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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 153 out of 3,524

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VAERS ID: 1357137 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-01
Onset:2021-05-16
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram, Computerised tomogram thorax, Cough, Dyspnoea, Full blood count normal, Metabolic function test normal, Pleural effusion, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LIPITOR; GABAPENTIN; IRBESARTAN; ROPINIROLE; LANTUS; METOPROLOL; SINGULAIR
Current Illness: Hypertension; Type 2 diabetes mellitus (TYPE 2)
Preexisting Conditions: Medical History/Concurrent Conditions: Hyperlipidemia; Lung cancer; Neuropathy; Radiation therapy; Restless leg syndrome; Tobacco user
Allergies:
Diagnostic Lab Data: Test Name: CT scan; Result Unstructured Data: Confluent right hilar lymphadenopathy and a large effusion was seen; Test Name: CT CHEST; Result Unstructured Data: abnormal; Comments: Showed vague ground glass opacities left lung base possibly representing pneumonitis or atelectasis; Test Name: cbc normal; Result Unstructured Data: normal; Test Name: cmp normal; Result Unstructured Data: normal; Test Name: COVID-19; Test Result: Negative ; Result Unstructured Data: NEGATIVE
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Large R pleural effusion; Worsening shortness of breath; cough; This spontaneous case was reported by an other health care professional and describes the occurrence of PLEURAL EFFUSION (Large R pleural effusion) and DYSPNOEA (Worsening shortness of breath) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 044B21A and 027C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Lung cancer in 2007, Restless leg syndrome, Tobacco user, Neuropathy, Hyperlipidemia and Radiation therapy in 2010. Concurrent medical conditions included Hypertension and Type 2 diabetes mellitus (TYPE 2). Concomitant products included ATORVASTATIN CALCIUM (LIPITOR), GABAPENTIN, IRBESARTAN, ROPINIROLE, INSULIN GLARGINE (LANTUS), METOPROLOL and MONTELUKAST SODIUM (SINGULAIR) for an unknown indication. On 01-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 16-May-2021, the patient experienced PLEURAL EFFUSION (Large R pleural effusion) (seriousness criterion hospitalization), DYSPNOEA (Worsening shortness of breath) (seriousness criterion medically significant) and COUGH (cough). The patient was hospitalized for 1 day due to PLEURAL EFFUSION. At the time of the report, PLEURAL EFFUSION (Large R pleural effusion), DYSPNOEA (Worsening shortness of breath) and COUGH (cough) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Computerised tomogram: Confluent right hilar lymphadenopathy and a large effusion was seen. On an unknown date, Computerised tomogram thorax: abnormal (abnormal) abnormal. On an unknown date, Full blood count normal: normal (normal) normal. On an unknown date, Metabolic function test normal: normal (normal) normal. On an unknown date, SARS-CoV-2 test: negative (Negative) NEGATIVE. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Cytology was significant for reactive mesothelial cells and negative for any malignancy. confluent right hilar lymphadenopathy and a large effusion was seen. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. This case was linked to MOD-2021-162944 (Patient Link).; 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: 1357319 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-15
Onset:2021-05-16
   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 EW0185 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dysphagia, Fatigue, Lip swelling, Peripheral swelling, Throat tightness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SPIRONOLACTONE; ALLEGRA; FLONASE [MOMETASONE FUROATE]; PRILOSEC [OMEPRAZOLE MAGNESIUM]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; GERD; Seasonal allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021549928

Write-up: minor swelling of my lips, hands, feet; minor swelling of my lips, hands, feet; extreme fatigue; a feeling of tightness and some difficulty swallowing in my throat; a feeling of tightness and some difficulty swallowing in my throat; This is a spontaneous report from a contactable consumer (patient). A 34-year-old non-preganant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), second dose via an unspecified route of administration, administered in left arm at the age of 34-year-old on 15May2021 16:30 (Batch/Lot Number: EW0185) as single dose for covid-19 immunisation. Medical history included seasonal allergies, asthma, gastrooesophageal reflux disease(GERD). Concomitant medications included spironolactone; fexofenadine hydrochloride (ALLEGRA); mometasone furoate (FLONASE); omeprazole magnesium (PRILOSEC), all the medications received from 2021 (within 2 weeks of vaccination). The patient previously took sulfa and doxycycline. The patient previously took BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), first dose via an unspecified route of administration, administered in left arm at the age of 34-year-old on 17Apr2021 18:00 (Batch/Lot Number: EW0164) as single dose for covid-19 immunisation. The patient woke up the next day with minor swelling of her lips, hands, feet, and a feeling of tightness and some difficulty swallowing in her throat. The swelling receded with a non drowsy antihistamine but the feeling of extreme fatigue and a histamine reaction continued. No treatment received for events a feeling of tightness and some difficulty swallowing in her throat. The start date of all events was on 16May2021 08:00 and no hospitalization prolonged. The patient didn''t receive any other vaccines within 4 weeks prior to the COVID vaccine. The outcome of the events was recovering.


VAERS ID: 1357692 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-12
Onset:2021-05-16
   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 ER8730 / 1 LA / IM

Administered by: Other       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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: advil, benadryl,
Current Illness:
Preexisting Conditions:
Allergies: mushrooms, penicillin,
Diagnostic Lab Data:
CDC Split Type:

Write-up: rash all over body from head to toe. It is especially bad on legs, groin, back, arms and wrist. Went to PCP Dr. on 5/18/2021 and was prescribed prednisone. Went back 5/19/2021 was given a methylprednisolone pack. This helped clear up the rash but after the medicine was completed the rash came back by 5/27/2021. Went back to work and feels like the heat made the symptoms worse.


VAERS ID: 1357872 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-05
Onset:2021-05-16
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram thorax abnormal, Fibrin D dimer increased, Lymphadenopathy mediastinal, Oropharyngeal pain, Painful respiration, Pleural effusion, Pleuritic pain, Pulmonary embolism, Pyrexia, Tachycardia
SMQs:, Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (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: no
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: D-dimer $g500 CT chest: Bilateral lower lobe pulmonary emboli; moderate mediastinal adenopathy with large subvarinal node, of unclear etiology; small left pleural effusion
CDC Split Type:

Write-up: The patient presented to his PCP''s office with a 2 day history of chest pain associated with deep inhalation NOT relieved by heat or Tylenol. He was vaccinated with the Moderna COVID vaccine on May 5th which caused fevers and sore throat that resolved. His pleuritic left sided chest pain began 11 days from vaccination. Given the symptoms, the PCP ordered a CXR and d-dimer. Because of the elevated d-dimer and tachycardia while in the office, she ordered a CT chest for PE protocol. This showed bilateral pulmonary emboli so the patient was directed to the ER. He was admitted and started on anticoagulation therapy. Given the CT chest findings of adenopathy, Hemotalogy-Oncology service was consulted and ordered labs.


VAERS ID: 1358088 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-05-11
Onset:2021-05-16
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / UNK RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Blood test normal, Computerised tomogram normal, Facial paralysis, Facial paresis, Headache
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Panadol
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: CT Scan: everything normal. Blood Sample: everything normal.
CDC Split Type:

Write-up: I got diagnosed with Facial Paralysis (Bell''s Palsy) on the left side of the face. One of the signs were weakness on my face when trying to make gestures. The day before (May 15, 2021) I got a headache and when I woke up the other day I felt the weakness in my face. By the end of the day around 9:00 pm I went to the Emergency Room and got injected with Decadron, but the doctor didn''t diagnosed me nothing only to see a Neurologist. The other day (May 17, 2021) I tried to get in contact with my primary doctor to explain the situation but I had to wait for the next day for an appointment. By the end of the day (May 17, 2021) I went again to another Emergency Room where the doctor Diagnosed with Facial Paralysis (Bell''s Palsy). He ordered a CT Scan, blood sample and anti-inflammatory.


VAERS ID: 1358218 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 - / -

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

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

Write-up: Very loud and debilitating ringing in my ears. I?ve always had ringing in my ears for the last 36 years from my time spent board the flight deck of an aircraft carrier, however, shortly after receiving the vaccine the sound is very very loud and debilitating


VAERS ID: 1358515 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-16
   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 EW0183 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Condition aggravated, Guillain-Barre syndrome, Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: meclizine, Zyrtec, Ventolin, Flonase
Current Illness: COVID-19 07/2020, Guillain-Barre diagnosed 2001
Preexisting Conditions: Guillain-Barre
Allergies: NKDA
Diagnostic Lab Data: Neurology referral pending
CDC Split Type:

Write-up: flare of GB symptoms including lower extremity weakness, numbness, and tingling.


VAERS ID: 1358570 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-21
Onset:2021-05-16
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045A21A / 1 LA / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram abnormal, Anticoagulant therapy, Chest X-ray abnormal, Hypoxia, Lung infiltration, Pleural effusion, Pneumonia, Pulmonary embolism, Pulmonary mass, SARS-CoV-2 test negative
SMQs:, Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydrochlrothiazide
Current Illness: none reported
Preexisting Conditions: copd h/o breast cancer
Allergies: ace-I, coreg, asa, pcn, sulfa, Norvasc, provera
Diagnostic Lab Data: CXR 5/16: PLEURAL EFFUSION AND PNEUMONIA CT ANGIO OF CHEST 5/20/21: PACTHY INFILTRATE, RIGHT EFFUSION, PULMONARY NODULES AND PULMONARY EMBOLI LEFT LOWER LOBE COVID PCR NEGATIVE
CDC Split Type:

Write-up: PATIENT DEVELOPED HYPOXIA, PNEUMONIA, PLEURAL EFFUSION AND LEFT LUNG PULMONARY EMBOLI PATIENT WAS TREATED WITH ANTIBIOTICS, OXYGEN ANDF STARTED ON HEPARIN DRIP, WHICH WAS D/C AND PATIENT WAS STARTED ON LOVENOX PRIOR TO D/C. PATIENT ALSO NOTED TO HAVE PULMONARY NODULES ON IMAGING AND ARRANGMENTS MADE TO F/U OUTPATIENT FOR BIOPSY.


VAERS ID: 1358631 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-16
Onset:2021-05-16
   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 EW0187 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Musculoskeletal stiffness, Skin warm, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: He and father stated that he does not take any medications
Current Illness: no other illness, after vaccination father said he was walking around since he didn''t feel well, but when asked in VAR and in immunization selection tool he stated he was feeling fine.
Preexisting Conditions: none that he stated
Allergies: none when asked
Diagnostic Lab Data: nothing at this point
CDC Split Type:

Write-up: When patient arrived his guardian was not here so he sat and waited. When dad came, we registered patient as normal asking if he feels ill or not and he stated no. When I brought him back to the room we were talking about school and activities he is in and he seemed normal and answering normally just tired. I cleaned his arm and talked him through things that can happen with the second dose of Pfizer. He seemed just fine and once I injected and bandaged him he went stiff and I tried to talk to him and he did not respond. I called for help and they got his dad. he finally started coming too and was extremely warm. I sat with him for 10 to 15 minutes and rubbed his back and we got him water to drink. we started an incident report right away while talking to the dad. nothing further happened and he was told to go straight to the clinic to be checked out.


VAERS ID: 1358695 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-14
Onset:2021-05-16
   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 EW0186 / 1 LA / SYR

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

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

Write-up: On either side of his neck, h e got a red (not quite a rash) - it was not bumpy (like eczema) but patchy red. Lymph nodes were swollen on neck underneath those red patches. Itchy - On that Sunday, when I noticed it, the Pharmacist said to take: Oral Benadryl and topical Benadryl for adverse reaction. We did that for a week and it started to go away. I outlined the rash with sharpie - t did get bigger and started spreading down his shoulders. As of today, it''s cleared up - you can see a dark mark where it was but it''s fading away.


VAERS ID: 1358738 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-16
Onset:2021-05-16
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Acoustic stimulation tests, Fatigue, Headache, Injection site pain, Injection site pruritus, Tinnitus
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xanax, Diazepam. Metropolol and Vitamin D
Current Illness: None aside from my normal anixety
Preexisting Conditions: Anxiety and Panic attacks well controlled by medications, High BP slightly controlled by medications and obesity
Allergies: penicillin
Diagnostic Lab Data: ENT visit, tests and Audiological exam 05/24/2021
CDC Split Type:

Write-up: Got dose 2 on 04/16/2021 and had soreness at the injection site for several days, Not much else initially - Headache and fatigue on day 1&2 and a few sparse and self resolving episodes of ringing in ears in the weeks that followed and the occasional light headache or itching sensation at the site of the injection. Woke up on 05/16/2021 with persistent high pitched tinnitus have seen an urgent care doc and ENT and Audiologist since all to no avail or relief. The condition persists and may be permanent at this point they don''t know.


VAERS ID: 1358851 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-15
Onset:2021-05-16
   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 EW0175 / UNK RA / SYR

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

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

Write-up: Extreme redness/swelling/pain at injection site. Treated with ice and ibuprofen ? lasted for approximately one week after symptoms appeared.


VAERS ID: 1359035 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-05-03
Onset:2021-05-16
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028732114 / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal, Insomnia, Medical diet, Nausea, Panic attack, Tinnitus, Weight decreased
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad)

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

Write-up: I experienced an increase in volume of my tinnitus perception in my left ear. My head feels stuffy and I am slightly dizzy. These symptoms have caused insomnia, nausea, rapid weight-loss, and panic attacks. Treatment has been Flonase daily, anti-inflammatory diet, no caffeine, drinking lots of water, and resting.


VAERS ID: 1359870 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-06
Onset:2021-05-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK AR / UN

Administered by: Other       Purchased by: ?
Symptoms: Chills, Diarrhoea, Fatigue, Headache, Lethargy, Neck pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: 10 days after the injection (on 5/16) , husband had headache, lethargy, prolonged diarrhea (48+ hours), fever, chills, neck and body pain that lasted 4-5 days. (Wife with no injection on 5/21 got headache, nausea/bloating feeling and neck ache that lasted 4 days.) Husband resumed outdoor activities on 5/22 but began relapsing on 5/27 with headache, fatigue, neck and body pain that still persists as of date of this report (5/29). Item 21 is PENDING how this continues or hopefully resolves. It is still ongoing but your computer insists I must enter something...and you do not have a box indicating ongoing.


VAERS ID: 1360550 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-16
Onset:2021-05-16
   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 EW0177 / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Malaise, Rash, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 INC2021555201

Write-up: developed a rash whole left arm; Feeling dizzy; dizziness was kind of severe dizziness where felt like everything was moving around; weak; Shaking; Chilling; Does not feel ok; half an hour lying down; This is a spontaneous report from a contactable consumer reporting for their daughter (patient). A 12-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 at 12-years-old intramuscular, administered in arm left on 16May2021 (Batch/Lot Number: EW0177) as 1st dose, single dose for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. It was reported that within 5 minutes after taking the vaccine on 16May2021, the patient started feeling dizzy, weak and little bit of shaking, chilling. Dizziness was kind of severe dizziness where felt like everything was moving around her. They took her to urgent care center because she does not feel ok after half an hour lying down there. The doctors were there and they gave medications as an injection of Promethazine 25 mg temporarily at first and also gave Ondansetron 4 mg and prescribed Meclizine 25 mg three times a day for 5 days as needed (treatment). The patient got the reaction at 1145 am within five minutes feeling dizziness. After 30 minutes waiting were advised to take her to the urgent care. She was prescribed Promethazine 25mg, Ondansetron 4mg, Meclizine 3 times a day for next five days. Reports adverse event (unspecified) still maintains. Then later developed a rash, whole left arm on an unspecified date. Therapeutic measures were taken as a result which included injection of Promethazine 25 mg temporarily at first and also gave Ondansetron 4 mg and prescribed Meclizine 25 mg three times a day for 5 days as needed. The outcome of the events was unknown.


VAERS ID: 1360577 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-05-16
Onset:2021-05-16
   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 - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Feeling abnormal, Vomiting
SMQs:, Acute pancreatitis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021568159

Write-up: Felt bad; has stomach pain; vomiting; This is a spontaneous report from a contactable consumer (patient''s friend) via a medical information team. A 55-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection), via an unspecified route of administration on 16May2021 (at the age of 55-year-old) as a single dose for COVID-19 immunization. The patient''s medical history and concomitant medication were not reported. Caller says they have a friend put on the Pfizer COVID vaccine on Sunday, 16May2021 and since then has felt bad, has stomach pain and vomiting. He wants to know where to take him, whether to the doctor or a hospital. Advised the caller that they should take the patient to the physician as he could get the medical history of the patient and give medical recommendations and rule out possibilities. The outcome of the events was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1360818 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-16
Onset:2021-05-16
   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 ER8629 / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Dyspnoea, Extrasystoles, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Hypokalaemia (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 taken
Current Illness: None taken
Preexisting Conditions: None taken
Allergies: None taken
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: Mother states her son had palpitations, after 3 hours of his vaccine at about 4:30pm. She also states he also experienced SOB and he explained he missed a beat to his heart". The days after he had same symptoms, two times a day for the next three days. Mother states he experienced his symptoms about ten times a day for about 15 seconds. On the second day I called the doctor, nurse told her to take his pulse after he had an episode, difference was very slight during the 15 second pule taken, normal was 20bpm in 15 seconds and then it changed to 22bpm in 15 seconds. On Monday while talking to other classmates in school, another kid said he experienced the same thing like him. On Tuesday 05-25-2021, his mother states her son told her her felt some palpitations but as of today he has not had any more palpitations.


VAERS ID: 1360896 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-16
Onset:2021-05-16
   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 EZ9267 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Streptococcus test negative, Vomiting projectile
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (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:
Other Medications: Chlonidine, Vyvanse, latuda, magnesium, sertraline, vit D
Current Illness: n/a
Preexisting Conditions: ADHD, anxiety, depression, born addicted to drugs (adopted)
Allergies: Penicillin
Diagnostic Lab Data: strep; negative
CDC Split Type: vsafe

Write-up: 5/16 Vaccination By 8 PM he started to have a stomach ache. He had went to bed. Went to school, was fine. Diarrhea started at home. 5:00 PM projectile vomiting. Continued with diarrhea for 20 minutes, uncontrollable. No temperature. *Was fine the next day.


VAERS ID: 1361157 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 637C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injected limb mobility decreased, Injection site pain, Musculoskeletal stiffness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: pain at the injection site beginning approximately 30 seconds after injection; stiffening of the muscle to the point of immobility beginning 10 minutes after receiving injection lasting for two days; fever (100F) beginning approx. five hours after injection lasting 16 hours; pain in joints (particularly wrists and fingers) beginning approximately two days after injection continuing on and off for 1.5 weeks


VAERS ID: 1361299 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Chills, Diarrhoea, Injection site erythema, Pain, Palpitations, Pyrexia, Rash, Swelling, Vertigo, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever 103 Chills Body pain Heart palpitations Diarrhea Vomiting Vertigo Redness at injection site Rash Burning Swelling All last 4 + days All of these last 4 days


VAERS ID: 1361607 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Paraesthesia, Physical examination
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), 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: none
Current Illness: patient had covid first week of January
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient woke up with "tingling" all over. Patient called it "like a stroke situation." Patient experienced symptoms and went to ER on Tuesday. Doctors ran test for stroke and stated patient had Bells Palsy. Patient went back in on Friday to do stroke test again to rule out stroke.


VAERS ID: 1361831 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-08
Onset:2021-05-16
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Appendicectomy, Appendicitis, Laparoscopic surgery
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Codeine, sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Appendicitis - laparoscopic appendectomy


VAERS ID: 1361838 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Herpes zoster, Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline 25MG Standard Process: Immuplex, Rehmania Complex, Ligaplex Phosphatidyl Serine
Current Illness: none
Preexisting Conditions: Epstein barr virus
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately 24 hours after injection (05/16/21), lymph nodes became sore and painful under right arm. Within 48 hours lymph nodes under left arm, right arm and breasts became very painful and felt swollen and remained like that for 5 days (through 5/21/21) when side effects began to diminish. In addition, 48 hours after injection, shingles appeared on right back, shoulder and chest. Still dealing with the shingles to date (5/30/21). Have a DR. appointment on 6/1/21.


VAERS ID: 1361852 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Dyspnoea, Headache, Malaise, Pain, Pain in extremity, Pulmonary function test, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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: Montelukast 10 mg; Cetirizine 10 mg; Doxycycline - for acne; Flovent - 220 mg
Current Illness: no
Preexisting Conditions: asthma; lactose intolerant
Allergies: no
Diagnostic Lab Data: Primary Care Doctor - Wednesday - He did an exhale test on her breathing and the exhale was 58 and he was not pleased; said she should have been at least at a 75.
CDC Split Type: vsafe

Write-up: She had troubles breathing. On the first day, she also had headaches and tummy pain. On the second day, she vomited in school. She also had a headache and troubles breathing. She had belly pain, as well. On Wednesday, around lunch break she called me to pick her up, she had troubles breathing and headache and feeling blah. Also on the first evening, Her arm was hurting and her left body side was hurting. (Wednesday this got a little bitter but she still had pain on her front left side -- especially her left leg.) I took her to primary care and he prescribed Prednisone. Prednisone started then. On Thursday, she still had troubles breathing and she stayed home from school. On Friday, it was okay for her to go to school.


VAERS ID: 1362050 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrostep fe Nexium Allegra
Current Illness:
Preexisting Conditions: Pcos Gerd/ heart burn Seasonal allergies
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Loud ringing in ears from tinnitus


VAERS ID: 1362365 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Site: Pain at Injection Site-Medium, Additional Details: Patient called 14 days after vaccine to report that arm is still sore at site of injection and to see if that was normal. he stated that it is 5/10 pain level when trying to do things with that arm. no redness or swelling or warm to touch or rash. patient stated he could lift it regularly just sore. patient also stated that his wife got hers in her "shoulder" and his was given in his "arm". Patient concerned it was given too low....


VAERS ID: 1362797 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-01
Onset:2021-05-16
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

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

Write-up: Extended period- started very slowly, came on aggressively, lasted over two weeks


VAERS ID: 1363968 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-05-16
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Cough, Nasal congestion, Nasopharyngitis, Pain, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210558571

Write-up: LIGHT COUGH; RUNNY NOSE; COLD; NASAL CONGESTION; CHILLS; BODY PAIN; This spontaneous report received from a patient concerned a 45 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 205A21A, and expiry: 23-JUN-2021) dose was not reported, administered on 16-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 16-MAY-2021, the subject experienced body pain. On 16-MAY-2021, the subject experienced chills. On 28-MAY-2021, the subject experienced light cough. On 28-MAY-2021, the subject experienced runny nose. On 28-MAY-2021, the subject experienced cold. On 28-MAY-2021, the subject experienced nasal congestion. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body pain, and chills on 16-MAY-2021, and was recovering from light cough, runny nose, cold, and nasal congestion. This report was non-serious.


VAERS ID: 1363982 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-02
Onset:2021-05-16
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C219 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Encephalitis
SMQs:, Noninfectious encephalitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Encephalitis; This spontaneous case was reported by a patient family member or friend and describes the occurrence of ENCEPHALITIS (Encephalitis) in a 19-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014c219) for COVID-19 vaccination. No Medical History information was reported. On 02-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage form. On 16-May-2021, the patient experienced ENCEPHALITIS (Encephalitis) (seriousness criterion medically significant). At the time of the report, ENCEPHALITIS (Encephalitis) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant products were reported. The patient''s mother reported that on 06-May-2021, patient developed a headache on both sides of her head and lost coherence and mobility. On 15-May-2021, she had the same episode and lasted seven hours and they went to the hospital and on 16-May-2021 she was diagnosed with encephalitis, and still waiting for autoimmune test result. No treatment information provided. Company Comment: Very limited information regarding the event has been provided at this time. Further information has been requested.; Sender''s Comments: Very limited information regarding the event has been provided at this time. Further information has been requested.


VAERS ID: 1364007 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness postural, Fatigue, Headache, Loss of consciousness, Myalgia, Nausea, Pyrexia, Urticaria
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), 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), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BENADRYL ALLERGY RELIEF; TYLENOL; ADVIL [IBUPROFEN]
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Dizziness on standing; Muscle pain; Fatigue; Nausea; Headache; Fever; Blacked out; Hives; This spontaneous case was reported by a patient and describes the occurrence of LOSS OF CONSCIOUSNESS (Blacked out) in a 32-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 022C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included ACRIVASTINE (BENADRYL ALLERGY RELIEF), PARACETAMOL (TYLENOL) and IBUPROFEN (ADVIL [IBUPROFEN]) for an unknown indication. On 16-May-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-May-2021, the patient experienced URTICARIA (Hives). On an unknown date, the patient experienced LOSS OF CONSCIOUSNESS (Blacked out) (seriousness criterion medically significant), DIZZINESS POSTURAL (Dizziness on standing), MYALGIA (Muscle pain), FATIGUE (Fatigue), NAUSEA (Nausea), HEADACHE (Headache) and PYREXIA (Fever). At the time of the report, LOSS OF CONSCIOUSNESS (Blacked out), URTICARIA (Hives), DIZZINESS POSTURAL (Dizziness on standing), MYALGIA (Muscle pain), FATIGUE (Fatigue), NAUSEA (Nausea), HEADACHE (Headache) and PYREXIA (Fever) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1364010 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-05-16
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Still's disease
SMQs:, Arthritis (narrow), Immune-mediated/autoimmune 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: Medical History/Concurrent Conditions: Still''s disease
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Flare up of his Still''s disease; This spontaneous case was reported by a consumer and describes the occurrence of STILL''S DISEASE (Flare up of his Still''s disease) in a 21-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Still''s disease. On 09-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 16-May-2021, the patient experienced STILL''S DISEASE (Flare up of his Still''s disease) (seriousness criterion medically significant). At the time of the report, STILL''S DISEASE (Flare up of his Still''s disease) outcome was unknown. No concomitant medication provided. Treatment information was included steroids. Patient hasn''t had a flare up since August of 2018. Action taken with mRNA-1273 in response to the event was not applicable. Company comment: 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.A; 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.A


VAERS ID: 1364299 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-15
Onset:2021-05-16
   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 - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Rhinorrhoea
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 INC2021568166

Write-up: very serious headache; Really bad runny nose; This is a spontaneous report from a contactable consumer, the patient. A 25-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number was not reported, Expiration Date: 31Jul2021), dose 2 via an unspecified route of administration on 15May2021 as single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. Patient previously took First Dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Expiration date: 31Jul2021) on 24Apr2021 for Covid-19 immunisation. Patient experienced runny nose on16may2021. On 18may2021, he had headache and next morning wake up with more serious headache (very serious headache). The outcome of the event was unknown. Follow attempts are needed; information about lot/batch number cannot be obtained.


VAERS ID: 1364689 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-16
Onset:2021-05-16
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH #$2613 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Amenorrhoea, Menstruation irregular
SMQs:, Fertility 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: Escitalopram, Zetia, Progesterone, Estradiol Supplements: B complex, D, C, Women''s 1 a day, zinc, fish oil, red yeast rice
Current Illness: none
Preexisting Conditions: anxiety
Allergies: amoxicillin
Diagnostic Lab Data: non
CDC Split Type:

Write-up: I have not had a menstrual cycle in 13 months. I suddenly had a light cycle that lasted 5 days.


VAERS ID: 1364731 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Disturbance in attention, Dizziness, Fatigue, Lethargy, Limb discomfort, Mydriasis, Nausea, Pain in extremity, Pyrexia, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), 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: Flu shot I believe 2008 last time I had one because of adverse event
Other Medications: NP Thyroid Adrenal Cortex Extract D3+K2 Vit C Kyo Dophilus + Enzymes Vrital-Zymes Milk Thistle
Current Illness: I had stomach upset/gastritis GERD as a result of my brothers passing 6 days apart in February, my sister also had COVID at the same time, they all lived together, she survived.
Preexisting Conditions: Hypothyroidism and cortisol/adrenal issues. Slight high blood pressure.
Allergies: I dont'' have an allergy but rather I experienced a toxic response to the following drugs: Levequin, Bioxin and also Ciprodex which floxed me in August of 2020. I reported to Novartis and FDA.
Diagnostic Lab Data: I spoke to an allergist/televisit and explained my adverse symptoms because I am now terrified to get the next shot. I already had adrenal fatigue from Levaquin that I will struggle with and now I got classic adrenal symptoms that I''m having to come back from. Doctors don''t know how to treat for this, need the advice of functional medicine doctors which insurance does not cover. The same run around as with toxic antibiotics that floxed me. There is no follow up care when a drug or vaccine floxes you.
CDC Split Type:

Write-up: Outside of the typical symptoms of: Nausea, became lethargic as the day went on, arm sore, felt feverish, fell asleep 8pm earlier than usual. When I awoke I had tremors, my feet hurt upon standing and were heavy to walk. I felt as though something was weighting me down as I walk and was difficult and heavy to walk up stairs. I had pain in my lower back that was more of a dull heavy ache upon standing that got better as I walked. My eyes were dilatated and I felt faint. I rested the entire day and returned to work on Monday, but felt exhausted and like I had to spend more time for concentration on my work and work slower than usual. That lasted for about 10 days slowly getting better as time went on. after about day 8 the tremors had lessened were all but gone. Now about 15 days out, I am not at full energy but close, pain in feet has lessened and lower back better, but not fully healed and no more tremors.


VAERS ID: 1364782 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Gait disturbance, Vertigo
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vestibular disorders (narrow), Hypoglycaemia (broad)

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

Write-up: Severe Vertigo, dizziness and spinning. Lasted for 2 days, day 3 lessened to instability and milder dizziness lasting for 2 weeks. Still occurring.


VAERS ID: 1365056 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-05-15
Onset:2021-05-16
   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 EW0170 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthma, Chest pain, Condition aggravated, Cough, Dyspnoea, Pyrexia, Respiratory tract congestion, Throat irritation, Vaccination site pain
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Patient suffers from mild allergy induced Asthma.
Allergies: None
Diagnostic Lab Data: Test still being conducted.
CDC Split Type:

Write-up: Patient started to develop a cough on the second day of the vaccine around 6 pm. The cough was accompanied by shortness of breath, given his asthma we assumed this was some asthma related reaction to the vaccine. Nonetheless, that evening he started to complain about chest pain every time he laid back on his bed. This symptom is not common in previous asthma attacks. Sitting up alleviated the symptom, chest pain and shortness of breath lasted for 2 nights (Sunday and Monday evening), by Tuesday he felt better. We assumed this was an asthma episode, but recent reports of Myocarditis leads us to believe the had a mild myocarditis episode, given the chest pain while lying down. He also had typical COVID vaccine symptoms such as low grade fever (100F), pain in the vaccination site, congestion, and itchy throat.


VAERS ID: 1365181 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Spinal pain
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: History of arachnoid cyst with subdural hygroma
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Developed chest pain radiates to spine shortness of breath due to chest pain


VAERS ID: 1365248 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Blood test normal, Chest pain, Coagulation time, Computerised tomogram head, Contusion, Headache, Myalgia, SARS-CoV-2 test, Vein disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cingular 10mg, Daily Vitamin
Current Illness: none
Preexisting Conditions: Asthma
Allergies: Ibuprofen, Augmentin, shellfish, nuts.
Diagnostic Lab Data: Bloodwork to check clotting factor, basic blood panel and also a CT of my head. I was told everything was normal.
CDC Split Type: vsafe

Write-up: The day after I experienced extreme muscle and joint pain that lasted about a week. And it started to get better but the following Saturday I got a very terrible headache. And over the course of that week I started bruising very easily and all the veins all over my body were very prominent. The headache wouldn''t go away and I started to have chest pain by that monday. And at that point all the muscle and joint pain came back and it was very very painful. At that point I called my primary care provider and they scheduled me with someone else in the clinic because i was having the chest pain. And they did a test for covid and urged me to go to the emergency room, which i did. After that I went to the emergency room and sat for 5 hours, they did bloodwork to check clotting factor, basic blood panel and also a CT of my head. According to them, everything was normal and they sent me home with a terrible headache. My biggest complaint was the bruising all over my body but no one ever looked at that.


VAERS ID: 1365320 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-05-10
Onset:2021-05-16
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Headache, Nausea, Retching, Vomiting, Weight decreased
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol 25mg QAM; Lipitor 20mg QAM; Levothyroxine 50mcgs QAM; Wellbutrin 450mg QAM Topamax 100mg QPM; Omeprazole 40mg QAM; Ibuprofen 800mg Q12HRS; Morphine S04 XR 15mg Q12HRS; Oxycodone/APAP 10/325 Q12HRS as needed; Robaxin 750mg Q12HRS
Current Illness: HTN; Degenerative Disc Disease; Degenerative Joint Disease; Osteoarthritis; Idiopathic Neuropathy; Major Depression Disorder; Migraine; GERD; Chronic pain /Opiate use
Preexisting Conditions: Same
Allergies: Quinine; Neurontin; Naproxen; Limital; IV CT dye (ok with Benadryl premed)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue; mild to overwhelming nausea, with or without accompanying frontal /facial headache. Totally different from a typical migraine for me. Not associated or affected by food intake. Worsened by heat and odors, and I will vomit or dry heave, depending on if I have eaten. I usually rarely vomit. .... Appetite is very subdued... Usually very good, and I have lost weight (10 pounds... Although I need to!) I am a former RN... So I recognize that this is ''different'' than just a passing illness.


VAERS ID: 1365433 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-15
Onset:2021-05-16
   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 EW0186 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Hyperhidrosis, Laboratory test, Night sweats, Pain in extremity, Platelet count decreased, Pyrexia, White blood cell count decreased
SMQs:, Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma
Preexisting Conditions: Asthma
Allergies: None reported
Diagnostic Lab Data: lab work was performed
CDC Split Type: vsafe

Write-up: My son experienced after the Pfizer vaccine and by the next day he had extremely left sore arm, by the evening he developed a fever of 101.F. The next day he still had with the fever of 101F getting some fatigue, then his fever was going up to 102.4F, on Tuesday, Wednesday and Thursday of that week. He also got chills, with the fever and then on one on the nights, Wednesday he had extreme sweat profusion, his clothes were drenched. We saw his doctor on Wednesday of that week, cheek his vitals, lab work, his WBC was low and platelets were low. On Friday 05-21-2021, his fever was 99.0F and then by the afternoon then he was fever free and started to feel better. His doctors did a second lab work, WBC, was normal and his platelets went form 1129 to 373. His due for his second vaccine on 06-05-2021.


VAERS ID: 1365486 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-11
Onset:2021-05-16
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blister
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: I get my first dose of COVID Pfizer vaccine on May 11, 2021, then 5 days later on May 16, about 20 small blisters (herpes) appea
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I didn''t any test.
CDC Split Type:

Write-up: I get my first dose of COVID Pfizer vaccine on May 11, 2021, then 5 days later on May 16, about 20 small blisters (herpes) appeared on each inner side of both my arms, which have not gone away so far. Today, I went to the pharmacy to get a second dose of vaccine. After telling the pharmacy staff about my side effects, they asked me to report the side effects to you and wait for the results before getting the second dose.


VAERS ID: 1365539 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Aphthous ulcer
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi vitamin; Allegra; Flonase
Current Illness: no
Preexisting Conditions: mild asthma and seasonal allergies
Allergies: no
Diagnostic Lab Data: Tuesday - May 18th - Pediatric OB/GYN doctor - Tested for any time of viral or bacterial infection and it was negative for everything
CDC Split Type: vsafe

Write-up: She developed genital aphthous ulcers. They gave her pain medication in a form of Toradol and Gabapentin - helped with the pain. She soaked in a bathtub. They didn''t give her steroids as they didn''t want it to affect the vaccine.


VAERS ID: 1365554 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-15
Onset:2021-05-16
   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 / IM

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Laboratory test normal, Lymph node pain, Lymphadenopathy, Pyrexia, SARS-CoV-2 test negative, Streptococcus test negative, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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:
Current Illness: Asthma
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: PT mother states that the next day her son started with fever 24 hours after the vaccine. He had a fever for the next 8 days. At times his fever got up to 103F. His other symptoms were that his lymph nodes in his neck got very swollen and painful to touch and was very tired. He also threw up 3 times on various days. He also had a very mild sore throat before his vaccine. His pediatrician thinks it was the vaccine with in combination with his virus, was tested for strep, mono and covid, and all was negative, also lab work was performed and all was negative. He slowly started to feel better after his fever went down.


VAERS ID: 1365918 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-01
Onset:2021-05-16
   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 EW0173 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chills, Herpes zoster, Musculoskeletal chest pain, Sleep disorder
SMQs:, Retroperitoneal fibrosis (broad), Arthritis (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: WP Thyroid
Current Illness: None
Preexisting Conditions: Hashimoto''s Thyroid
Allergies: None known
Diagnostic Lab Data: none needed- visual diagnosis of large rash
CDC Split Type:

Write-up: Shingles outbreak at right back spreading to front chest under the breast. Bad case. Started acyclovir night of 5/19 for 10 days. The weekend of the 16th I woke up feeling a deep dull ache at my lat and shoulder blade on the right side at 2am. Thought it was muscular and used a ball to massage the area which felt better, but I could not fall back asleep. Got better during the day and some thing happened on the 17th. I put a heating pad on the area and fell asleep. Woke up with a rash, but thought it was a heating pad burn and this is what it felt like. Blisters were starting to form on the 18th and I had the chills all day. I thought this was because it was a 2nd degree burn so made an appointment to see the doctor on the 19th at 4pm. At the doctor, they diagnosed this as shingles and said I was not the only person who had come in 2-3 weeks post Pfizer shot with Shingles. 2 weeks post shingles- The rash is fading. Still experiencing rib pain, and dull aching pains in my back where it originally started- at the Lat/shoulder blade. I wake up every night in pain at 2 or 3am and sleep on/off for maybe 1 hour at a time the rest of the night.


VAERS ID: 1365942 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Back pain, Fatigue, Feeling cold, Haematochezia, Headache, Vision blurred
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

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

Write-up: Regular symptoms from the shot, EXTREME back pain (lower) headache, felt cold and exhausted, on first day. The second day I had blurry vision and all those symptoms so I went to doctor. They said I was having a reaction and also gave me Toradol for the back pain. I started to feel better symptom wise but the following day I started to poop blood. That only happened for one day then went away after a day. But I?ve had one or two more bloody stools since then. The ER said that it?s likely from the Toradol but to keep an eye on it. I have had 2 episodes since but it?s been random. Haven?t taken any more ibuprofen at all, was told to take omeprazole for a month and see how my body recovers


VAERS ID: 1365946 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

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

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

Write-up: Facial numbness and tingly sensation that began in the chin and jaw area a few days after the 2nd dose. A week and a half later, the tingly sensation spread to the lips, cheeks and forehead. I am still experiencing this.


VAERS ID: 1366326 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, Dysmenorrhoea, Menstrual disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Norethindrone, Magnesium, Vitamin D3, Montelukast, Flunisolide, Zyrtec, Black seed oil, Chaste tree
Current Illness:
Preexisting Conditions: Allergies and dysmenorrhea
Allergies: Tree nuts, peanuts
Diagnostic Lab Data: None
CDC Split Type:

Write-up: My Dysmenorrhea was a huge issue for me until I started taking Norethindrone, which fixed the issue. However when I got the Covid vaccine my Dysmenorrhea returned. I vomited and had severe cramping. My cramping used to be two days. On Norethindrone I had no cramps or vomiting, I didn''t even have a flow during my menstrual cycle anymore. After the vaccine, I vomited, had cramps for 4 or 5 days, (so worse than before). I have continued to have spotty breakthrough bleeding on and off for three weeks, which is much longer than it has ever been. I''m concerned about what will happen with the second dose of the vaccine.


VAERS ID: 1367097 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-08
Onset:2021-05-16
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye pruritus, Injection site erythema, Injection site swelling, Ocular hyperaemia, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins C, D, K, Flaxseed, Fish Oil, Multivitamin, Glucosamine-Chondroitin, Turmeric, Lutein, Spironolactone.
Current Illness: N/A
Preexisting Conditions: Social anxiety/panic disorder.
Allergies: Sulfa drugs, penicillin.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 8 days after the injection site turned pink and raised and I experienced red itchy eyes and felt itchy all over.


VAERS ID: 1367158 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-07
Onset:2021-05-16
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021556251

Write-up: developed a swollen stomach; hardness in her stomach; diarrhea; vomiting; This is a spontaneous report from a contactable consumer (patient). A 65-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 07May2021 as single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. Patient said she was perfect, perfect, perfect until yesterday (16May2021) and she developed a swollen stomach, hardness in her stomach, diarrhea and vomiting. Her stomach was swollen up to her breasts and felt like it was up to her throat. She did get some sleep and it did go down but since been being on the phone it was swollen up again. She mentioned she didn''t take any of her medications yesterday. She took two sugar pills- Farxiga and Januvia, a heart pill Metoprolol 200mg XL, and then three stomach medications Protonix, Pepcid, and Nexium, but she said the Pepcid didn''t really do anything. Outcome of events was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1367204 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-16
   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 EW0185 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Discomfort, Feeling abnormal, Feeling hot, Headache, Rash erythematous, Thrombosis
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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 INC2021561472

Write-up: felt like a little fuzzy; Lot of discomfort; warm spots on her skin; Headache; Blood clots; itchy red rash; This is a spontaneous report from a contactable consumer (parent of the patient). A 13-year-old female patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0185), via an unspecified route of administration on 14May2021 as 1st dose, single for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. On an unspecified date the patient experienced blood clots, really warm spots on her skin in one of her legs, front of her thigh and her knees, her arms the tip part between her elbow and wrist on both of them, like where you can feel it''s warm to the touch, lot of discomfort, headache and she kind of feel like a little fuzzy like in her thinking, she said she felt like she was forgetting things like what you guys were saying. On 16May2021, she developed an itchy red rash on her legs and over her knees and on the tops of her arms from her wrist to her elbows. She has taken Benadryl to treat but it did not help. She is calling to see if this has been reported before. The outcome of events was unknown.


VAERS ID: 1367212 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-11
Onset:2021-05-16
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Lymphadenopathy, 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: Medical History/Concurrent Conditions: Tooth extraction
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021562772

Write-up: Severe Rash; Swollen Lymph node under left Armpit; This is a spontaneous report from a contactable consumer (patient wife). A 63-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), dose 2 via an unspecified route of administration on 11May2021 (Batch/Lot number was not reported) as single dose for covid-19 immunisation. Medical history included tooth extraction from 10May2021 to 10May2021. The patient''s concomitant medications were not reported. The patient experienced severe rash and swollen lymph node under left armpit on 16May2021 at 07:42. Outcome of the events was unknown. No follow-up attempts are possible; Information about lot/batch number cannot be obtained.


VAERS ID: 1368041 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-06
Onset:2021-05-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Antinuclear antibody, Erythema, Rash, Rosacea
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hormone replacement Therapy Multi vitamin Omega 3
Current Illness: None
Preexisting Conditions: Migraine
Allergies: Seasonal pollen allergy
Diagnostic Lab Data: ANA check after 2 dose side effect.
CDC Split Type:

Write-up: Within 10 days of dose one, severe outbreak rosacea or rash-like effect on face: hot, red and bumpy. Had to see MD for treatment. Also after #2 dose, lot EW0161 given 05/24/2021, same symptoms developed after 7 days from shot date. Again saw doctor this time for treatment.


VAERS ID: 1368148 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-30
Onset:2021-05-16
   Days after vaccination:47
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cerebrovascular accident, Facial paresis, Ischaemic stroke, Seizure
SMQs:, Systemic lupus erythematosus (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Convulsions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), 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? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I63.9 - CVA (cerebral vascular accident) I63.9 - Acute ischemic stroke R29.810 - Facial weakness R56.9 - Unspecified convulsions


VAERS ID: 1368191 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-05-16
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood test abnormal, Bradykinesia, Cerebrovascular accident, Dizziness, Dysstasia, Feeling abnormal, Gait disturbance, Grip strength decreased, Heart rate increased, Hypoaesthesia, Laboratory test abnormal, Monoparesis
SMQs:, 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), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: I take a Centrum Silver, vitamin D, vitamin C, Zinc, Oil of Oregao, Grape seed extract, levothyroxine .075mg and trelegy 100mcg/62.5mcg/25mcg.
Current Illness: I did not have any other illnesses.
Preexisting Conditions: I have thyroid problems.
Allergies: I am not aware if I do.
Diagnostic Lab Data: I had blood work and a lot of other tests.
CDC Split Type: vsafe

Write-up: Five weeks (05/16/2021) after receiving the Johnson and Johnson vaccine, my left leg just started feeling numb. I went into my kitchen and all of a sudden I started feeling dizzy. I lost all strength in my legs and in my left arm. I really couldn''t move my arms or my legs and I felt really light headed. I had to have my 5 year old boys get me some water to drink. My son noticed that my heart was beating really strong and really fast. I saw water boiling over in the pot on the stove and I couldn''t even get out of a chair to turn it off. I couldn''t stand up. I finally managed to go back by my bed from the chair and slowly moved around. I tried holding my phone and it dropped out of my hands a couple of times because I couldn''t hold it. A couple hours later, I felt a little better, but I had to fight to get around. We fell asleep and when I woke up, I still felt bad. I took my children to school and told them that I was going to the hospital to get checked out. At the hospital they performed multiple tests and they back showing I had stroke. I was treated for suffering from a stroke.


VAERS ID: 1368197 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-08
Onset:2021-05-16
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Eye irritation, Malaise, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Corneal disorders (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: Lexapro, Buspar, Doxepin, Saxenda, Apri, Inosital, B-Complex, Fish Oil, Multivitamin
Current Illness: none
Preexisting Conditions: IBS, PCOS, Generalized Anxiety Disorder
Allergies: Gluten intolerant
Diagnostic Lab Data: Rapid Strep, Rapid COVID19 and PCR for COVID19 --all negative
CDC Split Type:

Write-up: I don''t know if this would be considered an adverse reaction to the vaccine, or being a recovered COVID19 patient, but I started feeling unwell on the afternoon of May 16th, a little worse the next day with a sore throat, congestion, runny nose and burning eyes. On Tuesday the 18th I had a slight fever, so I went to the walk-in clinic to be assessed and tested for COVID19 to make sure it wasn''t that. The APN explained that I was experiencing seasonal/environmental allergies after having worked outside on May 16th and 17th. I have never had allergies before and it felt like I was coming down with a cold of some kind, so I wanted to be assessed and ensure I wouldn''t get anyone else sick. The APN agreed the slight fever (99.6) was atypical and she understood why I came in. She prescribed allergy eye drops and nasal spray and told me to take an OTC allergy medication. I have continued to experience some allergy symptoms (runny nose, congestion, burning eyes) even after 2 weeks of taking medication. I am unsure if my immune system has changed as a result of having COVID19 in April 2020 or a reaction to the vaccine.


VAERS ID: 1368538 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-05-14
Onset:2021-05-16
   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 EW0153 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Delirium, Electroencephalogram normal, Imaging procedure, Laboratory test normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: diazepam 5mg 2 times a day and 4mg at noon; quetiapine 100mg at bedtime, hydrocodone-acetaminophen 7.5-325mg three times a day; sinus rinse three times a day; bupropion ER 200mg 2 times a day; duloxetine 120mg daily; pantoprazole 40mg daily
Current Illness: none acute
Preexisting Conditions: chronic pain, generalized anxiety; PTSD; panic disorder; major depression; irritable bowel syndrome; chronic kidney disease stage III; chronic sinusitis; non-alcoholic fatty liver disease;
Allergies: aspirin - unknown; simvastatin - muscle aches
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was hospitalized with Delirium on 5/16/21 - 5/18/21. Lab, imaging and EEG did not reveal any definitive etiology for delirium


VAERS ID: 1368556 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-15
Onset:2021-05-16
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Orthostatic hypotension
SMQs:, Cardiomyopathy (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Patient presented to the ED and was subsequently hospitalized for orthostatic hypotension within 6 weeks of receiving COVID vaccination.


VAERS ID: 1368625 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-23
Onset:2021-05-16
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Acute kidney injury, Acute respiratory failure, Blood bicarbonate decreased, Blood chloride normal, Blood creatinine increased, Blood glucose increased, Blood lactate dehydrogenase normal, Blood potassium normal, Blood sodium normal, Blood urea increased, C-reactive protein increased, COVID-19, Chest X-ray abnormal, Chronic obstructive pulmonary disease, Condition aggravated, Diarrhoea, Ear pain, Fibrin D dimer normal, Haematocrit normal, Haemoglobin decreased, Inflammatory marker test, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Kidney infection, Liver function test normal, Lung opacity, Myalgia, Nasal congestion, Oxygen saturation decreased, Pain, Platelet count normal, Pneumonia, Prerenal failure, Productive cough, Prohormone brain natriuretic peptide, SARS-CoV-2 test positive, Serum ferritin normal, Sputum discoloured, Tachypnoea, Wheezing, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (broad), Lactic acidosis (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol MDI QID prn SOB ASA 81mg daily atorvastatin 80mg QHS carvedilol 25mg BID clopidogrel 75mg daily cetirizine 10mg daily cyclosporine 0.05% 1 gtt OU BID doxazosin 2mg QHS ferrous sulfate 35mg QD Fluticasone propionate 220mcg one puff
Current Illness: N/A
Preexisting Conditions: anemia anxiety arthritis carotid stenosis cataract COPD CAD depression insulin requiring type 2 DM hypothyroidism GERD hypertension hyperlipidemia kidney stones psoriasis stroke obesity BMI 35.75
Allergies: sulfa
Diagnostic Lab Data: 5/16/21 NP Swab + SARS-CoV-2, negative influenza A/B Na 138, K+ 4.5, CL 106, HCO3 20, BUn 42, Cr 1.94, glucose 174 WBD 7.49, Hgb 10.0, Hct 38.1, Plt 206 Normal hepatic function and pro BNP CXR Airspace opacity at the left lung base, may be related to atelectasis versus pneumonia
CDC Split Type:

Write-up: 5/16/21 Pt presented to a free standing ED with complaints of cough, body aches, nasal congestion and otalgia that started around 5/11/21. In the ED she had audible wheezing, mild tachypnea (RR19) and her RA pulse ox was 88-943%. She was placed on oxygen and found to be positive for SARS-CoV-2. CXR showed possible pneumonia and she was transferred to a tertiary care facility for admission. She was discharged on 5/21/21 Acute hypoxic respiratory failure, resolved Covid-19 Virus Infection Date of onset of symptoms: Approximately 7 days prior (5/15/2021) Symptoms present on admission: Nasal congestion, myalgias, productive cough of yellow-green sputum, diarrhea Date of covid positive test: 5/16 Vaccination status: vaccinated, received only first dose Imaging: CXR with lobar pneumonia Oxygen requirements on admission: 2 L Current oxygen requirements: None Medical therapy: Oral prednisone, not a candidate for remdesivir Inflammatory markers: CRP 18.1, ferritin 111, D-dimer 0.62, LDH 174 Community-acquired pneumonia Given lobar appearance on CXR and productive cough of green/yellow sputum I do feel it prudent to cover the patient for community-acquired pneumonia Treated with Azithromycin, Augmentin Acute on chronic kidney disease Baseline serum creatinine approximately 1.1-1.2, presenting serum creatinine 1.94 Prerenal versus intrinsic renal 2/2 infection Creatinine trending down to 1.24 at time of discharge COPD with acute exacerbation IV Solu-Medrol initially, transition to oral prednisone Schedule bronchodilators Started Symbicort per hospital formulary, and held home Flovent while hospitalized Antibiotic coverage as above


VAERS ID: 1368761 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-16
Onset:2021-05-16
   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 EW0158 / 2 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Chills, Diarrhoea, Headache, Injection site erythema, Injection site swelling, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, Zyrtec, Amlodipine, Triamt/HCTZ, Omeprazole DR, Azelastine, , Enhertu, Aprepitant, Palonosetron HCI,
Current Illness: High blood pressure & environmental allergies
Preexisting Conditions: Breast Cancer
Allergies: Penicillin, Codene, Trimadol, Sulfar, Percacep
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Right arm muscle soreness, started at 11pm on 5/16. Chills , fever, swelling & redness at injection point, diarrhea, headache & nausea 5/17-18. Contacted -Virtual doctor. Instructed to apply warm compress on swollen area , continue taking Tylenol as needed. Received a prescription for Doxycycline Hyclate..


VAERS ID: 1368766 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-05-15
Onset:2021-05-16
   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 EW0164 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Diarrhoea, Drainage, Ear pain, Headache, Nausea, Oropharyngeal pain, Pain in extremity, SARS-CoV-2 test negative, Streptococcus test negative
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies: Amoxicillin Lactose intolerance Cat
Diagnostic Lab Data: Covid-19 Strep test
CDC Split Type: vsafe

Write-up: She started to get a sore throat and drainage the day after the first dose of the vaccine. That day she had headache, sore arm with earache and joint pain. Those symptoms continued for several days with some loose stools which lasted for two to three days with abdominal pain which persisted for a little over two weeks. We visited the doctor because of ear and throat pain and nausea. All tests were negative, but the symptoms improved slowly but they are totally resolved right now.


VAERS ID: 1368804 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-14
Onset:2021-05-16
   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 ER8736 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Rash, Rash erythematous, Rash pruritic, Swelling, Swelling face, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine, glipizide, metformin er, metoprolol, allopurinol, Lomotil, hydroxyzine
Current Illness: none
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient developed swelling and red itchy rash on entire face, neck and abdomen. She also had tongue swelling on 5/16/21. She was waiting to get into urgent care when she reported adverse events. RPh advised her to take Benadryl to help reduce swelling and rash until she could find an urgent care her insurance covered.


VAERS ID: 1369294 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-24
Onset:2021-05-16
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Bladder catheterisation, CSF lymphocyte count increased, CSF white blood cell count increased, Lumbar puncture abnormal, Magnetic resonance imaging spinal abnormal, Muscular weakness, Myelitis transverse, Sensory level abnormal, Urinary retention
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Demyelination (narrow), Malignant lymphomas (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? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: LP showed 457 wbc, 90% lymph?s. Tspine MRI initially showed a lesion at T2-3, so motion artifact. Repeat imaging did not confirm this. Clinical exam consistent with significant bilateral leg weakness, sensory level at T8-T9.
CDC Split Type:

Write-up: Transverse myelitis resulting in bilateral leg weakness and urinary retention, weakness started 3 was after vaccine, mild abdominal pain started two weeks after vaccine. He was seen in the ED on 5/19 with abdominal pain and weakness, negative work up and sent home. Came again to the ED on 5/21, again with abdominal pain and weakness. Found to have urinary retention, required fully catheter for decompression which improved abdominal pain. Also significant weakness.


VAERS ID: 1369568 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Dizziness, Dyspnoea, Oxygen saturation
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Pt c/o difficulty breathing and dizziness 12 minutes after receiving second dose of vaccine. She was assessed and monitored by NP, EMT and paramedic. Initial BP 143/95 repeated BP 128/86, HR 80, RR 14, O2 saturation 99% on RA. She has history of anxiety. She had mod anxiety, she was instructed on relaxation measures, given water, allowed to remove mask and taken outside for fresh air. She was kept at site until she was calm and had no complaints. She was at site with her husband and her father. They were given the Vaccination information sheet, reinforced instructions on ADRs/ SEs to call 911 and go to the ED, follow up with her PCP and register with V-safe. They verbalized understanding and willingness to comply. Pt left site with husband and father in no acute distress, calm, no complaints, awake, alert and oriented to person, place, time and situation.


VAERS ID: 1369937 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-16
Onset:2021-05-16
   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 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Insomnia, Loss of personal independence in daily activities, Pain, Pain in extremity
SMQs:, Dementia (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: Birth control
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: For the first week I could not lift my arm enough to even put my hair in a pony tail. I was up every hour of the night. I?m a college athlete who normally works out find, but due to the shot even now (2 1/2 weeks later) I cannot lift any weight with my left arm. I?ve taken Tylenol almost every day since the shot. The first week my arm throbbed all night long. It?s not as bad now as the first week, but I still cannot lift with my left arm and wake up with a very fatigue arm.


VAERS ID: 1369959 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-10
Onset:2021-05-16
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal distension, Appendicitis, Computerised tomogram abdomen abnormal, Laboratory test
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: None
Preexisting Conditions: Hypothyroidism (treated using synthroid)
Allergies: None
Diagnostic Lab Data: CT scan and labs were done on 5/19.
CDC Split Type:

Write-up: Began feeling stomach discomfort/bloating on or before Sunday, 5/16. Symptoms worsened over next few days. Went to doctor on Wednesday, 5/19, who indicated I might have appendicitis, and recommended I go to the ER. Went to the ER on Wednesday, 5/19. They took a CT scan and labs, and determined I had appendicitis. I was admitted to the hospital that day and was released on Saturday 5/22.


VAERS ID: 1370534 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Bone pain, Chills, Haematochezia, Headache, Mucous stools
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Osteonecrosis (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: TYLENOL 8 HOUR
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (she did have the Covid 19 virus in Mar2020); Uterine cancer (about 30 years ago)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021562370

Write-up: blood in her bowel movements; bowel movement were like sticky mucus; really bad stomach cramps; her bones were aching; headache; chills; This is spontaneous report from a contactable consumer reported for self. This 59-years-old female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration right arm on 15May2021 13:20 at the age of 59-year-old (Lot number: EW0175) as 2nd dose, single for covid-19 immunisation. Medical history included Uterine cancer from 1991 (reported as had about 30 years ago, as of 18May2021), she did have the Covid 19 virus in Mar2020. Concomitant products included paracetamol (TYLENOL 8 HOUR) for headache. None other vaccinations within four weeks prior to the first administration date of the suspect vaccine. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) Left arm Lot number:ER8731 on 24Apr2021 12:15 PM at the age of 59-year-old for covid-19 immunisation and experienced sore arm. The second dose she received on Saturday, 15May2021 and Sunday morning, 16May2021, she had a bad headache and her bones were aching. Her concerns started yesterday, Monday, 17May2021 when she started getting real bad stomach cramps. And her bowel movements were not like normal bowel movements. Her bowel movements were like a sticky mucus. This morning, 18May2021, there was dark blood in her bowel movement. There was blood in the toilet. But on Sunday 16May2021 when she was getting the chills and stomach cramps (17May2021) and then the blood in her bowel movement this morning, 18May2021, she was concerned. She''s asking if this is normal. The chills have gone away but she''s still concerned since the sticky bowel movements and blood in her bowel movements started after she received the Covid 19 vaccine. Afterwards, she had headache and chills, but said it already subsided. She said her main concern was that she had really bad stomach cramps, and her bowel movement were like sticky mucus on 17May2021. AEs did not require a visit emergency room and physician office. Outcome of the event real bad stomach cramps, bowel movements were like a sticky mucus, blood in her bowel movements, bones were aching was not recovered. Outcome of the events headache and chills was recovered in May2021.


VAERS ID: 1370634 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-16
Onset:2021-05-16
   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 EN6207 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paralysis, Ulnar nerve palsy
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Latex allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021571949

Write-up: Within 30 minutes of receiving the 1st dose of the covid19 vaccine in my left shoulder my left hand and wrist became completely paralyzed.; Ulnar Palsy; This is a spontaneous report from a contactable consumer (patient). A 43-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EN6207, expiration date not provided), 1st dose via an unspecified route of administration, administered in arm left on 16May2021 15:30 at age of 43 years old as a single dose for COVID-19 immunisation. Medical history included latex sensitivity. The patient''s concomitant medications were not reported. The patient experienced within 30 minutes of receiving the 1st dose of the COVID-19 vaccine in her left shoulder her left hand and wrist became completely paralyzed on 16May2021 16:00. The ER said it was random coincidence and diagnosed it as Ulnar Palsy on 16May2021 16:00. The events were reported as being disability. Therapeutic measures were taken as a result of all events. The outcome of the events was not recovered. The patient had not received any other vaccines within 4 weeks prior to the COVID vaccine. The patient had not received any other medications within 2 weeks of vaccination. The adverse event resulted in visiting doctor or other healthcare professional office/clinic. The adverse event result in visiting Emergency room/department or urgent care. Treatment for the adverse event was included ER (emergency room) Exam. The patient was not pregnancy at time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. Information on the lot/batch number has been requested.


VAERS ID: 1370645 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-01-21
Onset:2021-05-16
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling abnormal, Pruritus, SARS-CoV-2 test, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Hypersensitivity (narrow), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: Covid test; Result Unstructured Data: Test Result:Negative
CDC Split Type: USPFIZER INC2021575711

Write-up: bad case of hives; its just annoying and really itchy; its just annoying and really itchy; This is a spontaneous report from a contactable Nurse (patient). A 71-years-old female patient received bnt162b2 (BNT162B2, Formulation: Solution for Injection, Batch/Lot Number: EL3302; Expiration Date: May2021), (age at time of vaccination was 71 years) dose 1 intramuscularly, administered in Deltoid Left on 21Jan2021 07:30 as single dose and dose 2 (Batch/Lot Number was EN6201, Expiration Date: not reported) intramuscularly, administered in Deltoid Left on 16Feb2021 07:30 as single for covid-19 immunization. Patient had some allergies not provide any further details. The patient underwent lab tests and procedures which included sars-cov-2 test: negative on 2021. Patient did not receive any prior vaccinations within 4 weeks. The patient''s concomitant medications were not reported. She knows the vaccine was a while ago but she wants to know if there have been people reporting any kind of delayed reaction to the Covid vaccine. She now has a bad case of hives, which is new for her. She mentions she is going to see her doctor next week. If the hives are still there, she will see her doctor. She doesn''t think its worth going to the ER. The hives are pretty bad on her left shoulder, and she has spots on her back and her trunk/body, kind of on her side. She adds they are itchy. She mentions she has been taking Benadryl and putting steroid cream/anti-itch cream on it. She confirms the hives have stayed the same. No further details provided. The outcome of the events was not recovered. Information on Lot/Batch number was available. Additional information has been requested.; Sender''s Comments: Based on the information available and a close temporal association, a possible contributory role of the suspect BNT162B2 cannot be excluded for the reported events of urticaria. The case will be reassessed once new 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: 1371212 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test normal, Blood thyroid stimulating hormone, C-reactive protein normal, Chest X-ray normal, Chest pain, Echocardiogram normal, Electrocardiogram normal, Epstein-Barr virus test negative, Fatigue, Full blood count normal, Palpitations, Postural orthostatic tachycardia syndrome, Red blood cell sedimentation rate normal, SARS-CoV-2 test negative, Tachycardia, Thyroxine free normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Methylphenidate ER Clonidine Fexofenadine Flonase
Current Illness: He had been having some mild left sided rib discomfort for about 7-10 prior to the vaccination. No fevers or other evidence of illness
Preexisting Conditions: ADHD Seasonal allergies
Allergies: Red and Yellow dye
Diagnostic Lab Data: CXR (5/17/21). Normal ECG (5/18/21). Normal Blood work: (5/20/21): CBC, ESR, CRP, EBV titers and Free T4/TSH all normal. Cardiology visit (5/24/21) - ECG/ECHO normal COVID PCR (5/27/21). Negative
CDC Split Type:

Write-up: Within 24 hours of the vaccine started to develop episodes of tachycardia (mom who is a physician measure heart rates as high as 130-140) with minimal activity. He noticed a couple of episodes of heart racing (was not noticing other episodes) but no HR obtained. He developed more pluetitic chest pain at the site of his rib pain and persistent fatigue. Seen in my office three times over the next 7-10 days. and symptoms persisted. Testing included CXR and ECG which were normal. COVID PCR NP swab was negative and blood work was normal (cbc, ebv/cmv titers, thyroid). He was evaluated by cardiology on 5/24/21 and diagnosed with POTS. Currently (early June) he continues to have fatigue significant enough that he can''t get through an entire school day (very atypical for him) and has intermittent pleuritic chest pain (which had mostly resolved about 10 days after the vaccine) The tachycardia has resolved for the most part (within 2 weeks of the vaccine)


VAERS ID: 1371270 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-27
Onset:2021-05-16
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Blood test, Chills, Exposure during pregnancy, Headache, Influenza like illness, Pain, 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: When I was 4 months old (43 years ago), I had a reaction to the MMR shot. I was very cranky and ran a fever, but when I received
Other Medications: I was taking prenatal vitamins and 27 mg of Iron.
Current Illness: I did not have any other illnesses.
Preexisting Conditions: I do not have any chronic or long-standing health conditions.
Allergies: I am allergic to penicillin, Keflex and amoxicillin.
Diagnostic Lab Data: I had blood work and an ultrasound done.
CDC Split Type: vsafe

Write-up: I miscarried on 05/16/2021. The baby was due 12/23/2021. I currently have 2 children and had 1 miscarriage before in my life. I was at 5 weeks of pregnancy when I received my 2nd dose and 8 weeks into my pregnancy when I miscarried. After I received my 2nd dose of the vaccine, the second night I experienced chills, had a minor headache and felt very achy. They felt like flu symptoms.


VAERS ID: 1371295 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Private       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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: n/a
Preexisting Conditions: elevated BP without diagnosis of HTN hyperlipidemia history of SVT
Allergies: Sulfa
Diagnostic Lab Data: Referral to allergist for evaluation
CDC Split Type:

Write-up: BLE rash; supportive home care


VAERS ID: 1371482 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Pain, Rash, Rash pruritic, Swelling, Yellow skin
SMQs:, Cholestasis and jaundice of hepatic origin (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Magnesium carbonate 90mg / Vitamin D3 2,500mg / Super B-complex with Folic acid & Vit. C / Omega 3 DHA- EPA 500mg
Current Illness: None
Preexisting Conditions: None
Allergies: Sulpha
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Slight itchy rash developed on right lower ankle which soon spread covering shin area and outside of ankle. The next day the left leg had some of the same rash but not as bad. Raised and sore for leg of pant to be rubbing on. Yellowish markings as from a bruise.


VAERS ID: 1371702 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-01
Onset:2021-05-16
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Echocardiogram, Ejection fraction, Myocarditis, Troponin I increased
SMQs:, Myocardial infarction (narrow), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: entocort EC
Current Illness: none
Preexisting Conditions: microscopic collageneous colitis
Allergies: nkda
Diagnostic Lab Data: TTE - 5/17/2021 CT coronary angio - 5/17/2021 tropoinin I - 5/16-5/17
CDC Split Type:

Write-up: myocarditis admission to the hospital. tropoinin I peak at 8.9 Normal LVEF and normal coronary CTA admission 5/16-5/18/2021


VAERS ID: 1371801 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-11
Onset:2021-05-16
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Induration, Injection site mass, Injection site pain, Injection site pruritus, Injection site reaction, Injection site swelling, Rash erythematous, Skin warm
SMQs:, Anaphylactic reaction (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)

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

Write-up: Began at night, itching at the injection site. In the morning, it was swollen, red, hard and hot lump on my upper arm. It was also quite itchy and sore. The rash was about 3 inches in diameter and circular. It was hard to the touch and very warm. Lasted about 5 days then went away.


VAERS ID: 1371880 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Dizziness, Headache, Nodule, Pain in extremity, Pyrexia, Syncope, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Focalin XR 5mg daily
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG 05/17/2021 Chest X-Ray 05/17/2021
CDC Split Type: vsafe

Write-up: At the time of the vaccine daughter dizzy and started to fade out 20 minutes after the vaccine. She couldn?t see and it seemed like it was a Vaso Vagal response which resolved quickly. At 5am the woke up with a fever of 102 and extreme left arm pain. The fever was controlled with Tylenol. Two days after the vaccine she woke up complaining of chest pain and a knot under her left arm. It felt like something was pressing on her chest. We went to the ER and all tests were negative. The feeling lasted until the end of the day. Three days after the shot the next morning she got a headache for half of the day and resolved with Tylenol. The next day all symptoms were gone. Emergency Room Dr.


VAERS ID: 1371883 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008B21-2A / 2 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Angiogram, C-reactive protein increased, Chest discomfort, Computerised tomogram thorax abnormal, Dyspnoea, Electrocardiogram T wave abnormal, Lymphadenopathy, Myocardial infarction, Myocarditis, Pain in extremity, Pain in jaw, Troponin T increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (broad), Immune-mediated/autoimmune 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? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Rosuvatatin, Centrum, Nordic Naturals Pro Omega, Fiber
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Medical test information taken from medical record: 5/18/2021 2:16:29 AM: ECG 12-LEAD: Diagnosis Normal sinus rhythm/Nonspecific ST abnormality/Abnormal ECG05/18/2021 2:16 AM: TnT-Gen5: 2658ng/L 05/18/2021 3:11 AM: TnT-Gen5: 2873ng/L 05/18/2021 3:52 AM: CT ANGIO CHEST: Negative study except for nonspecific mild left axillary adenopathy 05/18/2021 4:11 AM: ECG 12-LEAD: Diagnosis Normal sinus rhythm/Normal ECG 05/18/2021 5:16 AM: GEN5 Cardiac Troponin T(TnT5) 3H: 2628ng/L 05/19/2021 9:23 AM: ECHOCARDIOGRAM COMPLETE WO ENHANCING AGENT: Preserved biventricular size and systolic function,LVEF$g55%/Normal valvular structure and function/No Doppler evidence of pulmonary hypertension 5/20/2021 11:41:23 AM: ECG 12-Lead: Diagnosis Normal sinus rhythm/Nonspecific T wave abnormality/Abnormal ECG 05/19/2021 1:36 PM: C-Reactive Protein: CRP: 36.39mg/L 05/19/2021 9:16 AM: GEN5 Cardiac Troponin (TNT5) Baseline: 2339ng/L
CDC Split Type:

Write-up: Tightness in chest. Shortness of breath. Sore jaw. Pain in left arm. Called 911 and paramedic took EKG and informed me I was having a heart attack on the way to the hospital. Once at the hospital they measured my TnT-Gen5 and the baseline was 2658 ng/L with another test taken an hour later showing 2873 ng/L which led to additional tests listed in box 19. Final diagnosis was perimyocarditis and I received a prescription of Colchicine 0.6 MG to be taken twice a day for 6 weeks and then follow up with a cardiologist.


VAERS ID: 1371944 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-14
Onset:2021-05-16
   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 - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit C; Vit D; Multi-Vitamin; Turmeric gummies
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: High fever - I gave him Tylenol. For two days, and the second day I gave him Advil. He was very tired. I let him sleep. I gave him a lot of water. Urgent Care - For the shot broke his skin and caused him an infection, he had Prescription punicic acid ointment - 2% . The ointment worked to help the infection.


VAERS ID: 1372332 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-03-13
Onset:2021-05-16
   Days after vaccination:64
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003B21A / 2 LA / ID

Administered by: Other       Purchased by: ?
Symptoms: Contusion, Erythema, Induration, Pain in extremity, Swelling, Thrombophlebitis, Thrombophlebitis superficial
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Yaz, Sertraline, Acyclovir, Gabapentin, IBU
Current Illness: none
Preexisting Conditions: none
Allergies: NONE
Diagnostic Lab Data: Instacare visit. clinic. Superficial thrombophlebitis was the diagnosis.
CDC Split Type:

Write-up: Thrombophlebitis in my left arm. very painful hardening of the veins. 3 week duration. Swollen veins, redness. bruising. As of today my right arm has a hard vein in my right hand between my thumb and forefinger.


VAERS ID: 1373089 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-23
Onset:2021-05-16
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Balance disorder, Blood glucose normal, Blood pressure increased, Computerised tomogram normal, Dizziness, Electrocardiogram normal, Feeling abnormal, Headache, Metabolic function test, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Methylphenidate Cetirizine Famotidine
Current Illness:
Preexisting Conditions: Chronic cough
Allergies:
Diagnostic Lab Data: See above. Session ti.ing out... I have additional results and tests to report.
CDC Split Type:

Write-up: 3 weeks after initial dose (4/23/2021), I started experiencing dizziness and a constant mild headache. With the dizziness, there was no visual perception of moving or spinning objects and no proprioception problems. The dizziness is more like a sense of being unsteady and an inability to maintain balance. The feeling has never gone away and persists in any position. On different occasions, many times per hour, there is a sweeping feeling that is never in a persistent direction. On the first day of symptoms, the headache was moderate with a feeling of facial puffiness with an elevated blood pressure near hypertensive crisis levels... which was on a Sunday. The following Wednesday morning, I visited the Emergency room at 0034 EST 5/19/2021 because the dizziness was not getting better. A review of systems was performed with no abnormal results. EKG was normal. Cranial CT scan showed no indications of stroke either although I have not looked at it myself yet. Blood sugar level was at 90. Chem12 test was normal. Well for more details, please contact me. Session is about to time out and I don''t know how to extend it on my phone. I have tried vestibular therapy motions. None improved the dizziness. I also have intermittent fog and below normal focus capacity.


VAERS ID: 1373725 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / -

Administered by: Unknown       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: CYCLOBENZAPRINE; GABAPENTIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Back pain
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021577250

Write-up: Fainted; Feeling very light-headed; Slightly nauseous; This is a spontaneous report from a non-contactable consumer (patient). A 50-year-old female patient received 2nd dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, LOT number: EW0179, expiration date unknown) via unspecified route of administration on left arm on 15May2021 at 12:00 PM at age of 50-year-old at single dose for COVID-19 immunization. Patient was not pregnant at time of vaccination and events onset. Medical history included back pain. Patient had no known allergies. Patient previously received 1st dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, LOT number: EW0171, expiration date unknown) on 24Apr2021 at 12:00 PM at age of 50-year-old via unspecified route of administration on left arm for COVID-19 immunisation. Concomitant medications included cyclobenzaprine, gabapentin, both administered within 2 weeks of vaccination. Patient didn''t receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient wasn''t diagnosed with COVID-19. Since the vaccination, patient hasn''t been tested for COVID-19. In the morning after the injection on 16May2021 at 09:30 AM, patient was in the kitchen and started feeling very light-headed and slightly nauseous. Patient sat in a chair but still felt the same. She got up to go lie down and fainted. After crawling to the couch and lying down for a few minutes, she felt better. The events didn''t result in emergency room visit or physician office visit. Outcome of the events was recovered. No treatment received for the events. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1373755 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Decreased appetite, Feeling abnormal, Mental impairment, Nausea
SMQs:, Acute pancreatitis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: AZATHIOPRINE; BALSALAZIDE
Current Illness: Ulcerative colitis (Verbatim: Ulcerative colitis)
Preexisting Conditions: Medical History/Concurrent Conditions: Autoimmune disorder NOS (Verbatim: auto immune diseases)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021592704

Write-up: Feels out of it Mentally; chills; lack of energy/Zero Energy; loss of appetite; nausea; feeling super crappy/Not feeling 100%; This is a spontaneous report from a contactable consumer (patient, self-reported). A 25-years-old female patient received bnt162b2(PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection; Lot Number: EW0177, Expiration date: Unknown), dose 2 via an unspecified route of administration in the left arm, on 15May2021 in afternoon at 15:00-16:00 (age at the time 25-year-old) last Saturday, as single dose for her autoimmune disease (COVID-10 immunization). The patient''s medical history included colitis ulcerative from 2012 and ongoing and has auto immune diseases. The patient previously received bnt162b2(PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection; Lot Number: ER8736, Expiration date: Unknown), dose 1 via an unspecified route of administration in the left arm, on 24Apr2021 (age at the time 25-year-old), as single dose for COVID-10 immunization. No additional vaccines administered on same date of the Pfizer suspect. Concomitant medications included azathioprine and balsalazide was anti-inflammatory taken for colitis ulcerative from 2012, the patient takes a bunch of other medications, but these are the only two, she felt these concomitant medications could be related to her adverse events and she takes valsalide. The patient reported she took high dose of immunosuppressants. No prior vaccination within 4weeks. On 16May2021 (Sunday morning) at 07:00-08:00, the patient started having chills, still feels mentally out of it, lack of energy/Zero energy, nausea, loss of appetite, feeling super crappy, not feeling 100% and everything CDC has on the list. She enquired that how long will her side effects last, and any connection to the immunosuppressants. On 24May2021, today, the patient still feels out of it mentally, had zero energy, and she tried going into work and can''t do what she needs to do. The patient stated that it took her up until Friday to stop having chills and to stop feeling super crappy. The patient doesn''t know if there was any information about how long it will take to fully recover, and she was worried, and her boss was worried about her too. The patient did not visit emergency room. The patient enquired her physician last week and her boss wants her to go see a doctor or someone, so she probably will be going to some form of Urgent Care today. Therapeutic measures were taken with Tylenol. The patient underwent lab tests and procedures which were not included. The clinical outcome of the events loss of appetite, and asthenia was not recovered, chills was recovered on 21May2021, all other events was recovering. Additional information has been requested.


VAERS ID: 1374367 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-03
Onset:2021-05-16
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Bilirubin conjugated increased, Biopsy liver abnormal, Blood alkaline phosphatase increased, Blood bilirubin increased, Hepatic enzyme increased, Hepatitis, International normalised ratio normal, Jaundice
SMQs:, Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Hepatitis, non-infectious (narrow), Acute pancreatitis (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: OCP, loratadine
Current Illness: None
Preexisting Conditions: None
Allergies: Dog dander, lactulose
Diagnostic Lab Data: Liver biopsy- hepatitis INR 1 alk phos 136 ALT 586 AST 426 D bili 5.4 T bili 9
CDC Split Type:

Write-up: Jaundice, elevated liver enzymes. Etiology unclear after extensive work up. Not clearly related to Moderna vaccine.


VAERS ID: 1374523 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-30
Onset:2021-05-16
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Anterior spinal artery syndrome, Spinal cord infarction
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? No
Hospitalized? Yes, 21 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Anterior spinal artery syndrome with C5-T1 infarct


VAERS ID: 1375655 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-01
Onset:2021-05-16
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metolprolol, Hydroxychloroquine, Low Dose Naltrexone, NP Thyroid
Current Illness: None
Preexisting Conditions: Systemic Lupus, Sjogren''s, Hyperactive Thyroid
Allergies: Codein, Cipro
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever 48 hours and Diarrhea 4 days subsequent to injection


VAERS ID: 1375956 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: An 11 year old patient was vaccinated. Patient presented to a vaccination clinic at a high school with her father. Procedures for the vaccination clinic required the parent or legal guardian to complete a prevaccination checklist. This checklist required the date of birth of the patient to be written and the parent/legal guardian signed a statement that certified that the individual receiving a vaccine was "at least 12 years old on this day" and that they offer their consent for the patient to be vaccinated. The father wrote the patient''s date of birth as 2008 and the patient was vaccinated. The last step in the vaccination clinic involved entering the vaccination into the state immunization registry. Upon looking up the patient it was discovered that the patient''s date of birth was 2009 not 2008. At this time the individual working on the registry notified the pharmacist. The pharmacist then retrieved the signed prevaccination checklist and questioned the parent about the responses. The parent admitted to falsifying the patient''s date of birth so she could be vaccinated. The pharmacist informed the patient and her father that she would not be able to receive the 2nd dose until she turns 12 in November (or the eligibility is expanded further).


VAERS ID: 1376222 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-16
Submitted: 0000-00-00
Entered: 2021-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Pruritus, Rash macular
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 INC2021620211

Write-up: Red, itchy bumps mostly on ankles.; Red, itchy bumps mostly on ankles.; being tired after vaccine; This is a spontaneous report from a contactable consumer (patient). A 65-years-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number and Expiration date not reported) via an unspecified route of administration on an unspecified date as 2nd dose single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The historical vaccine included first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number and Expiration date not reported) via an unspecified route of administration on an unspecified date as 1st dose single for COVID-19 immunization. After vaccination on 16May2021, the patient was tired. The physicians did not have her Xeljanz to stop for vaccines. The patient reported that, she was been bitten by 9 or 10 mosquitos recently. The patient also experienced Red, itchy bumps mostly on ankles. The patient reported that, the physician was aware that she was taking Neosporin. The outcome of events was unknown. Information on the lot/ batch number has been requested.


VAERS ID: 1376324 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-07
Onset:2021-05-16
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: fenofibric acid, atovastatin, lisinopril, aspirin, magnesium, b-complex/b12, COQ10, e, c, glucosamine, chondroitin, d, fish oil, flaxseed oil, Ocuvite, nicotinamide, melatonin
Current Illness: none
Preexisting Conditions: Cholesterol, sinusitis,
Allergies: walnuts, dust, mold, pollen.
Diagnostic Lab Data: Have not sought medial care at this time
CDC Split Type:

Write-up: Flaking of skin in ear conch area and at least part of the ear canal. tried eucerin cream, aloe vera.


VAERS ID: 1376487 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-09
Onset:2021-05-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)

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

Write-up: Rash on injection site


VAERS ID: 1376578 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Pharmacy       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: METALLIC TASTE IN MOUTH STARTING THE DAY AFTER VACCINATION, AND HAS CONTINUED SINCE THEN.


VAERS ID: 1376648 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 RL / IM

Administered by: School       Purchased by: ?
Symptoms: Chills, Cold sweat, Fatigue, Feeling of body temperature change, Headache, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Non-stop nausea, vomiting, headache, body aches, high fever, chills & MASSIVE fatigue for 3 days. Then massive fatigue for 5 more days. It?s been 3 weeks and I still feel fatigued and get clammy/hot and cold


VAERS ID: 1376744 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-29
Onset:2021-05-16
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chills, Diarrhoea, Dyspnoea, Echocardiogram, Electrocardiogram, Heart rate increased, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), 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: Cognitive decline, loss of muscle tone/drooling, loss of eye contact, stupor/dazed state @ 14 months day after receiving the MMR
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Urgent Care Center of - Metabolic panel blood test, oxygen level /lungs checked, EKG. emergency room visit (5/19/21) - Chest x-ray, IV administered Cardiology on 6/2/21: EKG, heart monitor placed on 6/2/21, Echocardiogram on 6/4/21
CDC Split Type:

Write-up: Rapid heartbeat, shortness of breath, chills, vomiting, diarrhea


VAERS ID: 1376929 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033CZ1A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oligomenorrhoea
SMQs:, Fertility 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: N/A
Current Illness: Sinus infections recurring, chronic post nasal drip since age of 6
Preexisting Conditions: Fibromyalgia, IBS, CFS etc
Allergies: N/A
Diagnostic Lab Data: Not yet. Will find out if clinic appt will do this
CDC Split Type:

Write-up: Whole 2nd half of May was nonstop menstrual period. Paused June 1-3. By June 4 was heading into a 3RD WEEK of continual bleeding!!! Gonna make appt with Gyno doc this week to see what can be done to make it stop


VAERS ID: 1376956 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test, Colonoscopy, Diarrhoea, Endoscopy, Flatulence, Haematochezia
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NoneNpne
Current Illness: None
Preexisting Conditions: First degree AV block Beta Thalassima
Allergies: None
Diagnostic Lab Data: She has had several blood tests starting May 25, 2021 and was hospitalized on June 3rd. She had a colonoscopy and endoscopy. Waiting for results.
CDC Split Type:

Write-up: Patient had gas starting the day after shot. It then progressed to stomach pain intermittent and then diarrhea with bloody stools. It progressively got worse and has been suffering with it for 3 weeks now.


VAERS ID: 1377017 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-20
Onset:2021-05-16
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK UN / -

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory distress syndrome, Confirmed e-cigarette or vaping product use associated lung injury, Deep vein thrombosis, Dyspnoea, Endotracheal intubation, Gastrointestinal disorder, Pyrexia, Systemic inflammatory response syndrome
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sepsis (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: The patient developed progressively worsening dyspnea, GI symptoms and fevers starting 5/16/2021, 3.5 weeks after receiving second Moderna vaccine. She was admitted 5/22/2021 with ARDS requiring intubation, found to have severe systemic inflammation with acute DVT of right right subclavian, axillary, brachial, and upper arm radial veins, chronic DVT of left subclavian, and possible thrombus tricuspid valve. Remains intubated with ongoing evidence of systemic inflammation. Working diagnosis EVALI.


VAERS ID: 1377115 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-08
Onset:2021-05-16
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009CZ1A / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram abdomen, Small intestinal obstruction
SMQs:, Gastrointestinal obstruction (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: None
Current Illness: None
Preexisting Conditions: Subclinical Hypothyroidism
Allergies: None
Diagnostic Lab Data: Seen in ER 5/16/2021 ABD Ct Scan Labs
CDC Split Type:

Write-up: 1 week since second dose of vaccine-patient had spontaneous Small BowelObstruction (SBO)


VAERS ID: 1377737 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-23
Onset:2021-05-16
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu vaccination reaction in 2017 and 2018. Developed large cysts about a week and a half after each of the vaccinations. Went
Other Medications: Vitamin C, Vitamin D, zinc, Plaquenil
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The adverse event is related to menstrual symptoms after the vaccine. My menstrual cycle started a few days early (which isn''t necessarily unusual) but the bleeding was so heavy. I had a myomectomy 2 years ago and prior to that surgery, I had extremely heavy and painful menses. I experienced very similar symptoms after the 2nd dose of the Pfizer vaccine. I can only attribute this to the vaccine because I have not had those symptoms since then.


VAERS ID: 1378070 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Headache, Pain in extremity
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient described chest pain (pain scale of 6.5, from 0-10 with 10 being the highest) located centrally near the heart, extreme headache and sore arm. The chest pain lasted about 24hrs until patient took acetaminophen.


VAERS ID: 1378224 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: none
Allergies: Possibly to watermelon. never diagnosed
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 2 days after 2nd moderna vaccine started having significant hives - worst over R arm (location of shot) but also over L arm, torso, both thighs. Has now got them recurrently every day for 3 weeks - some days worse than others. responding well to ant-histamines. no GI or pulm symptoms. Is starting to slowly improve but still persistant


VAERS ID: 1378783 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-05
Onset:2021-05-16
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013A21A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / UNK - / -

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

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

Write-up: Acute CVA (cerebrovascular accident) Cerebral infarction, unspecified


VAERS ID: 1379068 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal distension, Chest pain, Fatigue, Fluid retention, Headache, Pain, Pain in jaw, Palpitations, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Osteonecrosis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE.
Preexisting Conditions: Celiac
Allergies: Sulfa, NSAIDs, gluten, wheat, rye, barley.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: In addition to "normal" symptoms, (fever, aching, sever headache, fatigue, body aches, bloating, water wight gain) racing heart, hard heart beats. Slept 20 hours on 05/16/2021. Sever chest pain. Experienced jaw pain also. Chest pain has persisted. Much worse when laying down. Gets better when sitting up. As of today, still experiencing significant chest pain. No chest pain previously.


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