC Split Type: USPFIZER INC2021585915

Write-up: Headache; Chills; my heart rate is up; body ache ever since; I have abdominal pain on the right left side and its like my kidney area; This is a spontaneous report from a contactable consumer (patient). A 53-years-old female patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration on 17May2021 (Batch/Lot number was not reported) as 1ST DOSE, SINGLE for covid-19 immunization. Medical history included hypothyroidism (dates unknown). Concomitant medications included thyroid (ARMOUR THYROID) taken for hypothyroidism, start and stop date were not reported. On 18May2021, the patient experienced headache, chills, abdominal pain on the right left side and it''s like my kidney area, heart rate is up, body ache. Outcome of events was unknown. Additional information has been requested.


VAERS ID: 1367736 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Arthralgia, Condition aggravated, Dysgeusia, Nausea, Vertigo
SMQs:, Acute pancreatitis (broad), Taste and smell disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: Patient suffered vertigo, dysequilibrium leading to fall risk, relapse of anxiety disorder, relapse of formerly-improved post-COVID sx (dysgeusia, nausea), and suffers from migratory arthralgias.


VAERS ID: 1367882 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Injection site pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: First COVID shot, 20 Apr 2021, fatigue, fever, chills.
Other Medications: Atorvastatin Lisinopril
Current Illness: None
Preexisting Conditions: Hypertension Hyperlipidemia
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe fatigue, headache, fever, chills, body aches, soreness at injection site.


VAERS ID: 1367900 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-16
Onset:2021-05-18
   Days after vaccination:91
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cerebral infarction, Cerebrovascular accident
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

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

Write-up: I63.9 - Stroke (cerebrum) I63.9 - Cerebral infarction, unspecified


VAERS ID: 1367950 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-01
Onset:2021-05-18
   Days after vaccination:47
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Menstrual disorder, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mometasone furoate nasal spray Vitamin c Magnesium Multi-vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore arm starting the evening of the first and second shots and then fatigue the next day. These side effects are not concerning and not a big deal. I did want to report that my menstrual cycle had a ?double peak? ovulation and a resulting very late period (3 weeks late). I chart my cycle extensively and this has never happened to me before; the only change during this cycle was the second covid shot close to my typical ovulation time. I know that stress and illness can cause a double peak (meaning ovulation is delayed), so I believe this shot may have been interpreted by my body as an illness as I was not under stress or sick at this time. I did not have an issue with my cycle during the first shot. I felt this was important to report as I had only heard of women having early or very heavy periods after the shot.


VAERS ID: 1367992 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-06
Onset:2021-05-18
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Ocular hyperaemia, Photophobia, Vision blurred
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

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

Write-up: My eyes became very blood shot, blurry vision, light sensitive for a couple weeks now.


VAERS ID: 1368052 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-05-18
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 RA / IM

Administered by: Other       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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.


VAERS ID: 1368192 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-11
Onset:2021-05-18
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: According to pt he takes nothing
Current Illness: According to pt none
Preexisting Conditions: According to pt none
Allergies: According to pt none
Diagnostic Lab Data: none at this time
CDC Split Type:

Write-up: pt states that approx. one week after receiving the vaccine his left hand went numb and he has numbness throughout his arm. His hand is also swollen. Pharmacist advised that he see is PCP or go to the dr. Pt stated he doesn''t have a doctor and that he has never hand any medical issues or problems until he got the vaccine


VAERS ID: 1368210 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dysstasia, Fatigue, Hypoaesthesia oral, Immediate post-injection reaction, Pyrexia, Swollen tongue, Tongue pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: omeprazole 40MG, potassium chloride ER 20mEQ, pramiprexole 1mg, buspirone 7.5mg, furosemide 40mg, glimepiride 2mg, Lantus Solostar, lisinopril 5mg, meloxicam 15mg, metoprolol ER 25mg, trazodone 150mg, metformin 1000mg, albuterol hfa
Current Illness:
Preexisting Conditions: diabetes
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediately after vaccine dose 1, patient had lips feel number and tongue itch, dizziness and unable to stand after multiple attempts. Patient observed for 30 minutes. For two days after vaccination patient experienced fever 102.4, tongue swelled up and fatigue for two days. Treated with Benadryl after vaccination and the two days after. Prescriber recommended to patient to not go forward with dose number 2.


VAERS ID: 1368212 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Hypotension, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Patient reported feeling nauseous and light-headed post-vaccination. EMS evaluated her, determined her blood pressure was low, and gave her snacks and water. Patient was driven home by her mother. 6/1/21:10:50am - TC to mom - daughter is doing fine and have no concerns or questions. - RN


VAERS ID: 1368215 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 reported feeling nauseous and light-headed post-vaccination. EMS evaluated patient and gave him water. 6/1/21: 11:37am - TC to parent. No answer. left message to call back. - RN 6/1/21: 12:22pm - Mom returned call. Child doing fine. No concerns or questions. - RN


VAERS ID: 1368383 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-10
Onset:2021-05-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I21.4 - Non-ST elevation (NSTEMI) myocardial infarction


VAERS ID: 1368454 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Hyperhidrosis, Migraine, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HYDROXYZINE PAMOATE 25MG CARVEDILOL 3.125MG
Current Illness:
Preexisting Conditions: CHRONIC PAIN PERIPHERAL NEUROPATHY RHEUMATOID ARTHRITIS SCOLIOSIS SPONDYLOSIS TMJ
Allergies: Celecoxib 02/18/21 ? ? 1 Most Severe: MIGRAINE, STOMACH CONVULSIONS, RAISED BLOOD PRESSURE ? ? Cephalexin 08/06/20 ? ? 1 Most Severe: SEIZURES, CHRONIC MIGRAINES, SWOLLEN ANKLES/FEET, GI BLEED ? ? Codeine 09/20/16 ? ? 1 Most Severe: HIVES, VOMITING, DIZZINESS, STOMACH PAIN, VERTIGO ? ? Fentanyl 08/06/20 ? ? 1 Most Severe: BLEEDING SORES, DIZZINES, MIGRAINES, SEROTONIN SYNDROME ? ? Hydrocodone 08/06/20 ? ? 1 Most Severe: BURNING PAIN FROM CENTER OF BONES TO SKIN, ITCHING BRAIN F ? ? NSAIDs 08/05/20 ? ? 1 Most Severe: BAD. DONT FILL. ORGAN FAILURE, ETC.... ? ? Aspirin 08/06/20 ? ? 2: THROW UP GRANULATED BLOOD, STOMACH CONVULSIONS/PAIN/BURNING ? ? diphenhydrAMINE 08/06/20 ? ? 2: PALPITATIONS, CNS SIDE EFFECTS ? ? Gabapentin 09/20/16 ? ? 2: SEIZURES, SWOLLEN HANDS, BRUISES, MUSCLE PAIN Morphine 08/06/20 * ? 2: THORWING UP BLOOD, GI EFFECTS, VERTIGO, INSOMNIA, LOST VOICE ? ? NSAIDs 09/20/16 ? ? 2: STOMACH BLEEDING WITH ALL NSAIDS, SEIZURE ? ? Oxycontin 08/06/20 ? ? 2: COMA ? ? Sulfa Antibiotics 09/20/16 ? ? 2: GI EFFECTS, THROWING UP BLOOD, GI REFLUX ? ? Acetaminophen 02/18/21 ? ? 3: ? ? Adhesive (Not Screened) 02/18/21 ? ? 3: SKIN PEELS AND BLEEDS ? ? Amoxicillin 08/06/20 ? ? 3: PROJECTILE VOMITING ? ? Aspirin 09/20/16 ? ? 3: THROWING UP BLOOD ? ? buPROPion 08/06/20 ? ? 3: SEIZURE, THROWING UP, SEROTONIN SYNDROME Chlorzoxazone 02/18/21 * ? 3: ? ? Dexamethasone 02/18/21 ? ? 3: ? ? Diazepam 02/18/21 ? ? 3: ? ? Diclofenac 02/18/21 ? ? 3: GI BLEED AND ORGAN COMPRESSION ? ? Hepatitis B Virus Vaccines 02/18/21 ? ? 3: SEVERE REACTION, MIGRAINE LASTING 3 DAYS & SEVERE PAIN ? ? Ibuprofen 02/18/21 ? ? 3: THREW GRANULATED BLOOD, STOMACH CONVULSIONS, REFLUX ? ? Influenza Vaccines 02/18/21 ? ? 3: REACTIONS TO 3/4 OF ALL VACCINES ? ? Ketorolac 02/18/21 ? ? 3: SEIZURES, EARS RINGING, SWOLLEN ANKLES/HANDS, STOMACH CRAMPS ? ? Latex (Not Screened) 08/06/20 ? ? 3: HIVES Lorazepam 02/18/21 * ? 3: SEIZURES ? ? Nabumetone 02/18/21 ? ? 3: DIZZINESS, SHAKING, TUNNEL VISION ? ? Oxycodone 08/06/20 ? ? 3: COMA ? ? Pantoprazole 02/18/21 ? ? 3: DIARRHEA ? ? Pentazocine 08/06/20 ? ? 3: MUSCLE & STOMACH PAIN, MIGRAINE, DIZZINESS ? ? Sinemet 08/06/20 ? ? 3: TIGHT CHEST, CNS EFFECTS ? ? Sumatriptan 08/06/20 ? ? 3: PALPITATIONS, SEIZURE, SHORTNESS OF BREATH, VISION, BALANCE ? ? Tylenol 09/20/16 ? ? 3: THROWING UP BLOOD ? ? Gentamicin 08/06/20 ? ? 4: NAUSEA & VOMITING, MUSCLE SPASMS predniSONE 08/06/20 ? ? 4: RASH, ITCHING ? ? Albuterol 08/06/20 ? ? 5 Least Severe: DIZZINESS, HYPERACTIVITY, ANXIETY ? ? Sinemet 02/18/21 ? ? 5 Least Severe: PARKINSON''S ONLY MEDICATION PER PAST RPH
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient experienced migraines, fever, abdominal pain, sweating and felt stabbing pains for 7 & 1/2 hours.


VAERS ID: 1368463 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Migraine, Pain, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Multiple reactions from hospitalization, additionally severe reactions to a few less severe.
Other Medications: hydrOXYzine 25 MG capsule Commonly known as: Vistaril Learn more Take 1 capsule by mouth 3 times daily as needed for Itching. Prescription Details Refill Details Quantity120 capsule Request refillRequest refill RemoveRemove ondansetron 4
Current Illness: Asthma Added 6/15/2020 Learn more Fibromyalgia Added 6/15/2020 Learn more Chronic pain Added 6/15/2020 Learn more COPD (chronic obstructive pulmonary disease) (HCC) Added 6/15/2020 Learn more Hepatitis C virus infection Added 6/15/2020 Learn more Migraines Added 6/15/2020 Learn more OA (osteoarthritis) Added 6/15/2020 Learn more Rheumatoid arthritis (HCC) Added 6/15/2020 Learn more Falls Added 6/15/2020 Learn more Left shoulder pain Added 6/15/2020 Learn more Ascites of liver Added 11/20/2020 Learn more Candidal dermatitis Added 12/31/2020 Learn more Cirrhosis of liver with ascites (HCC) Added 9/19/2020 Learn more Gait abnormality Added 12/31/2020 Learn more Hiatal hernia Added 9/19/2020 Learn more History of seizure Added 5/11/2020 Learn more Impaired range of motion of left shoulder Added 12/31/2020 Learn more Impingement syndrome, shoulder, left Added 3/27/2018 Intercostal pain Added 12/31/2020 Learn more Intractable acute post-traumatic headache Added 12/31/2020 Learn more Iron deficiency anemia Added 11/25/2020 Learn more Low iron stores Added 11/25/2020 Learn more Lumbar spondylosis Added 8/23/2017 Learn more Osteoarthritis of left shoulder Added 3/27/2018 Learn more Osteoporosis Added 2/17/1985 Learn more Recurrent falls Added 5/11/2020 Learn more Restless leg syndrome Added 5/11/2020 Learn more Right carpal tunnel syndrome Added 10/4/2017 Learn more Right hand paresthesia Added 12/31/2020 Learn more Scoliosis of thoracic spine Added 5/11/2020 Learn more Secondary esophageal varices without bleeding (HCC) Added 9/19/2020 Learn more Acquired unequal limb length Added 4/4/2018 Learn more Ulnar nerve neuropathy Added 10/4/2017 Learn more Generalized osteoarthritis Added 5/11/2020 Learn more This information is from another organization. Neuropathy, peripheral Added 8/23/2017 This information is from another organization. Oth specific joint derangements of left hip, NEC Added 7/8/2020 Decompensated HCV cirrhosis (CMS/HCC)
Preexisting Conditions: Asthma Added 6/15/2020 Learn more Fibromyalgia Added 6/15/2020 Learn more Chronic pain Added 6/15/2020 Learn more COPD (chronic obstructive pulmonary disease) (HCC) Added 6/15/2020 Learn more Hepatitis C virus infection Added 6/15/2020 Learn more Migraines Added 6/15/2020 Learn more OA (osteoarthritis) Added 6/15/2020 Learn more Rheumatoid arthritis (HCC) Added 6/15/2020 Learn more Falls Added 6/15/2020 Learn more Left shoulder pain Added 6/15/2020 Learn more Ascites of liver Added 11/20/2020 Learn more Candidal dermatitis Added 12/31/2020 Learn more Cirrhosis of liver with ascites (HCC) Added 9/19/2020 Learn more Gait abnormality Added 12/31/2020 Learn more Hiatal hernia Added 9/19/2020 Learn more History of seizure Added 5/11/2020 Learn more Impaired range of motion of left shoulder Added 12/31/2020 Learn more Impingement syndrome, shoulder, left Added 3/27/2018 Learn more Injury of head, subsequent encounter Added 12/31/2020 Learn more Intercostal pain Added 12/31/2020 Learn more Intractable acute post-traumatic headache Added 12/31/2020 Learn more Iron deficiency anemia Added 11/25/2020 Learn more Low iron stores Added 11/25/2020 Learn more Lumbar spondylosis Added 8/23/2017 Learn more Osteoarthritis of left shoulder Added 3/27/2018 Learn more Osteoporosis Added 2/17/1985 Learn more Recurrent falls Added 5/11/2020 Learn more Restless leg syndrome Added 5/11/2020 Learn more Right carpal tunnel syndrome Added 10/4/2017 Learn more Right hand paresthesia Added 12/31/2020 Learn more Scoliosis of thoracic spine Added 5/11/2020 Learn more Secondary esophageal varices without bleeding (HCC) Added 9/19/2020 Learn more Acquired unequal limb length Added 4/4/2018 Learn more Ulnar nerve neuropathy Added 10/4/2017 Learn more Generalized osteoarthritis Added 5/11/2020 Learn more Right hand pain Added 6/8/2020 Learn more Body mass index (BMI) 22.0-22.9, adult Added 11/4/2019 Learn more This information is from another organization. Neuropathy, peripheral Added 8/23/2017 Learn more This information is from another organization. Oth specific joint derangements of left hip, NEC Added 7/8/2020 Learn more This information is from another organization. GI bleeding Added 9/15/2020 Learn more This information is from another organization. Acute deep vein thrombosis (DVT) of femoral vein of left lower extremity Added 3/26/2021 Learn more This information is from another organization. Seizures (CMS/HCC) Learn more This information is from another organization. Decompensated HCV cirrhosis (CMS/HCC) Added 11/20/2020 Learn more
Allergies: Adhesive Other Added 2/9/2019 Learn more Latex Hives, Rash Added 10/25/2012 Learn more Oxycodone-Acetaminophen Nausea and Vomiting Added 2/9/2019 Learn more Sulfa Drugs Nausea and Vomiting, Unknown, Headache Added 4/23/2018 Learn more Sumatriptan Shortness of Breath, Palpitations Added 10/19/2018 Learn more Promethazine Myalgia, Dizziness, Headache Added 1/14/2019 Learn more Prednisone Rash Added 11/16/2017 Learn more Pentazocine Unknown Added 10/25/2012 Learn more Ibuprofen GI Upset, Nausea and Vomiting Added 10/25/2012 Learn more Ketorolac Seizure Added 10/19/2018 Learn more Acetaminophen Nausea and Vomiting, GI Upset Added 10/25/2012 Learn more Albuterol Dizziness Added 4/23/2018 Learn more Amoxicillin Nausea and Vomiting Added 10/25/2012 Learn more Aspirin Nausea and Vomiting Added 10/25/2012 Learn more Bupropion Rash, Seizure Added 4/23/2018 Learn more Carbidopa W-Levodopa Headache Added 1/14/2019 Learn more Celecoxib Nausea and Vomiting, Joint Pain, Headache Added 4/23/2018 Learn more Chlorzoxazone Headache Added 12/4/2019 Learn more Codeine Other Added 4/23/2018 Learn more Hydrocodone Skin Rashes/Hives, Rash Added 10/25/2012 Learn more Oxycodone Nausea and Vomiting Added 10/25/2012 Learn more Diazepam Unknown Added 2/9/2019 Learn more Lorazepam Seizure Added 2/9/2019 Learn more Diphenhydramine Confusion Added 4/23/2018 Learn more Fentanyl Unknown Added 7/20/2017 Learn more Gabapentin Seizure Added 7/12/2016 Learn more Gentamicin Nausea and Vomiting Added 4/23/2018 Learn more Nabumetone Dizziness Added 9/15/2020 Learn more Dexamethasone Headache Added 11/16/2020 Learn more Cephalexin Headache Added 12/3/2020 Learn more Pantoprazole Diarrhea Added 12/15/2020 Learn more Hepatitis B Virus Vaccine Reacted to both generic and name brand Added 12/24/2020 Learn more Hepatitis A-Hep B Recomb Vac Joint Pain, Headache Added 12/24/2020 Learn more Diclofenac hemorrhage Other reaction(s): "hemorrhage" Added 12/24/2020 Learn more Nsaids Itching, Photosensitivity, Swelling, Palpitations, Nausea/Vomiting/Diarrhea, Anemia/Blood Disorder, Cough, Joint Pain, Headache Added 12/31/2020 Learn more Tape Rash Added 2/9/2019 Learn more Erythromycin Headache Added 4/23/2018 Learn more Adhesive Bandages Misc Skin Rashes/Hives Added 3/2/2021 Learn more Influenza Vaccines Other Added 5/12/2021 Learn more Carvedilol Dizziness, Fatigue Added 5/17/2021 Learn more This information is from another organization. Latex, Natural Rubber Added 10/25/2012 Learn more This information is from another organization. Hydrocodone-Acetaminophen Unknown (specify in comments) Added 10/13/2013 Learn more This information is from another organization. Morphine Nausea and/or Vomiting Added 2/9/2019 Learn more This information is from another organization. Pentazine Unknown (specify in comments) Added 2/9/2019 Learn more This information is from another organization. Sulfa (Sulfonamide Antibiotics) Unknown (specify in comments) Added 2/9/2019 Learn more This information is from another organization. Adhesive Tape-Silicones Unknown (specify in comments) Added 2/9/2019 Learn more This information is from another organization. Carbidopa Unknown (specify in comments) Added 1/30/2021 Learn more This information is from another organization. Lactate Unknown Added 1/14/2019 Learn more This information is from another organization. Hepatitis A And B Vaccine (Pf) Other (See Comments), Headache, Myalgias Added 12/24/2020 Learn more This information is from another organization. Hepatitis B Virus Vaccine Unknown Added 12/24/2020 Learn more This information is from another organization. Nsaids (Non-Steroidal Anti-Inflammatory Drug) Hyperkalemia, Cough, Headache, Itching, Nausea And Vomiting, Palpitations, Photosensitivity, Edema Added 12/31/2020 Learn more
Diagnostic Lab Data: None, ER doctor refused to treat me & was reported.
CDC Split Type:

Write-up: Migraine, fever & stabbing pains from heart to pelvic bone. It felt like 40+ knives stabbing me for 7 1/2 hours.


VAERS ID: 1368485 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-14
Onset:2021-05-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccine positive rechallenge
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: Started getting a weird headache 3 - 4 days after the second shot - the headache is different - its almost like I hit my head hard. It gets better and then it comes back. I still have it today - 6/2/2021 I got a very slight version of this headache after my first shot but didn''t realize it was from the vaccine. I haven''t called my doctor yet but will do now.


VAERS ID: 1368509 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Nasal congestion, Nausea, Pain in extremity, Pyrexia, Rhinorrhoea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Sore arm Small headache Exhausted Nauseous Fever Runny nose Congestion


VAERS ID: 1368662 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-13
Onset:2021-05-18
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arterial occlusive disease, Ischaemic limb pain, Revascularisation procedure
SMQs:, Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the ED on 5/18/2021 for arterial occlusion. She was subsequently hospitalized. Per doctor''s notes: 5/18/21 was admitted with ischemic leg pain and w/ urgent need for a planned complex revascularization procedure of the RLE w/ Dr. of vascular surgery which was completed later 5/18/21. This is within 6 weeks of receiving COVID vaccination.


VAERS ID: 1369047 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-06
Onset:2021-05-18
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Abdominal discomfort, Appendicectomy, Bundle branch block right, Computerised tomogram abdomen abnormal, Electrocardiogram abnormal, Laboratory test normal
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: all labs WNL CT shows blockage; surgery required
CDC Split Type:

Write-up: slight abdominal discomfort x3 days ER 5/20/21 with admission appendectomy 5/21 /21 Right Bundle Branch Block on EKG (no prior ekg abnormalities)


VAERS ID: 1369327 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-07
Onset:2021-05-18
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone, Dizziness, Fatigue, Full blood count, Metabolic function test, Tinnitus, Vertigo
SMQs:, Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular 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: -Amlodipine/benazepril -Simvastatin
Current Illness: None
Preexisting Conditions: -Hypertension -Hypercholesterolemia
Allergies: -Prochloperazine
Diagnostic Lab Data: -BMP -CBC -TSH
CDC Split Type:

Write-up: -Fatigue -Dizziness/Vertigo -Tinnitus


VAERS ID: 1369561 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 41C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Headache, Lymphadenopathy, Nausea, Pyrexia, Rash, Vomiting, Weight decreased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: AMIODARONE, KCL, MAG OXIDE, VALTREX, AMBIEN, NORCO, TEGRETOL, CLARITAN, COREG, ZESTRIL, THYROXIN, ALDACTONE, VIT D, FEOSOL, MVI,
Current Illness: NONE
Preexisting Conditions: HYPERTENSION, SIEZURE DISORDER, CARDIOMYOPATHY, HYPOTHYROIDISM, ANEMIA, zoster
Allergies: LIDOCAINE
Diagnostic Lab Data:
CDC Split Type:

Write-up: NAUSEA, VOMITING, ABDOMINAL PAIN, FEVER(101F), RASH, ADENOPATHY, WEIGHT LOSS(5#), headache for 5 days


VAERS ID: 1369978 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (narrow)

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

Write-up: Constant ringing in ears that started within hours of receiving the vaccine and hasn?t gone away yet.


VAERS ID: 1370352 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004M20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Disturbance in attention, Dizziness, Fatigue, Feeling abnormal, Loss of consciousness, Nasopharyngitis, Oropharyngeal pain, Pain in extremity, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergy; Anxiety; Clinical depression; Hypertension; Lupus erythematosus; Post-traumatic stress disorder; Psoriasis
Preexisting Conditions: Medical History/Concurrent Conditions: Hip replacement
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: sore throat; cold symptoms; felt funny and weird; losing focus like a blackout; blacking out while driving; throwing up; feeling tired; light headedness/dizziness; sore arm; This spontaneous case was reported by a consumer and describes the occurrence of LOSS OF CONSCIOUSNESS (blacking out while driving) in a 49-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Hip replacement. Concurrent medical conditions included Allergy, Hypertension, Clinical depression, Post-traumatic stress disorder, Anxiety, Psoriasis and Lupus erythematosus. On 18-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-May-2021, the patient experienced DIZZINESS (light headedness/dizziness), PAIN IN EXTREMITY (sore arm) and FATIGUE (feeling tired). On 19-May-2021, the patient experienced LOSS OF CONSCIOUSNESS (blacking out while driving) (seriousness criterion medically significant), OROPHARYNGEAL PAIN (sore throat), NASOPHARYNGITIS (cold symptoms), FEELING ABNORMAL (felt funny and weird), DISTURBANCE IN ATTENTION (losing focus like a blackout) and VOMITING (throwing up). On 23-May-2021, LOSS OF CONSCIOUSNESS (blacking out while driving), DIZZINESS (light headedness/dizziness), OROPHARYNGEAL PAIN (sore throat), NASOPHARYNGITIS (cold symptoms), FEELING ABNORMAL (felt funny and weird), DISTURBANCE IN ATTENTION (losing focus like a blackout), PAIN IN EXTREMITY (sore arm), VOMITING (throwing up) and FATIGUE (feeling tired) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided. 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. Most recent FOLLOW-UP information incorporated above includes: On 28-May-2021: Additional document received on 28-may-2021. No new information present in additional document.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1370555 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-16
Onset:2021-05-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / -

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? 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 INC2021563199

Write-up: My fiance has now fainted 3x times 32 hours after having his second dose.; This is a spontaneous report received from a non-contactable consumer reported for 30-year-old male consumer (reporter''s fiance). A 30-years-old male patient received second dose bnt162b2 (PFIZER-BIONTECH COVID 19 VACCINE), via an unspecified route of administration, administered in Arm Left on 16May2021 15:00 (at 30 years old age) (Lot Number: EW0173) at single dose for covid-19 immunisation . The patient medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient previously received first dose bnt162b2 (PFIZER-BIONTECH COVID 19 VACCINE), via an unspecified route of administration, administered in Arm Left on 25Apr2021 15:00 (at 30 years old age) (Lot Number: EW0172) at single dose for covid-19 immunisation. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Reporter''s fiance had now fainted 3x times 32 hours after having his second dose. The last time was just after a couple minutes of standing and he started to sieze before coming to. They wouldn''t be able to work today because we need to monitor it. Reporter would bring him to the ER if it continued. Adverse event start date was 18May2021. Adverse event start time was 03:00 AM. No treatment was received for the adverse event. The event did not result in death and caused/prolonge hospitalization, was not Life threatening, disabling/incapacitating, congenital anomaly/birth defect. Facility where the most recent COVID-19 vaccine was administered was Public Health Clinic/Veterans. Since the vaccination, the patient has not been tested for COVID-19. The outcome of the event was not recovered.


VAERS ID: 1370585 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 2 LA / -

Administered by: School       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Heart rate, Heart rate increased, Inflammation, Myocardial infarction
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Migraine; Penicillin allergy (known_allergies: penicillin); Psoriasis
Allergies:
Diagnostic Lab Data: Test Date: 20210518; Test Name: heart beat; Result Unstructured Data: Test Result:rapid
CDC Split Type: USPFIZER INC2021567163

Write-up: having a heart attack might feel like; tightening around upper body especially around the base of heart; inflammation; heart beat became rapid; short of breath; This is a spontaneous report from a contactable consumer. A 28-year-old female patient received the second dose of bnt162b2 (Pfizer-Biontech COVID-19 vaccine) via an unspecified route of administration in left arm on 18May2021 04:15 PM (Lot Number: EW0165) at single dose for COVID-19 immunization. The patient''s medical history included penicillin allergy and migraines/psoriasis. The patient was not diagnosed with COVID-19 prior to vaccination. The patient''s concomitant medications were not reported. The patient previously received the first dose of bnt162b2 (Pfizer-Biontech COVID-19 vaccine) via an unspecified route of administration in right arm on 27Apr2021 04:15 PM (Lot Number: EW0175) at single dose for COVID-19 immunization. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient had tightening around upper body especially around the base of heart, accompanied by inflammation. Her heart beat became rapid and she was short of breath. The event start date and time was reported as 18May2021 07:30 PM. It was also reported this happened "4.5 hours after injection". The event lasted 25 minutes. The patient felt what she assumed having a heart attack might feel like. The events were reported as non-serious. The patient did not receive treatment. The outcome of event was resolved. The patient has not been tested for COVID-19 since the vaccination.


VAERS ID: 1370627 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PROGESTERON; ESTROGEN; DILTIAZEM
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Dermatographic urticaria (autoimmune condition); Endometriosis; Rhinitis
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021571002

Write-up: Numbness and tingling down left shoulder, arm and into hand. Numbness and tingling of left side of face (forehead, cheek, mouth, chin).; Numbness and tingling down left shoulder, arm and into hand. Numbness and tingling of left side of face (forehead, cheek, mouth, chin).; This is a spontaneous report from a contactable other healthcare professional (patient). A 43-year-old female patient (not pregnant) received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) (Lot Number: EW0169), at the age of 43-year-old, via an unspecified route of administration, administered in Arm Left on 18May2021 10:00 at single dose for COVID-19 immunisation. Medical history included endometriosis, dermatographic urticaria (autoimmune condition), and nonallergic rhinitis. Concomitant medications included progesteron; estradiol (ESTROGEN); diltiazem. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient was not diagnosed with COVID-19 prior to vaccination. The patient had not been tested for COVID-19 since the vaccination. The patient had numbness and tingling down left shoulder, arm and into hand. Numbness and tingling of left side of face (forehead, cheek, mouth, chin) on 18May2021 16:00. Been in contact with her physician. Has not resolved in 24 hrs. Treatment received for the events and included antihistamines, anti-inflammatories. The event resulted in physician office visit. The outcome of the event was not recovered.; Sender''s Comments: The causal association between the reported events and vaccine administered cannot be excluded based on a plausible temporal association. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1370638 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: CEPHALEXINE; SULFAMETHOXAZOLE; DOXYCYCLINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (diagnosed, prior to vaccination)
Allergies:
Diagnostic Lab Data:
CDC Split Type: PFIZER INC2021572561

Write-up: Hives; rash; This is a spontaneous report from a contactable consumer (patient). A 32-years-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration, administered in arm left at age of 32 years on 17May2021 15:00 (Lot Number: EW0182) as single dose for covid-19 immunisation. The patient medical history was included diagnosed COVID-19 prior to vaccination. No known allergies. Concomitant medications included cefalexin (Cephalexine), sulfamethoxazole, doxycycline. The patient previous took fist dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection) via an unspecified route of administration at age of 32 years on 26Apr2021 15:00 (Lot Number: ER8736) as single dose for Covid-19 immunization. Patient didn''t receive any other vaccines within 4 weeks prior to the COVID vaccine. Facility where the most recent covid-19 vaccine was administered was pharmacy or drug store. Since the vaccination, the patient has not been tested for COVID-19. Hives and a rash started to appear on body roughly 24-26 hours after second shot. The rash started around both arms, mostly above the elbow and slightly on the torso. By the next morning, the rash spread to the rest of body, growing denser in many areas on arms and back and middle of the chest and stomach. The adverse event resulted in Emergency room/department or urgent care. Treatment received for the adverse event included prescribed prednisone, taking Tylenol and Benadryl. Adverse event start date was 18May2021 19:00 PM. Seriousness reported as no. The outcome of the events was recovering. Follow attempts are needed. Further information is expected


VAERS ID: 1370696 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Diarrhoea, Fatigue, Feeding disorder, Headache, Malaise, Nausea, Pruritus, Rash, Somnolence, Vaccination site mass, Vaccination site swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 INC2021605938

Write-up: skin itching/ skin itches; skin break out/ rash that spread in both arms; knot in the arm (hard ball) on the administration site; nauseous/sick to her stomach; upset stomach described as almost killing her; felt very Sleepy/ she is just in a sleepy mode; have to run back in forth popping all the time (diarrhea).; swollen administration site; felt very drain; got headaches like shot pain on the temporal on the right side; she has not been able to eat; Not feeling well/feel sick; This is a spontaneous report from a contactable consumer (patient) via medical information team. A 63-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: EW0182; Expiration Date: Jul2021), via an unspecified route of administration on 18May2021 (at the age of 63-year-old) as a single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient previously took first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), on 27Apr2021 (patient provided the numbers 1887 but could not read rest) (at the age of 63-year-old) as a single dose for COVID-19 immunisation. It was reported that patient had skin itching/skin itches and skin break out on 18May2021, knot in the arm (hard ball) on the administration site, swollen administration site, nauseous, upset stomach described as almost killing her, felt very drain, felt very sleepy/she was just in a sleepy mode, have to run back in forth popping all the time (diarrhea) all in 2021. She also additionally mentioned that she got headaches like shot pain on the temporal on the right side and she even have a rash that spread in both arms in 2021. She added that she had used Cortisone but that didn''t worked. she mentions her stomach was nauseous, she hasn''t been able to eat, and her skin was all broke out from the 2nd vaccine and it itches in 2021. Her arms have been itching as soon as she got the vaccine. Her skin broke out after she had the shot on 18May2021, she states she was still itchy and still broken out. She started putting cortisone on her arms and it did not work. patient clarified that was was a maximum strength cortisone 10 cream with aloe. patient verifies that the itching has not improved and was persisting. While probing the caller for event details she stated that all these questions were making her feel sick and sick to her stomach in 2021. patient states that she really was not feeling well in 2021. The outcome of the events pruritus and rash was reported as not recovered. The outcome of all other events was reported as unknown. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1370824 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-30
Onset:2021-05-18
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078B20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Transient ischaemic attack
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: DICLOFENAC; FINASTERIDE
Current Illness:
Preexisting Conditions: Comments: No medical history was reported.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: TIA; This spontaneous case was reported by a patient (subsequently medically confirmed) and describes the occurrence of TRANSIENT ISCHAEMIC ATTACK (TIA) in an 80-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 078B20A) for COVID-19 vaccination. No medical history was reported. Concomitant products included DICLOFENAC and FINASTERIDE for an unknown indication. On 30-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-May-2021, the patient experienced TRANSIENT ISCHAEMIC ATTACK (TIA) (seriousness criterion medically significant). The patient was treated with ASPIRIN [ACETYLSALICYLIC ACID] at a dose of Low dose and CLOPIDOGREL BISULFATE (PLAVIX) at an unspecified dose and frequency. At the time of the report, TRANSIENT ISCHAEMIC ATTACK (TIA) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment provided were unknown blood thinner medication. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1371222 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C218 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Skin swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Blood pressure, Anxiety
Allergies: Sulfa
Diagnostic Lab Data: Physical visitation to doctor office patient received antibiotic cefadroxil and prednisone to treat.
CDC Split Type:

Write-up: Raised size of quarter to half dollar circumference, red and surrounding area 1/2 inch red like cellulitis.


VAERS ID: 1371542 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling hot, Headache, Heart rate increased, Mobility decreased, Pain in extremity, Pyrexia, Sluggishness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: Dr. - at Pediatricians - vitals - 19th
CDC Split Type: vsafe

Write-up: The next morning he woke up with arm hurting him (he couldn''t lift it). He felt a little warm - had a low grade fever -99.something. He had a headache all day. He was very sluggish, tired. He did online school that day. He took a nap and laid down on the couch in between classes. He was really tired. I was giving him Tylenol every four hours. The first time he felt a little better, The second time, it didn''t work. I called the doctor for advice and he told me to give him Children''s Motrin. That seemed to do better. I gave that to him once that day. The next morning, he felt better. I gave him a Motrin anyway because he had a light headache. He did say he felt some heart racing. And he was a little tired. He called me from school around 11:30 am and he said that his heart has been racing through the whole morning - he was gym and said he couldn''t run or anything but his heart was racing. I told him to go to t he school nurse - he had a pulse of 120. I met him there and I called the pediatrician and he saw him at 03:00. His pulse was high but not as high as before. He had rested in between. My son did see a cardiologist in June 2020- they put him on a heart monitor and she couldn''t find anything at that time. At the regular doctor on the 19th, the doctor checked breathing and heart but did not have the materials at that location to do an EKG but said with the lowered heart rate just to watch and if it goes up again to go to Cardiologist we saw in June 2020. He rested some more and it went away on it''s own. After that he was fine and no other issues. In fact, the next day he felt better and was running around and had energy and felt great.


VAERS ID: 1371654 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Illness, Malaise, Mobility decreased, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: SAYS SHE FELT VERY BAD AND HAD BEEN SICK FOR 10+ DAYS AND UNABLE TO GET OUT OF BED. MUSCLE ACHES, PAIN, FEVER, MALAISE. TOLD HER TO GO TO ER AND GET CHECKED OUT. HAVE BEEN UNABLE TO REACH HER TO FOLLOW-UP DUE TO NOT HAVING A VALID PHONE NUMBER ON FILE


VAERS ID: 1371704 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-15
Onset:2021-05-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Cardiac imaging procedure abnormal, Chest discomfort, Chest pain, Electrocardiogram PR segment depression, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Intensive care, Magnetic resonance imaging heart, Mycoplasma test negative, Mycoplasma test positive, Myocardial oedema, Myocarditis, Pain, Sleep disorder, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad)

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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 5/18 - EKG with diffuse PR depression and ST elevation. Troponin elevated at 4.5. 5/19 - Mycoplasma IGM + but PCR neg 5/21 - Cardiac MRI - Late gadolinium enhancement pattern and edema on T2 STIR images are consistent with acute myocarditis (and other nonischemic cardiomyopathies). Normal biventricular size and systolic function. Pericardial inflammation without significant effusion.
CDC Split Type:

Write-up: 16-year-old male with no significant past medical history, now presenting with chest pain. Patient had 2 episodes of left-sided mid-chest pain. The initial episode was at ~ 3 am on 5/18 when the pain woke him up from sleep, lasted for ~ 20 minutes and he was able to fall back to sleep, he did not mention it to his parents at that time. Then it recurred at 2.30 pm - pressure-like pain in the same area, which radiated to his left shoulder. There were no significant worsening or alleviating factors. No change in pain quality or intensity with position. No shortness of breath, near-syncope or syncope, no palpitations. Upon his second pain episode, he called his parents on video chat and they instructed him to take 81 mg of aspirin and the pain subsided after 30 minutes. His parents promptly took him to the urgent care where he was found to have ST elevation and elevated troponin. He was transferred to CICU for further management. Admitted for myopericarditis with ST elevation and elevated troponin. On motrin q8h ATC, 12 lead EKG and troponin levels q6h. Underwent cardiac MRI on 5/20 which confirmed the diagnosis.


VAERS ID: 1371974 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-13
Onset:2021-05-18
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypersensitivity, Injection site pruritus, Ocular hyperaemia, Rhinorrhoea, Throat irritation, Vision blurred, Visual impairment, Vitreous floaters
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: None
Preexisting Conditions: Allergies, see item #10
Allergies: Amoxicillin, Potassium Dichromate, Gold sodium thiosulfate, Fragrance Mix
Diagnostic Lab Data: None yet.
CDC Split Type:

Write-up: Eye floaters - large increase in floaters. Vision blurriness, decreased clarity. Allergic symptoms not going away, runny and stuffy nose, itchy throat, red eyes, some itching at injection site.


VAERS ID: 1372297 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Increased resting heart rate. He wears a fitness tracker and resting heart rate increased to 104-105 BPM. When he went on a walk increased to 160-170 bpm. Lasted 2 days from onset (approx 24 hours after injection)


VAERS ID: 1373268 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Connecticut  
Vaccinated:0000-00-00
Onset:2021-05-18
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205821A / UNK - / -

Administered by: Other       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: USJNJFOC20210604828

Write-up: ARM REALLY HURTS; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 205821A, and batch number: 205821A expiry: UNKNOWN) dose was not reported, administered on 18-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On MAY-2021, treatment medications included: ibuprofen, and paracetamol. On 18-MAY-2021, the subject experienced arm really hurts. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from arm really hurts. This report was non-serious.


VAERS ID: 1373378 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Baby Aspirin, progesterone, red rice yeast, synthroid
Current Illness: None
Preexisting Conditions: Nonr
Allergies: Macrobid, lotions, sun
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Small bruises 2mm 1st on inside upper left next day 2nd bruise 5? lower same arm few days later 3rd bruise opposite inside forearm few days later 4th bruise on right shoulder/neck on 6/2/2021


VAERS ID: 1373706 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 7/21 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Antibody test, Balance disorder, Deafness unilateral, Ear disorder, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy (Vitamin E oil and Hair dyes)
Allergies:
Diagnostic Lab Data: Test Date: 20210430; Test Name: Antibody; Test Result: Negative ; Comments: Blood test
CDC Split Type: USPFIZER INC2021574348

Write-up: feels like there is water inside my ear; impacted my equilibrium; I can''t hear from left ear; tinnitus; This is a spontaneous report from a contactable consumer (patient). This 44-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) in right arm on 18May2021 11:30 (Lot number: ER8735 7/21) at single dose for COVID-19 immunization. Medical history included allergy with Vitamin E oil and Hair dyes. Concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. In the afternoon of the day she had received the vaccine (18May2021) she got ringing (tinnitus) in ears which is unusual for her. It went away by the evening time but when she woke up the next morning (day after the vaccine, 19May2021 07:00) she noticed that she can''t hear from her left ear. It almost felt like there was water inside her ear but not quite really. It''s a strange sensation that she had never felt before. She also felt that it had impacted her equilibrium somewhat. No treatment received for events tinnitus and can''t hear from left ear. Lab data included antibody (blood test) on 30Apr2021: negative. Patient was not diagnosed with COVID-19 prior to vaccination. Since the vaccination, the patient has not been tested for COVID-19. The outcome of tinnitus was recovered on 18May2021, outcome of she can''t hear from her left ear was not recovered, outcome of other events was unknown.


VAERS ID: 1373737 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-16
Onset:2021-05-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Oral pain, Pain in jaw, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Osteonecrosis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021581089

Write-up: my face was swollen; right side of my mouth and jaw hurting; right side of my mouth and jaw hurting; This is a spontaneous report from a contactable consumer (patient). A 50-years-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: EW0186), dose 2 via an unspecified route of administration, administered in left arm on 16May2021 at 08:45 as 2nd dose, single for COVID-19 immunization (at the age of 50-years). Patient previously received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: EW0175), dose 1 via an unspecified route of administration, administered in left arm on 25Apr2021 as 1st dose, as a single dose for COVID-19 immunization. Patient''s medical history and concomitant medications were not reported. Neither the patient diagnosed with COVID-19 prior to vaccination nor tested for COVID-19 since the vaccination. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient had received no other medications within 2 weeks of vaccination. On 18May2021, the patient woke up with the right side of my mouth and jaw hurting and her face was swollen. The first day, she tried to rinse with salt water and applied hot compresses to her face it didn''t do anything. So she decided to do a tele doc video call the after the second day it wasn''t getting better. The doctor prescribed antibiotics and told to her it was her tooth, however, she knew that it wasn''t her tooth. The outcome of events was not recovered.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-2021582710 different patient, same drug and event


VAERS ID: 1373752 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-03
Onset:2021-05-18
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VIT D; FOLIC ACID
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021587264

Write-up: Shingles; soreness in my left arm/I woke with severe pain in that arm; This is a spontaneous report received from a contactable consumer (Patient). A 58-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EW0165 and expiry date was not reported), dose 1 via an unspecified route of administration, administered in arm left on 03May2021 single dose for covid-19 immunisation. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient''s medical history included COVID-19, prior to vaccination on unspecified date, start and stop date were not reported. Since the vaccination, patient has not been tested for COVID-19. The patient had no relevant medical history and concurrent conditions and no past drug event. Concomitant medication(s) included ergocalciferol (VIT D) and folic acid taken for an unspecified indication, start and stop date were not reported. Patient did not feel anything for 2 weeks post vaccination but on 18May2021 in the evening, patient felt soreness in her left arm. By 1:30 AM, patient woke with severe pain in that arm. patient tried to treat it with Ibuprofen, but nothing happened. The pain continued throughout the next day and she tried to treat it with Norco (hydrocodone), but nothing was relieved. The next day on 20May2021, patient was diagnosed by my doctor with Zoster (Shingles). The outcome of the events was recovering. Follow up needed, further information has been requested.


VAERS ID: 1374147 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-01
Onset:2021-05-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C 21, AND 0 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Rash, Rash erythematous, Rash papular
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 81 mg aspirin Centrum multi vitamin
Current Illness: None
Preexisting Conditions: Hay fever
Allergies: I had an allergic reaction to penicillin after completing the course of medication. I developed a rash which, after several days, corrected itself.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Four days after my second injection I developed, at first on my right wrist to forearm, a serious of blisters (which appeared to look like shingles) as well as bumps (mosquitoe bite size) on my head, ring finger, and face. Within three days thereafter the rash spread to my chest, abdomen, left ankle, left wrist, and buttocks. The size of those rashes varied from a few millimeters to over 100 millimeters. Most were raised, and were discolored red. Not all were itchy. By happenstance my annual dermatology visit was scheduled two days after the first reaction. My dermatologist PA looked at the site and told me she had seen numerous patients who had reactions to the Moderna vaccine, including two of the staff.


VAERS ID: 1374264 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin 20 mg
Current Illness: None
Preexisting Conditions: Elevated Cholesterol
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Accute Tinnitus. Started the morning after receiving the vaccine


VAERS ID: 1374368 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Affective disorder, Arthralgia, Depression, Eye pain, Feeling cold, Hallucination, Headache, Hypersensitivity, Myositis, Pain, Sleep disorder, Taste disorder, Urticaria, Visual impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: i consume energy drinks or coffee daily, and am a tobacco smoker
Current Illness: none
Preexisting Conditions: nearsighted, scholiosis, possible glaucoma in left eye (never had a followup with optometrist), bad knees (was diagnosed with aushgood slaters as a child, no idea how to spell that)
Allergies: pollen, nickle/chromates (uncertain which, concrete breaks me out badly), strawberries cause kidney pain (likely calcium oxalate), some beers cause cardiac arrythmia (palpatations), bees, shellfish, tomatoes
Diagnostic Lab Data: havent seen a professional as i dont have health coverage.
CDC Split Type:

Write-up: pupils underwent myosis for several hours after the injection before returning to normal dialation rates. (not sure if this was a side effect or just a shock response to foreign matterials entering the body) localized soreness in arm for a few days. worse second day than first. chemical taste in mouth resembling isopropyl alcohol for about an hour or so, starting about 30 minutes after recieving vaccine, i assume this was just some of the sterilizing agent entering the body and getting circulated. mild head fog in the days following the shot, this seems to have mostly gone away and i cant say with certainty if it is a side effect or was caused by some other factor such as stress. mood disturbance / depression starting the day of the shot, this one might be completely unrelated, I attended a funeral of a family friend on that day which seems a reasonably likely cause for such, im just listing it because I want to be concise with my reporting of what Ive been experiencing. mild headache behind the temple on the right side of my head, and behind both eyes. heightened reaction to concrete allergy, not sure what exactly in concrete/cement i am allegric too possible nickel or chromates as pomphlox seems to fit the description, this has been recurrent for years but after recieving the vaccine a ring of hives formed on my left hand and my feet were the most broken out theyve ever been, i worked with cement 1 day after recieving the shot. a relatively consistent feeling of coldness, since getting the shot ive felt abnormally cold, sometimes feeling the need for wearing a coat in 80+ degree weather. this is completely abnormal, typically i could wear a tshirt in 50?F weather and a hooded sweatshirt would suffice down into the 20s. persistent joint pain in almost every joint of my body and the surrounding muscles, feels like it may be in the cartilidge or connective tissue, occasional pains had been experienced before and considered a normal part of life, but this has been relatively constant like an inflammatory response. sleep cycle disturbance, normally i had abnormal sleeping habbits where being awake for 24+ hours at a time wasnt particularly uncommon (oddly this one seemingly gets worse when i stop drinking caffinated drinks), and it was impossible for me to get to sleep prior to like 2-3 am most nights followed by sleeping for around 4-10 hours a night on average. however since recieving the shot ive been sleeping a lot more than this and at strange times (for me) like the middle of the afternoon. fever/constant headache on the side the injection was recieved on has set in after about 2weeks and has been terrible, ive had to take ibuprophen for two days just to function, mild visual hallucinations have also occured in the past couple days mostly spatial distortions where the depth perception isnt working properly, and framerate issues where objects in motion leave a trail momentarily.


VAERS ID: 1374543 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-10
Onset:2021-05-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Injection site pain, Neck pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MULTIVITAMIN
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: FISH, LATEX, HYDROCODONE, MORPHINE, NSAIDS
Diagnostic Lab Data: 05/21/2021 x-ray of left shoulder and MRI of cervical spine ordered
CDC Split Type:

Write-up: Patient experienced soreness at injection site and fatigue for about 12 hours after vaccination. on 05/18/2021 began experiencing pain at top of shoulder, radiating to front of shoulder, up neck and down to fingertips.


VAERS ID: 1374691 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-16
Onset:2021-05-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blister
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (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: Denies
Current Illness: Denies
Preexisting Conditions: Denies
Allergies: NKA
Diagnostic Lab Data: Denies
CDC Split Type:

Write-up: As per pt self report, "after I took the COVID19 Pfizer vaccine, about 48 hours afterwards I developed blisters all over my body. On my face about 100, in my mouth, arms, legs, feet, just all over. I did a televisit with a doctor. I do not have a PCP, so the person I spoke with my insurance plan referred me to Doctor (pt does not have the phone number for MD) and he said it was an allergic reaction. The doctor prescribed Hydrocortisone and told me to take Benadryl and Claritin. It got worse the next day and over time. It took about a week to resolve"


VAERS ID: 1375112 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

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

Write-up: CLIENTS MOTHER REPORTS CHILD HAD HEART PALPITATIONS AFTER RECEIVING SECOND DOSE. EXACT TIME AND HOW LONG PALPITATIONS STARTED AND LASTED UNKNOWN. CLIENTS MOTHER INFORMED STAFF CHILD WOULD RECEIVE SECOND DOSE AT HIS DOCTORS OFFICE.


VAERS ID: 1375166 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 - / -

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fainted within 15 minutes of vaccination. Patient felt better after resting and drinking some juice; was released to home.


VAERS ID: 1375170 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-05-14
Onset:2021-05-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Palpitations, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Hives and rash on left arm, diarrhea, palpitations
Preexisting Conditions:
Allergies: Penicillin and ibuprofen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives, diarrhea, palpitations


VAERS ID: 1375259 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 2 - / -

Administered by: Public       Purchased by: ?
Symptoms: Hypoaesthesia oral
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)

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

Write-up: Patient reported numbness on lower lip and tip of tongue within 15 minutes of vaccination. Was given 25 mg Benedryl and improved; given second dose of Benedryl 25 mg. Patient was released to home.


VAERS ID: 1375595 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Bradyphrenia, Fatigue, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalopathy/delirium (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: Clonazepam Trazodone Ibuprofen
Current Illness: SARS Covid-19 Hospitalization March 23 through March 26, 2021
Preexisting Conditions: PTSD
Allergies: Keflex Penicillin Tramadol Tylenol Vicodin
Diagnostic Lab Data: While at this hospital patient had a CBC which was essentially normal, a CMP which again was essentially normal a urinalysis, again essentially normal. Further, lactate level was normal, PT/APTT both normal, sed. rate normal, lipase normal, BNP normal, and cardiac troponin I normal. Lastly, ammonia level less than 10.0.
CDC Split Type:

Write-up: Patient hospitalized on March 25, 2021 for active covered disease, did well spending 3 days in-hospital. On April 19, 2021 patient received 1st vaccination against covid-19 at local pharmacy. She states she told the pharmacy team about her hospitalization for active covid-19 disease. Patient reports no side effects after 1st immunization and followed up with her 2nd vaccination on May 17, 2021. Patient further states that starting May 18, 2021 she has had extreme fatigue, a weight loss of 30 lb, and vagueness in her thinking.


VAERS ID: 1375662 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Hypoxia, Respiratory distress
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nifedipine, carvedilol, losartan. Clopidogrel, aspirin, gabapentin, avonex, clonazepam, torsemide, atorvastatin, Novolog, Levemir
Current Illness: MS. History of diabetes, stroke, hypertension
Preexisting Conditions: MS
Allergies: Penicillin, erythromycin, Darvon
Diagnostic Lab Data:
CDC Split Type:

Write-up: Respiratory distress, hypoxia, memory loss


VAERS ID: 1376180 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-03
Onset:2021-05-18
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Diabetic (diagnosed at least 12 years ago)
Preexisting Conditions: Medical History/Concurrent Conditions: Breathing difficult (she is not allowed out in public even after her vaccination)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021581895

Write-up: she developed a red rash from her knees to her ankle, and from the elbow to the wrist; This is a spontaneous report from a contactable consumer (patient). A 79-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration, administered in Right Arm on 03May2021 10:55 AM (Lot Number: ER8735) as 2nd dose, single for covid-19 immunisation. Medical history included ongoing diabetic (diagnosed at least 12 years ago), she has breathing problems (she is not allowed out in public even after her vaccination). The patient''s concomitant medications included she has been taking the medicines now for a while, she did not feel like it was a reaction to any of that. Historical Vaccine included Patient gets a flu shot every year for immunization; she also received the first dose of BNT162B2 (at age of 78 years old, lot number: EP7533) on 31Mar2021 injected before noon at right arm for COVID-19 immunization. Patient has received both doses of the Pfizer Covid 19 Vaccine. The second vaccine was received on 03May2021. Patient reports that on 18May2021 she developed a red rash from her knees to her ankle, and from the elbow to the wrist. Caller denied stinging, pain, or burning. She also denied any changes to detergent. Caller asking if symptom has been reported. Patient calling to see if she is having a reaction to the Covid vaccine. Patient states she is calling because she at her wits end, she had her second shot on 03May2021 and maybe three days ago now, she started breaking out with a red rash, it does not sting, burn, or hurt but it was from her knees to her ankles and from her elbows to her wrist. Patient states thought everything they can think of and she has had no new laundry detergents or eaten no new foods. breaking out with a red rash: Caller states she would say this past Tuesday and it seems to be more predominant when she takes a shower, with the warm water it seems to bring it back out. Caller states she has been taking some Benadryl. Patient states like she says, its just there, it did not sting, it did not itch, it did not burn, she just looks down at her arm or leg and it was kind of weird looking. Pfizer Covid Vaccine: No Investigation Assessment. The event was not required a visit to Emergency Room nor Physician Office. Outcome of the event was not recovered. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1376183 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-16
Onset:2021-05-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Oral pain, Pain in jaw, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Osteonecrosis (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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy (known allergies:Penicillin ,Doxycycline ,Tetracycline)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021582710

Write-up: my face was swollen/ a classmate of my daughter at school this morning was having the same issue; right side of my mouth and jaw hurting; mouth & jaw hurting/a classmate of my daughter at school this morning was having the same issue; This is a spontaneous report from a contactable consumer (patient). A 50-year-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: EW0186), dose 2 via an unspecified route of administration, administered in left arm on 16May2021 at 08:45 as 2nd dose, single for COVID-19 immunization (at the age of 50-years). Patient previously received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: EW0175), dose 1 via an unspecified route of administration, administered in left arm on 25Apr2021 (Also reported as: 25Mar2021) as 1st dose, as a single dose for COVID-19 immunization. Patient''s medical history and concomitant medications were not reported. Patient''s past drug history included penicillin, tetracycline and doxycycline. Neither the patient diagnosed with COVID-19 prior to vaccination nor tested for COVID-19 since the vaccination. The patient did not received any other vaccines within 4 weeks prior to the COVID vaccine. The patient did not received other medications within 2 weeks of vaccination. On 18May2021, the patient woke up with the right side of her mouth and jaw was hurting and her face was swollen. The first day, she tried to rinse with salt water and applied hot compresses to her face it did not do anything. So she decided to do a tele doc video call, after the second day it wasn''t getting better. The physician prescribed her antibiotics and told to her that it was her tooth, however, she knew that it wasn''t her tooth. A class mate of her daughter at school this morning was having the same issue, she however, went to her dentist and they could find anything wrong, so she too is taking an antibiotic. This classmate also received her vaccines the same two days. The outcome of events were not recovered. Follow-up attempts are completed. No further information is expected; Sender''s Comments: Linked Report(s) : US-PFIZER INC-2021581089 different patient, same drug and event


VAERS ID: 1376390 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 had gotten the first COVID19 vaccine at another location and gotten the Moderna as their first dose.


VAERS ID: 1376495 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age, Vaccination 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: Assessor and vaccinator did not realize that the patient was only 17 years old, and the Moderna vaccination was given. A call from the DPH was received by the pharmacy to notify us of the error. The patient''s sibling (age $g 18yo) was contacted since he spoke English. The sibling stated that patient did not have any side effects. I notified the family of the administration error, and they opted to continue with the 2nd dose as planned.


VAERS ID: 1376960 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-14
Onset:2021-05-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vertigo, Vertigo positional
SMQs:, Vestibular 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: Nome
Preexisting Conditions: None
Allergies: Wheat/Gluton
Diagnostic Lab Data:
CDC Split Type:

Write-up: Short episodes of extreme vertigo. Persistent 24x7 minor vertigo (BPPV) lasting 2 weeks and still continuing. Symptoms starting ~1 week after vaccination.


VAERS ID: 1377045 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Injection site reaction
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: Unknown
Current Illness: None known
Preexisting Conditions: Unknown
Allergies: None known
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Small white oval area around vaccination site, also slight swelling at first a day or two post vaccination. Continues to be a white area despite tanning around area on arm. No swelling at present time 3 weeks post 1st vaccine dose.


VAERS ID: 1377161 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Cough, Fatigue, Headache, Influenza like illness, Malaise, Neck pain, Pain in extremity, Pruritus
SMQs:, Anaphylactic reaction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: He had fatigue, arm pain.
Other Medications: Isosorbide mononitrate, Glimepiride, baby aspirin, Simvastatin, Imdur, Cilostazol, Atenolol, Janumet, Alendronate, Gabapentin, Vitamin E, Vitamin B, fish oil.
Current Illness: None.
Preexisting Conditions: COPD, diabetes, high cholesterol, high blood pressure, 1998 4 vessel heart bypass, stent placement 2 weeks ago (only has 2 arteries working).
Allergies: Penicillin, Tylenol.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: He got his vaccine, and just didn''t feel well, overall feeling like he had the flu, coughing. He had extreme fatigue and not able to assist his wife when she was sick as he was in excruciating pain and the fatigue. He is still having excruciating pain in his arm, shoulder, neck and chest area. He did not have this pain prior to the vaccine itself. The arm did itch like crazy. He did not anything for the symptoms as he is not able to. The itching has gone, but the shoulder and arm pain are still there on the left side only, and headache are still present.


VAERS ID: 1377304 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dysphagia, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Vestibular disorders (broad), Hypersensitivity (broad)

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

Write-up: Pt stated that he noticed that his throat felt tight and difficult to swallow. He also stated that he was dizzy. We administered 25mg of diphenhydramine orally and monitored until a family member came to get him. He went home and I followed up with him later and he said that his symptoms had resolved


VAERS ID: 1377337 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-27
Onset:2021-05-18
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal distension, Hypoacusis
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Adverse event only after the second dose
Other Medications: (1) Full size Bayer aspirin (1) 120mg Verapamil ER Centrum 50+ Multi Vitamin (2) Fish oil pill 690mg total (1) 350mg cinnamon capsule (1) 400mg cranberry capsule
Current Illness: None
Preexisting Conditions: Borderline high blood pressure since Jan. 2007
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: About three weeks after second shot, 05/18/2021, my hearing in both ears has become stuffy and muted, like when you have a head cold. I did not note the exact time a day because I thought it would just clear up. My stuffy hearing has been constant since roughly 05/18/2021. Also, I have had a constant bloated upset stomach during roughly that same timeframe. Again, thinking it would go away but has not.


VAERS ID: 1377760 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-03-30
Onset:2021-05-18
   Days after vaccination:49
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chest X-ray abnormal, Condition aggravated, Cough, Exposure to SARS-CoV-2, Lethargy, Pneumonia, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Seizure, Tremor, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 15 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin, Tegretol XR, Colace, Estrace, Amaryl, Mobic, Glucophage, Mylicon, Prilosec, Dilantin, Lyrica, Topamax, Desyrel, Zyrtec, Breztri inhaler, Ayr nasal spray
Current Illness: unknown
Preexisting Conditions: Seizure disorder, Autism, T2DM, OA, chronic allergic rhinitis, peripheral neuropathy, GERD, urinary incontinence
Allergies: No Known Allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to PCP on 05/18/2021 office from group home with C/O cough, runny nose, lethargic, fever, lungs rattling, uncontrollable shaking. Patient had a seizure the night before and had been having weak spells and coughing and fever since that time. Patient admitted to hospital on 05/18/2021 and chest Xray showed pneumonia. Patient tested for COVID-19 on 05/21/2021 after learning of potential exposure at group home and result was positive.


VAERS ID: 1377842 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood disorder, Malaise, Transfusion
SMQs:, Haematopoietic cytopenias affecting more than one type of blood cell (broad)

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

Write-up: Patient reported feeling ill within hours of injection, saw PCP that day, was sent home, went to hospital by ambulance next day. Patient reported "blood poisoning," received blood transfusion in hospital and spent 3 days in hospital. Patient could not give name of PCP.


VAERS ID: 1377923 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Magnetic resonance imaging normal, Migraine, Nausea, Photophobia, Venogram normal
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (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: fluoxetine, klonopin, sythoid, zyrtec, gabapentin (periodic), omega 3, coq10, zinc, bioactive queretin, d3, c, daily vitamin, red yeast rice, metamucil
Current Illness: none
Preexisting Conditions: none
Allergies: cipro, red die
Diagnostic Lab Data: MRI - normal MRV - normal
CDC Split Type:

Write-up: sensitivity to light, nausea, migraine (5 days), lightheadedness overall lasted for approximately 15 days with various symptoms


VAERS ID: 1378005 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-31
Onset:2021-05-18
   Days after vaccination:48
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, COVID-19, COVID-19 pneumonia, Condition aggravated, Cough, Diarrhoea, Myalgia, Pulmonary congestion
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Supraventricular tachyarrhythmias (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (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, aspirin, carvedilol, losartan, omeprazole, rosuvastatin
Current Illness:
Preexisting Conditions: Alcohol dependence, tobacco use disorder, squamous cell carcinoma of skin, seronegative rheumatoid arthritis, polyp of nasal cavity, Hx of malignant melanoma of skin, peripheral neuropathy, OSA, orchitis and epididymitis (unknown date), obesity, mononeuritis, HTN, GERD, dyslipidemia, dentofacial anomaly, BPPV due to bilateral vestibular disorder, basal cell carcinoma, atrial flutter, arthritis, adenomatous colon polyp
Allergies: Cefuroxime, metoprolol, atorvastatin, azithromycin, erythromycin, sulfa ABX
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt had first dose of Pfizer COVID vaccine on 3/9/2021 and second dose on 3/31/2021. Pt tested positive for COVID-19 on 5/18/2021 and did have symptoms, such as diarrhea, myalgia, and cough/chest congestion. He presented to the ED on 6/2/2021 and was admitted for COVID-Pneumonia and afib with RVR. Pt still inpatient.


VAERS ID: 1378301 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angioedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (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: NONE
Current Illness: SEASONAL ALLERGIES
Preexisting Conditions: BASAL SKIN CA, COLON PLOYP, HYPERTENSIVE DISORDER, OVERWEIGHT, HYPERLIPIDEMIA
Allergies: AMOXICILLIN, BACITRACIN, HYDROCHORTHIAZIDE, IODINATED CONTRAST MEDIA, SULFANAMIDE
Diagnostic Lab Data:
CDC Split Type:

Write-up: THE NEXT DAY 5/18/21 AT 900 AM WHEN PT WOKE UP NOTED TO HAVE ANGIOEDEMA ON THE FACE, BOTH CHEEKS ARE SWOLLEN. Pt took Zyrtec per advise of provider, for 2 days, edema resolved but came back. after 4 days, then she took Zyrtec again for another 2 days.


VAERS ID: 1378314 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-09
Onset:2021-05-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: I had a reaction at injection site nine days later. Injection site was red, swollen and very firm to the touch. It was about the size of a quarter and was very hot and sore.


VAERS ID: 1378351 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-05-11
Onset:2021-05-18
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Erythema, Photosensitivity reaction, Polymorphic light eruption, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Sudden allergy to Sunlight, Polymorphous Light Eruption present on areas of skin exposed to sunlight. No prior history of sensitivity to sunlight. Appeared 24 hours after prolonged exposed to sunlight with sunscreen on. Broke out in red, itchy hives on backs on hands, forearms and back and front of thighs and legs. First appeared a week after first dose administered, went away and the reappeared after prolonged exposure (90+ minutes) two weeks later. First event treated with steroid cream, second event treated with prednisone


VAERS ID: 1378492 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-10
Onset:2021-05-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Itchy, redness, swelling at the site of injection (Left deltoid)


VAERS ID: 1378519 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-11
Onset:2021-05-18
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Anxiety, Blood thyroid stimulating hormone normal, Fatigue, Feeling jittery, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Haschimoto disease, thyroid disease
Allergies: Avoids gluten because of her Haschimoto disease
Diagnostic Lab Data: lab work
CDC Split Type: vsafe

Write-up: My daughter experienced fatigue, GI issues, heart racing, anxiety, jittery (these are signs that her thyroid is not working). All her thyroid issues were off, her TSH value was up to 6. My daughter still has her symptoms of anxiety, GI issues and anxiety.


VAERS ID: 1378539 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, 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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: N/A, patient presented for first dose of COVID vaccine but had actually received a dose of Moderna 10 days earlier from another facility. Not discovered until reconciliation in state database


VAERS ID: 1379043 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-10
Onset:2021-05-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (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: Flonase Nasal Spray
Current Illness:
Preexisting Conditions:
Allergies: None Known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated she developed redness below the injection site eight days after receiving her first Moderna vaccine. The site was very itchy. She applied Caladryl to alleviate. The redness gradually dissipated over a couple days.


VAERS ID: 1379044 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-05-14
Onset:2021-05-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Chest discomfort, Dyspnoea, Electrocardiogram normal, Magnetic resonance imaging heart, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: No Allergies
Diagnostic Lab Data: Emergency Room (5.21.21) - chest x ray, bloodwork, EKG, negative rapid COVID test. Everything came back normal Cardiac MRI (5.28.21) - came back normal
CDC Split Type:

Write-up: Received second dose of Pfizer vaccine on Fri 5.14.21. On Tuesday 5.18.21 started to develop chest tightness and pressure (like someone was pushing against the center of my chest). Also experienced some shortness of breath. Went to Emergency Room Fri 5.21.21, all tests came back fine. Went to cardiologist in early June 2021 and in early June a cardiac MRI found everything to be normal. Cardiologist has me taking advil and prilosec at the moment. Have experienced these symptoms since 5.18.21 and has not gone away.


VAERS ID: 1379315 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-29
Onset:2021-05-18
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Coagulation test, Computerised tomogram thorax abnormal, Deep vein thrombosis, Dyspnoea, Pulmonary embolism, 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), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: tamoxifen, hctz, metoprolol, simvastatin, Vit D, melatonin
Current Illness:
Preexisting Conditions: Hx of breast and ovarian cancer, osteoarthritis, hyperlipidemia, hypertension, obesity
Allergies: sulfa
Diagnostic Lab Data: CT, doppler US, hypercoag work up
CDC Split Type:

Write-up: Patient presented to the office with SOB and chest discomfort on 5/11. She was sent to the ED and diagnosed with BIL DVT and BIL PE


VAERS ID: 1381061 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Blindness, Blood test, Body temperature, Breast mass, Chest pain, Headache, Lymphadenopathy, Mammogram, Pyrexia, Retching, Tremor, Ultrasound scan, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Food allergy (known allergies:Bees)
Allergies:
Diagnostic Lab Data: Test Date: 202105; Test Name: blood test; Result Unstructured Data: Test Result:Unknown results; Test Date: 20210518; Test Name: fever; Result Unstructured Data: Test Result:103 fever; Test Date: 202105; Test Name: mammogram; Result Unstructured Data: Test Result:Unknown results; Test Date: 202105; Test Name: sonogram test; Result Unstructured Data: Test Result:Unknown results
CDC Split Type: USPFIZER INC2021581682

Write-up: loss of vision; very hard, large lump has surfaced in her left breast/originates from the lymph node in her arm pit and runs to her nipple/Hard lump surfaced on lymph node at base of skull; very hard, large lump has surfaced in her left breast/originates from the lymph node in her arm pit and runs to her nipple/Hard lump surfaced on lymph node at base of skull; 103 fever; constant shaking; uncontrollable vomiting; dry heaving; headaches; extreme aching in back and chest; extreme aching in back and chest; This is a spontaneous report from a contactable consumer (patient) reported for herself. A 48-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration into left arm on 17May2021 16:00 (Batch/Lot number was not reported) as 2nd dose, single for covid-19 immunisation in Pharmacy or Drug Store. Medical history included allergy to bees (known allergies: Bees). The patient''s concomitant medications were none (no other medications the patient received within 2 weeks of vaccination), the patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. patient previously received first dose of BNT162B2 for COVID-19 Immunization. The patient experienced very hard, large lump has surfaced in her left breast, It is shaped like a straw, over two inches long. it originates from the lymph node in her arm pit and runs to her nipple, Hard lump surfaced on lymph node at base of skull. During 72 hours following second shot: 103 fever, constant shaking, loss of vision, uncontrollable vomiting, dry heaving, headaches, extreme aching in back and chest, all on 18May2021 08:00. the adverse event result in Doctor or other healthcare professional office/clinic visit. The patient underwent lab tests and procedures in May2021: blood test, mammogram, sonogram test with unknown results. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient been has not tested for COVID-19. treatment received for the events included Bloodwork, sonogram and mammogram. Outcome of the events was not recovered. It was reported as non-Seriousness. Seriousness criteria of Results in death, Life threatening, Caused/prolonged hospitalization, Disabling/Incapacitating, Congenital anomaly/birth defect were all no. Information on the lot/batch number has been requested.


VAERS ID: 1381066 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, 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), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021581810

Write-up: passed out; dizzy; This is a spontaneous report received from a contactable pharmacist via Pfizer sponsored program. A 28 years old male patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration in left deltoid on 18May2021 6:00 PM central time (Lot Number: EW0185, Expiry Date: Aug2021, NDC Number: 5926-1000-01) at single dose for COVID-19 immunization. The patient''s medical history, family medical history and concomitant medications was none. The patient has not had any other vaccines within the last 8 weeks. The patient got dizzy and passed out on 18May2021 after 6:00 PM after the first dose of the vaccine. They ended up calling 911 and the paramedics came. The paramedics checked him and released him, said he was good to go. He was not taken to the hospital. The patient did not visit emergency room neither physician office. The pharmacist assessed the events related to the vaccine and assessed as serious due to medically significant. The outcome of event was recovered completely. The pharmacist asked if he should get the second dose.; Sender''s Comments: As there is limited information in the case provided, the causal association between the events loss of consciousness and dizziness and the suspect drug bnt162b2 (PFIZER-BIONTECH COVID-19 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 Committees, and Investigators, as appropriate.


VAERS ID: 1381107 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Influenza, Lymph node pain, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SYNTHROID; BUPROPION
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hashimoto''s disease; Thyroidectomy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021583656

Write-up: This is a spontaneous report from a contactable consumer. A 64-years-old female patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration, administered in left arm on 17May2021 at11:00 (at the age of 64 years-old), (Batch/Lot Number: ER8734) as a single dose, for covid-19 immunisation. Medical history included Hashimoto and total thyroidectomy on unspecified dates. Concomitant medications included levothyroxine sodium (SYNTHROID) and bupropion (BUPROPION) and unspecified HRT (hormone therapy). The patient reported that on 18May2021 at 0100: "First 2 days just typical flu symptoms with bad headache. Then on 4th day fainting episode, 5th day pain in lymph node left side of neck. Hurts to turn my head." There was no treatment reported for the events. The outcome of the events was not recovered. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19.


VAERS ID: 1381174 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Chills, Dyspnoea, Fatigue, Movement disorder, Muscle twitching, Pain in extremity, Paralysis, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021592222

Write-up: felt like she could not move it and then she felt like paralyzed for less than three second; right arm little bit hurting/pain in her hand like she couldn''t grab something; pain in her hand like she couldn''t grab something, and it''s twitching; felt short breath/felt like she need to grab air to breathe, she can''t breathe/it was hard to breathe; chest kept hurting/short pain in chest; felt like she could not move it; body felt super tired; Chills; little fever; This is a spontaneous report from a contactable consumer (patient). A 36-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 18May2021 (at the age of 36 years old; Lot Number: EW0182, unknown expiration) as 1st dose, single for COVID-19 immunisation. Medical history and concomitant medications reported as none. The patient reported that she received her first shot on 18May2021. She came home with her right arm little bit hurting, felt pain in her hand like she couldn''t grab something, and it''s twitching. As soon as she received the vaccine, she felt short breath, she called the place where she received the vaccine, she was there for 20 minutes. In her aid, she walked out as she needed air and her chest kept hurting and hurting on 18May2021. Every time she breathes, she felt like she need to grab air to breathe, she can''t breathe/it was hard to breathe. Since 18May2021 to today, she felt short pain in chest and right hand and in the morning it was like twitch, she felt like she could not move it and then she felt like paralyzed for less than three second and then the shortening went to exactly to her chest and felt like she was losing air. She mentioned she need air to breathe and her body felt super tired on 18May2021. She is a very active person; she feels so tired. She also experienced chills, little fever, and her chest was hurting more on 18May2021. Due date of second shot is on 08Jun2021. The patient did not receive treatment for the events. The patient had not yet recovered from the events. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1381413 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Chills, Cough, Dyspnoea, Nasal congestion, Pain, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210524; Test Name: COVID-19 test; Result Unstructured Data: Test Result:Negative
CDC Split Type: USPFIZER INC2021650327

Write-up: chills; cough; shortness of breath; body aching; loss of taste; lots of nasal congestion and mucus; lots of nasal congestion and mucus; This is a spontaneous report from a contactable consumer (patient). A female patient of unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for Injection), via an unspecified route of administration on 14May2021, as 1st dose, single dose for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. On 18May2021, 4 days after receiving the vaccine, patient experienced chills, cough, shortness of breath, body aching, loss of taste, lots of nasal congestion and mucus, did not have a fever. Therapeutic measure taken for the events included unspecified antibiotics. The patient underwent lab test and procedure on 24May2021 which included for COVID-19 virus test and tested negative. Patient wanted to know if she could receive the second dose of the vaccine on Friday if they are still taking antibiotics. It was reported that no contraindications for patients with infections taking antibiotics. The patient stated that she prefers to make a written report and accepted to get contacted back. The patient was referred to her physician for treatment recommendations. The outcome of the events was unknown. Information about Lot Batch number has been requested.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-2021651028 Same reporter/drug/event, different patient.;US-PFIZER INC-2021651029 Same reporter/drug/event, different patient.


VAERS ID: 1381716 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

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

Write-up: shingles


VAERS ID: 1381765 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-07
Onset:2021-05-18
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Might be allergic to medications based on Sulfa products (don''t know yet)
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I experienced a bit of soreness to my left arm, my arm felt a little bit warm to touch. I also felt tired and some fever on the second day. The pain went away in 3-4 days.


VAERS ID: 1381993 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 RA / IM

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

Write-up: Systemic: Numbness (specify: facial area, extremities)-Severe


VAERS ID: 1382233 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Delaware  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

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

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

Write-up: PATIENT LIED ABOUT DATE OF BIRTH ON COVID-19 REGISTRATION FORM . PATIENT WAS NOT ELIGIBLE FOR VACCINATION.


VAERS ID: 1382307 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Dyspnoea, Facial paralysis, Mobility decreased, Motor dysfunction
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hearing impairment (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Dizziness Weakness Face dropped. Right side Breathing labored 30 mins. Benadryl given Happened again that night. Right side face droop and right side motor function affected. Still can''t lift right leg correctly


VAERS ID: 1382490 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: Vascular malformation in arm with a history of blood clotting disorder. Takes immunosuppressive therapy to treat.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented for 2nd dose and reported having a blood clot the day after receiving her first dose. She is unsure if it was due to the vaccine or her vascular malformation. She did not seek medical help or receive a diagnosis from a medical professional. States the clot dissolved on its own. Pfizer Covid vaccine


VAERS ID: 1382541 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac failure, Hypertension
SMQs:, Cardiac failure (narrow), Neuroleptic malignant syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Asthma
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: In patient hospital stay
CDC Split Type:

Write-up: High blood pressure, heart failure, hospitalization


VAERS ID: 1382636 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 RA / IM

Administered by: Other       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer COVID vaccine was given to an 11 year old off label.


VAERS ID: 1382707 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 recieved wrong vaccination for second dose


VAERS ID: 1382925 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-28
Onset:2021-05-18
   Days after vaccination:110
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 2 LA / IM

Administered by: Pharmacy       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? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: UNKNOWN
Diagnostic Lab Data:
CDC Split Type:

Write-up: COOVID INFECTION POST VACCINATION


VAERS ID: 1383641 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-16
Onset:2021-05-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Myalgia
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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 81 mg aspirin / amlodipine 10 mg. / praluent 75 mg injection every 2 weeks
Current Illness:
Preexisting Conditions: heart
Allergies: penicillin
Diagnostic Lab Data: Didn''t seek medical attention since I am going for ecp treatment 3 times a week for my heart condition. And I was waiting to see if the symptom would go away.
CDC Split Type:

Write-up: Two days after getting the Moderna covid-19 shot I started to get muscle and joint pain and still have it in my hands and shoulders . it has been 3 weeks now and I am do to have my second shot this weekend, and I am not sure if I should get it.


VAERS ID: 1384346 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-05-18
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Malaise, Nausea, Pyrexia, Taste disorder
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: no other medical history reported
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210614483

Write-up: TASTE HAS CHANGED; FEELING SICK; CHILLS; FEVER; NAUSEA; EXHAUSTION; This spontaneous report received from a patient concerned a 70-year-old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included no other medical history reported. The patient experienced drug allergy when treated with codeine, and levofloxacin. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: UNKNOWN) dose was not reported, administered on 17-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 18-MAY-2021, the subject experienced taste has changed. On 18-MAY-2021, the subject experienced feeling sick. On 18-MAY-2021, the subject experienced chills. On 18-MAY-2021, the subject experienced fever. On 18-MAY-2021, the subject experienced nausea. On 18-MAY-2021, the subject experienced exhaustion. Treatment medications (dates unspecified) included: paracetamol, and ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever, and nausea on MAY-2021, was recovering from chills, and had not recovered from exhaustion, taste has changed, and feeling sick. This report was non-serious.


VAERS ID: 1384353 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-05-18
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: blood clots; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of THROMBOSIS (blood clots) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-May-2021, the patient experienced THROMBOSIS (blood clots) (seriousness criteria hospitalization and medically significant). At the time of the report, THROMBOSIS (blood clots) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not reported. Treatment information included blood thinners. This a case of a male patient of unknown age who had blood clots and was hospitalized after receiving a dose of Moderna COVID Vaccine. Very limited information has been provided at this time.; Sender''s Comments: This a case of a male patient of unknown age who had blood clots and was hospitalized after receiving a dose of Moderna COVID Vaccine. Very limited information has been provided at this time.


VAERS ID: 1384589 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Immune thrombocytopenia, SARS-CoV-2 test
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: SLE
Allergies:
Diagnostic Lab Data: Test Date: 20210521; Test Name: COVID-19 Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC2021593145

Write-up: ITP; This is a spontaneous report from a contactable physician. A 33-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), via an unspecified route of administration, on 14May2021 (batch/lot number was not reported), as unknown, single dose, at age 33 years old, for COVID-19 immunisation. The patient was not pregnant at the time of vaccination. Medical history included systemic lupus erythematosus (reported as "h/o SLE0") from an unknown date and unknown if ongoing. The patient was not diagnosed with COVID-19 prior to vaccination. The patient''s concomitant medications were not reported. On 18May2021, the patient experienced ITP (immune thrombocytopenia). The event required hospitalization on an unspecified date with duration 4 days. Treatment included Decadron 40 mg IV x 4 days. On 21May2021, the patient underwent COVID-19 nasal swab with result: negative. The patient recovered from the event on an unspecified date. Information on the lot/batch number has been requested.; Sender''s Comments: A causal association between BNT162B2 and the reported events cannot be excluded based on a compatible temporal relation. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1384632 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Crying, Depression, Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Coronary bypass (He''s had a heart bypass); Diabetes (He is diabetic); Heart valve replacement (Verbatim: Heart valve replacement); Kidney infection (He has had a kidney infection)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021600207

Write-up: crying; feeling nausea; depression; feeling dizziness; This is a spontaneous report from a contactable consumer (patient''s wife). An 80-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in Arm Left on 17May2021 09:00 (Batch/Lot Number: ER8729) as 1st dose, single for covid-19 immunization. Medical history included heart valve replacement from 12Mar2021, kidney infection, had a heart bypass and is diabetic. The patient has no concomitant medications. The patient got the Pfizer Covid Vaccine on 17May2021, and the next day (18May2021) he woke up with dizziness. The reporter asked how long the symptoms last after the Covid vaccine. He is sort of getting nausea when he tries to get up. He was also real depressed. It kind of started the next day after the vaccine (18May2021), but Wednesday she was concerned because the patient was crying a lot which is unusual for him. The nausea started today (25May2021). He hasn''t been up and about. The dizziness is about the same. They called his primary caregiver who started him on some antidepressants. She picked up the information sheet that was given to them with the Covid vaccine and read there that dizziness was a side effect and a feeling of impending doom which is sort of how he was feeling. Now that''s why she was wondering when the symptoms would be over. She doesn''t really think he needs anything. He has never been depressed. She thinks now it is a side effect from the vaccine. She thinks the depression has improved. He is not crying anymore, but somebody is with him all the time. This was his first dose of the vaccine. He is supposed to go back on 07Jun2021 for his second. The outcome the event depression was recovering, event crying was recovered on an unspecified date and the other events was not recovered.


VAERS ID: 1384661 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chest discomfort, Chest pain, Dehydration, Feeling abnormal, Hypokinesia, Impaired work ability, Joint stiffness, Muscle tightness, Musculoskeletal discomfort, Neck pain, Neuralgia, Oral disorder, Pain, Pain in extremity, Sleep deficit, Vaccination site pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Carpal tunnel syndrome; Flu; Walking pneumonia (twice)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021620693

Write-up: Had no decent sleep for the last few nights; His mouth wide open which then makes him dehydrated of course; His mouth wide open which then makes him dehydrated of course; Moving so slow and had lower back and thigh tightness; shoulder aches like someone took a bat and hit it/ feels like he was 80 years old/ it looks like it is something with air in his bloodstream; Has no energy and the pain is like it is hitting a nerve where he barely can pick up 5 pounds; Has no energy and the pain is like it is hitting a nerve where he barely can pick up 5 pounds; Has no energy and the pain is like it is hitting a nerve where he barely can pick up 5 pounds; Had intense pain and soreness to his upper body, shoulder blades, and neck area, biceps and triceps/it hurts from his elbow down to his shoulder and it aches; Had intense pain and soreness to his upper body, shoulder blades, and neck area, biceps and triceps/his shoulder area on the right side is a little bit in pain; Had intense pain and soreness to his upper body, shoulder blades, and neck area, biceps and triceps; He is sore and tight on his upper body like his chest, both arms, his shoulder blades, biceps, triceps, lower neck muscles and on his shoulder blades behind him; He is sore and tight on his upper body like his chest, both arms, his shoulder blades, biceps, triceps, lower neck muscles and on his shoulder blades behind him; he has some pain and there was pain in his triceps, he also has pain between those muscles, it hurts, and It was maybe where he had the COVID vaccine; He is sore and tight on his upper body like his chest, both arms, his shoulder blades, biceps, triceps, lower neck muscles and on his shoulder blades behind him; He is sore and tight on his upper body like his chest, both arms, his shoulder blades, biceps, triceps, lower neck muscles and on his shoulder blades behind him; He is sore and tight on his upper body like his chest, both arms, his shoulder blades, biceps, triceps, lower neck muscles and on his shoulder blades behind him; He rotates his head and looks around, neck pops frequently; This is a spontaneous report from a contactable consumer (Patient). A 64-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection), second dose via an unspecified route of administration on 17May2021 (at the age of 64-year-old, Batch/Lot Number: EW0177) as a single dose for COVID-19 immunisation. Medical history included was walking pneumonia twice and other than that just a typical flu. The patient races dirt bikes so he was tough. Also, he had carpel tunnel from his job, and he had left over pain pills from that, and he had been taking them to help reduce the pain since he cannot really do anything about his side effects. Concomitant medication included pain pills, no other products reported. The patient previously received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection), first dose via an unspecified route of administration on 26Apr2021 (Batch/Lot Number: EW0162) as a single dose for COVID-19 immunisation and on an unspecified date in Apr2021, experienced muscle stiffness and soreness that was in left arm and around his buttocks and his thighs and reported felt soreness for a few days afterward. This report is not related to study or programme. It was reported that, honestly, he wishes he never got it because he cannot do anything. He was on the fence about getting it since we are at the end of the pandemic and the hospitals are not as overwhelmed anymore. Everyone thinks that he was still in his 50''s, he was very healthy, and he has no medical or health issues and he works out all the time, which was why he was so concerned about why it was affecting him like this. He has had his second dose of the COVID vaccine, and he wanted to report what was going on with his body. It was reported that, then he got the 2nd dose and within a day or two he was sore, and he was at the 11th day of experiencing this. He was sore and tight on his upper body like his chest, both arms, his shoulder blades, biceps, triceps, lower neck muscles and on his shoulder blades behind him. He had his 2nd dose not last Monday but the Monday before that. It did dissipate during the day. He jokingly said it was like the Pfizer vaccine retreats and hides during the day. Because of this he has had no decent sleep for the last few nights. His shoulder aches like someone took a bat and hit it. It feels like that on his left arm too but a little less pain. He was a side body sleeper, and he cannot sleep on his side because of this so then he ends up sleeping on his back with his mouth wide open which then makes him dehydrated of course. he has no energy, and the pain was like it was hitting a nerve where he barely can pick up 5 pounds. This was an extending issue and he just wanted to report and see if anyone else has had this before. The hospital said that they have not had anyone else report this before. It was slowly dissipating but he did not understand why it reinforces itself in the evening. Yesterday, he had to go service a customer and he was moving so slow and had lower back and thigh tightness. His upper body was sore and tight so when he got home, he was walking around trying to get his blood flowing and stretching some but then in the middle of the night those reserves came out and he gets attacked. The stiffness, soreness and pain were all concentrated mostly on his upper body. Also, his neck pops and he has never had that happen before. He looked it up and it looks like it was something with air in his bloodstream or something and when he rotates his head and looks around it makes a pop sound, and it has been doing it ever since his 2nd shot. He says this started probably on 18May2021 right after the vaccine. The patient clarified that for the side effects after his second dose that began soon after the COVID vaccine and he states that it was like all hell broke loose. This has gotten a little bit better but not a lot. Maybe 10% better or maybe 15% better. As he was sitting there his shoulder area on the right side was a little bit in pain. He feels like he was 80 years old, he was walking slow, and his body was stiff. No further details provided on the pain pills. He says he was flexing his bicep and he has some pain and there was pain in his triceps. He also has pain between those muscles, it hurts. It was maybe where he had the COVID vaccine. He also has this same pain on the left side except his bicep doesn''t hurt but his tricep does and it hurts from his elbow down to his shoulder and it aches. On a scale of 1-10 his pain was at a 3-4 but at night it was worse. The patient and health care professional consent to be contacted was reported as yes. Investigation assessment was reported as no. The outcome of the events Sleep deficit, oral disorder, dehydration, hypokinesia, feeling abnormal was unknown and for all other events recovering. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1384857 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-16
Onset:2021-05-18
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031821A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram abnormal, Anticoagulant therapy, Antiphospholipid antibodies negative, Beta-2 glycoprotein antibody negative, Blood immunoglobulin G normal, Blood immunoglobulin M, Chest discomfort, Dental caries, Differential white blood cell count normal, Dyspnoea, Dyspnoea exertional, Echocardiogram normal, Electrocardiogram ST-T segment abnormal, Fatigue, Fibrin D dimer increased, Full blood count, Headache, Magnetic resonance imaging head normal, Malaise, Mastoiditis, Metabolic function test, Nausea, Pulmonary embolism, Pyrexia, Tooth disorder, Toothache, Ultrasound Doppler, Venogram
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Eliquiss 5mg bid, diltiazem 360mg daily, vit d 2000 units daily, losartan 50mg daily, metformin 500mg daily, trelegy daily, ferrous sulfate daily, albuterol prn, claritin 10mg daily, primidone 50mg daily, rofumilast 500mg,simvastatin 20mg
Current Illness: None
Preexisting Conditions: HTN, DM-2, copd 2L oxygen dep, gerd, anemia, diet controlled hyperlipidemia, hx of PE/DVT following suspected to be caused following covid 19 infection in dec 2020 treated with eliquis
Allergies: None
Diagnostic Lab Data: as above beta 2 glycoprotein IgG and IgM, antiphospholipid ab''s are negative d dimer 1088 cbc with diff normal cmp normal
CDC Split Type:

Write-up: Patient is a very pleasant 75-year-old female with a past medical history significant for COPD chronically on 2 L of oxygen, hypertension, type 2 diabetes which is diet controlled and oral Metformin controlled, hyperlipidemia, GERD, anemia, past history of PE and DVT diagnosed in January 2021 following COVID-19 infection currently on Eliquis compliant twice daily and kidney stone history who presented with worsening exertional chest tightness and shortness of breath as well as nausea for the past 2 weeks. Patient reported she got to the point that she was hardly able to walk due to her exertional shortness of breath and chest tightness and needed to be evaluated. She also reported some nausea as well as some headaches that have come on around a similar timeframe. She also reported some poor dentition and mild dental pain and has been having a difficult time getting into a dentist due to her Medicaid and lack of coverage. She has a history of hospitalization from January 30 to February 25 for sepsis secondary to healthcare associated pneumonia and UTI and at that time was treated with vancomycin, azithromycin and cefepime during that hospitalization she was noted to have a new onset left peroneal vein DVT and peripheral PE which was thought secondary to possibly her past history of Covid infection from December 28, 2020. She was placed on Eliquis twice a day. During her lengthy hospital from January 30 to February 25 she had bacteremia with Enterococcus and echocardiogram showed a possible pacemaker lead vegetation and therefore her pacemaker was removed on February 12 and she was discharged to rehab for 6 weeks of ampicillin and ceftriaxone which was completed on March 23, 2021. She was then ultimately discharged home. She had follow-up with cardiology who felt that she no longer needed to have a pacemaker and it was therefore left out. She reports she was doing well up until about 2 weeks ago when she began to have the shortness of breath. She received her COVID-19 vaccines on 3/18 and 4/16. She reported after the 2nd one on4/16 she was ill with significant fatigue and fever and malaise. She reports she completely recovered from that but again began having shortness of breath and exertional chest pain 2 weeks ago which prompted her current admission. She was subsequently admitted to the hospital and ultimately underwent a CTA of the chest when her D-dimer was noted to be elevated at 1800. CTA of the chest revealed a new left lower lobe pulmonary artery emboli with right heart strain. She subsequently underwent an echocardiogram which did not reveal any evidence of acute heart strain. She had a CT venogram of the head and subsequent MRI of the brain which revealed no cavernous vein thrombosis and no acute abnormality other than possible mastoiditis which may be chronic. The case was reviewed with hematology and her Eliquis was discontinued and she was placed on Lovenox injections twice daily. She was educated on administering these injections herself. She will be following up with hematology as an outpatient for close monitoring. She was also placed on an antibiotic for her dental caries and the mastoiditis as she did complain of the nausea and persistent headache and we arranged dental follow up on dc. At this time she is felt stable for discharge to home. She remains with some shortness of breath above her usual baseline but feels that it is getting better each day. Her O2 sat is 95% on her usual 2 L of oxygen. Reason for report:new PE of the left lower lobe -radiologist who reviewed past cta chest from jan and reports that that old small pe is gone and this is a new much larger PE in a different location Sx''s started and worsening the last few weeks pta She has been compliant with her eliquiss twice a day Venous dopplers neg and previous dvt of the L peroneal vein seen 1/30/21 and re imaged on 2/21/21 was also noted to be gone Pt had her 2nd covid 19 vaccine just last month 4/16/21 Current echo shows no R heart strain and nl ef started on lovenox bid per hematology beta 2 glycoprotein IgG and IgM, antiphospholipid ab''s are negative


VAERS ID: 1384883 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site rash, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

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

Write-up: Started as pain at the injection site then a red, bulgy rash appeared around, measuring about 3inch in diameter. Rash went away after 4-5 days.


VAERS ID: 1384897 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-04
Onset:2021-05-18
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / UNK - / IM

Administered by: Other       Purchased by: ?
Symptoms: Injection site rash, Pruritus, Swelling, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sprinolactone
Current Illness: none
Preexisting Conditions: asthma; allergies (mold; cat hair; pollen; seasonal)
Allergies: Penicillin; Bactrim based antibiotics
Diagnostic Lab Data: none
CDC Split Type:

Write-up: covid arm; rash on right arm at site if injection. Itchy; swelling; persists still


VAERS ID: 1385154 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-18
Onset:2021-05-18
   Days after vaccination:61
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003B21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (broad)

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? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: I do not know if this is related to my vaccine but I thought you should know this information. I was diagnosed with Bell''s Palsy, on 5/18/21 treatment valacyclovir


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