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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 147 out of 3,524

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VAERS ID: 1355310 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Hypersensitivity, Immediate post-injection reaction, Multiple sclerosis relapse, Rash, Seizure, Tuberculin test positive, Wheelchair user
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Demyelination (narrow), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: baclofen, biotin, cholecalciferol, cladribine, clonazepam, galcanezumab-gnlm, hydrocodone/acetaminophen, lacosamide, lamotrigine, levothyroxine, lidocaine patch, linaclotide, mirabegron, mirtazapine, nortriptyline, oxycodone, oxycodone myri
Current Illness:
Preexisting Conditions: Anxiety ? Arrhythmia ? Chronic back pain ? Conversion disorder 5/7/2014 ? Depression ? Disease of thyroid gland ? Glaucoma ? Helicobacter pylori gastritis 2009 ? Helicobacter pylori gastritis (chronic gastritis) 7/16/2018 ? History of transfusion ? Mastalgia in female 2011 Lt Breast. ? Migraine ? MS (multiple sclerosis) (HCC) 2009 ? MS (multiple sclerosis) (HCC) ? Nosebleed ? Osteopenia 2013 ? Positive PPD 9/30/2019 ? Premature menopause 3/2/2018 ? Seizures (HCC) 2007 ? Seizures (HCC) ? Sympathetic uveitis, left eye 2011 ? Vitamin D deficiency
Allergies: gadobenate, iohexol, omnipaque, aspirin, gadavist, latex, shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: This is a 45-year-old female with past medical history of multiple sclerosis, hypothyroidism, pseudoseizures, conversion disorder, who presents to the emergency department from COVID-19 vaccination clinic after having a reported allergic reaction and seizure-like activity. She presents by EMS who reports that she was given intramuscular epinephrine as well as IV Benadryl for her symptoms. EMS reports that they saw generalized convulsive activity while the patient was alert and oriented, he reports this as "pseudoseizure-like activity". She was receiving her second dose of the COVID-19 vaccination today, she reports that she immediately thereafter got a rash to her torso and became short of breath. She was feeling well prior to the vaccination. She denies any other recent acute illnesses including fevers, chills, nausea, vomiting, diarrhea, chest pain. She says that she is currently undergoing a relapse of her multiple sclerosis and has been wheelchair-bound for 1 month. This is a 45-year-old female with past medical history of multiple sclerosis, hypothyroidism, pseudoseizures, conversion disorder, who presents to the emergency department from COVID-19 vaccination clinic after having a reported allergic reaction and seizure-like activity. She presents by EMS who reports that she was given intramuscular epinephrine as well as IV Benadryl for her symptoms. EMS reports that they saw generalized convulsive activity while the patient was alert and oriented, he reports this as "pseudoseizure-like activity". She was receiving her second dose of the COVID-19 vaccination today, she reports that she immediately thereafter got a rash to her torso and became short of breath. She was feeling well prior to the vaccination. She denies any other recent acute illnesses including fevers, chills, nausea, vomiting, diarrhea, chest pain. She says that she is currently undergoing a relapse of her multiple sclerosis and has been wheelchair-bound for 1 month.


VAERS ID: 1355365 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-12
Onset:2021-05-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       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: ibuprofen
Current Illness: none
Preexisting Conditions: RA, Fibromyalgia, Arthritis
Allergies: none
Diagnostic Lab Data: I went to Immediate Care and was diagnosed with Shingles. I was given antiviral, pain and Steroid meds.
CDC Split Type:

Write-up: I developed Shingles on the same side of my body as I got the vaccine on. The symptoms started 5 days after the vaccine.


VAERS ID: 1355373 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-15
Onset:2021-05-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Electrocardiogram normal, Loss of consciousness, Syncope, Tachycardia
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), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Dtap at 2 months resulted in fever of 105 and swelling of his leg.
Other Medications: none
Current Illness: none
Preexisting Conditions: Grade 1 heart murmur
Allergies: none
Diagnostic Lab Data: EKG was performed 6 hours later and was found to be normal.
CDC Split Type:

Write-up: Patient had a syncopal episode with complete LOC and question of seizure activity. Was found to be tachycardic, BP within normal range.


VAERS ID: 1355590 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-01
Onset:2021-05-17
   Days after vaccination:77
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anisomastia, Breast mass, Breast tenderness, Ultrasound scan
SMQs:

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

Write-up: tender breasts, mass in breasts, breasts changed shape


VAERS ID: 1355598 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-16
Onset:2021-05-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Confusional state, Diarrhoea, Fatigue, Feeling abnormal, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Severe fatigue Severe confusion, ?brain fog? Chills Fever Diarrhea Muscle fatigue Joint pain


VAERS ID: 1355766 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-10
Onset:2021-05-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: no known
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient claims she developed a blood clot approximately one week after receiving her first dose of the Pfizer Covid-19 vaccine.


VAERS ID: 1356510 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Chills, Contusion, Dizziness, Heart rate increased, Heart rate irregular, Injection site haemorrhage, Injection site pain, Injection site swelling, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: D3, 5,000 IU Vit A, 10,000 IU Chromium, 200mcg
Current Illness: None
Preexisting Conditions: Asthma (mild)
Allergies: Birch trees and, therefore, maybe almonds Cats Dogs Mold Pollen
Diagnostic Lab Data: None
CDC Split Type:

Write-up: During shot administration (which was angled from the bottom, up rather than straight in), I felt burning. The injection site bled, and the nurse had to staunch it a bit. Injection site burned/stung as I drove away to wait in line in the parking lot and for a few more minutes. Then my arm swole up around the injection site to a size of about a silver dollar and maybe 1 cm high. Four nurses monitored me, including the one who gave the shot, but she did not talk and stood slightly behind my driver''s side window. They let me go after maybe 25 minutes of monitoring and making sure I was OK, and what seemed like the head nurse gave me her phone number and asked me to report in in 24 and 48 hours to let them know how I was doing. I reported 24 hours later that I developed a 99* to 100* fever, chills, and slightly achy joints over night and experienced that for one day. I texted again around 48 hours to let her know those symptoms were gone, I felt a little dizzy now and again, and I developed a bruise around the injection site. I took a photo and texted that to her. She was very kind in asking me to report my adverse effects and get care if needed. As of this typing, 10 days later, I still have a slight bruise, and I have experienced heartbeat lapses once or twice a day. Yesterday (9 days after shot), I was sitting on the toilet resting (not exerting) and felt my heart beat hard four times slightly faster than it was at resting pace. I''ve experienced minor dizziness off and on but not fainted or blacked out.


VAERS ID: 1357376 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-13
Onset:2021-05-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pseudoephedrine decongestants?not every day, just when particularly congested.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have had occasional brief chest pains, like a painful tightness around my heart that lasts a couple seconds at a time. They have been random and infrequent enough I have not done anything about it (also, I am currently uninsured), but v-safe suggested I should submit a VAERS report of it anyway. Obviously I cannot be entirely sure it is related, but it is not something I have experienced before.


VAERS ID: 1357449 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-05-15
Onset:2021-05-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Diarrhoea, Dyspnoea, Gait inability, Hyperhidrosis, Insomnia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: amLODIPine (NORVASC) 5 mg tablet aspirin 81 mg chewable tablet atorvaSTATin (LIPITOR) 40 mg tablet doxazosin (CARDURA) 8 mg tablet furosemide (LASIX) 20 mg tablet HYDROcodone-acetaminophen (NORCO) 5-325 mg metoprolol succinate (TOPROL-XL) 1
Current Illness: unknown
Preexisting Conditions: Exertional dyspnea LBBB (left bundle branch block) History of transcatheter aortic valve replacement (TAVR) Coronary artery disease involving native coronary artery of native heart without angina pectoris Essential hypertension Hyperlipidemia LDL goal <70
Allergies: NKDA
Diagnostic Lab Data: Blood pressure 147/65, pulse 87, temperature 36.3 ?C (97.3 ?F), temperature source Temporal, resp. rate 19, height 1.778 m (5'' 10"), weight 110.4 kg (243 lb 6.2 oz), SpO2 92 %.
CDC Split Type:

Write-up: Patient received second COVID 19 vaccine 5/15/21. Patient presented to the ED on 5/17/21 with cheif complaint of increased shortness of breath and weakness. On 5/16/21, he did not sleep well and felt sweaty with chills. He took ibuprofen and Tylenol. He states he feels like he has no power when he walks. No chest pain. No fevers. He also notes slight diarrhea. Patient denies any Covid contacts. There are no other modifying factors or associated symptoms


VAERS ID: 1357666 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Seizure, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Mild, Systemic: Seizure-Mild, Additional Details: While sitting on the chair, patient fainted and started to have seizure for 1-2 second then recovered completely by himself. Called 911 but patient did not want to have any medical attention. After that, patient sit for more than 30 minutes before going home.


VAERS ID: 1357794 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-14
Onset:2021-05-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO186 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Feeling abnormal, Flushing, Headache, Hyperhidrosis, Oropharyngeal pain, Pain in extremity, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xeljanz, 0.5 Estrodial, 100mg Progesterone 5mg Paxil, 1 mg Lorezepam and occasional 3mg Lunesta, multivitamin
Current Illness: No
Preexisting Conditions: Rheumatoid Arthritis
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: For 14 days from vaccination in the following order varying from day to day Day 1 and2-sore arm and fatigue Day 3-Fever, chills, joint pain Day 4,5,6-bad headache Day 7-felt better thought clearing out Day 8-terrible sore throat and heavy sweating at night gone by next day Day 9-ok just fatigue Day 10-fatigue and Brain Fog Day 11- Woke up with flush leg rash that was alarming took a picture, it was gone by lunch time Day 12-Brain Fog and Fatigue Day 13-Brain Fog and Fatigue Day 24-Brain Fog and Fatigue


VAERS ID: 1357842 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-10
Onset:2021-05-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster, Sensitive skin
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: multi vitamin
Current Illness: none
Preexisting Conditions: None
Allergies: Erythromycin, laytex
Diagnostic Lab Data: I went to the doctor on May 19th.
CDC Split Type:

Write-up: I developed shingles on my left side one week after the COVID second dose. The shingles are on the same side as I received the 2nd dose of COVID. I have sensitivity to the touch on my entire left side that developed after the shot and shingles outbreak.


VAERS ID: 1357847 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-16
Onset:2021-05-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Fatigue, Headache, Impaired work ability, Injection site pain, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Headache, fatigue, muscle ache (mainly in back), joint ache (legs), soreness at injection site. All of these started within 6 hours of having been vaccinated. Alternating ibuprofen and acetaminophen provided good relief for muscle/joint ache. This also reduced the severity of the headache, but did not relieve it. Headache, muscle ache, and joint ache resolved by 40 hours post-vaccination. Mild fatigue/tiring more easily gradually improved over the next 48 hours. I took one day of sick leave from my job to rest.


VAERS ID: 1357955 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-16
Onset:2021-05-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Arthritis, Fatigue, Headache, Osteoarthritis, Pain in extremity
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit D; Vit C, multivitamin; essential oils
Current Illness: none
Preexisting Conditions: osteoarthritis
Allergies: sulfa; codeine; seasonal allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 1st shot: severe left arm pain and shoulder pain-improved but not resolved on 5/28/21 fatigue for 2 weeks resolved Increased Inflammation of arthritis in many joints that were not previously affected-has not resolved headache


VAERS ID: 1358312 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-05-14
Onset:2021-05-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram abnormal, Heart rate increased, Supraventricular tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Dehydration (broad)

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

Write-up: He received the Pfitzer BioNTech vaccine (Lot Number: EW0177, Exp.: 8/31/2021). During a routine doctor''s visit on May 17, Patient''s pediatrician noticed an elevated heart rate. A cardiologist diagnosed him with asymptomatic supraventricular tachycardia (SVT) (abnormal ECG, heart rate around 150) on May 20. Patient has no other cardiorespiratory symptoms (dizziness, shortness of breath etc.).


VAERS ID: 1358339 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 AR / IM

Administered by: Work       Purchased by: ?
Symptoms: Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Vital signs were taken by the immediate response team and pt was given Benadryl does x one by mouth by medical response team
CDC Split Type:

Write-up: Pt c/o "tongue feeling thick" while sitting in observation area after receiving the Covid vaccine. No shortness of breath, chest pain or trouble breathing. No drooling or trouble swallowing.


VAERS ID: 1358480 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 2 LA / IM

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

Life Threatening? Yes
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: synthroid, celexa (took at 8am that morning, daily meds)
Current Illness: none
Preexisting Conditions: hypothyroidism, depression
Allergies: sulfa (hives)
Diagnostic Lab Data: called 911, vitals were fine, they said i only needed to go to the hospital if i passed out again or threw up within 24 hrs
CDC Split Type:

Write-up: passed out in my car while i was driving on the highway. woke up in my car in the ditch


VAERS ID: 1358576 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-13
Onset:2021-05-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Electrocardiogram, Magnetic resonance imaging, Myocarditis, Troponin
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Myocarditis


VAERS ID: 1358734 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-14
Onset:2021-05-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Abdominal pain, Fatigue, Pyrexia, Vomiting
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)

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: Cymbalta - 60 mg;
Current Illness: no
Preexisting Conditions: Eczema; anxiety/depression
Allergies: allergic to Augmentin; Cefuroxime
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: He started vomiting just before midnight and he was vomiting violently for about 6 hours. The next morning, I kept him home. Vomiting was slowing down. There was no fevers as of yet. He was very tired. He started having abdominal pain. We made an appt with the doctor. The next day, he started having fevers to 101.9. I gave him Motrin and that brought the fever down. He started food and drinks again. The day after all of his symptoms resolved.


VAERS ID: 1359000 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Dizziness, Hot flush, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None but using Cleocin gel and Differin gel topically prescription.
Current Illness: NONE
Preexisting Conditions: Acne
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT DID EXPERIENCE A REACTION WITIN 5MINS AFTER VACCINATION WITH PFZIER 1ST SHOT. SHE EXPERIENCED BLURRY VISION, LOSS OF HEARING AND DIZZINESS FOR 15MINS WITH HOT FLASHES. GAVE HER APPLE JUICE AND HAD HER PUT HER FEET UP ON CHAIR. AFTER 20 MINS SHE WAS FEELING FINE AGAIN AND LEFT WITH DAD.


VAERS ID: 1359280 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Neck pain, Vertigo
SMQs:, Vestibular disorders (narrow), Arthritis (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: Gabapentin
Current Illness: No
Preexisting Conditions: Neck pains
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe vertigo lasting 6hours, headache, neck pains, chills.


VAERS ID: 1359724 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-05-17
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? No
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:
CDC Split Type:

Write-up: Miscarriage on 5/17/2021 10 days after second shot


VAERS ID: 1359869 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8375 / 1 LA / SYR

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

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

Write-up: CHILD DOES NOT MEET AGE CRITERIA, NO NEGATIVE OUTCOMES REPORTED


VAERS ID: 1359880 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-07
Onset:2021-05-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Fatigue, Headache, Myalgia, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: April 1 - first dose May 7 - second dose May 8 - Headache, muscle soreness, fatigue May 17 - I thought I had a headache (I don''t ever get headaches)... As the day progressed, I became incredibly dizzy and had to get on all fours at some points due to the dizziness. I was told by provider that I was experiencing vertigo. May 18 - continued to experience vertigo symptoms. May 19 - continued to experience vertigo symptoms, but less than the 2 previous days May 20 - mild dizziness May 21 - no more dizziness


VAERS ID: 1359981 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-13
Onset:2021-05-17
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018B21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Nausea, Pain in extremity, Pyrexia
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: woke up in the middle of the night with fever; nausea; foot started to hurt, bottom of it and pain in the top back of left thigh; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (foot started to hurt, bottom of it and pain in the top back of left thigh) in a 24-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 003C21A and 018B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 13-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 17-May-2021, the patient experienced PAIN IN EXTREMITY (foot started to hurt, bottom of it and pain in the top back of left thigh) (seriousness criterion medically significant). On 18-May-2021, the patient experienced PYREXIA (woke up in the middle of the night with fever) and NAUSEA (nausea). At the time of the report, PAIN IN EXTREMITY (foot started to hurt, bottom of it and pain in the top back of left thigh), PYREXIA (woke up in the middle of the night with fever) and NAUSEA (nausea) outcome was unknown. Concomitant medication included birth control pills, not otherwise specified. Treatment included ibuprofen. Company 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.; 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: 1359988 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-07
Onset:2021-05-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 2 RA / OT

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? 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: USMODERNATX, INC.MOD20211

Write-up: Bell''s Palsy with facial drooping; This spontaneous case was reported by a health care professional and describes the occurrence of BELL''S PALSY (Bell''s Palsy with facial drooping) in a 33-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014C21A) for COVID-19 vaccination. No Medical History information was reported. On 07-May-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-May-2021, the patient experienced BELL''S PALSY (Bell''s Palsy with facial drooping) (seriousness criterion medically significant). At the time of the report, BELL''S PALSY (Bell''s Palsy with facial drooping) had not resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication information was provided. The patient was treated in the Emergency Department with antiviral therapy. Based on current available information and the temporal association between product use and the start date of the event a causal relationship cannot be excluded.; Sender''s Comments: Based on current available information and the temporal association between product use and the start date of the event a causal relationship cannot be excluded.


VAERS ID: 1360560 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Neck pain, Pain in extremity
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021562446

Write-up: sharp pain in her neck and shoulder; sharp pain in her neck and shoulder; arm was hurting/arm pain; This is a spontaneous report from a contactable consumer (patient''s mother) via medical team. A 14-year-old female patient received BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date were not reported), via an unspecified route of administration on 14May2021 (at the age of 14-years-old) as first dose, single for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient experienced sharp pain in her neck and shoulder and her arm was hurting/ arm pain on 17May2021 night. The reporter was concerned because the pain appeared after a few days and not within 24-48 hours. She asked is this could be an indication that the vaccine was placed in the wrong place like not in the muscle. She asked if this is normal or when the patient should have this checked. The reporter stated that her and her husband did not experience any side effects. Outcome of the events was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1360562 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Off label use, Overdose, Pain, Pain in extremity, Product preparation issue
SMQs:, Drug abuse and dependence (broad), Tendinopathies and ligament disorders (broad), Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021562763

Write-up: They made a mistake and it was an overdose; When mixing the vaccine they used less of the diluent and more of the vaccine.; Do not recommend the vaccine for a 13 year old; Body aches; Pain at the arm; This is a spontaneous report from a contactable consumer (father) reported for a 13-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number was not provided) via unknown route of administration on 17May2021, as a single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The consumer reported that his daughter received the first dose of the vaccine and then was called and they stated that they made a mistake and it was an overdose. The pharmacist told him that when mixing the vaccine they used less of the diluent and more of the vaccine. He stated he was scared because overdose sounded like something is wrong. He also stated he spoke with the primary care physician and they said they do not know and do not recommend the vaccine for a 13 years old and told him to call Pfizer. His daughter said she had pain and at that time he gave her some medicine, some Tylenol she feel little bit eased, she seemed okay. Every time she had pain and then the Tylenol kicks in and it helps but the second thing is he cannot understand why. She had pain at the arm and then body aches on 17May2021 and they gave her Tylenol and that medicine kind of eased her. That is what they did as far as medicine to treat. No further information provided. The outcome of the events body aches and pain in arm was resolving and the other at risk events was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1360634 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-13
Onset:2021-05-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 INC2021600296

Write-up: rash all over his body including his eyes/rash all over his body including his eyes/still there on his toes; This is a spontaneous report from a contactable consumer (mother) via medical team. A 13-year-old male patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE: Lot number: not reported) dose 1 via unspecified route of administration on 13May2021 as a single dose for COVID-19 immunisation (age at vaccination was 13 years). Caller was asking for guidance regarding getting the second vaccine dose after having a side effect following the first dose. She reports that her son received his first vaccine dose on 13May2021 and 4 days later on 17May2021 he began having a rash all over his body including his eyes. She reports that the rash lasted for about 6 days and is still there on his toes. She reports concern about what he may experience after getting the second dose, which is scheduled for 03Jun2021, and asks for guidance on if it will be safe for him to get it or not. Patient had a side effect after the first dose of the vaccine. Should get the second dose? Caller talking about her 13-year-old son, asking how much protection will my son get or what is the efficacy following 1 dose of the Pfizer covid vaccine? The outcome of the event was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1360945 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-01
Onset:2021-05-17
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A22A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, 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:
Allergies:
Diagnostic Lab Data: ULTRA SOUND-5/17/2021
CDC Split Type:

Write-up: POSITIVE FOR DVT IN LEFT FEMORAL VEIN AND LEFT CFV/GSV JUNCTION.


VAERS ID: 1361126 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 RA / SYR

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

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

Write-up: After 10 days I have experienced incrementally stronger daily headaches


VAERS ID: 1361182 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-15
Onset:2021-05-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dry skin, Lip swelling, Peripheral swelling, Rash, Skin abrasion
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Accidents and injuries (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: PT father states that two days after her second dose Pfizer vaccine his daughter developed allergies in her whole body. Her skin became dry with little bumps all over her body, face, arm, hands and feet. He also states his daughter?s lips, hands and feet swelled up. Also that on her inner thighs and vaginal region her skin was also dry with cuts of dry skin. PT father states his daughter went to the doctor where they prescribed Cephalxin, Triamcinolone and Acetonide as medication. As of today, PT father states she continues with the dry skin and little bumps on her whole body, face and arms. PT father states that for her first dose vaccine, his daughter only had soreness to her left arm.


VAERS ID: 1361298 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-05-16
Onset:2021-05-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Cough, Fatigue, Pyrexia, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

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

Write-up: I developed a cough that?s worsened as my fever worsened the day after I got the shot. It?s been 11 days and I still have the cough and my chest feels weird and scratchy. I also felt fatigued for about a week after and still don?t feel quite like I did before. I know several people who developed coughs with the vaccine. It should be LISTED as a side effect. I was tested for covid when my cough was at its wrost and the test was negative.


VAERS ID: 1361424 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Asthenia, Chills, Computerised tomogram, Dizziness, Dysstasia, Electrocardiogram, Full blood count, Headache, Hyperhidrosis, Hypersensitivity, Influenza like illness, Influenza virus test negative, Liver function test increased, Pain, Pancreatic enzymes increased, Pyrexia, SARS-CoV-2 test negative, Scan with contrast, Ultrasound scan, Ventilation/perfusion scan, Vomiting, White blood cell count increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? Yes
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: Suboxone 8mg/2mg End of list
Current Illness: None at all!!
Preexisting Conditions: Asthma [mild] There is multiple things in my medical chart that was added without knowledge but no proof 9f or why doctor added them without evidence
Allergies: Paxil-hives
Diagnostic Lab Data: All facilities tested for covid & flu all negative Urgent care, 2pm referral to er immediately for rare allergic reaction 5/18 Referral to hospital [ I was refused treatment and concerns with covid vaccine as was there over 2 hrs and never had any vital signs after referral from urgent care. Hospital was told by my family that we are leaving as I had to leave car at urgent care center for my safety and concerns with dizziness [doctor recommended family to take me] Hospital was at 445pm and signed paper that I was leaving to go to hospital 2. They were surprised I did not get called for vitals. Another hospital was around 7pm and immediately ekg, cbc, covid flu and paperwork brought from urgent care doctor was concerned. Cat scan and lungs.. ultrasound and with and w/o contrast. Liver and pancreas levels high caused concern as blockage at bile duct. Fever still present. They immediately gave me before all test a shot of steroids and benadryl. Emergency Surgery for ercp was discussed with 3 other MD and awaited bed. Liver levels and wbc extremely high. Transport 6am to another hospital for surgery.
CDC Split Type:

Write-up: 8 hrs later 99.7 temp , sweat body aches, dizziness 5/17 2am fever 100.7 fever chills severe headache, vomiting fly like symptoms, stomach aches, could not stand no energy finally 2pm 5/18 drove to urgent care as I could not go any further


VAERS ID: 1361563 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-16
Onset:2021-05-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Arthralgia, Asthenia, Bone pain, Chills, Decreased appetite, Gait disturbance, Lethargy, Malaise, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (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: Multi-vitamins, 81 mg asprin, no RX.
Current Illness: Seasonal Allergy to tree pollen
Preexisting Conditions: Borderline Seizure Disorder (medication induced)
Allergies: None known
Diagnostic Lab Data: None, No insurance
CDC Split Type:

Write-up: Within 24 hours fever, chills, loss of appetite/taste and lethargic gradually subsiding over a week. 2nd week after shot - Still no appetite /taste. Lethargy continues (needing multiple naps) and just not feeling well. Severe pain scale of 1-10 (1 being least and 10 being most) at varying from 5-10 (non specific to joint or muscles and including both muscle and bones) Bilaterally across both lower legs . Gradually subsiding in left leg, continuing in Right leg (2 weeks out still a 4 in right leg) . Still not able to walk normal. Still no energy and loss of appetite and smell.


VAERS ID: 1361656 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-07
Onset:2021-05-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Thrombophlebitis superficial, Vascular pain, Vein disorder
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Superficial thrombophlebitis blood clots in right leg. This under line issue doesn?t run in either side of my family. This issue popped up a week & three days after taking my first dose of the Moderna, NIAID vaccine.
Allergies: None
Diagnostic Lab Data: None yet that?s still to come.
CDC Split Type:

Write-up: superficial thrombophlebitis In my right leg. Pain, redness, swollen, hard vines. Take Ibuprofen and to put Hot compresses on it for about 20 minutes.


VAERS ID: 1361709 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-08
Onset:2021-05-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Pruritus, Rash, Skin exfoliation
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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Linear scleroderma
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Rash on trunk of body started on 5/17 as small red spots that covered from chest to pubic area and back from neck to lower back. Spots were raised and began itching after a day or so then they got bigger and spread and in some cases peeled. It seems to be getting better as of today 5/30.


VAERS ID: 1361855 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient reported dizziness, nauseous and had syncope. EMS was called, vitals were checked, patient refused hospital services and was stable after 10 minutes. Patient received hydration and left at 1pm.


VAERS ID: 1361930 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-05
Onset:2021-05-17
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Aneurysm, Aspartate aminotransferase increased, Blood alkaline phosphatase normal, Blood bilirubin normal, Computerised tomogram abdomen, Computerised tomogram abnormal, Decreased appetite, Diarrhoea, Fatigue, Headache, Liver function test increased, Malaise, Nausea, Splenic infarction, Splenomegaly, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine, losartan, levothyroxine, omeprazole, metoprolol
Current Illness:
Preexisting Conditions: Hypothyroidism, hypertension, GERD, hyperlipidemia
Allergies: Nitrofurantoin
Diagnostic Lab Data: CT abd/pelvis on 5/29: Splenomegaly with Splenic infacts and small Splenic Artery Aneurysm on CT abdomen/pelvis. Elevated LFTs on 5/29/21: AST 102, ALT 120, Alk phos 107, Tbili 0.9.
CDC Split Type:

Write-up: She was vaccinated on 5/5. Symptoms started with headache, malaise, anorexia, and fatigue on 5/17. Then developed into nausea, vomiting, and diarrhea. Presented to ER on 5/29 and found to have splenomegaly with splenic infacts and small splenic artery aneurysm on CT abdomen/pelvis.


VAERS ID: 1362043 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-15
Onset:2021-05-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ear discomfort, Ear pain, Fatigue, Hypoacusis, Lymphadenopathy, Tinnitus, Vertigo
SMQs:, Hearing impairment (narrow), Vestibular disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 10 mg. of Citalopram taken the night before at dinnertime (roughly 6:40 pm on the 14th), possibly Equate nasal spray (antihistamine) but cannot remember.
Current Illness: None, other than seasonal allergies.
Preexisting Conditions: Clinical Depression and motion-sickness.
Allergies: Allergic to Tetracycline (acne medication), Crest Toothpaste, nickle metal, Ragweed, Poison Ivy, tree pollen, and grass pollen.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: For two days after I got my shot, I was really tired. Then, in the afternoon on the second day, I got up and suddenly my right ear felt like it was clogged, and I worried about wax buildup. Ear felt like it was stuffed with wool, and hearing capability went down approx. 30-40%. Tinnitus was detected, but attributed to earwax buildup. Attempts with cotton swabs and washing with warm water in the shower did not work. Right lymph node in lower jaw swelled a little bit on the 18th. Swelling went away on the 19th. After two days of trying to clean it out traditionally, I got an appointment at Hospital. Closest appointment I could get was on the 21st. 2 hours before the appointment on the actual day, the doctor canceled, so I had to go to the ER instead. Left ear was irrigated along with the right. ER doctor insisted on doing both, despite nothing wrong with the left ear. Left ear was irrigated 3x. Right ear was irrigated 4x, but failed and resulted in slight pain. Debrox ear drops were used for the next 5 days, and while most of the wax appears to have been cleaned out, right ear still feels like it is slightly stuffed with wool, and the Tinnitus is louder now. Tinnitus is still going on as of this report. Hearing capability has improved, but still 10-15% less than the left ear. Mild bouts of vertigo have been occurring on and off since the irrigation.


VAERS ID: 1362148 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-07
Onset:2021-05-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Facial paralysis, Herpes zoster, Herpes zoster oticus
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Opportunistic infections (narrow)

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

Write-up: I developed shingles in my ear that led to Ramsay Hunt syndrome with facial paralysis. As an otherwise healthy, 20 year old girl it?s very rare for my demographic and should not have happened


VAERS ID: 1362281 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 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: no know allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was due to receive Moderna Vaccine, but was given Pfizer vaccine instead. Mistake was recognized about 15 minutes after dose was given. This was supposed to be the second dose of the moderna Series. Counseled patient that they should still receive an immune response


VAERS ID: 1362282 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Feeling abnormal, Immediate post-injection reaction, Pruritus, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I spoke with a nurse in our pediatrican''s office the day after the shot to let them know about her reaction after the shot and the itchy issues. They said to give Benadryl around the clock for 48 hours and Tylenol as needed if she was in pain. They did not want to see her and told me to go to the Emergency Room if things became unbearable for her.
CDC Split Type:

Write-up: Immediately after the shot... Felt like passing out, red rash developed around her neck and was red all over neck - front and back. Rash was also on chest and a few places on her stomach. Redness from her left shoulder down arm to elbow. The next day she felt itchiness under her skin in muscles and joints and this lasted for 7 days. It gradually got better until it ended after 7 days.


VAERS ID: 1362294 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 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 received Pfizer vaccine instead of getting the 2nd dose of Moderna vaccine. Mistake was discovered about 15 minutes after the vaccine was given. Counseled patient on vaccine, and that they should still have an immune response.


VAERS ID: 1362351 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-05-08
Onset:2021-05-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Hypoaesthesia oral
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), 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: Levothyroxine (Euthyrox 100 mg)
Current Illness: None. Numbness of tip of tongue
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: A few days after I got my shot, I noticed unexplained bruises on my thighs around my knees and a very large bruise across my left thigh. Today I feel numbness on the tip of my tongue. It started about an hour ago.


VAERS ID: 1362390 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-11
Onset:2021-05-17
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood urine present, Nephrolithiasis, Renal pain, Urine analysis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: I take the following medications daily: Flonase Alvesco Montelukast
Current Illness: No
Preexisting Conditions: Asthma
Allergies: I have a mild allergic to citric acid.
Diagnostic Lab Data: I had a urinalyses test and it showed blood in my urine which is characteristic of a kidney stone.
CDC Split Type: vsafe

Write-up: I ended up with a Kidney stone two weeks after taking the vaccine. I had intense pain in my right kidney and it was very painful overnight and the following day the nursing line advised that I go to the Doctor''s office (stayed home and went to the Doctor''s office for testing the next day). My Doctor advised that I passed the stone and to change my diet so it doesn''t happen again).


VAERS ID: 1362405 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-05-13
Onset:2021-05-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bronchitis, Cough, Fatigue, Influenza virus test negative, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test negative, Sinus congestion, Streptococcus test negative
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, Pristiq, Losartan, tizanidine, meloxocam, gabapentin, multi vitamin
Current Illness: No e
Preexisting Conditions: Borderline high blood pressure
Allergies: None
Diagnostic Lab Data: Strep, flu (2 times) and COVID (2 times) all negative
CDC Split Type:

Write-up: Sinus congestion, sore throat, severe cough, exhaustion, bronchitis, chest congestion for 2 weeks


VAERS ID: 1362523 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-05-17
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 20SAZIA / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Arthritis, Condition aggravated, Laboratory test normal, Pain, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Systemic lupus erythematosus (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I took my usual medications and supplements: HCTV 12.5mg and Losartan 25mg (take half of it) Quercetin, Horton (liquid), Vitamin C, Magnesium, CQ10, Vitamin D, Turmeric, and Bromelain.
Current Illness: No
Preexisting Conditions: Asthma
Allergies: I have allergies to Diltiazem causes my tongue to swell, lips, and causes hives on my thighs. I''m also allergy to a lot of pollens, mole and mildew, etc.
Diagnostic Lab Data: I had an Echo Cardia Gram performed and blood work which came back normal. The slight elevation in the kidneys was not anything serious to worry about.
CDC Split Type: vsafe

Write-up: The vaccine made my arthritis in my knees, and hips worst after two weeks. My Doctor order an EKG done because of the swelling in my feet related to my heart and kidneys. My hips and knees continued to ache whenever I stand up (still an issue).


VAERS ID: 1362536 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-15
Onset:2021-05-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscular weakness, Pain in extremity, Pruritus, Rash, Skin warm
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tramadol 50 mg (1-2 tablets every 6 hours as needed for pain). Triamterene-HCTZ 37.5-25 mg capsule once daily.
Current Illness:
Preexisting Conditions:
Allergies: NKDA.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received COVID vaccine on 5/15/2021. Pt called 10 days later on 5/26/2021, reporting bilateral rash on arms from shoulder to elbow. Started 1-2 days after vaccine administration, continuing until point of reporting. Pt reported sensitivity to touch, redness, hot/warm to touch, and some itchiness. Pt denied any sharp or shooting pain. Experienced some itchiness on torso, but no hives. Pt also reported arm soreness, hurt to lift arm, and weak. Pharmacist counseled pt to take anthistamine (i.e. Benadryl) in the meantime, to help with possible allergic reaction to the vaccine dose. Wait for second dose until resolution or medical advice. Also to follow up with MD/PCP. Pharmacist called 14 days post-vaccine administration on 5/29/2021, left message, no response yet from pt.


VAERS ID: 1362544 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-25
Onset:2021-05-17
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: HPV vaccine 09/2020, 15 years old, lymph node swelling
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Seasonal allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1st dose: fatigue, slight headache, pain in left arm. during arm circles, would be pain during movement pain for a day or two. Took Tylenol 2 tablets 500mg each on the night of the vaccine. 2nd dose: received vaccine at 5pm, during night of vaccine day, got a fever and headache and chills. flu-like symptoms for 24 hours. fever of 101F. soreness of muscles. on second day, fever was almost gone. lasted 2 days total. most severe symptoms on first day. Took Tylenol 2 tablets 500mg in the morning, 2 tablets 500mg in the evening. Took 1 tablet of Advil 200mg on day 2.


VAERS ID: 1362635 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-05-14
Onset:2021-05-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Axillary pain, Blood test, Chest pain, Dizziness, Dyspnoea, Headache, Nausea, Palpitations, Urine analysis
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Had heart palpitations and shortness of breath with first covid 19 vaccination lasting one to two days.
Other Medications: paxil 20mg. benadryl 25 mg. multi vitamin
Current Illness: Had been waking up some nights with possible sleep apnea and erratic heartbeat.
Preexisting Conditions: mitral valve leak, fibromyalgia, spinal degenerative disc disease with neuropathy, Sleep apnea
Allergies: Allergic to morphine and sulpha drugs hypersensitive to most meds.
Diagnostic Lab Data: Bloodwork, urinalysis both on May 24th.
CDC Split Type:

Write-up: Experienced dizziness, weakness, shortness of breath, nausea, headache, heart palpitations and intermittent minor chest pain. Could not get an appointment with cardiologist till June 30th. Saw family doctor on May 24th. He stated that heart and lungs sounded good but ordered heart monitor appointment for June 3rd at hospital outpatient. Also have continuing pain under left arm


VAERS ID: 1362843 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-17
Onset:2021-05-17
   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 ER8736 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Burning sensation, Chills, Headache, Nausea, Pyrexia, Tinnitus
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: None. I have spoken to several doctors (friends) by phone and I felt the symptoms would dissipate. It has now been 2 weeks and they have not. I will start seeking treatment in the morning.
CDC Split Type:

Write-up: At 4:00 p.m. after shot, had nausea, fever, chills and headache. This lasted until 8:00 p.m (4hrs). Symptoms went away but started again at 1:15 a.m and lasted until 4:15 a.m. After waking up at 8:00 a.m. noticed pronounced ringing in my right ear. Later that day noticed that the top of my toes (at the base of my toes) had a burning sensation, my lower back hurt and a general overall unwell feeling. The ringing in my right ear has been nonstop since it started. The other symptoms have come and gone intermittently but are still present.


VAERS ID: 1363928 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Alabama  
Vaccinated:0000-00-00
Onset:2021-05-17
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, Product temperature excursion issue
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210556727

Write-up: PRODUCT TEMPERATURE EXCURSION ISSUE; POOR QUALITY PRODUCT ADMINISTERED; This spontaneous report received from a pharmacist concerned multiple patients. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 17-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 17-MAY-2021, the subject experienced product temperature excursion issue. On 17-MAY-2021, the subject experienced poor quality product administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the product temperature excursion issue and poor quality product administered was not reported. This report was non-serious.


VAERS ID: 1363976 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:2021-02-06
Onset:2021-05-17
   Days after vaccination:100
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abnormal loss of weight, Aggression, Asthenia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Dementia (broad), Guillain-Barre syndrome (broad), Hostility/aggression (narrow)

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

Write-up: Weakness; Weight decreased; Violent; This spontaneous case was reported by a patient family member or friend (subsequently medically confirmed) and describes the occurrence of ASTHENIA (Weakness), ABNORMAL LOSS OF WEIGHT (Weight decreased) and AGGRESSION (Violent) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 8CDPBC and 031L20A) for COVID-19 vaccination. No Medical History information was reported. On 06-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 06-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 17-May-2021, the patient experienced ASTHENIA (Weakness) (seriousness criterion hospitalization), ABNORMAL LOSS OF WEIGHT (Weight decreased) (seriousness criterion hospitalization) and AGGRESSION (Violent) (seriousness criterion hospitalization). At the time of the report, ASTHENIA (Weakness), ABNORMAL LOSS OF WEIGHT (Weight decreased) and AGGRESSION (Violent) outcome was unknown. No treatment information was provided. Action taken with the mRNA-1273 in response to the event is not applicable. Patient was currently admitted in the hospital and the doctors could not figure out the root cause of her illness. Company comment: Very limited information regarding these events has been provided at this time. Further information has been requested.; Sender''s Comments: Very limited information regarding these events has been provided at this time. Further information has been requested.


VAERS ID: 1363998 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-17
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210515; Test Name: Covid-19 Antigen; Test Result: Negative ; Result Unstructured Data: Negative; Test Date: 20210517; Test Name: Covid-19 Antigen; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Respiratory infection; Got sick there; Tested again 5/17 this time Positive; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of RESPIRATORY TRACT INFECTION (Respiratory infection) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-May-2021, the patient experienced SARS-COV-2 TEST POSITIVE (Tested again 5/17 this time Positive). On an unknown date, the patient experienced RESPIRATORY TRACT INFECTION (Respiratory infection) (seriousness criterion medically significant) and ILLNESS (Got sick there). At the time of the report, RESPIRATORY TRACT INFECTION (Respiratory infection), ILLNESS (Got sick there) and SARS-COV-2 TEST POSITIVE (Tested again 5/17 this time Positive) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-May-2021, SARS-CoV-2 test: negative (Negative) Negative. On 17-May-2021, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) was unknown. Concomitant medications was not provided/ unknown. Text: AE submitted via social media: "I received 2 Moderna vaccines, 2/14 and 3/14. I traveled to another country 5/5 and got sick there (respiratory infection). Got Covid tested there 5/15, which was negative. (Antigen test). Tested again 5/17, this time Positive! Received Re" "Seems that my body did not produce enough antibodies to prevent infection. C I get re-vaccinated or would that even help?" Treatment information was provided/ unknown. Company Comment: Limited information regarding the reported sick / respiratory infection has been provided at this time and a causal relationship cannot be excluded. The positive test for Covid-19 is unlikely related to the previous administration Moderna vaccine.; Sender''s Comments: Limited information regarding the reported sick / respiratory infection has been provided at this time and a causal relationship cannot be excluded. The positive test for Covid-19 is unlikely related to the previous administration Moderna vaccine


VAERS ID: 1364300 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-17
Onset:2021-05-17
   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 UNKNOWN / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Off label use, Product use issue, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Medication errors (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021570428

Write-up: 11-year-old male patient received BNT162B2; 11-year-old male patient received BNT162B2; My son had a seizure 4 hours after receiving his first dose of the Pfizer vaccine.; This is a spontaneous report from a non-contactable consumer (patient''s father). An 11-year-old male patient (reporter''s son) received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number unknown), on 17May2021 03:00 PM (at the age of 11-year-old) as 1st dose, single for COVID-19 immunisation. Facility where the most recent COVID-19 vaccine was administered was reported as other. The patient''s medical history and concomitant medications were not reported. The patient was not diagnosed with COVID-19 prior to vaccination. Patient''s father stated that his son had a seizure 4 hours after receiving his first dose of the Pfizer vaccine (onset date also reported as 17May2021 20:30). The event resulted in emergency room/department or urgent care visit. Since the vaccination, the patient had not been tested for COVID-19. The outcome of the events was resolved for "seizure" and unknown for the other events. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1364321 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-04
Onset:2021-05-17
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arrhythmia
SMQs:, Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (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:
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 INC2021608293

Write-up: arrhythmia two weeks after first shot.; This is a spontaneous report received from a contactable consumer (patient). An 18-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number: EW0161, expiry date was not provided) via an unspecified route of administration, administered in left arm on 04May2021 at 17:00 (age at vaccination 18-year-old) as 1st dose, single for COVID-19 immunisation in Pharmacy or Drug Store. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient did not have any medical history or any known allergies. The patient concomitant medications were not reported. The patient was not the diagnosed with COVID-19 prior to vaccination. The patient had not been tested for COVID-19 since the vaccination. On 17May2021 (two weeks after first shot), patient experienced arrhythmia. The patient visited emergency room/department or urgent care for adverse event. The outcome of the events was not recovered. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1364322 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-01
Onset:2021-05-17
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ALLEGRA; ZYRTEC ALLERGY
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210517; Test Name: Covid; Test Result: Positive
CDC Split Type: USPFIZER INC2021610298

Write-up: tested positive for Covid; tested positive for Covid; This is a spontaneous report from a contactable nurse (patient) from a Pfizer sponsored program. A 30-years-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EW0170; Expiration Date: 31Aug2021), via an unspecified route of administration on Apr2021 (at the age of 30-year-old) as single dose, administered in Deltoid Left for covid-19 immunization. Medical history included allergy. Concomitant medications included fexofenadine hydrochloride (ALLEGRA), cetirizine hydrochloride (ZYRTEC ALLERGY) both taken for allergy (Further not clarified). On 17May2021, after the first dose (on last Apr2021), the patient was tested positive for covid-19. The patient was scheduled for her second dose on 18May2021 but missed the dose as she was tested positive. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 17May2021. The outcome of the events was unknown. Follow up needed, further information has been requested.; Sender''s Comments: Based on known drug safety profile and temporal relationship there is reasonable possibility of causal association between the reported events and the suspect drug.


VAERS ID: 1364673 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-16
Onset:2021-05-17
   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 EW0176 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Headache, Inappropriate schedule of product administration, Lip swelling, Loss of personal independence in daily activities, Swelling of eyelid
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no - but may have taken a Multi-Vitamin that day (children''s_
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: Was fine the night before. Woke up and his eyelids were swollen and his lips were swollen. Immediately, my wife called Telehealth and described the situation. They said to get him some Benadryl and we gave him that. He also had a headache - we might have give him a Tylenol. With Benadryl - he took four or five doses according to the protocol on the Benadryl. He did not go to school. The next day, he was swollen but not as bad. My wife bought him Claritin and he didn''t do anything because he didn''t know which to take (Benadryl or Claritin). His swelling went away quite a bit that day without taking anything and he went back on Wednesday -there was still a little bit of swelling but not much. He wasn''t feeling great though that whole week. He was still tired and was a bit headachy until Friday or so. Somewhere on the weekend he felt back to himself. He is due for second vaccine this weekend and we aren''t going to have him take it then. We''re concerned and have decided to hold - the physician said he shouldn''t have had a COVID vaccine two weeks before this Pfizer one (he received the Varicella) on the 29th of April- -Dr said it should have been a month or so of waiting still before he had this vaccine after that.


VAERS ID: 1364837 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-10
Onset:2021-05-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dark circles under eyes, Rash papular, Tooth infection
SMQs:, Osteonecrosis (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: covid pfizer 1st dose
Other Medications: duloxetine ER 20mg po qd
Current Illness: Pt had similar adverse reaction after first covid vaccine: tooth infection, bilateral dark circles around eyes and papular skin lesions.
Preexisting Conditions: anxiety
Allergies: nifedipine: headache penicillin: diarrhea Not true allergies but adverse reactions
Diagnostic Lab Data: Pt had to have tooth removed by dentist
CDC Split Type:

Write-up: bilateral dark circles around eyes, tooth infection and skin papular lesions.


VAERS ID: 1365108 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-17
Onset:2021-05-17
   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 ER8736 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Hypoacusis, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Patient received their first dose of Pfizer vaccine. Began to feel lighted headed and hearing was going in and out. EMS responded and their blood pressure was low, after 20 mins, vitals were normal.


VAERS ID: 1365361 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-05-07
Onset:2021-05-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: None. I have a appointment to follow up for a blood test.
CDC Split Type: vsafe

Write-up: I had a rash that formed on all four of my limbs that looked like a poison ivy rash. The rash was under my arm and legs. It wasn''t spreading but it became very painful. It is slowly starting to go away with the medication that the doctor provide.


VAERS ID: 1365400 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-13
Onset:2021-05-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ear pain, Fatigue, Headache, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 antibody test negative, SARS-CoV-2 test negative
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: 18th - GS Labs - COVID test - negative for the rapid test and the antibody test and then the longer test
CDC Split Type: vsafe

Write-up: He started off with a sore throat and it progressed into really bad congestion; headache; earache and fatigue. No fever. Ibuprofen was given for headache and throat lozenges for his throat. He drank a lot of water. It lasted four days. He started to feel better. The congestion hung around about a full week before he had no more congestion. He got sick first and then his little brother followed and then I got sick - we were all sick about the same amount of time - 5- 7 days. His Dad got his second shot at the same time as patient got his first shot. I had been fully vaccinated by that time.


VAERS ID: 1365482 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-07
Onset:2021-05-17
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Back pain, Cardiac stress test, Chest discomfort, Chest pain
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (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: Clonazepam, fluoxetine, vitamin d
Current Illness:
Preexisting Conditions: Anxiety disorder, mitral valve prolapse, premature ventricular contraction
Allergies: Penicillin, Cipro, codeine, latex
Diagnostic Lab Data: Stress Test 5/21/21 fine
CDC Split Type:

Write-up: Pain in left shoulder blade, back, shoulders and chest, felt like weight on chest. Adjusted meditation to capsule from tablet, blander diet, stress test. Symptoms decreased.


VAERS ID: 1365547 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-22
Onset:2021-05-17
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 - / SYR

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

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

Write-up: I am 3 weeks late on my menstrual cycle. No cramps or period related side effects. I was suppose to start on May 17. Not pregnant.


VAERS ID: 1365685 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-05-17
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / N/A LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal X-ray, Abdominal pain, Computerised tomogram abdomen abnormal, Food intolerance, Scan with contrast abnormal, Small intestinal obstruction
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Saw Palmetto; Glucosamine Sulfate
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: ER - CAT SCAN of abdomen with a contrast - dx''d small bowel obstruction; they gave me some other solution the next day and did a series of x-rays on my abdomen to monitor the results and then I was basically being monitored and they determined that the obstruction had gone away so they let me go. No take home treatment.
CDC Split Type: vsafe

Write-up: I had really severe abdominal pain. I went to ER because of those symptoms. I was treated there. They determined I had a small bowel obstruction. I was hospitalized for three days and eventually was released. Gave me a solution that cleared everything out - no surgery or anything. To be honest, I''m still kind of having the issue. I have changed my diet around and can''t eat normal food. If I do, I get pain back. I can''t eat a normal meal anymore - I am coping but haven''t recovered.


VAERS ID: 1365747 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-06
Onset:2021-05-17
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Anticoagulant therapy, Cerebral infarction, Computerised tomogram head abnormal
SMQs:, Ischaemic 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? 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: 17May21 - CT scans showed hypoattenuation centered within the left parietal lobe, compatible with a left MCA acute infant
CDC Split Type:

Write-up: possible linked to isquemic stroke. Patient was given TPa. Left MCA acute infart


VAERS ID: 1366133 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Fatigue, Headache, Impaired work ability, Influenza like illness, Pain
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Headache to a lesser degree the day after, pretty minor.
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Starting at 6:30 I could feel my body getting tired. Rapidly got chills and an extreme headache. Body aches the entire next day in addition to being extra tired and constant diarrhea. Had to stay home from work. I haven''t felt 100% since, even though it has been over 2 weeks. After my wife got her second shot, our entire household got a suspicious flu like cold, then it happened again right after my second dose. That lasted almost a week each time and just seems unlikely to be a complete coincidence.


VAERS ID: 1366138 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-02
Onset:2021-05-17
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Amenorrhoea, Pregnancy test negative
SMQs:, Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prozac, vitamin b12, magnesium
Current Illness: None
Preexisting Conditions: None
Allergies: NA
Diagnostic Lab Data: Pregnancy test
CDC Split Type:

Write-up: Missing period with all pregnancy tests being negative.


VAERS ID: 1366557 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Type 2 diabetes
Preexisting Conditions: Type 2 diabetes
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left eye is losing vision rapidly. No pain. Eyesight very fuzzy


VAERS ID: 1366582 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-05-17
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001A21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Menstrual disorder, Menstruation delayed
SMQs:, Fertility disorders (broad)

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

Write-up: Menstrual cycle is off; one week early after first dose of vaccine, and now currently 2+ weeks late and counting after second dose. Not pregnant.


VAERS ID: 1366897 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-19
Onset:2021-05-17
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Atrial flutter, Computerised tomogram thorax, Electrocardiogram, Full blood count, Heart rate, Mean arterial pressure, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Hyperlipidemia; Hypertension; Obesity
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (was not hospitalized and got recovered at home); Ex-smoker
Allergies:
Diagnostic Lab Data: Test Date: 20210517; Test Name: Chest CT; Test Result: Negative ; Result Unstructured Data: Negative for a pulmonary embolism (PE); Test Date: 20210517; Test Name: EKG; Test Result: Inconclusive ; Result Unstructured Data: new onset atrial flutter with rapid ventricular response (RVR), no ST changes; Test Date: 20210517; Test Name: CBC; Result Unstructured Data: normal; Test Date: 202105; Test Name: heart rate; Result Unstructured Data: $g 120 bpm; Test Date: 202105; Test Name: heart rate; Result Unstructured Data: $g 100 bpm; Test Date: 20210517; Test Name: heart rate; Result Unstructured Data: 115-150 bpm; Test Date: 20210517; Test Name: Mean arterial pressure; Test Result: Inconclusive ; Result Unstructured Data: $g 75
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: palpitations; atrial flutter with RVR; This spontaneous case was reported by a physician (subsequently medically confirmed) and describes the occurrence of PALPITATIONS (palpitations) and ATRIAL FLUTTER (atrial flutter with RVR) in a 62-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 046B21A and 037A21B) for COVID-19 vaccination. The patient''s past medical history included Ex-smoker and COVID-19 (was not hospitalized and got recovered at home) in December 2020. Concurrent medical conditions included Hypertension, Hyperlipidemia and Obesity. On 19-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-May-2021, the patient experienced PALPITATIONS (palpitations) (seriousness criterion hospitalization) and ATRIAL FLUTTER (atrial flutter with RVR) (seriousness criterion hospitalization). The patient was hospitalized from 17-May-2021 to 18-May-2021 due to ATRIAL FLUTTER and PALPITATIONS. The patient was treated with DILTIAZEM (CARDIZEM [DILTIAZEM]) (oral) ongoing from 17-May-2021 for Palpitations and Atrial flutter with rapid ventricular response, at a dose of UNK dosage form and DILTIAZEM (CARDIZEM [DILTIAZEM]) (intravenous) ongoing from 17-May-2021 for Palpitations and Atrial flutter with rapid ventricular response, at a dose of UNK dosage form. On 18-May-2021, PALPITATIONS (palpitations) and ATRIAL FLUTTER (atrial flutter with RVR) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In May 2021, Heart rate: high heart beats per minute (High) $g 120 bpm and high heart beats per minute (High) $g 100 bpm. On 17-May-2021, Computerised tomogram thorax: negative (Negative) Negative for a pulmonary embolism (PE). On 17-May-2021, Electrocardiogram: inconclusive (Inconclusive) new onset atrial flutter with rapid ventricular response (RVR), no ST changes. On 17-May-2021, Full blood count: normal (normal) normal. On 17-May-2021, Heart rate: high heart beats per minute (High) 115-150 bpm. On 17-May-2021, Mean arterial pressure: inconclusive (Inconclusive) $g 75. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The patient denied any history of sleep apnea. He denied fevers, night sweats, shaking, chills recently and denied any other complaints of chest pain, dyspnea or lightheadedness. He was not an alcohol user and had no new prescriptions. He had no history of thyroid disease and had not been diagnosed with chronic obstructive pulmonary disease. No concomitant medications were reported. Patient was hemostable throughout his emergency department stay. The patient got converted to sinus rhythm overnight and got discharged to home on 18-May-2021. Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. Patient?s cardiovascular risk factors are an important confounder for the event atrial flutter.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. Patient?s cardiovascular risk factors are an important confounder for the event atrial flutter.


VAERS ID: 1367170 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angina pectoris, Cardiac disorder, Chest discomfort, Chest pain, Dyspnoea at rest, Hypersensitivity, Pain
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Hypersensitivity (narrow), Respiratory failure (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: Medical History/Concurrent Conditions: Heart disease, unspecified
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021556759

Write-up: Shortness of breath/ woke up at 3am with shortness of breath; felt like he was having an angina attach; chest pain; chest pain and tightness; allergic like reaction; an aching pain; heart disease; This is a spontaneous report received from a contactable consumer (patient). A 57-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 14May2021 as single dose for Covid-19 immunization. Medical history included heart disease (patient had a history of heart disease and he had heart surgery in 2008. Patient did not take heart disease medications). The patient''s concomitant medications were not reported. Historical vaccine included the first dose of BNT162B2 for Covid-19 immunization and was observed for 15 minutes and he felt fine and when he got home then he started feeling light headed and tired. Patient had the second dose on 14May2021 and patient woke up at 3am on 17May2021 with shortness of breath and he felt like he was having an angina attach which he had had before. Patient had chest pain and tightness, like an allergic like reaction. His chest was still having mild pain but not as severe. He woke up at about 03:00 this morning, on 17May2021 and started feeling shortness of breath. After the Pfizer BioNTech Coronavirus Vaccine shot on 14May2021 he was feeling great, fine. This morning the shortness of breath just hit him, an aching pain. He had heart disease for one thing; and he consulted with the nurse, informed her that he had heart disease; and she mentioned this won''t affect anything to do with your heart disease. When he was feeling shortness of breath it was kind of like an allergic reaction so he wanted some more information on this, to see if that had anything to do with the Pfizer BioNTech Coronavirus Vaccine. Patient clarified he was not having the shortness of breath at time of the call, but had ongoing tightness of chest. Outcome of events shortness of breath was recovered and tightness of chest was not recovered and the other events was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1367175 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-17
Onset:2021-05-17
   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 - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dementia, Dementia Alzheimer's type, Hallucination, Nervous system disorder
SMQs:, Anticholinergic syndrome (broad), Dementia (narrow), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021557195

Write-up: hallucinations; neurological disorder classified as early Alzheimer''s/dementia; neurological disorder classified as early Alzheimer''s/dementia; neurological disorder classified as early Alzheimer''s/dementia; This is a spontaneous report from a contactable pharmacist. An 80-year-old female patient (non-pregnant at time of vaccination) received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 17May2021 as single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not provided. Unknown if the patient received any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient did not diagnose with COVID-19. Since the vaccination, it was unknown if the patient had been tested for COVID-19. On 17May2021, the patient was admitted to the hospital due to hallucinations, neurological disorder classified as early Alzheimer''s/dementia. AE resulted in Emergency room/department or urgent care, Hospitalization. Unknown if patient had treatment received for events. The outcome of the events was unknown. This report was assessed by the reporting pharmacist as serious; the seriousness criteria was caused/prolonged hospitalization. Information on the lot/batch number has been requested.; Sender''s Comments: The information available in this report is limited and does not allow a medically meaningful assessment. Based on the limited information provided, the reported events are likely intercurrent condition that is unrelated to BNT162B2. This case will be reassessed once additional information becomes available. 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: 1367205 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-01-19
Onset:2021-05-17
   Days after vaccination:118
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210517; Test Name: Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC2021561492

Write-up: positive COVID test, nasal swab/ developing a cough/fatigue, sore throat, lost sense of taste/smell; positive COVID test, nasal swab/ developing a cough/fatigue, sore throat, lost sense of taste/smell; This is a spontaneous report from a contactable consumer (patient). A 26-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EL3247) intramuscular in left arm single dose for COVID-19 immunization; second dose on 09Feb2021, first dose on 19Jan2021, at 25-year-old. The patient medical history was not reported. The patient''s concomitant medications were not reported. The patient received a positive COVID test on 17May2021. COVID test post vaccination via nasal swab tested positive on 17May2021. On 12May2021, the patient started developing a cough/fatigue. On 15May2021, the patient developed a sore throat. On 15May2021, the patient lost sense of taste/smell. Outcome of the events was unknown.


VAERS ID: 1367209 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-17
Onset:2021-05-17
   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 EW01S5 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscle spasms, Nausea, Pain, Pyrexia, Rash, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021562314

Write-up: throwing up; feels nauseous; fever; rash, growing on the arm she got the covid vaccine; severe cramping; pain; This is a spontaneous report from a contactable consumer (patient). This 20-year-old female patient received BNT162B2 (Pfizer-BioNTech COVID-19 mRNA vaccine) (lot number: EW01S5), dose 2, via an unspecified route of administration in the left arm on 17May2021 08:35 (at the age of 20-years-old) as 2nd DOSE, SINGLE for covid-19 immunisation. The patient''s medical history was not reported. Concomitant medications were reported as none. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient previously received BNT162B2 (Pfizer-BioNTech COVID-19 mRNA vaccine) (lot number: EW0167), dose #1, via an unspecified route of administration in the left arm on 26Apr2021 at 08:35 as 1st DOSE, SINGLE for COVID-19 immunization and experienced no adverse effects. After the first dose of the vaccine, the patient reported being fine. After the second dose, on 17May2021, the patient reported experienced severe cramps at 10:00. The patient developed a rash on the same day at 12:00 that is reportedly growing on the arm she got the covid vaccine. At about 23:00, she could not handle the pain and was going to go to the emergency room, but her mother talked out of it and told her to sleep it off. On 17May2021 at 23:30, the patient experienced a fever. And at 00:00 on 18May2021, the patient reported throwing up. At around 02:00 on 18May2021, the patient awoke screaming in pain. It was not a period cramp. She stated she could not tolerate it. She stated the fever comes and goes. The patient mentioned every time she smells food, she wants to vomit. She feels nauseous. The adverse events experienced did not require a visit to the emergency room or to a physician''s office. Clinical outcome of the event severe muscle spasms was not resolved. Clinical outcome of the remaining events was unknown.


VAERS ID: 1367214 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-05-15
Onset:2021-05-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Rash, Vaccination site erythema, Vaccination site pain, Vaccination site pruritus, Vaccination site swelling, Vaccination site warmth
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: ATORVASTATIN; METOPROLOL; EXCEDRIN [CAFFEINE;PARACETAMOL]; XANAX; SUDAFED [XYLOMETAZOLINE HYDROCHLORIDE]
Current Illness: Blood cholesterol abnormal (Verbatim: Cholesterol)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021563279

Write-up: I got a large cutaneous erythema at the site of the injection which was still very warm and is swollen and itchy and it hurts; I got a large cutaneous erythema at the site of the injection which was still very warm and is swollen and itchy and it hurts; I got a large cutaneous erythema at the site of the injection which was still very warm and is swollen and itchy and it hurts; I got a large cutaneous erythema at the site of the injection which was still very warm and is swollen and itchy and it hurts; I got a large cutaneous erythema at the site of the injection which was still very warm and is swollen and itchy and it hurts; Rash; This is a spontaneous report from a contactable consumer (patient). A 71-year-old female patient received bnt162b2 (BNT162B2), dose 2 via an unspecified route of administration, administered in Arm Left on 15May2021 (Batch/Lot Number: EW0182) as single dose for covid-19 immunisation at the age of 71-year-old. Medical history included ongoing blood cholesterol abnormal. Concomitant medications included atorvastatin taken for blood cholesterol abnormal; metoprolol; caffeine, paracetamol (EXCEDRIN [CAFFEINE;PARACETAMOL]); alprazolam (XANAX) taken for sleep disorder; xylometazoline hydrochloride (SUDAFED [XYLOMETAZOLINE HYDROCHLORIDE]) taken for sinus disorder. The patient reported it''s the second shot and it was 15May2021 of this year. On 17May2021, its delayed by 3 days but I got a large cutaneous erythema at the site of the injection which was still very warm and is swollen and itchy and it hurts not so bad that I can little bit but itself hurts no so bad that I can live with it but it still hurts. Now its second day of it and I still have it. I used ice according to the pharmacist told me do. I am taking Benadryl since yesterday. I guess you could call it a rash. It started yesterday and it is continuing today. I only took one tablet Benadryl one time 25 mg. The reporter stated may be a few months ago. Everything was good all my labs were good. The outcome of events was not recovered.


VAERS ID: 1367220 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-17
Onset:2021-05-17
   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 - / 1 RA / -

Administered by: School       Purchased by: ?
Symptoms: Arthralgia, Eye pain, Feeling abnormal, Headache, Joint stiffness, Musculoskeletal stiffness, Pain, Pain in extremity, Paraesthesia, Vitreous floaters
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Glaucoma (broad), Retinal disorders (narrow), 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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Clot blood (They put a lot of shots in her stomach for blood clots.); COVID-19 (She was hospitalized for pneumonia, hysterectomy, and COVID19 in 2020.); Hysterectomy (She was hospitalized for pneumonia, hysterectomy, and COVID19 in 2020.); Pneumonia (She was hospitalized for pneumonia, hysterectomy, and COVID19 in 2020.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021566772

Write-up: felt like someone was putting pins on her head/it hurt; The joints were hurting/It was stiff; The joints were hurting/It was stiff; When she was asleep she was seeing green and another color bright shells going; someone poking her with a needle in her leg; all over her body it felt like pins going in; stiff; Her knees were hurting; headache; had a horrible feeling and felt like the walls were crawling in; pains all over the body; Eyes are hurting; This is a spontaneous report from a contactable consumer (patient). A 70-year-old female patient received first dose BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection; Batch/Lot number: It is handwritten. It is either EW0186 or EWD186., Expiration date: Unknown), via an unspecified route of administration in right arm on 17May2021 as single for covid-19 immunization. The patient''s medical history included has been in the hospital three times this last year. They put a lot of shots in her stomach for blood clots. Patient was hospitalized for pneumonia, hysterectomy, and COVID19. She had all the hospitalizations in 2020. When she got home after she had pneumonia, 2 days later she had COVID19 because one of her family members had it. Hospitalizations were prior to COVID shot. She has had fever shot and pneumonia shot and not had this issue. She gets the fever shot every year. The patient''s concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient did not receive any additional vaccines on same date of the Pfizer Suspect. Patient took COVID shot on 17May2021, Monday and everything was ok. It did hurt when they stuck the needle in. Eight hours later she felt like someone was putting pins on her head. She rubbed it because it hurt. The joints were hurting on her right side where they put it. It was stiff. She did exercise and started moving it because she didn''t want it to be stiff. It has been hurting. When she was asleep she was seeing green and another color bright shells going. She was experiencing someone poking her with a needle in her leg. All over her body it felt like pins going in. Patient''s knees were hurting. She got up in the morning and last night she had pains all over the body. For 8 hours it was stiff but then it was fine. She also had pain on the left. She has not had a fever. Patient''s eyes are hurting on 17 May 2021. It is like a headache, get a little and eyes hurt. She went to work Wednesday, she had a horrible feeling and felt like the walls were crawling in. She is supposed to go in three weeks for second dose. The second shot would be worse, and she feels like that will be a danger. She expressed her concerns about the second shot as she read in the paper that the second one is more stronger. She doesn''t plan to get the second one. Something could happen to her with the second shot. The paper said the second shot would have side effects. The people that have done the second shot got sleepy, dizzy, and weak. She want to make sure she can get to work but was still experiencing the adverse events. The outcome of eyes are hurting was not recovered, while with other events was unknown. No follow-up attempts are needed; information about lot/batch number cannot be obtained.


VAERS ID: 1367222 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-16
Onset:2021-05-17
   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 EW0172 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lethargy, Lymphadenopathy, Neck pain, Vaccination site pain
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: ADHD
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021567834

Write-up: Visibly and palpable enlargement of the left supraclavicular lymph node (Virchow''s node), accompanied with pain; Neck pain on posterior and left lateral aspect; Lethargy; Mild soreness of the left arm at the site of vaccination; This is a spontaneous report from a contactable healthcare professional (patient). A non-pregnant 33-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot Number: EW0172), via an unspecified route of administration in left arm, on 16May2021 at 10:00 AM (at the age of 33 years), as second dose, single dose, for COVID-19 immunization. The patient''s medical history included attention deficit hyperactivity disorder (ADHD). There were no concomitant medications. The patient previously took the first dose of BNT162B2 (Lot Number: ER8736) on 25Apr2021 at 12:00 PM (at the age of 33 years) for COVID-19 immunization (left arm). The patient had no known drug allergies (NKDA). The patient was not diagnosed with COVID-19 prior vaccination. The most recent vaccine was administered in a pharmacy or drug store facility. Two days after the second dose (as reported) (administered on 16May2021), the patient noted a visibly and palpable enlargement of the left supraclavicular lymph node (Virchow''s node), accompanied with pain, locally and neck pain on posterior and left lateral aspect starting on 17May2021. Other symptoms past the 24 hours of second dose administration (17May2021) were lethargy that lasted 2 days and mild soreness of the left arm at the site of vaccination. It was unknown if treatment was given for the events. The patient has not been tested for COVID-19 post vaccination. The patient recovered from "Lethargy" on 19May2021. The patient had not recovered from the other events.


VAERS ID: 1367231 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-17
Onset:2021-05-17
   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 - / 2 RA / -

Administered by: Other       Purchased by: ?
Symptoms: Limb discomfort, Panic disorder
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: USPFIZER INC2021568928

Write-up: Magnets are sticking to her arm/ started to get a little panicked when the magnet stuck to her arm; Magnets are sticking to her arm/ started to get a little panicked when the magnet stuck to her arm; This is a spontaneous report from a contactable consumer (Patient). A 42-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number was not reported), dose 2 via an unspecified route of administration, administered in Arm Right on 17May2021 (at the age of 42-year-old) as 2ND DOSE, SINGLE DOSE for covid-19 immunization. The patient medical history and concomitant medications were not reported. Family medical history relevant to AE and relevant tests was none. The patient did not emergency room and physician Office. The patient previously took first dose of BNT162B2 administered in Arm Right for COVID-19 immunization on 20Apr2021 and experienced headache. The patient experienced Magnets are sticking to her arm/ started to get a little panicked when the magnet stuck to her arm on 17May2021. It was reported that patient was received the second dose of the vaccine on 17May2021, and she reported that she experiences magnets are sticking to her arm on 17May2021, she also mentioned that a coworker has been experiencing the same thing. It was reported that the caller verified the information provided by the transferring agent. She would not believe it and saw videos of it online and tried it after she got it. She said that it physically happened to her and she said that she can feel the magnet pulling on her arm. She was concerned about something being in there that does not belong. She can feel the pull of the magnet. It was reported that She started to get a little panicked when the magnet stuck to her arm and it kept happening. It was reported by the caller it held a fairly heavy magnet. The seriousness of the events was reported as non-serious. The outcome for events was not recovered. Information about batch/lot number has been requested.


VAERS ID: 1367278 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-09
Onset:2021-05-17
   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 EW0179 / 2 LA / -

Administered by: Work       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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021584913

Write-up: Shingles developed on abdomen.; This is a spontaneous report received from a contactable consumer (patient). A 42-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot Number: EW0179, and Expiration date: Unknown), via an unspecified route of administration, administered in left arm on 09May2021 15:45 (at the age of 42-year-old) as 2nd dose, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient did not receive any other vaccine within 4 weeks prior to the COVID vaccine. The patient had no allergies. The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot Number: ER8737, and Expiration date: Unknown), via an unspecified route of administration, administered in left arm on 18Apr2021 03:45 PM as 1st dose, single for COVID-19 immunization. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. On 17May2021, the patient experienced shingles developed on abdomen. The patient visited emergency room and physician office for the event. The patient received Valacyclovir as treatment for the event. The outcome of the event was reported as not recovered.


VAERS ID: 1367296 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-14
Onset:2021-05-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Lethargy, Oropharyngeal pain, Rash, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210519; Test Name: Nasal Swab; Result Unstructured Data: Test Result:Negative
CDC Split Type: USPFIZER INC2021588846

Write-up: lethargic; sore throat; radh; This is a spontaneous report from a contactable consumer or other non hcp. This consumer reported for a 15-years-old non-pregnant female patient received bnt162b2 (BNT162B2, Formulation: Solution for injection, Batch/Lot number: not reported), dose 1 via an unspecified route of administration, administered in Arm Left on 14May2021 16:30 as 1ST DOSE, SINGLE for covid-19 immunisation . The patient''s medical history was none. Patient''s concomitant medications were not reported. Patient had no known allergies. On17May2021, 3 days after vaccine, she had a very sore throat, radh and was lethargic. Patient treatment was unknown. It was reported that most recent COVID-19 vaccine was administered at Public Health Clinic. Patient did not received any other vaccines within 4 weeks prior to the COVID vaccine. Patient did not received any medications within 2 weeks of vaccination. Prior to vaccination, patient was not diagnosed with COVID-19. Since the vaccination, patient has been not tested for COVID-19. The patient underwent lab tests and procedures which included sars-cov-2 test and strep: negative on 19May2021. The outcome of all event was recovering. Information on the batch/lot number has been requested.


VAERS ID: 1367299 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-16
Onset:2021-05-17
   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 - / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anger, Asthenia, Diplopia, Headache, Inflammation, Neck pain, Nervousness, Pain in extremity, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Hostility/aggression (narrow), Ocular motility disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021592567

Write-up: Inflammation of entire body/ specifically lower body; Headaches; double vision; Low energy; Low sensation; Neck pain; Extreme foot pain; Nervousness; anger; This is a spontaneous report from a contactable consumer (patient, self-reported). A 33-year-pld male patient received bnt162b2 (COMIRNATY, Formulation: Solution for injection, Lot number and Expiry date: unknown), dose 2 via an unspecified route of administration in the right arm, on 06May2021 at 17:00, as single for COVID-19 immunization in the pharmacy or drug store. The patient''s medical history and concomitant medications were not reported. The patient had no allergies. The patient previously patient received bnt162b2 (COMIRNATY, Formulation: Solution for injection, Lot number and Expiry date: unknown), dose 1 via an unspecified route of administration in the right arm, on 24Apr2021 at 11:00, as single for COVID-19 immunization. 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 was not tested for COVID-19 since the vaccination. The patient did not receive any other medications within 2 weeks prior. On 17May2021 at 01:00, the patient had inflammation of entire body/ specifically lower body, headaches, double vision, low energy, low sensation, neck pain, extreme foot pain, nervousness, and anger. The outcome of the events were not recovered. Information on the lot/batch number has been requested.


VAERS ID: 1367395 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-17
Onset:2021-05-17
   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 EW0183 / 1 LA / OT

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Insomnia, Muscle spasms, Paraesthesia, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy (when he was a child); Rash (allergy to penicillin)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021601835

Write-up: Spasms in hands and feet/spasms in his feet was a weird sensation like little explosions going off, like a nerve issue, around feet, toes, and ankles; Both hands went numb; Both hands went numb and were tingling quite a bit and the next day when he woke up it was worse; He is having the tremors around ankles and feet; It is very uncomfortable and has not been able to sleep well because of it.; This is a spontaneous report from a contactable consumer (patient). A 46-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, lot number: EW0183), via intramuscular route administered in left arm (left shoulder as reported) on 17May2021 (age 46-year-old at time of vaccination) (in noon as reported) as single dose for preventative/COVID-19 immunisation. Medical history included had an allergy to penicillin and that was when he was a child, he thinks he had a rash. He does not know if he was still allergic. Prior Vaccinations (within 4 weeks) were none. Concomitant medications were none. It was reported that the evening after getting the first shot on 17May2021, both hands went numb and were tingling quite a bit and the next day when he woke up it was worse. On the third day after getting the shot he started getting and was still have spasms in hands and feet on 20May2021. The spasms in feet was a weird sensation like little explosions going off, like a nerve issue, around feet, toes, and ankles, stated it was also in his hands but not quite as much in hands. He still has numbness and tingling in hands and fingers. It was worrisome since he was an artist and paints. It is hard to paint with numbness and tingling. The numbness and tingling has stayed the same but there are periods of it getting intense from time to time, it has not subsided. He was hoping it would only last 2 or 3 days. As he was talking, he was having the tremors around ankles and feet in 2021. It was very uncomfortable and had not been able to sleep well because of it in 2021. The spasms are still the same, if anything they have worsened. No treatment received for events. The outcome of events tremor and insomnia was unknown and for remaining events was not recovered. Follow up needed, further information has been requested.


VAERS ID: 1367742 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-13
Onset:2021-05-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I take a prenatal vitamin, fish oil, Zofran, and Doxylamine.
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: No, I only received a follow up email from her on 06/01/2021 since it hasn''t gone down or subsided and that I am nervous about getting the 2nd dosage. She let me know continue to continue with the 2nd dose since the research and literature stated that it could take up to 8 weeks for my swollen Lymph Node to go down.
CDC Split Type: vsafe

Write-up: I noticed a very large swollen Lymph Node under your right arm and I immediately went to Doctor after receiving email her (ask me to come in). She acknowledged that it was very large and said that it should go down but if it didn''t go down she would need to see me again. My Doctor let me know that from some literature that it could be a side effect.


VAERS ID: 1367896 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-02
Onset:2021-05-17
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Blood osmolarity decreased, Cerebral infarction, Hyponatraemia, Seizure
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Systemic lupus erythematosus (broad), Ischaemic central nervous system vascular conditions (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (narrow), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I63.9 - Cerebral infarction, unspecified N17.9 - Acute kidney failure, unspecified E87.1 - Hypo-osmolality and hyponatremia R56.9 - Unspecified convulsions


VAERS ID: 1367954 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-09
Onset:2021-05-17
   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 ER8729 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Epistaxis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Nose Bleeds


VAERS ID: 1368156 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-05-17
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: D69.6 - Thrombocytopenia


VAERS ID: 1368206 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014B21A / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Exposure during pregnancy, Foetal death, Intermenstrual bleeding, Ultrasound antenatal screen abnormal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sulfasalazine, Azathioprine, Folic Acid, Prenatal vitamin
Current Illness: None
Preexisting Conditions: Ulcerative colitis
Allergies: None
Diagnostic Lab Data: I had a spotting on 5/29/21 and again on 6/1/21. I called my OB both times and they brought my in for an ultrasound on 6/1/21. On 6/1/21, it was determined via ultrasound that my baby passed away on the exact day that I received my first Moderna vaccine.
CDC Split Type:

Write-up: I was 14 weeks, 4 days pregnant when I received the vaccine. My due date was November 11, 2021. I had three ultrasounds prior to my shot and all showed that the baby was normal and healthy. We also had normal genetic testing results with this pregnancy. We found out in 6/1/2021 that we lost the baby and based on the size of the baby when it passed, it was determined that the baby passed on 5/17/21 - the date I received my first Moderna vaccine.


VAERS ID: 1368414 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-05-17
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Deep vein thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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: R leg DVT, Sx started 5/17, Dx 5/26


VAERS ID: 1368493 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-10
Onset:2021-05-17
   Days after vaccination:96
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / 2 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Back pain, COVID-19 pneumonia, Chest X-ray normal, Computerised tomogram abnormal, Inflammatory marker test, Liver function test increased, Pneumonia, Pyrexia
SMQs:, Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Admit 5/17. Vaccine 2/10. CHief complaint in ED lower back pain. Hx of Leukemia, degenerative disc disease. Developed high feveral. Admit COVID PNA. Elavated LFT, inflammatory markers. Neg CXR, CT shows lower lobe PNA. Treated w/antibiotics, steroid. Remained asymptomatic respiratory wise, stable on RA. DCd to home


VAERS ID: 1368613 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-07
Onset:2021-05-17
   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 ER8737 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Blood test, Exposure during pregnancy, Ultrasound scan
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (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: I take a anit depression meds Wellbutrin and prenatal vitamins.
Current Illness: No
Preexisting Conditions: I have Celiac and IBS.
Allergies: No
Diagnostic Lab Data: They did a ultra sound, full blood work and my HCG hormone tested and a physical done as well.
CDC Split Type: vsafe

Write-up: I was 6 weeks along and I was suppose to deliver in January 2022. I missed carried May 17, 2021. It can take upto 4 weeks with the miscarried.


VAERS ID: 1368840 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-19
Onset:2021-05-17
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Exposure during pregnancy, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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: Prenatal vitamin, low dose aspirin, Omeprazole,
Current Illness: None
Preexisting Conditions: Asthma, allergies
Allergies: None
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Woke up nauseas. Ended up vomiting after an hour or so. Vomited twice more that morning. I was 26 weeks pregnant. I am due Aug 21st 2021. Dr. Prescribed anti nausea meds and I took those. The next day I was feeling better no more symptoms.


VAERS ID: 1368904 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-22
Onset:2021-05-17
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Pneumonia
SMQs:, Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

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

Write-up: Pneumonia of right lower lobe due to infectious organism


VAERS ID: 1369024 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-03
Onset:2021-05-17
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hallucination, auditory
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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: CITALOPRAM, CLOZAPINE, GLYCOPYRROLATE, INGREZZA, PALIPERIDONE, TERAZOSIN
Current Illness: UNKNOWN
Preexisting Conditions: SCHIZOPHRENIA, CHRONIC INSOMNIA
Allergies: NKDA
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient reports that approx. two wks after dose 1, an increase in auditory hallucinations with greater conviction occurred. These were severe enough to warrant initiation of paliperidone on 05/27/21 as needed for breakthrough symptoms. Patient reports symptoms have subsided somewhat. Patient has formal diagnoses of Schizophrenia and Mild Mental Retardation.


VAERS ID: 1369567 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dysgeusia
SMQs:, Taste and smell disorders (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: Salty taste in mouth.


VAERS ID: 1370320 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C211A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebrovascular accident, Chest pain, Dyspnoea, Feeling abnormal, Headache, Heart rate increased, Paraesthesia, Speech disorder, Visual impairment
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LIPITOR; BABY ASPIRIN; METOPROLOL; VITAMINS [ASCORBIC ACID;ERGOCALCIFEROL;NICOTINAMIDE;RETINOL;RIBOFLAVIN;THIAMINE HYDROCHLORIDE]; PRASUGREL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Stent placement
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: sustained a stroke; lot of chest pain; experienced difficulty in breathing; heart rate went high up; headache; tingling sensation over the face, tingling sensation in the tongue; problem to speak well; " face felt wearied", "squeezing felling of the face"; ''I can''t see clearly, can''t read clearly, all letters are seen double; This spontaneous case was reported by a consumer and describes the occurrence of CEREBROVASCULAR ACCIDENT (sustained a stroke), CHEST PAIN (lot of chest pain) and DYSPNOEA (experienced difficulty in breathing) in a 58-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 021C211A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Stent placement. Concomitant products included ATORVASTATIN CALCIUM (LIPITOR), ACETYLSALICYLIC ACID (BABY ASPIRIN), METOPROLOL, ASCORBIC ACID, ERGOCALCIFEROL, NICOTINAMIDE, RETINOL, RIBOFLAVIN, THIAMINE HYDROCHLORIDE (VITAMINS [ASCORBIC ACID;ERGOCALCIFEROL;NICOTINAMIDE;RETINOL;RIBOFLAVIN;THIAMINE HYDROCHLORIDE]) and PRASUGREL for an unknown indication. On 17-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-May-2021, the patient experienced PARAESTHESIA (tingling sensation over the face, tingling sensation in the tongue), SPEECH DISORDER (problem to speak well), FEELING ABNORMAL (" face felt wearied", "squeezing felling of the face"), VISUAL IMPAIRMENT (''I can''t see clearly, can''t read clearly, all letters are seen double) and HEADACHE (headache). On 19-May-2021 at 5:00 AM, the patient experienced CHEST PAIN (lot of chest pain) (seriousness criterion hospitalization), DYSPNOEA (experienced difficulty in breathing) (seriousness criterion hospitalization) and HEART RATE INCREASED (heart rate went high up). On 20-May-2021, the patient experienced CEREBROVASCULAR ACCIDENT (sustained a stroke) (seriousness criteria hospitalization and medically significant). The patient was hospitalized from 20-May-2021 to 23-May-2021 due to CEREBROVASCULAR ACCIDENT. At the time of the report, CEREBROVASCULAR ACCIDENT (sustained a stroke), CHEST PAIN (lot of chest pain), DYSPNOEA (experienced difficulty in breathing), PARAESTHESIA (tingling sensation over the face, tingling sensation in the tongue), SPEECH DISORDER (problem to speak well), FEELING ABNORMAL (" face felt wearied", "squeezing felling of the face"), VISUAL IMPAIRMENT (''I can''t see clearly, can''t read clearly, all letters are seen double), HEART RATE INCREASED (heart rate went high up) and HEADACHE (headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Treatment included blood thinner medications started while the patient was at the hospital. The patient saw their healthcare provider on 23-May-2021 who advised them to cancel the scheduled second dose of the vaccine until the patients health is stabilized. The stent placement is in the heart. Company Comment: Very limited information regarding these events have been provided at this time. Further information has been requested. Subject''s history of stent placement in the heart can be a confounding factor.; Sender''s Comments: Very limited information regarding these events have been provided at this time. Further information has been requested. Subject''s history of stent placement in the heart can be a confounding factor.


VAERS ID: 1370560 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-05-11
Onset:2021-05-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 88945 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Anaphylactic reaction, Blood test, Erythema, Hyperhidrosis, Inflammation, Injection site pain, Pain, Pain in extremity, Peripheral swelling, Pruritus, Skin burning sensation, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: DEXILANT
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (He did not know initially he had it. He had lost of taste and smell.); Gastrooesophageal reflux disease; Testosterone decreased
Allergies:
Diagnostic Lab Data: Test Name: blood; Result Unstructured Data: Test Result:unknwon result
CDC Split Type: USPFIZER INC2021564202

Write-up: Anaphylactic reaction; skin was on fire; sweating; stomach cramps; throwing up; his arms and saw they were solid red; inflamed; hands swelled up; itchy; sore; sore where injected the Testosterone into left arm.; sore where injected the Testosterone into left arm.; This is a spontaneous report from a contactable consumer (patient). An 49-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in arm left on 11May2021 16:45 (Lot Number: EW0182; Expiration Date: 31Aug2021) as 1st 0.3 ml single dose at the age of 49-years-old for covid-19 immunisation; testosterone cipionate, via an unspecified route of administration from 2020 (Lot Number: 88945; Expiration Date: 30Sep2021) and ongoing, at 150 mg, 2x/week (150 mg injection bi weekly ) for gonads, low testosterone. The patient medical history included low testosterone, gastrooesophageal reflux disease, COVID in the past (He did not know initially he had it, he had lost of taste and smell). Concomitant medication included dexlansoprazole (DEXILANT) taken for gastrooesophageal reflux disease from an unspecified start date and ongoing. None prior vaccinations (within 4 weeks). No family medical history relevant to AEs. No additional vaccines administered on same date of the pfizer suspect. The patient experienced anaphylactic reaction (medically significant) on 17May2021. Time of onset (24-hour clock): Roughly 18:00. Usually he took the testosterone in the morning, but he forgot. He was wrapping up the day, took the testosterone and by 18:02 he was on the ground, cold. The patient got his vaccination last Tuesday (11May2021). He was also on testosterone for gonadism. He usually administered the vaccine in his shoulders. He took the testosterone bi-weekly. On Monday he administered it his left shoulder and on Thursday it is in his right shoulder. After getting the vaccine he administered testosterone in his right shoulder on Thursday and had no issues. The patient mentioned everyone else who got the COVID Vaccine he knows had sore arm, nausea, but he did not have any of that. On Monday (17May2021) he injected his testosterone into the same arm/location, left arm, where he got the COVID vaccine and had an anaphylactic reaction. He contacted his doctor and went to the emergency room. The patient confirmed he felt like he had recovered completely from the anaphylactic reaction. Caller clarified the anaphylactic reaction. He did the testosterone injection in the same spot he had the COVID injection. Within 5 minutes it was like his skin was on fire. He was sweating, had stomach cramps, and was throwing up. Once he stopped throwing up he looked at his arms and saw they were solid red. They were all inflamed. His legs were inflamed. His hands swelled up. They were red. He had to take his wedding ring off. He was itchy. It was like he was on fire. He was sore, and sore where injected the Testosterone into left arm. He confirmed he had no problems swallowing or breathing. Based on the symptoms he was experiencing he realized these were things listed to be aware of when getting the COVID shot and to seek medical attention for. He went to the ER and they verified it was an anaphylactic reaction. Treatment included: He was given an Epi-Pen. It made him feel like off, like he had too much coffee or something. he was also given Benadryl and some Anti-Inflammatory to calm his body down. Investigations: He had blood drawn at the ER. However, he does not know if was actually tested. He was informed when the nurse drew blood it would be up to the doctor, but he has no knowledge if anything was done. Action taken of testosterone cypionate was dose not changed. Outcome of the events was recovered on 17May2021.


VAERS ID: 1370572 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-15
Onset:2021-05-17
   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 EW0177 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pulmonary embolism
SMQs:, Embolic and thrombotic events, 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Sulfonamide allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021565368

Write-up: Pulmonary embolism; This is a spontaneous report from a non-contactable pharmacist. A 32-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0177; Expiration date was not reported) on 15May2021 (13:45) as a 1st dose, single dose, with route of administration unspecified, for COVID-19 immunization. Medical history included allergies to sulfa. The patient''s concomitant medications were not reported. The patient was not pregnant at the time of vaccination. On 17May2021, the patient had pulmonary embolism. The event had resulted into an emergency room/department or urgent care. The patient had received enoxaparin (LOVENOX) as treatment for the event. The outcome of the event was recovering. The patient was not diagnosed with COVID-19 prior to vaccination, and had not been tested since the vaccination. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported event of pulmonary embolism due to temporal relationship. However, the reported event may possibly represent intercurrent medical condition in this patient. There is limited information provided in this report. Additional information is needed to better assess the case, including complete medical history, diagnostics including pulmonary angiogram, VQ scan, chest CT/MRI and coagulation panel, counteractive treatment measures and concomitant medications including any history of use of oral contraceptives. This case will be reassessed once additional information is available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.


VAERS ID: 1370578 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-17
Onset:2021-05-17
   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 EW0178 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Arrhythmia, Chest discomfort, Chest pain, Heart rate increased, Palpitations
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypoglycaemia (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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021566513

Write-up: felt like he could collapse, He felt like he was going into cardiac arrest; heart beat increased really fast; He felt his heart beating up to his neck; had slight chest pain; feeling uncomfortable in his chest; anxious; This is a spontaneous report from a contactable consumer (patient). A 31-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Left on 17May2021 13:50 (Batch/Lot Number: EW0178) (at the age of 31 years old) as 1ST DOSE, SINGLE DOSE for COVID-19 immunisation. Medical history was none. There were no prior vaccinations within 4 weeks. There were no family history and no relevant tests. The patient''s concomitant medications were not reported. Patient took the first dose of the COVID vaccine. About 25 minutes after, all of a sudden, his heartbeat increased really fast. He could not figure out what was going on. He had slight chest pain as well. It started out with him feeling uncomfortable in his chest. He told his wife that something was wrong. He was driving and had to pull over on the side of the road. The total episode lasted two to three minutes. He felt like he was going into cardiac arrest. His wife called 911. Within five minutes, they were there. They checked him out, and everything was normal. He thinks that normally his heart beats 70 to 80 beats per minute. His heart felt like it was beating 200 beats per minute. He felt his heart beating up to his neck. He felt like he could collapse. He clarifies that his heart was beating very fast for about 30 seconds. After that, his heart was still beating fast, but it started going down. Then after two minutes, it started going back to normal. His heart was still beating fast because he was still very anxious. He thinks the anxiety after ward was making his heart pump very fast. He was going to talk with his doctor next week to get checked out and find out if he has any underlying heart problems. He has never had any heart issues in the past. The outcome of events was recovered. No follow-up attempts are needed. No further information is expected.


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