National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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 161 out of 3,524

Result pages: prev   62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260   next


VAERS ID: 1378503 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-05-10
Onset:2021-05-15
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Computerised tomogram abdomen, Computerised tomogram head, Dehydration, Ear discomfort, Ear infection, Ear pain, Echocardiogram, Electrocardiogram normal, Gastrointestinal pain, Headache, Hypotension, Inferior vena cava dilatation, Inflammation, Metabolic function test, Musculoskeletal stiffness, Neck pain, Pain, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow), Hypokalaemia (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: levothyroxine birth control Hydrochlorothiazide loratadine
Current Illness: None
Preexisting Conditions: Hashimoto''s thyroiditis Idiopathic edema RBBB
Allergies: Codeine Mucinex DM
Diagnostic Lab Data: CT scan of head and abdomen Complete blood and metabolic panel EKG
CDC Split Type:

Write-up: Had typical symptoms within 24 hrs - low grade fever (101F), body aches and arm pain. On second day developed mild headache that went across forehead. On 5/15/21, developed right ear pain - pressure in ear and headaches continued. Intermittently the left ear would also have pain. Started developing stiffness on the right side of neck that accompanied the ear pain. Went to urgent care on 5/20/21. Doctor said both ears were visibly full, especially the right ear. Prescribed Azelastine nasal spray. Called PCP in morning of 5/21/21, and was prescribed prednisone for 5 days to control inflammation. Prednisone worked after a few days but was still run down and pain developed in my abdomen and along the right side of back/leg. Went to ER on 5/24.21. Doctors performed tests for blood clots. Was told I was weak and dehydrated and given IV and pain meds. Was negative for blood clots but my IVC was dilated. Pains persisted for about 2 weeks - especially in the right abdomen. Went to cardiologist on 6/4/21 and had a normal EKG but low BP. Doctor believes abdominal pain is gastrointestinal and put me on proton pump inhibitor. I am getting echocardiogram on 6/10./21 to check IVC. Since then most pains have subsided except weak, right sided abdominal pain. The right ear pain is back. Starts in the morning with outer cartilage of ear getting inflamed, followed by pressure/pain in right ear, then pain in right neck. Has been going on for a month now. 100% related to vaccine - came after vaccination and never had before.


VAERS ID: 1378808 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-05-15
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / UNK - / -

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

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

Write-up: Unspecified convulsions


VAERS ID: 1379286 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-05-15
Onset:2021-05-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: 16 YEAR OLD RECEIVED 1ST DOSE ON 5/1/21 (ER8736). PT CAME TO CLINIC ON 5/15/21 AND RECEIVED 2ND DOSE 7 DAYS TOO EARLY.


VAERS ID: 1380745 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-15
Onset:2021-05-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

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

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

Write-up: Bells palsy, Blink reflex abnormal, Facial discomfort, Eating disorder, Swallowing difficult; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 28-May-2021 and was forwarded to Moderna on 28-May-2021. This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of BELL''S PALSY (Bells palsy, Blink reflex abnormal, Facial discomfort, Eating disorder, Swallowing difficult) in a 45-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 15-May-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-May-2021, the patient experienced BELL''S PALSY (Bells palsy, Blink reflex abnormal, Facial discomfort, Eating disorder, Swallowing difficult) (seriousness criteria disability and medically significant). At the time of the report, BELL''S PALSY (Bells palsy, Blink reflex abnormal, Facial discomfort, Eating disorder, Swallowing difficult) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication were provided. Patient received Steroid injection. Eye Lubricant as treatment medication. patient had to wear a patch and use eye lubricants to prevent permanent eye damage. Was told this may last for months and sometimes for life. This had affected their whole life. 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.; 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.


VAERS ID: 1381075 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-15
Onset:2021-05-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / OT

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chills, Diarrhoea, Dyspnoea, Heart rate, Heart rate increased, Hypersensitivity, Rash pruritic, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (narrow), Angioedema (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), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: CETIRIZINE; CLOTRIMAZOLE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergic rhinitis; Conjunctivitis
Allergies:
Diagnostic Lab Data: Test Date: 20210519; Test Name: HR; Result Unstructured Data: Test Result:was going up to 120s; Comments: was going up to 120s; Test Date: 20210520; Test Name: HR; Result Unstructured Data: Test Result:120; Comments: still elevated, went up to 120; Test Date: 20210520; Test Name: HR; Result Unstructured Data: Test Result:150; Comments: went to take a shower and HR was 150; Test Date: 20210516; Test Name: Covid 19-PCR/Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC2021581972

Write-up: Noticed on apple watch HR was going up to 120s/HR still elevated. Goes up to 120 when standing. Went to take a shower and HR was 150; diarrhea; Developed rhinorrhea; Developed a pruritic rash on right side of back; chest heaviness; allergic reaction; SOB; chills; This is a spontaneous report from a contactable nurse. A 12-years-old female patient (non-pregnant) received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Solution for injection, Lot Number: EW0168, expiry date not reported), intramuscular, administered in left arm on 15May2021 as first dose, single dose for covid-19 immunisation. Medical history included allergic rhinitis/conjunctivitis from an unknown date and unknown if ongoing. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient''s concomitant medications included medications the patient received within 2 weeks of vaccination as cetirizine 5mg, and clotrimazole 1% topical cream. The patient previously took amoxicillin and experienced allergies. The most recent COVID-19 vaccine was administered in a hospital. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Since the vaccination, the patient been tested for COVID-19 which included Covid 19-PCR (nasal swab) on 16May2021 as negative. On 15May2021, the patient received vaccine (Pfizer) and got chills a couple hours later. On 16May2021, patient developed a pruritic rash on right side of back and mom gave an allergy medicine (cetirizine), developed chest heaviness, and SOB (shortness of breath), no tongue/lip or throat swelling. Patient came to ED and received albuterol and decadron due to concern for an allergic reaction. On 17May2021, patient developed rhinorrhea; and chest and SOB improved, but continued to use albuterol. On 18May2021, patient had rhinorrhea and diarrhea; continued to use albuterol. On 19May2021, patient had diarrhea and noticed on apple watch HR (heart rate) was going up to 120s; last use of albuterol. On 20May2021, patient''s diarrhea resolved, HR still elevated, went up to 120 when standing; and went to take a shower and HR was 150. The events were reported as serious medically significant, resulting in doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care. Therapeutic measures in response to the events included diphenhydramine, decadron, and albuterol. The patient recovered from the event diarrhea on 20May2021. The outcome of the other events reported was not recovered.; Sender''s Comments: Based on temporal association and profile of the product, the events are considered related to BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Solution for injection, Lot Number: EW0168, expiry date not reported).


VAERS ID: 1381396 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-13
Onset:2021-05-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OXYCODONE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Accident automobile (I was in hit and run car accident a while ago few 5 years ago and so I have pain in my face my trigeminal nerve associated with that but I am taking medication for that)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021648986

Write-up: sore arm muscle pain/forearm pain; sore arm muscle pain; This is a spontaneous report from a contactable pharmacist (patient). A 66-year-old male patient received the BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: EW0167, Expiry Date, UPC, NDC number of Pfizer BioNTech COVID-19 Vaccine: Unknown), via an unspecified route of administration, administered in upper left arm on 13May2021 as 1st dose, single dose for covid-19 immunisation. The patient medical history included as was in hit and run car accident a while ago few 5 years ago and so I have pain in my face my trigeminal nerve associated with that but I am taking medication for that. Concomitant medication included oxycodone at 10 mg taken for an unspecified indication, start and stop date were not reported. At pharmacy where COVID-19 vaccine was administered. The patient stated as, the patient had first Pfizer vaccine three weeks ago and patient supposed to get second one tomorrow, but patient have been having for the last 3 weeks really, on 15May2021, sore arm muscle pain / forearm pain, pain prohibits him from lifting glass or door knob and thought it would just meant to go away but it hasn''t gotten any less so patient wondering if patient should get the second one and what to do you know I don''t. Due date of second shot was confirmed as 03Jun2021. The patient think doesn''t have it in any other part of his body and haven''t injured himself or fallen or knocked it against the door knob or it''s patient forearm where he experiencing extreme muscle pain for the last 3 weeks. The patient took Ibuprofen or Aleve but, don''t know sometimes patient stomach was sensitive to that but patient tried to take Ibuprofen, one day it didn''t seem to do or do much but maybe he should take in successive days I don''t know the events were just persisting it''s not getting better or worse. Outcome of the events not recovered. Follow-up actions are needed. Further information is requested.


VAERS ID: 1381700 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-24
Onset:2021-05-15
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C217 / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA OU1C21A / 2 LA / SYR

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

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

Write-up: Dizziness and nausea since week 3 of first shot


VAERS ID: 1381767 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-13
Onset:2021-05-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal distension, Abdominal pain, Adverse drug reaction, Blood culture negative, Chills, Culture urine negative, Cytomegalovirus test negative, Epstein-Barr virus test negative, Haematemesis, Headache, Hepatic enzyme increased, Hyperhidrosis, Hypotension, Intensive care, Lymphadenopathy, Lymphopenia, Malaise, Mobility decreased, Nausea, Neck pain, Odynophagia, Oropharyngeal pain, Pain, Pyrexia, Respiratory viral panel, SARS-CoV-2 test negative, Swelling
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Haematopoietic leukopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Gastrointestinal haemorrhage (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad), COVID-19 (broad)

Life Threatening? Yes
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: Rifampin 300mg as directed JUnel 1/20 (birth control)
Current Illness: Here is full timeline: See for routine visit on 4/21. Given flu shot and meningitis vaccine. Ordered TB test due to travel history Quantiferon gold was positive. Chest xray was negative Rifampin was prescribed May 11th and she started it May 12th. COVID vaccine was given 5/13/21. She first began to feel ill on May 15th. She had throat pain and it hurt to swallow. She then had headaches that were severe. The week after, she started having fevers and sweats. She noticed left sided neck swelling and felt fullness of her lymph nodes. She also felt generalized abdominal pain. Her symptoms were on and off. -On 6/1/21, she felt very sick with headaches and body aches. On 6/2/21, she felt nauseous and then had severe abdominal pain. She was feeling very bloated. She felt chills. She then vomited what she thinks was blood. She had neck pain and had trouble moving her head normally. Her mom called our clinic for an appt but then drove her to the ER. --In the ER, she was noted to have hypotension. Lowest BPs were 80s/40s. In the ER, she had a temperature of 102.7. She was given a dose of ceftriaxone in the ER and three saline boluses. She was also noted to have elevated liver enzymes to the 300s and lymphopenia. Patient was admitted to the ICU for hypotension. A urine culture was negative. Blood cultures were negative. A respiratory viral panel and COVID test were negative. Acute CMV and EBV were negative. No hepatitis panel was done. --She was discharged on 6/3/21. Doctors suspected that her symptoms were a result of a drug reaction to rifampin. This was discontinued and she was started on Zyrtec. She was referred for follow up of her latent TB. --Since being home, she has not had any rash. She is not taking Zyrtec. She stopped both birth control and rifampin. She feels OK currently without any lingering fevers or symptoms. Her headaches have stopped but she has mild neck soreness. No pain with urination. Last sexually active 5/8/21 with the same partner. LMP 5/23. clinic is supposed to call her with an appt for latent TB.
Preexisting Conditions: latent TB, recently found No other chronic conditions
Allergies: no allergies prior to episode
Diagnostic Lab Data: see prior
CDC Split Type:

Write-up: see prior


VAERS ID: 1381872 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 40mg Famotidine daily 10mg cetirizine daily 5mg temazapam daily
Current Illness: None
Preexisting Conditions: None
Allergies: Gluten
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Tinnitus. No treatments.


VAERS ID: 1382160 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-15
Onset:2021-05-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Head discomfort, Presyncope, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Pt was laying down for 2nd Covid vaccination as she fainted for 1st Covid vaccination. After 2nd vaccination was given- she had a vaso vagal reaction. BP 102/72 Pt has had 4 episodes of ears ringing & pressure both sides of head. Recommended to see her primary Dr. after leaving clinic.


VAERS ID: 1382161 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Unknown  
Location: Minnesota  
Vaccinated:2021-05-15
Onset:2021-05-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW018/6 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

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

Write-up: Pt became anxious & started to shake during vaccination. Mother witnessed pt vomiting. Laid down in Observation area. Quickly began to feel better. Escorted to car with parent.


VAERS ID: 1382253 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: North Dakota  
Vaccinated:2021-04-14
Onset:2021-05-15
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 2 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Cerebrovascular accident, Confusional state, Facial paralysis, Fatigue, Lethargy, Magnetic resonance imaging head abnormal, Neurological symptom, Speech disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: levothyroxine , lisinopril, hydrochlorothiazide none
Current Illness: none
Preexisting Conditions: recent hypertension treated with medication
Allergies:
Diagnostic Lab Data: MRI did confirm CVA findings
CDC Split Type:

Write-up: He had a stroke- sudden onset of weakness,- facial drooping, speech impairment, lethargy, and confusion obvious symptoms did resolve over 24 hour- he has some residual fatigue and questionable changes post stroke


VAERS ID: 1382590 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-11
Onset:2021-05-15
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Diarrhoea, Fatigue, Headache, Paranasal sinus discomfort, SARS-CoV-2 test positive, Sinus congestion
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Positive COVID-19 antigen test on 5/17/2021
CDC Split Type:

Write-up: Developed cough, headache, fatigue on 5/15/2021. Diagnosed with COVID on 5/17/2021. Week following diagnosis, developed worsening headache, diarrhea, sinus congestion, sinus pressure.


VAERS ID: 1382611 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-10
Onset:2021-05-15
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphasia, Seizure
SMQs:, Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (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), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Epilepsy
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Five days after the vaccine, 05/15/2021, the patient began having seizures and was not able to speak. The patient arrived to the emergency department of the hospital at 10:30 PM and was seen by the ED doctor at 2:30 AM. The patient''s seizure medications dose was increased and the patient was initiated on hydrochlorothiazide. She was discharged from the hospital on 05/19/2021.


VAERS ID: 1382921 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-15
Onset:2021-05-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: PATIENT DOESNT REPORT ANY ADR HOWEVER, THE MODERNA 2ND SHOT WAS ADMINISTERED ON DAY 22 NOT THE RECOMMENDED DAY 28


VAERS ID: 1382951 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-05-14
Onset:2021-05-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hypoacusis, 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: Armour thyroid, multivitamin, probiotics, black cahoosh
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: pet dander, dust
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Soon after the second vaccine I developed ringing in my ears. It''s been ongoing since. And loud enough that I can hear it even when I am in my car driving.


VAERS ID: 1384596 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-05-13
Onset:2021-05-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure measurement, Body temperature, Chest discomfort, Chest pain, Dyspnoea, Heart rate, Hypertension, Investigation, Myocarditis, Oxygen saturation, Pyrexia, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: GUANFACINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: ADHD; Autism
Allergies:
Diagnostic Lab Data: Test Name: blood pressure; Result Unstructured Data: Test Result:151/108; Test Name: temperature; Result Unstructured Data: Test Result:99.7; Test Name: pulse; Result Unstructured Data: Test Result:128; Test Name: a bunch of lab test; Result Unstructured Data: Test Result:unknown result; Test Name: oxygen level; Result Unstructured Data: Test Result:96-97
CDC Split Type: USPFIZER INC2021593359

Write-up: he has developed myocarditis; Chest was hurting; Chest pain; Tachycardia; Hypertension; his temperature was 99.7; Tight chest; shortness of breath; This is a spontaneous report from a contactable consumer (patient''s mother). A 15-years-old male patient received bnt162b2, dose 1 via an unspecified route of administration, administered in Arm Left on 13May2021 16:00 (Batch/Lot number was not reported) as SINGLE DOSE for covid-19 immunisation at the age of 15 years old. Medical history included Autism and ADHD. Concomitant medication(s) included guanfacine. The patient experienced he has developed myocarditis, inflammation of the muscle in his heart that was caused by covid vaccine, chest was hurting; chest pain, tachycardia, hypertension on an unknown date, shortness of breath, tight chest on 15May2021. Clinical course details was reported as: She thinks he has developed myocarditis. Experienced shortness of breath, went to the Emergency Department. She wishes for him to receive second dose. "They did a bunch of tests". Saturday he had to rush in to the hospital because his chest was hurting, he has chest pain on Saturday that''s why he went to the emergency room. The doctor said, he had inflammation of the muscle in his heart that was caused by COVID vaccine, she wants to submit that to Pfizer." Reporter stated, "No, not exactly, he got the COVID vaccine on May 13th. He started developing shortness of breath and tight chest on Saturday night which is May 15th, I woke him up because all night long he was complaining, I take him to the emergency room at the morning like 4:30 am, 4:30 in the morning of May 16th. The doctor told me that, he said that he didn''t believe that it was a side effect of a vaccine because it was not, it didn''t developed like within 1 or 4 hours to the vaccine like now when I''ve seen on the news that the inflammation that is happening to some kind on the heart, he matches all the symptoms of that. So I need to know what do I need to make and what do we do for the second dose?" Lab test: They did when he was in the hospital, When he was in the hospital 2 days after they did a bunch of lab test." Treatment: They did give him some medication in the hospital. The notes from the hospital they gave, they says he has tachycardia, hypertension, shortness of breath, chest pain. They gave him Ativan. Caller states she is calling about the Pfizer COVID19 vaccine and states she is thinking her son had the side effect that is being reported of myocarditis and took the 1st dose of the vaccine on 13May2021 and on 15May2021, at night he complained of shortness of breath, and a very heavy chest and moaned all night long; states at 4:00am she and her husband got up and took the patient''s blood pressure and oxygen level and pulse and his blood pressure was elevated at 151/108, oxygen levels were ok at 96-97 and his pulse was 128, and his temperature was 99.7 she thinks. States they took him to the emergency room at that time because they did not know if something was going on with his blood pressure elevated. Caller states she has not reported this information to the patient''s HCP and is calling to ask if she should wait or have to wait on the patient''s 2nd dose of the Pfizer COVID19 vaccine. Caller states she did previously file this report but was not given a report reference number and had to call back to ask for her questions. States the patient''s 2nd dose of the Pfizer COVID19 vaccine is scheduled for 04Jun2021. States given that they did not expect the patient to have any side effects and they do not want to be in this situation and are planning on traveling the day the patient is scheduled for his 2nd dose of the Pfizer COVID19 vaccine would they have to wait for his 2nd dose; states she wants to do things the proper way. States given that they did not expect the patient to have any side effects and they do not want to be in this situation and are planning on traveling the day the patient is scheduled for his 2nd dose of the Pfizer COVID19 vaccine would they have to wait for his 2nd dose; states she wants to do things the proper way. Pfizer is aware of the observations of myocarditis that occurred predominantly in a population of young men who received the Pfizer-BioNTech COVID-19 vaccine. Adverse events are regularly and thoroughly reviewed and we have not observed a higher rate of myocarditis than what would be expected in the general population. A causal link to the vaccine has not been established. There is no evidence at this time to conclude that myocarditis is a risk associated with the use of Pfizer/BioNTech COVID-19 vaccine. More than 260 million doses of the Pfizer-BioNTech COVID-19 vaccine have been administered globally. Serious adverse events unrelated to, but close in timing to vaccination, are expected to occur at a similar rate in vaccinated individuals as they would in the overall population. [for non-HCPs]: we refer you to your healthcare provider to discuss this topic. Your healthcare provider knows your medical history, can discuss the risks and benefits of the vaccine, and can provide vaccination recommendations to you. Pfizer is aware of the reports of myocarditis in recipients of the Pfizer-BioNTech COVID-19 vaccine. More than 260 million people globally have now been vaccinated with the Pfizer/BioNTech COVID-19 vaccine and we have not observed a higher rate of myocarditis than what would be expected in the general population. A causal link to the vaccine has not been established. Serious adverse events unrelated to but close in timing to vaccination will likely occur at a similar rate in vaccinated individuals as they would in the overall population. With a vast number of people vaccinated to date, the benefit risk profile of our vaccine remains positive. If asked on the specific casesMore specific information on the specific cases or demographics are not currently available to Pfizer Medical Information. The outcome of the events was unknown. No follow attempts are needed; information about lot/batch number cannot be obtained.


VAERS ID: 1384681 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Amnesia, Cold sweat, Computerised tomogram, Concussion, Dehydration, Dizziness, Electrocardiogram, Fall, Hypophagia, Malaise, Panic attack, Skin laceration
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (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: PROZAC
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210515; Test Name: CT; Result Unstructured Data: Test Result:Normal; Test Date: 20210515; Test Name: EKG; Result Unstructured Data: Test Result:Normal
CDC Split Type: USPFIZER INC2021634530

Write-up: fell straight over on her face, hitting her chin and splitting it open; felt dizzy; cold sweating; panic attack; significant memory loss; mild concussion; dehydration; fell straight over on her face, hitting her chin and splitting it open; insufficient food intake (had not eaten yet); felt more sick then usual; This is a spontaneous report from a contactable consumer. An 18-years-old non-pregnant female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: ER8736, expiration date: not reported), via an unspecified route of administration on 14May2021 as single dose for Covid-19 immunisation (Age at Vaccination: 18years). The patient medical history was not reported. Concomitant medications included fluoxetine hydrochloride (PROZAC) 10mg/day (as medications in two weeks) taken for an unspecified indication, start and stop date were not reported. No known allergies and no other vaccine in four weeks. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient had not been tested for COVID-19. On 15May2021, the patient felt dizzy, had cold sweating, was scared, and thought she was having a panic attack but felt more sick than usual. On 15May2021, the patient stood up from couch, walked 15 - 20 steps and then fell straight over on her face, hitting her chin and splitting it open; she was conscious when rolled over by her parents but had significant memory loss (knew her name but not her school grade or which classes she was taking). She was taken to the hospital, computerized tomogram (CT) Scan, electrocardiogram (EKG) was normal, and no evidence of seizure were there. On 15May2021, the patient was diagnosed with mild con-cussion and got stitches on the chin as therapeutic measure for her chin splitting. Doctor suggested dehydration may had been a factor, also insufficient food intake (had not eaten yet) (start date: 15May2021). The patient stayed home from school for a week with memory improving each day and still did not remember completely a period of 48 hours starting around time of vaccination however, other symptoms had resolved. The patient had never fainted before. The treatment for rest of events was unknown. The patient underwent lab tests and procedures which included CT scan and EKG both as normal, both on 15May2021. The outcome for mild con-cussion and significant memory loss was recovering; and rest all events were resolved.


VAERS ID: 1384750 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210524; Test Name: tested for COVID; Test Result: Negative
CDC Split Type: USPFIZER INC2021651029

Write-up: chills; cough; shortness of breath; body aching; loss of taste; lots of nasal congestion and mucus; lots of nasal congestion and mucus; This is a spontaneous report from a contactable consumer or other non hcp (parent). A 16-year-old patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation solution for injection, Batch/Lot number was not reported), dose 1 via an unspecified route of administration on 14May2021 as 1ST DOSE, SINGLE DOSE for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On 15May2021, one of her children experienced chills, cough, shortness of breath, body aching, loss of taste, lots of nasal congestion and mucus, did not have a fever, then she presented the symptoms 4 days after receiving the vaccine and her other son presented it a week later. The patient underwent lab tests and procedures which included sars-cov-2 test: negative on 24May2021. Treatment medication included antibiotics for the events. Outcome of the reported events are unknown at this point of time. Information on lot/batch number has been requested.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-2021651028 Same reporter/drug/event, different patient.;US-PFIZER INC-2021650327 Same reporter/drug/event, different patient.


VAERS ID: 1385005 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-05-15
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dizziness, Dyspnoea, Headache, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NO
Current Illness: NO
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data: Test (1) - Negative, May 25th. Test (2) - June 8th, Positive.
CDC Split Type:

Write-up: Cough, dizzy, faint, short of breath, headaches at onset. These are the symptoms since May 22nd through today, June 9th. Cough still persists, along w/ headaches and dizzy. Still short of breath...


VAERS ID: 1385937 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-21
Onset:2021-05-15
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site hypoaesthesia, Malaise
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Entresto
Current Illness: No
Preexisting Conditions: Heart Condition
Allergies: No
Diagnostic Lab Data: none so far - my doctors office said to give it time
CDC Split Type:

Write-up: After the first shot in my left arm I had occasional numbness from that shoulder all the way down to my pinky and ring finger. EVER SINCE MY 2ND SHOT IN MY LEFT ARM I NOW HAVE CONSTANT NUMBNESS ALL THE WAY DOWN FROM MY LEFT SHOULDER TO MY PINKY AND RING FINGER, IT NEVER GOES AWAY! Also, after the 2nd shot i was sick for 5 days.


VAERS ID: 1385978 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-05-14
Onset:2021-05-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram, Blood test, Computerised tomogram, Hepatic enzyme increased, Pain, Rheumatoid factor, Ultrasound scan, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: celexa vyanse trazadone
Current Illness: no
Preexisting Conditions: no
Allergies: penicillian
Diagnostic Lab Data: CT, CTA, ultra sound and RA as well as blood work
CDC Split Type:

Write-up: felt achy and sore on 5.14.2021 and on 5.15.2021 by the night of 5.15.2021 I was throwing up wen to the ER and was told my liver enzymes were almost 800 in which I was admitted to the hospital. I stayed in the hospital until 5.18.2021


VAERS ID: 1386013 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-15
Onset:2021-05-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / IM

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

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

Write-up: Patient''s guardian provided inaccurate information regarding Patient''s date of birth. The date of birth provided on the consent form, and subsequent identity verification steps, was incorrect. The correct date of birth was actually a year later making Patient only 11 years old, and an ineligible candidate for the Pfizer covid-19 vaccine. Patient received her first dose on 5/15/2021 and the second dose on 6/5/2021. No adverse effects were reported to my knowledge.


VAERS ID: 1386055 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-14
Onset:2021-05-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Eye pain, Fatigue, Headache, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Glaucoma (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: Been taking ibuprofen and herbal tea.
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have been suffering from fatigue, chills, headaches, eye pain, pain in my arm (where I received the vaccine) for the past several weeks after my second dose of the Pfizer vaccine. The symptoms started the day after my second dose and continue to persist (almost a month later).


VAERS ID: 1386191 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-05-15
Onset:2021-05-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 1 LA / -

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: None on file
Current Illness: None listed on consent form
Preexisting Conditions: None on file
Allergies: None listed on consent form
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient given the shot outside of FDA emergency authorization eligibility.


VAERS ID: 1386383 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-05-14
Onset:2021-05-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Depression, Feeling abnormal
SMQs:, Dementia (broad), Depression (excl suicide and self injury) (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: Multivits, probiotics, prilosec
Current Illness: none
Preexisting Conditions: GERD
Allergies: Sulfa, Erythromycin, Sulfa, Kenalog, Calcium Channel Blockers, Amiodarone, Darvocet
Diagnostic Lab Data:
CDC Split Type:

Write-up: Brain fog, depression, increased emotional state


VAERS ID: 1386878 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-13
Onset:2021-05-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (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: oxycodone/APAP 10/325, NP thyroid 30mg
Current Illness:
Preexisting Conditions: fibromyalgia
Allergies: latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated her blood pressure increased from SBP~140 to SBP ~170. She stated blood pressure remained elevated for about a week, then returned to normal levels.


VAERS ID: 1387743 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-13
Onset:2021-05-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Therapeutic response unexpected
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: VITAMIN D [VITAMIN D NOS]; ZINC
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Arthritis (severe arthritis in his left shoulder; he has bad arthritis in his knees); Blood cholesterol abnormal; Dengue fever (He had Dengue fever twice); Diabetes; Gout
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021601655

Write-up: severe arthritis in his left shoulder;normally can''t raise his left arm above his shoulder;can now raise his left arm above his shoulder/bad arthritis in his knees;knees have not been hurting as bad; This is a spontaneous report from a contactable nurse (patient). A 59-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), intramuscular, administered in the left arm on 13May2021 10:20 AM (Batch/Lot Number: EW0170) (at the age of 59-years-old) as 2nd dose, single dose for COVID-19 immunization. Medical history included arthritis (severe arthritis in his left shoulder; he has bad arthritis in his knees), dengue fever from 2001 to an unknown date (he had Dengue fever twice), cholesterol, diabetes, and gout. Concomitant medications included vitamin D taken for an unspecified indication, start and stop date were not reported; zinc taken for an unspecified indication, start and stop date were not reported; unspecified antacid and unspecified medications for cholesterol, diabetes and gout. The patient previously took Percocet from an unspecified date (over 10 years ago) and it did not have any effect on him. The patient previously received the first dose of BNT162B2 on 22Apr2021 (Lot number: ER8735) (at the age of 59-years-old) at 10:20AM intramuscular injection in left arm. The patient received the vaccine because that was what they said everyone should do. He does not take the flu vaccine, because he does not get sick. He takes Vitamin D 5000iU. In 2001, he got Dengue fever. They say there is no cure for that, but he has a fever. It is an old wise tell, but he drank Sunguni, which is some kind of alcohol in. It did not taste good, but it took care of the Dengue fever. Eight hours later, and it was gone. He was hit by a skeeter. He was sick for three days. After three days of being sick, this old lady was like here take this. He was like well why not, because he was hurting everywhere. Then bam, eight hours later, he was fine. The second time he got Dengue fever, the same thing happened. He is a "Military brat", so he has all of his vaccines. The patient reported that he was just an old guy, fat guy person (as reported). He takes medication for cholesterol, diabetes and gout. He also self-medicates; he takes Zinc 50mg, and Vitamin D 5000iU, and sometimes he takes a typical antacid. The patient reported that he received the second dose of the COVID vaccine last week or the week before. Clarified he received the second dose on 13May2021. He received the first dose of the COVID vaccine three weeks prior to the second dose. He had a surprising outcome. He was hoping that other people have had it too. He has severe arthritis in his left shoulder. He normally takes Ibuprofen like crazy, like boom boom boom (as reported). He normally can''t raise his left arm above his shoulder. He had no reaction to the COVID vaccine. He has had no swelling, no muscle aches, nothing. He can now raise his left arm above his shoulder, and he can reach all the way up to the ceiling. He wanted to see if it was true; it has now been five days since he noticed. The next day after he got the COVID vaccine, it started getting better. He noticed about five days ago, that it was completely gone. He has not had to take Ibuprofen in five days. He wanted Pfizer to know that he does drink, and he did not stop drinking this whole time like they told him too. He does not wear a mask. He states, "if a mask cannot keep a fart out, it ain''t going to keep covid out". The patient clarified that it began on 15May2021. Every morning, he wakes up and takes a shower. One day it dawned on him that he could lift his hands above his head. It was either 19May2021 or 20May2021, that he realized he could lift his arm above his head. He has had no issues operating a push mover or weed whacking. He feels like he has wings. He asked his doctor if he could get the COVID vaccine in his knees too. He has bad arthritis in his knees. His knees have not been hurting as bad. He feels like the COVID vaccine attacked his arthritis. He has not had to take Ibuprofen for five days now. He was hoping that there was something in the COVID vaccine that might lead to something Pfizer was not planning for. Kind of like Viagra, how it was used for something it was not created for (as reported). He told his doctor to sit a few doses of the COVID vaccine up for him. He wants another dose of the COVID vaccine. He has been swinging his arms all around. He has been climbing on ladders. Normally he was too old of a guy to climb on the ladders. He did not change any habits, including eating habits. The only thing he stopped was taking Ibuprofen. He did not have any reactions to the COVID vaccine. The outcome of "severe arthritis in his left shoulder; normally can''t raise his left arm above his shoulder; can now raise his left arm above his shoulder/bad arthritis in his knees; knees have not been hurting as bad" was unknown. The patient reported the causality for the event as: He thinks this is a sign in a positive way. He hopes that this will create new stuff, that there is something in there that might help people, like people with rheumatoid arthritis. He does not take anything. Percocet does not have any effect on him. He does not know why people steal Percocet. Lot number, NDC, expiration date: Unknown. That was 10 years ago. He has a high threshold to pain. He does not feel pain.


VAERS ID: 1388172 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-05
Onset:2021-05-15
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 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 within 6 weeks of receiving COVID vaccination.


VAERS ID: 1388273 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-14
Onset:2021-05-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Endoscopy gastrointestinal, Magnetic resonance imaging, Scan with contrast, Ultrasound scan, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: sonogram, MRI with contrast, Upper and Lower GI scope
CDC Split Type:

Write-up: vomiting for 17 days, not holding down food


VAERS ID: 1388446 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-05
Onset:2021-05-15
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Hydronephrosis, Nausea, Renal disorder, Uterine obstruction, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Hydronephrosis with renal and ureteral calculous obstruction BACK PAIN VOMITING NAUSEA


VAERS ID: 1388580 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-02-06
Onset:2021-05-15
   Days after vaccination:98
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Adenovirus test, Antibody test, Arthralgia, Cardiac imaging procedure abnormal, Catheterisation cardiac normal, Chest discomfort, Chest pain, Computerised tomogram thorax normal, Cytomegalovirus test, Echovirus test, Electrocardiogram T wave inversion, Electrocardiogram abnormal, Enterovirus test negative, Epstein-Barr virus test, HIV test negative, Herpes virus test, Influenza A virus test, Influenza B virus test, Myalgia, Myocardial fibrosis, Myocardial oedema, Myocarditis, Parvovirus B19 test, SARS-CoV-2 antibody test negative, SARS-CoV-2 test negative, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Other ischaemic heart disease (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: atorvastatin (LIPITOR) 40 MG tablet Take 1 Tablet (40 mg) by mouth daily rivaroxaban (XARELTO) 20 MG TABS tablet Take 1 Tablet (20 mg) by mouth daily at 6pm bisoprolol (ZEBETA) 5 MG tablet TAKE 1 TABLET DAILY Multiple Vitamins-Minerals (CE
Current Illness: HTn, Hyperlipidemia , Myxomatous MV disease/ MVP s/p MVR ( her EF changed from 20 to 65 % after the valve was replaced ) HFpEF(65%) paroxysmal Afib. .
Preexisting Conditions: as above
Allergies: Malarone : Nausea And Vomiting Prednisone Anaphylaxis : pt states about 1995 took po steroids became SOB, hyperventilating and high anxiety. Stopped taking and symptoms resolved. cipro : Gi symptoms
Diagnostic Lab Data: see above
CDC Split Type:

Write-up: Per pt : had midsternal chest pain for a few min the day of the first infection and then resolved . SHe mentioned that the the vaccine center during the second shot got mid sernal chest pain x 2 for a few min each time after the second dose _ within 24 hr of the vaccine and self resolved. + arthralgia''s and muscle aches throughout the time She presented on 5/15/2021 with complains of chest pain in the midsternal area and to bilateral sides, no radiation and felt like pressure. EKG pertinent for v2,v3 TWI new from before. Troponin from 0.02--3.5 L heart Cath 5/17: No CAD , Normal LVEF Ct chest PE protocol : neg MRI heart :5/18: acute focal myocarditis left mid inferolateral segment with focal myocardial edema and fibrosis LYME AB SCREEN (Outside Lab) Latest Units: index <0.90 Negative SARS CoV 2 AB IGG (Outside Lab) Negative SARS COV 2 AB (IGG) SPIKE, SEMI QN Latest Ref Range: <1.00 index $g20.00 (H) Adenovirus PCR Not Detected Enterovirus PCR Not Detected Sars-Cov-2 (Covid 19) by PCR Negative CYTOMEGALOVIRUS ANTIBODY (IGG) (Outside Lab) Latest Units: U/mL $g10.00 (H) CYTOMEGALOVIRUS ANTIBODY (IGM) (Outside Lab) Latest Units: AU/mL <30.00 EchoV T6 Ab <1:10 EchoV T7 Ab <1:10 EchoV T9 Ab <1:10 EchoV T11 Ab <1:10 EchoV T30 Ab <1:10 EBV VIRAL CAPSID AG (VCA) AB (IGM) (Outside Lab) <36.00 EBV VIRAL CAPSID AG (VCA) AB (IGG) (Outside Lab) 242.00 (H) EBV NUCLEAR AG (EBNA) AB (IGG) (Outside Lab) 252.00 (H) INTERPRETATION (Outside Lab) Unknown PAST INFECTION HERPESVIRUS 6 AB (IGG) (Outside Lab) 1:20 (H) HERPESVIRUS 6 AB (IGM) (Outside Lab) <1:20 INFLUENZA TYPE B ANTIBODY SERUM (Outside Lab) Latest Ref Range: <1:8 titer 1:8 (H) PARVOVIRUS B19 ANTIBODY (IGG) (Outside Lab) Unknown 0.2 INFLUENZA TYPE A ANTIBODY SERUM (Outside Lab) Latest Ref Range: <1:8 titer 1:32 (H) PARVOVIRUS B19 ANTIBODY (IGM) (Outside Lab) Unknown 0.1 HIV 1 And 2 Latest Ref Range: Non-Reactive Non-Reactive


VAERS ID: 1388904 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-22
Onset:2021-05-15
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: Pt c/o having heart palpitations and shortness of breath post 3 to 5 days after receiving pfizer vaccine.


VAERS ID: 1388974 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-15
Onset:2021-05-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 RA / IM

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

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

Write-up: Patient received first dose of Pfizer. Patient received the 7th dose of the vaccine vial.


VAERS ID: 1389178 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-05
Onset:2021-05-15
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deep vein thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D, Eliquis, Tramadol, Rexulti, Pantoprazole, Benzonatate, Lorazepam, Wixela
Current Illness:
Preexisting Conditions: Asthma
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented with symptoms of DVT on 05/15 at Urgent Care. Was admitted to ER on 05/17 to treat DVT


VAERS ID: 1389349 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-15
Onset:2021-05-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: Client has already received Moderna dose, then Pfizer dose. Did not report previous Moderna dose, so Pfizer series was complete. Client received 3 total doses of COVID vaccine.


VAERS ID: 1389786 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-05-13
Onset:2021-05-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Fatigue, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: Singular taken night before
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe chest pain , low grade fever and extreme fatigue Chest pain/ fever got better with 800 mg of ibuprofen every 6 hours and seemed to resolve itself in 2 days


VAERS ID: 1389803 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-15
Onset:2021-05-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Balance disorder, Confusional state, Crying, Depressed level of consciousness, Fatigue, Gait disturbance, Hallucination, Headache, Pain, Pain in extremity, Tremor
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: birth control: Norethindrone Tablets USP, 0.35mg daily multivitamin pack: "GNC Whole Body:
Current Illness: 22 days prior- COVID ARM from first dose.
Preexisting Conditions: Thalassemia, Anemia
Allergies: none
Diagnostic Lab Data: none.. I did not see a physician.
CDC Split Type:

Write-up: Around 6pm, I started to feel confused and cloudy. By 9pm, I was completely tired and needed to lay down. Around midnight, I woke up with pain throughout my whole body and was unable to walk. This was pain that I never felt before. As I tried to walk my legs were shaky and I could not balance at all. This lasted until about 9 a.m. the next morning. I needed help to walk to the bathroom because my legs basically stopped working. This happened several times during the night. I also felt like I was hallucinating and still in the state of confusion. I heavily cried due to the pain in my legs and contemplated going to the hospital. I also had a type of headache on my left side that I never felt before in my life. It was a different type of pain. It lasted on and off for one week. Also, my whole left side had lingering pain for one week. This was very concerning and I''m frightened to get a booster shot, if needed. I also experienced Covid Arm from my first vaccination but that did not happen in my second. Covid arm lasted for 3 days.


VAERS ID: 1390913 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-05-15
Onset:2021-05-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Fatigue, Pain in extremity, Sluggishness
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Heart murmur (has a really small heart murmur)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021605986

Write-up: complained of chest pain after having the vaccine; very fatigued; very sluggish; Sore arm; This is a spontaneous report received from a contactable consumer (parent). A 16-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 15May2021 (Lot Number: EW0177, at the age of 16-year-old) as single dose for covid-19 immunisation. Medical history included heart murmur. The patient''s concomitant medications were not reported. Historical Vaccine included 2 vaccines in Mar2021 (Caller said that her son had 2 vaccines in Mar2021 on his annual doctor visit, she did not have the names of the vaccines and then had a booster for the vaccine 4 weeks later. The booster was 14 days prior to receiving the Covid vaccine), and meningococcal vaccine on 01May2021 (at the age of 16-year-old, Caller said that it was a meningococcal vaccine. She thought there were 2 different meningococcal vaccines). Caller was a consumer that was calling on behalf of her son that received his first dose of the Covid-19 Vaccine. She said that she saw on the news recently that Pfizer was looking into reports that teenagers were developing heart issues after receiving the vaccine. The caller said that her son was 16 years old and received his first dose on 15May2021. The caller said that her son had a really small heart murmur. When they got home later that day after he received the vaccine on 15May2021, he said that he had chest pain. She said that he did not have a fever, but was very fatigued and very sluggish for a couple of days. She said that this had been on her mind since she saw it on the news. She was concerned if he should get the second dose on 05Jun2021 with his pediatrician. The caller also said that because he turned 16 in Mar2021, he recently had 2 other vaccines and he had a booster. So he had 3 shots prior to having the Covid-19 Vaccine. The caller said that he received the Covid-19 Vaccine after 14 days of receiving the booster. The caller said that the fatigue and feeling sluggish lasted a couple of days, but stated that he was still tired a lot. The caller said that her son also reported that he had a sore arm. She said that he noticed it a couple of hours after his vaccination and lasted about 3 days. He had completely recovered from the sore arm. The outcome of the event chest pain was unknown, of event fatigue was not recovered, of event sluggish was recovering, of the event sore arm was recovered on 18May2021.


VAERS ID: 1390955 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-12
Onset:2021-05-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pneumothorax spontaneous, SARS-CoV-2 test
SMQs:, 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, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210518; Test Name: Nasal swab; Test Result: Negative
CDC Split Type: USPFIZER INC2021612427

Write-up: Spontaneous Pneumothorax; This is a spontaneous report from a contactable consumer (patient). A 30-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration, administered in arm left on 12May2021 09:30 (Batch/Lot number was not reported) as 2ND DOSE, SINGLE for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient was not diagnosed with COVID-19 prior to vaccination. The patient previously took the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 23Apr2021 at 17:15 (age: 30-years) in the right arm for COVID-19 immunization. On 15May2021 06:00, the patient experienced spontaneous pneumothorax. The patient was hospitalized for the event for 9 days. Therapeutic measure was taken as a result of the event which included chest drain. The patient underwent Nasal swab test with negative result on 18May2021. The outcome of the event was not recovered. Information about lot/batch number has been requested.


VAERS ID: 1391285 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-12
Onset:2021-05-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 2 - / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Heart attack oct 17th 2020 Diabetic
Allergies:
Diagnostic Lab Data: Had EKG at cardiologists office on 6/2/2021 which showed abnormalities Had a Holter monitor pit on 6/9/2021 Have an echocardiogram scheduled for 8/5/2021
CDC Split Type:

Write-up: 3 days after 2nd dose Ic started having pain in left side of chest which got stronger


VAERS ID: 1391410 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-20
Onset:2021-05-15
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046A21A / 2 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Antinuclear antibody, Arthralgia, Blood test normal, Contusion, Erythema, Mass, Night sweats, Oedema, Pain in extremity, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase
Current Illness: None
Preexisting Conditions: None
Allergies: Aspirin
Diagnostic Lab Data: Full set of blood tests that report nothing unusual. Lupus test negative.
CDC Split Type:

Write-up: Severe joint pain in ankles, knees, elbows, and feet. Swelling under the skin causing several red lumps and bruising along both legs and on feet. Two lumps on elbows. Low fever with night sweats. Substantial pain in feet that feels like walking on rocks without shoes. Symptoms vary in severity but have continued for four weeks.


VAERS ID: 1391840 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-15
Onset:2021-05-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0461321A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Fatigue, Heart rate increased, Hypertension, Muscle tightness, Skin tightness, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Hypertension (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Ear infection,
Preexisting Conditions: Obease, ear issues. Had my gallbladder removed
Allergies: Allergic to bees, Adverse reaction to Codeine. Make my stomach have extreme pain for about 12 hours. Even after taking food with it
Diagnostic Lab Data: 5-21 ER visit, blood work came back normal. 6-1 primary DR office visit
CDC Split Type:

Write-up: About 45 mins after getting the shot. I experienced a tightening of the face with hives. It felt like the last time I got a bee sting and found out I was allergic to bees. My neck musscles where tight but it was not enough for me to take my epi pen I slepped until 5-19. only awake for about 6 hours a day. When I normally sleep that much. Then on 5-19. Around noon time I woke up and was able to stay awake. I was experiencing fast heart rates from time to time. Still very tired. I was drinking about 32 ounces of water an hour. Then on friday 5-21. The heart issues where very severe and I went to the Emergency room. They gave me an iv bag of fluid and I felt better but still had minnor heart fast rates from time to time. I still felt off. and had a follow up with my primary dr. During the visit he observed high blood preasure of around 144/90. Currently i am observation phase and purchased a blood pressure monitor. According to the over the counter blood pressure monitor . I have been as high as 152/106 and slowly over time it has gone down to as low as 79/58. With more of an average currently holding around 122/80. The monitor has detected two irregular hearbeats with bp stat(138/82, 82bp anb 79/58, and bp 76. I will continue to monitor and report these self monitoring finding to my primary DR on 7-6. I left a message today about updates.


VAERS ID: 1315829 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-11
Onset:2021-05-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Military       Purchased by: ?
Symptoms: Full blood count, Petechiae, Prothrombin time normal
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, multivitamin, zinc
Current Illness: None
Preexisting Conditions: HTN
Allergies: None
Diagnostic Lab Data: Normal CBC, PT/INR
CDC Split Type:

Write-up: Developed petechiae to bilateral lower extremities 3 days following vaccination. Otherwise asymptomatic at the time of evaluation.


VAERS ID: 1315973 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

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

Write-up: Pt received J&J yesterday. Pt c/o having fever/ha/unable to sleep. Pt is walking w/o issue. Pt VSS and NAD.


VAERS ID: 1316005 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-05-05
Onset:2021-05-14
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW051 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product temperature excursion issue
SMQs:, Medication errors (broad)

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

Write-up: temperature excursion with vaccine administered


VAERS ID: 1316292 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Feeling cold, Headache, Nausea, Pain in extremity, Skin warm, Sleep disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nortrel birth control
Current Illness: None
Preexisting Conditions: None
Allergies: None that I know of
Diagnostic Lab Data: Currently experiencing symptoms. so no response yet.
CDC Split Type:

Write-up: About 5-6 hours after the shot I started to experience nausea. It is night time so I attempted to sleep. I just woke up with the urge to vomit. Have been vomiting now for more or less 10minutes (all of what I ate during dinner). Other symptoms include slight headache, feeling slightly warm although I have not checked my temperature and also at the same time slightly cold, and pain in the right arm. On the previous dose the only symptom I had was pain in my left arm (I switched sides this time around although don?t think that is relevant)


VAERS ID: 1316305 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest discomfort, Erythema, Feeling hot, Flushing, Pruritus
SMQs:, Anaphylactic reaction (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: POLYETHLYENE GLYCOL; NAPROXEN, OMEPRAZOLE,RIZATRIPTAN
Current Illness: N/A
Preexisting Conditions: MIGRAINS, GASTRITIS, OBESITY
Allergies: PSUEDOPHEDRINE WITH CARBINOXAMINE; PSEUDOPHEDRINE/GUAIFENESIN DM; PYRIDIUM; XYZAL, FISH OIL, TUMMERIC
Diagnostic Lab Data: PATIENT REPORTED TO CLINIC FOR FURTHER ASSESSMENT.
CDC Split Type:

Write-up: AT 25 MINUTE POST VACCINATION, PATIENT APPROACHED ME AND ASKED IF WAS ABLE TO LEAVE. WHEN ASKING HER HOW SHE FELT, SHE STATED "HOT, FLUSHED, REDNESS TO FACE, AND A LITTLE BIT OF CHEST TIGHTNESS" PATIENT DID TAKE BENADRYL 50MG PRIOR TO 2ND DOSE OF VACCINATION. STATES SHE WAS ALSO ITCHY AT UPPER EXTREMITIES.


VAERS ID: 1316313 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Asthenia, Dizziness, Headache
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: I experienced a great head ache followed by weakness and then I experienced a great stomach ache and dizziness.


VAERS ID: 1316331 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-05-01
Onset:2021-05-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042B21-2A / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: First covid shot on March 11. Was sick for 3 weeks
Other Medications: Armor thyroid, quetipane, crestor
Current Illness: None
Preexisting Conditions: Hashimotos disease
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Right after leaving the facility I started itching on my left arm . When I got home I had a red raised lump on the injection site. It was very hot, it itched and it hurt


VAERS ID: 1316335 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Loss of consciousness, Nausea, Pain in extremity, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: I woke at 4 am with intense chills and nausea. I looked at my watch at 5:24 waiting for my husband''s alarm to go off. I thought to myself that I felt I was going to throw up. Next thing I know, my husband is yelling and the dogs are barking around me. I''m drowning in my vomit (laying on my back because the arm hurt). He sits me up and I throw up multiple times all over the bed. I had blacked out while vomiting and without him there, I could have died.


VAERS ID: 1316499 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Pain
SMQs:

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

Write-up: chills tired ache headache


VAERS ID: 1316599 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-07
Onset:2021-05-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal and fertility vitamin
Current Illness: N/a
Preexisting Conditions: Psoriasis, eczema, asthma
Allergies: Seasonal allergies and pet allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash the size of a golf ball, had redness after the vaccine for 2-3 days with general soreness but no other symptoms. When I woke this morning my arm was again rashy around the vaccination site but with itchiness this time.


VAERS ID: 1316665 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-12
Onset:2021-05-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit d 100 units daily Prental vitamin daily Zoloft 100 mg daily
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness, mildly blurred vision when reading print, "brain fog"


VAERS ID: 1316730 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal, Nausea, Pallor, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient states she did not eat or drink anything in the morning prior to her vaccine. Crackers and water given prior to vaccine. Vaccine administered at 0730. 0748 patient stated she was dizzy, pale, and had blurry vision. She states she felt a whoosh. She was transported to wheelchair and transferred to observation area. BP 81/34 HR 86 100% RA. Patient drank more water and crackers. Remained pale, nauseous. Denies dizziness/blurred vision. 0751 85/40, HR 68 100%RA. 0756 89/53, HR 60, 100% RA. 0801 100/49, 61, 100% RA. 0807 95/64, 57, 100% RA. Patient denies any symptoms. Educated patient and mother on when to call 911. Patient ambulated without difficulty. Discharged home with mom.


VAERS ID: 1316830 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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)

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: Wellbutrin, Lexapro
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: FEVER, BODY ACHES, NAUSEA AND VOMITING TREATED WITH TYLENOL FOR FEVER


VAERS ID: 1316860 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

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

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

Write-up: Patient received vaccine approximately 2.5 hours outside 6-hour window (refrigerated). Contacted Manufacturer and stated" Janssen has not conducted studies to evaluate the efficacy or safety following administration of expired vaccine or vaccines stored outside of the recommended storage conditions." Representative asked to inform patients to contact their PCP.


VAERS ID: 1316926 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 LA / IM

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

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

Write-up: 16 year old previously got 1st dose of Moderna, so had to give 2nd Moderna per guidance, no problems identified


VAERS ID: 1316928 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Unknown  
Location: Michigan  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / UNK LA / IM

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

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

Write-up: pt received the Moderna Vaccine instead of the Pfizer, RN grabbed the wrong syringe


VAERS ID: 1317001 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Hypoaesthesia 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Numbness under nose and lips


VAERS ID: 1317019 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 LA / IM

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

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

Write-up: Patient fainted after leaving vaccination administration room and passed out on the floor. Patient was conscious and 911 was called and arrived. Patient did not leave in ambulance and was doing fine.


VAERS ID: 1317024 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 50mg Zoloft
Current Illness: No
Preexisting Conditions: No
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: My daughter passed out 2 times within 5 minutes of receiving her first dose. She complained of being nauseous after both fainting episodes. We gave her water and orange juice and she ultimately felt better after about 25 minutes of resting.


VAERS ID: 1317036 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Blood glucose, Head injury, Loss of consciousness, Seizure
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient is not currently on any medications, supplements or herbal remedies.
Current Illness: Patient reported no other illness during vaccination or a month prior.
Preexisting Conditions: Patient reports no other chronic or long-standing health conditions.
Allergies: Patient has no allergies to medications, foods or other products.
Diagnostic Lab Data: EMS provided blood pressure, pulse ox and blood sugar testing.
CDC Split Type:

Write-up: Patient was given Janssen COVID-19 immunization via intramuscular route in the deltoid region of the left arm. Patient was fine following the vaccination and was instructed to sit for 15 minutes to be monitored. Approximately 5 minutes after patient was sitting, his body suddenly went straight and his eyes were open. He started to seizure for about 5 seconds and hit his head against the counter. He regained consciousness afterwards and was in distress. After calling EMS, they checked for his blood pressure, Pulse Ox, and blood sugar levels, which they considered stable. They asked the patient if he felt fine at that time, which he said yes. They told him to wait at the pharmacy until his Dad came to pick up him.


VAERS ID: 1317084 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 1 LA / IM

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

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

Write-up: A 16 year old got the Moderna Vaccinatin


VAERS ID: 1317192 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

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

Write-up: Vaccine was administered after vaccine sat at room temperature for 2 hours and 40 minutes prior to administration.


VAERS ID: 1317200 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Glassy eyes, Headache, Heart rate increased, Hypopnoea, Impaired work ability, Influenza like illness, Injection site pain, Nasal congestion, Ocular hyperaemia, Pain, Pyrexia, Respiratory rate increased, Throat irritation
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: Chronic pain due to fx heel (7 surgeries), staph infection.
Allergies: None.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: He got the vaccine, He felt as if he was breathing shallow on the bus to get to work, within 15 minutes of the vaccine. He came home and collapsed due to the fatigue which is not normal for him. About 12 hours later his throat got scratchy, achy but doable. He went to work and had to leave early due to flu-like symptoms, felt feverish. Really bad aches now, and his breathing and heart rate are elevated right now. Achy-like headaches. He did take some Ibuprofen 800 mg and seems to be helping. He has had the typical soreness of getting the vaccine in the left shoulder, but otherwise ok. He also has a stuffy nose, scratchy throat and his eyes are a little red and glassy. He was directly exposed to somebody for 25 hours that was positive for COVID, but nobody else in the car got COVID in January.


VAERS ID: 1317207 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 RA / IM

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

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

Write-up: Patient was given and expired/invalid dose of the vaccine as it was drawn up $g6 hours from which it was given.


VAERS ID: 1317223 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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

Write-up: Patient recieved vaccination, within 5 minutes she reported not feeling well. She was seated and briefly passed out. She was shaky and sweating. Paramedics were called. Patient was evaluated in ambulance. Within 30 min of initial reaction patient returned to pharmacy feeling well as her reaction had passed.


VAERS ID: 1317246 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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

Write-up: Patient passed out for less than 5 seconds after receiving the immunization.


VAERS ID: 1317249 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Visual impairment
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient did not mention anything
Current Illness: unknow
Preexisting Conditions: unknow
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: After the vaccine patient complained about change in vision not able to see things, sweating ,dizzy. As per patient request called 911.By the time ambulance came patient felt better and did not want to go to hospital . As per patient he felt okay after 20 minutes or so..


VAERS ID: 1317254 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Epinephrine, Hypoaesthesia, Pain in extremity, Swollen tongue, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None on file
Current Illness:
Preexisting Conditions: Not aware
Allergies: Shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported arm soreness, few minutes later left leg starting to feel numb, shortness of breath. Then he reported tight throat and tongue swelling. Immediately called 911 and activated ems. Vitals: 0xygen 100%, bp 230/130, HR 80. Symptoms seem progressing so epinephrine 0.3 mg was administered at 11:30 a. EMS arrived 2-3 minutes later after epi was administered . Epi lot: OFM242, exp 11/01/2021. Patient left with EMS on gurney


VAERS ID: 1317294 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Feeling hot, Hyperhidrosis, Visual impairment
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Patient started feeling "dizzy", "woozy", "seeing spots" approximately 1 hour after she received her vaccine. She stated that she was very tired. She appeared to be very sweaty and said that she "felt hot" when she took a deep breath. EMS was called and patient went to ambulance with EMTs.


VAERS ID: 1317298 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Hypoaesthesia, Nausea, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: patient became diaphoretic and dizzy, mild nausea hands went tingling and numb. pt was moved to well ventilated area and recovered quickly. regained color and dizziness diminished.


VAERS ID: 1317305 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (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: LOSARTAN, ORAL BIRTH CONTROL
Current Illness: UNKNOWN
Preexisting Conditions: HIGH BLOOD PRESSURE
Allergies: LISINOPRIL, HYDROCHLOROTHIAZIDE
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT STATES PAIN IN LEFT ARM, SHORTNESS OF BREATH, DIFFICULTY BREATHING, LIGHTHEADEDNESS/DIZZINESS AFTER ADMINISTRATION. PATIENT SAT AND THEN LIED DOWN ON FLOOR, AMBULANCE SERVICE CALLED. PATIENT DRANK WATER WHILE LYING DOWN AND STATED SHE FELT BETTER. AMBULANCE SERVICE CHECKED PATIENT OUT, OFFERED TO TAKE HER TO HOSPITAL FOR FURTHER EVALUATION, PATIENT REFUSED. PATIENT WENT HOME WITH HUSBAND ON HER OWN ACCORD.


VAERS ID: 1317308 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER EW0173 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site hypoaesthesia, Injection site paraesthesia
SMQs:

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: no history taken
Current Illness: no history taken
Preexisting Conditions: no history taken. patient is looking at their bp after recieving potential diagnosis of hypertension
Allergies: no history taken
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Numbness and tingling in the left arm post injection, radiating up the arm.


VAERS ID: 1317314 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypopnoea, Hypotension, Injection site pruritus, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (narrow), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Shallow breathing, low blood pressure, loss of consciousness, itchiness at site of injection.


VAERS ID: 1317317 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Epistaxis, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (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), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Severe, Additional Details: pt fainted and fell to floor, was bleeding from nose- was picked up by ambulance following


VAERS ID: 1317318 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 2 LA / IM

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

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

Write-up: Pt was 17 years old when vaccinated, verbal consent received from patient''s guardian to proceed with vaccination.


VAERS ID: 1317322 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Error: Incorrect Reconstitution


VAERS ID: 1317332 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Anaphylactic reaction, Pruritus
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient received her 1st Covid vaccine today, with a known history of anaphylaxis to the flu shot 6 months prior. She was assigned a 30 minute wait time. She received her vaccine at 1225 on 14May2021, and approximately 15 minutes later developed itchiness around her mouth and face. She reported this felt similar to the beginning of her prior episode. Physician and nurse were notified, who evaluated patient. Patient?s airway was clear, respirations unlabored and normal to auscultation. Vitals were within normal limits. EMS was notified, and 50mg Benadryl was given at 1255. At this time patient?s reaction appeared minor and stable, so epipen was at patient?s side however not given yet. EMS arrived rapidly, and repeated eval, confirming same evaluation and history. Patient was transferred in stable condition to the ER for extended monitoring.


VAERS ID: 1317336 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Hypotension, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: dizziness, faint, low blood pressure, sweating. patient laid down and put legs up on a chair, blood pressure returned to normal and patient felt better


VAERS ID: 1317349 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Dizziness
SMQs:, Anticholinergic syndrome (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Th, e patient is on her 3 weeks post partum. She felt dizzy, anxiety. She takes lLmictal for seizers. Pulse 64 respiration 10 spo2 98% bp 90/55 at 12:10 pm She felt better and her husband took her to door on wheelchair to discharge on 12:36pm


VAERS ID: 1317352 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / IM

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

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

Write-up: Patient reports fainting after receiving any inject.


VAERS ID: 1317365 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: FLU SHOTS
Other Medications: BENADRYL 37.5MG DOSE; AND ICE PACKS
Current Illness: ANXIETY/ASTHMA
Preexisting Conditions: ASTHMA/ANXIETY
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT GOT HER SHOT AT 10:55 AM . SHE HAS HX OF PANIC ATTACK ASTHMA AND DEPRESSION. PT SHOWED AT PHARMACY COUNTER AFTER SITTING FOR 20 MINS . CHECKED BP 11:25 151/111, GAVE HER BENADRYL 25MG (10 MLS PO ONCE ). PT WAS ASKED TO SIT ANOTHER 15MINS AND RECHECKED HER BP IT WAS STILL HIGH, OFFERED EMS SERVICE PT INITIALLY DECLINED BUT THEN SHE STILL WAS NOT FEELING ANY DIFFERENT SHE TOOK EMS. PT WAS TRANSPORTED TO THE HOSPITAL


VAERS ID: 1317369 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Fatigue, Headache, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (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: Prenatal vitamin, escitalopram
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nausea, vomiting, headache, severe upper body aches, fatigue


VAERS ID: 1317411 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Feeling abnormal, Head injury, Hyperhidrosis, Mydriasis, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: reports passing out but not that severe
Other Medications: unknown
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was the 4th person to receive today?s vaccine of Pfizer. This was his second dose. He did fine the first dose. Patient sat down in the chair and rolled sleeve up. Chose L deltoid for injection site. He was talking with a friend and writer gave injection. Placed band aid. Patient was quiet and looked like he was going to get up but fell forward out of the chair. He hit his L forehead on side of wall. Writer caught patient and sat him up on the ground. Eye?s were dilated, he was diaphoretic, zoned out and not responding initially to voice, but eyes were open. Eventually got patient up to a wheelchair and taken to office area to lay down and monitor. Father was notified and sat with us after he arrived at the school. Patient drank 1 full 120cc orange juice and approximately 6oz of water. Throughout monitoring patient gradually felt better. Pupils corrected to normal, wasn?t diaphoretic anymore, and vitals improved. He stated this has happened before with lab draws and shots, but not this severe. Writer and colleagues informed him to notify people that are going to give him shots or lab draws about his history. Also informed him to notify his teachers if he feels anything out the ordinary for the rest of the day. Make sure he hydrates. Patient then sat up and walked in the room. He stated he felt fine like before getting the shot. Patient left stable and under his own power.


VAERS ID: 1317420 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

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

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

Write-up: Patient fainted for a few seconds and regained consciousness quickly. We gave him some water and he was fine.


VAERS ID: 1317425 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 RA / SYR

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

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

Write-up: 0.5 ML INJECTION INSTEAD OF 0.3 ML INJECTION ADMINISTERED


VAERS ID: 1317436 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / IM

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

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

Write-up: 0.5 ML INJECTION INSTEAD OF 0.3 ML INJECTION ADMINISTERED


VAERS ID: 1317441 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / IM

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

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

Write-up: 0.5 ML INJECTION INSTEAD OF 0.3 ML INJECTION ADMINISTERED


VAERS ID: 1317448 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / IM

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

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: NONE


VAERS ID: 1317462 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / IM

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

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

Write-up: NONE


VAERS ID: 1317465 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

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

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

Write-up: Patient received Johnson and Johnson Vaccine and almost immediately developed a swollen goose egg the size of a baseball at the injection site. Patient was given an ice pack, and after 10 minutes the swelling still had not reduced and she was complaining of pain. The patient was given 50mg of liquid diphenhydramine. After 30 minutes the swelling had reduced some so the patient was told to ice again in a few hours and dose with diphenhydramine again if swelling continued.


VAERS ID: 1317469 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 LA / IM

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

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

Write-up: 0.5 ML INJECTION INSTEAD OF 0.3 ML INJECTION ADMINISTERED


VAERS ID: 1317479 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 LA / IM

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

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

Write-up: 0.5 ML INJECTION INSTEAD OF 0.3 ML INJECTION ADMINISTERED


VAERS ID: 1317480 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Vitals taken: 1446 - HR 71, Resp 12, BP 92/55, SPo2 99. 1453: HR 77, Resp 12, BP 98/67, SPo2 100.
CDC Split Type:

Write-up: Pt started to feel lightheaded with a tingling sensation in her arms 5-10 minutes after vaccination. Pt was given water and observed for 15 minutes. Pt was released in Good Health to her mother


VAERS ID: 1317489 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

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

Write-up: Patient was given johnson and johnson vaccine and immediately felt lightheaded and faint. She laid down on the floor. I went to get cool wet papertowels and upon returning she was unresponsive. I immediately had staff call for an ambulance. Patient came to before needing to administer the epipen or diphenhydramine. Patient denied throat swelling or pain and was alert x3. EMS checked her out and determined it was just a fainting episode, which the patient admitted to having frequently in the healthcare setting. Patient was able to walk out of the pharmacy and is feeling fine now.


VAERS ID: 1317492 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / IM

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

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

Write-up: 0.5 ML INJECTION INSTEAD OF 0.3 ML INJECTION ADMINISTERED


VAERS ID: 1317505 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 LA / IM

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

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

Write-up: Patient''s age is less than acceptable (<18). No symptoms or adverse reactions reported during visit.


VAERS ID: 1317561 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Pallor
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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: N/A
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: vitals and medics called patient did not go to hospital remained in observation
CDC Split Type:

Write-up: post vaccination patient became dizzy and pale vitals 13/66, 96, 22, 98.6, o2 98..911 called to assess patient on arrival patient was stable remained in observation for 30 minutes-mom reported that patients has a history of having extreme anxiety after any injection which causes her to get dizzy, nauseous, sweaty and at times pass out.


Result pages: prev   62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=161&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166