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

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



Case Details (Reverse Sorted by Onset Date)

This is page 167 out of 3,524

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VAERS ID: 1353772 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-16
Onset:2021-05-14
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Epilepsy, Muscle spasms, Muscle twitching, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Generalised convulsive seizures following immunisation (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: Comments: No medical history was reported.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Epileptic seizure; Twitching of the legs/Twitching of the arms/Her body would not stop twitching; Muscle spasm; Fever at 104 degrees Fahrenheit; This spontaneous case was reported by a consumer and describes the occurrence of EPILEPSY (Epileptic seizure), MUSCLE TWITCHING (Twitching of the legs/Twitching of the arms/Her body would not stop twitching), MUSCLE SPASMS (Muscle spasm) and PYREXIA (Fever at 104 degrees Fahrenheit) in a 20-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 008C21A and 008C21A) for COVID-19 vaccination. No medical history was reported. On 16-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-May-2021, the patient experienced EPILEPSY (Epileptic seizure) (seriousness criterion medically significant), MUSCLE TWITCHING (Twitching of the legs/Twitching of the arms/Her body would not stop twitching) (seriousness criterion medically significant), MUSCLE SPASMS (Muscle spasm) (seriousness criterion medically significant) and PYREXIA (Fever at 104 degrees Fahrenheit) (seriousness criterion medically significant). At the time of the report, EPILEPSY (Epileptic seizure), MUSCLE TWITCHING (Twitching of the legs/Twitching of the arms/Her body would not stop twitching), MUSCLE SPASMS (Muscle spasm) and PYREXIA (Fever at 104 degrees Fahrenheit) outcome was unknown. Patient received her second dose of the Moderna COVID-19 vaccine yesterday on 14MAY2021 at 10:30 AM. Patient experienced epileptic seizure, twitching of the arms, twitching of the legs, muscle spasm, and fever at 104 degrees Fahrenheit after receiving the second dose of the vaccine. She was sent to hospital twice yesterday. She came home last night from the hospital, went to sleep, and then she woke up around 4am screaming for his wife. Her body would not stop twitching and she kept punching herself with her arm. She went to the hospital again so they can calm her symptoms down. The emergency room doctors prescribed her medications for her shakiness and twitchiness. Her symptoms have been going on for 28 hours. The caller mentioned that the emergency room doctors did not know what to do with patient but to prescribe her medications to treat her symptoms. Patient was a healthy young girl until she got the second dose of the vaccine. Patient received the first dose of the Moderna COVID-19 vaccine on 16APR2021 and she experienced only experienced arm soreness for a couple days. No treatment information provided. No concomitant medication provided. Action taken with mRNA-1273 in response to the events was not applicable. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. This case was linked to MOD-2021-132361 (Patient Link).; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1354113 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-23
Onset:2021-05-14
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), 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: Second dose given 21 days after 1st dose. Patient reports on 5/21/21 that she feels great and she has had no signs and symptoms to report other than a slight sore arm at the injection site lasting only for a few hours the first night.


VAERS ID: 1354169 (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: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Other       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: None reported
Current Illness: None reported
Preexisting Conditions: None reported
Allergies: None reported
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt stated he was 18 years old upon arrival. Pt and his father requested J&J single dose vaccine for him. Consent form was signed by patient. Year of birth was noted. Upon documentation, pt is noted to be 17 years old and at time of vaccination was approximately 1 month before his 18th birthday. Pt received vaccine May 14,2021, he turns 18 on later date. Follow up with patient completed. No adverse event reported.


VAERS ID: 1354257 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling abnormal, Headache, Hyperhidrosis, Injection site pain, Pyrexia, Sleep disorder, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: The first Moderna COVID-19 vaccination (lot 039A21B), received on 4/14/2021, at age 31. Milder fever, headache, and fatigue.
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately 9 hours after receiving the 2nd COVID-19 vaccination, a fever developed that reached 99.8F. This was accompanied by chills, severe fatigue, and moderate soreness in the left deltoid. Sleep was disrupted by shaking due to chills, moderate headache to the frontal and occipital areas, and sweating. The fever and chills improved the next day but persisted until around 36 hours post-vaccination. Headache, fatigue, and a "hung over" feeling persisted until 72 hours post-vaccination.


VAERS ID: 1354327 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-11
Onset:2021-05-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Blood pressure increased, Chills, Cough, Dyspnoea, Eye irritation, Fatigue, Headache, Injection site pain, Lacrimation increased, Lymphadenopathy, Malaise, Myalgia, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative, Sneezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypertension (narrow), Cardiomyopathy (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Lacrimal disorders (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine, emergen c, zinc, vitamin d
Current Illness: I had not been sick for 2 years prior to vaccine. Not even a sniffle.
Preexisting Conditions: None
Allergies: sulfa and aspirin
Diagnostic Lab Data: Had a rapid covid test on May 21st that was negative.
CDC Split Type:

Write-up: headache, congestion, runny nose, sneezing, burning eyes, watery eyes, higher than normal blood pressure, fever, chills, body aches, shortness of breath, coughing, muscle pain, injection arm pain, tiredness, feeling unwell, no energy, swollen lymph nodes under arm and below ear lobe,


VAERS ID: 1354415 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-07
Onset:2021-05-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Coagulopathy, Condition aggravated, Coronary artery aneurysm, Coronary artery dilatation, Echocardiogram abnormal, Fibrin D dimer, Immunoglobulin therapy, Inflammatory marker increased, Pain, Prothrombin time prolonged, Pyrexia, Sickle cell anaemia with crisis, Tachycardia
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydroxyurea, Tylenol-Hydrocodone, Vitamin D, Folic acid, Omeprazole, Miralax, Albuterol inhaler,
Current Illness: Vaso-occlusive crisis from sickle cell disease
Preexisting Conditions: sickle cell disease
Allergies: Morphine, ketamine, Zofran, Tegaderm
Diagnostic Lab Data: C-RP 36, PT 18 , D-dimer 22,000 05/14. Echocardiogram - Diffusely dilated LMCA and LAD arteries, they meet criteria for small to moderate aneurysms but do not havedefinite evidence of luminal irregularities or outpouchings
CDC Split Type:

Write-up: Sickle cell disease patient with a history of Covid infection in Dec 2020, received first dose of Pfizer vaccine in April 2021 followed by second dose on May 7th2021. He was admitted to the hospital on May 11th 2021 for a vaso-occlusive pain crisis. He then developed fevers, increased inflammatory markers, coagulopathy and significant tachycardia- echocardiogram, was done which showed coronary artery aneurysms raising concern for Mis-C. Retrospectively, his previous echocardiogram few years ago also showed coronary dilation although now it was slightly worse. patient was given IVIG and steroids as treatment for Mis-C following which fevers resolved and his inflammatory markers improved. He is being followed with serial echocardiograms which shows stable echo findings. He remains in the hospital still for treatment of his pain crisis.


VAERS ID: 1354460 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-11
Onset:2021-05-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Catheterisation cardiac normal, Chest pain, Echocardiogram normal, Myocarditis, Palpitations, Troponin
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lorazepam, lithium carbonate, fluvoxamine
Current Illness: Bit by a venomous catfish one week prior
Preexisting Conditions: OCD, anxiety, depression
Allergies: Risperidone - dry mouth, restlessness
Diagnostic Lab Data: Troponin 23 echocardiogram normal cardiac catheterizatoin normal
CDC Split Type:

Write-up: Chest pain, palpitations. Diagnosed with myocarditis at hospital. (admitted 5/14/21-5/16/21).


VAERS ID: 1354501 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-09
Onset:2021-05-14
   Days after vaccination:66
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tamsolusin, Finasterise, Ca, Mg, Vitamin C, saw palmetto
Current Illness:
Preexisting Conditions: enlarged prostate
Allergies: penicillin, meth-sulfa
Diagnostic Lab Data: -----
CDC Split Type:

Write-up: Beginning 5/14/2021 shortly after rising, and continuing on most but not all days but still continuing to date, a red rash and/or red bumps (hives) over small areas of arms and/or thighs and they were mildly itchy. Treated with cortisone-10 cream and condition gone within 30-60 minutes for rest of the day. Also additionally tried Benadryl one day but stopped when label showed possible impact on prostate. Saw Dr. on 5/25/2021, a dermatologist, who confirmed hives and predicted condition should likely disappear in 6 weeks.


VAERS ID: 1354614 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Chills, Fatigue, Paraesthesia, Pyrexia, Tenderness
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: BURNING SENSATION IN ARM AFTER INJECTION THAT RADIATED TO OTHER ARM AND DOWN SPINE SORE TO TOUCH RIBS. TINGLING IN UPPER SPINE FOR 2 WEEKS FOLLOWING INJECTION. CHILL. FEVER. FATIGUE.


VAERS ID: 1354687 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045A21A / 1 - / -

Administered by: Work       Purchased by: ?
Symptoms: Headache, Migraine
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: Flonase, claritin, elderberry, probiotics, omega3
Current Illness:
Preexisting Conditions:
Allergies: Sulfura, Codeine, penicillin and scallops
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headaches and migraines. Treated with Tylenol and icing head.


VAERS ID: 1354724 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-09
Onset:2021-05-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Computerised tomogram, Dyspnoea, Pain in extremity, Pulmonary thrombosis, Thrombosis, X-ray
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vit B & D, Predisone 10mg 1 daily
Current Illness: none
Preexisting Conditions: Asthma, COPD, Hyperlipidema
Allergies: Sulfa
Diagnostic Lab Data: CT scan & Xrays 5/26/21
CDC Split Type:

Write-up: bi-lateral leg pain within 1 week of shot. then severe back pain after 2 weeks. difficulty breathing week 3. Admitted to hospital for multiple blood clots in legs & lungs.


VAERS ID: 1354977 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-09
Onset:2021-05-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Anaemia, Full blood count abnormal, Haemoglobin decreased, Heavy menstrual bleeding
SMQs:, Haematopoietic erythropenia (broad), Haematopoietic leukopenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (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: Mirena IUD
Current Illness: None
Preexisting Conditions: Chronic Hepatitis B
Allergies: None
Diagnostic Lab Data: CBC - found to be anemic, Hgb 10.4 and started on iron Prescribed Provera 10mg PO daily x 10 days to control bleeding
CDC Split Type:

Write-up: Excessive and prolonged menstruation - pt had a normal period at the time of her 2nd covid vaccine and had bleeding from 5/8-5/13, then on 5/14 she began experiencing heavy bleeding and is still bleeding at the time of this report, x 19 days now. Bleeding was heavy saturating 2-3 menstrual pads/hour. Patient has no prior history of abnormal bleeding like this and thinks it is from Covid vaccine.


VAERS ID: 1355023 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lantus Solostar, Quetiapine 400, Lithium Carbonate ER 450, Gabapentin 600mg. Norco 10/325, Metformin 500 SA
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Shellfish, Penicillin, Morphine, Ibuprofen, Codeine, Aspirin, Amoxicillin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient described fever of 104 F the following day and for 24 hours after Covid Shot.


VAERS ID: 1355030 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none listed
Current Illness: none stated on form
Preexisting Conditions: none stated on form
Allergies: no known allergies
Diagnostic Lab Data: none at this point
CDC Split Type:

Write-up: patients caregiver has described pain at injection site -7 days past injection. pain at injection site started morning after injection. patient informed me that they will seek medical evaluation. no other details given.


VAERS ID: 1355113 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-12
Onset:2021-05-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Pruritus
SMQs:, Anaphylactic reaction (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Uncontrollable itching on arms and pain in joints very low energy


VAERS ID: 1355142 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-29
Onset:2021-05-14
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cardiac imaging procedure abnormal, Chest pain, Echocardiogram, Magnetic resonance imaging heart, Myocardial fibrosis, Troponin increased
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Troponin 5/23/2021-5/24/2021 cardiac MRI 5/25/2021 echocardiogram 5/24/2021
CDC Split Type:

Write-up: Patient was admitted to healthcare facility on 5/23 with chest pain and elevated troponin. Normal biventricular systolic function. Cardiac MRI showed myocardial fibrosis


VAERS ID: 1355287 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Rash, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: - Omeprazole 40 milligram once daily - Albuterol inhaler as needed. - Symbicort inhaler two times daily - Montelukast 10 milligram once daily - HCTZ 25 milligram once a day. - Vitamin D - Vitamin B12 - Amatiza 24 milligram two times daily
Current Illness: Asthma, HTN, IBS, Constipation, Allergic Rhinitis.
Preexisting Conditions: Asthma, HTN, IBS, Constipation.
Allergies: Latex, Morphone Sulfate.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Rash, Hives, difficulty breathing and chest tightness.


VAERS ID: 1355584 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-05
Onset:2021-05-14
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: sulfa drugs
Diagnostic Lab Data: I have not been to a doctor about this yet.
CDC Split Type:

Write-up: My left shoulder feels weak and unstable as if it could become dislocated. I have pain/soreness when lifting my left arm. It has never felt this way before in my life.


VAERS ID: 1356508 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-05
Onset:2021-05-14
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

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

Write-up: Measles like or eczema like rash on neck and chest


VAERS ID: 1356544 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Hot flush, Pyrexia, Rash, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Had chills and hot flashes. Fever got up to 101.4. I couldn''t keep any food or liquid down for 48 hours. This all began 12 hours after getting the shot. A week later my face began breaking out. It''s either pimples or rosacea.


VAERS ID: 1357084 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Hypopnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (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: Comments: The patient has allergies of unspecified drug
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210551473

Write-up: SHORTNESS OF BREATH; CAN''T TAKE A DEEP BREATH; This spontaneous report received from a patient concerned a 5 decade old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient has allergies of unspecified drug. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 203A21A expiry: UNKNOWN) dose was not reported, administered on 14-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 14-MAY-2021, the subject experienced shortness of breath. On 14-MAY-2021, the subject experienced can''t take a deep breath. The action taken with covid-19 vaccine was not applicable. The patient was recovering from shortness of breath, and can''t take a deep breath. This report was non-serious.


VAERS ID: 1357111 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-31
Onset:2021-05-14
   Days after vaccination:44
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Hospitalisation, Inappropriate schedule of product administration
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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Hospitalized after 1st dose; second dose of the Moderna COVID-19 Vaccine on today, 14May2021; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of HOSPITALISATION (Hospitalized after 1st dose) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 31-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 14-May-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second dose of the Moderna COVID-19 Vaccine on today, 14May2021). On an unknown date, the patient experienced HOSPITALISATION (Hospitalized after 1st dose) (seriousness criterion hospitalization). On 14-May-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (second dose of the Moderna COVID-19 Vaccine on today, 14May2021) had resolved. At the time of the report, HOSPITALISATION (Hospitalized after 1st dose) outcome was unknown. No relevant concomitant medications were reported. The caller reported that both he and his mother received the first dose on 31-Mar-2021. His mother was then hospitalized due to unspecified reason. Due to the hospitalization, his mother missed her second dose. The caller then took her to receive her second dose on 14-May-2021. No treatment information was provided. Action taken with mRNA-1273 in response to events was not applicable. Company comment: Very limited information regarding this event has been provided at this time. However, This report refers to a case of (inappropriate schedule of product administration) for mRNA-1273, lot # unknown, with no associated AEs.; Sender''s Comments: Very limited information regarding this event has been provided at this time. However, This report refers to a case of (inappropriate schedule of product administration) for mRNA-1273, lot # unknown, with no associated AEs.


VAERS ID: 1357296 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lip discolouration, Nausea, Pallor, Physical examination, Product use issue, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Medication errors (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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210514; Test Name: checked; Result Unstructured Data: Test Result:everything was normal/fine
CDC Split Type: USPFIZER INC2021547571

Write-up: fainted; Nausea; lips white; Really pale; 12 year old daughter; This is a spontaneous report from a contactable consumer (patient''s mother). A 12-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Left on 14May2021 got it closer to 12:00 (Batch/Lot number was reported: First letter was R, W or B, followed by A6256) at the age of 12-years-old as SINGLE DOSE for covid-19 immunization. The COVID-19 vaccine was administered at Pharmacy/Drug Store. Medical history reported as none. No family medical history relevant to adverse event, reporter who was the patients mother, is a fainter, who fainted a lot when she saw blood. The patient''s concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. As they were driving away, her daughter started feeling really nauseous, then fainted, was super pale, lips were white and she was really pale. It all occurred at the same time all started 10 minutes after vaccine on 14May2021. Then the ambulance came. Her daughter looked really bad and it freaked reporter out. Her daughter sat for a little while and was feeling better now. Her daughter was no longer pale, it went away. They checked her and everything was normal. No Emergency Room and no Physician Office visit required. Ambulance was called, they checked her and she was fine. Told her to keep any eye on her at home. The outcome of the events pale, lips were white was recovered on 14May2021, the outcome of the events nauseous, and fainted was recovering. Information about Lot/Batch number has been requested.


VAERS ID: 1357299 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021547701

Write-up: throat was closing; throat was itching; This is a spontaneous report received from a contactable consumer (patient). This 12-year-old male patient received the first dose of bnt162b2 (BNT162B2), via an unspecified route of administration, administered in arm left on 14May2021 18:00 (Batch/Lot number was not reported) as single dose for covid-19 immunisation. There was no medical history or concomitant medications. The patient previously took penicillin. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced throat was itching on 14May2021 18:05 and throat was closing on 14May2021 18:08. Within 5 min of shot throat was itching, at 8 minutes throat was closing and 911 was called. The adverse event result in Emergency room/department or urgent care. Treatment received for the adverse event included Oxygen treatment, epinephrine, diphenhydramine hydrochloride (BENADRYL). The outcome of the events was recovering. Since the vaccination, the patient had not been tested for COVID-19. Information about Lot/Batch number has been requested.


VAERS ID: 1357308 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic reaction
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Monocytes (mono); MRSA meningitis (MRSA); Rocky mountain spotted fever (Rocky mt spotted fever); Sepsis (sepsis x2)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021548253

Write-up: Anaphylaxis; This is a spontaneous report from a contactable consumer (patient). A 22-years-old female patient received bnt162b2 (BNT162B2), via an unspecified route of administration, administered in arm left on 14May2021 11:00 (Batch/Lot number was not reported) as 2nd dose, single for covid-19 immunisation. Medical history included asthma, rocky mt spotted fever, MRSA, sepsis x2, mono (monocytes) from an unknown date. The patient''s concomitant medications were none. No other vaccines within 4 weeks prior to the COVID vaccine. No any other medications the patient received within 2 weeks of vaccination. The patient received first dose of bnt162b2 on 23Apr2021 for covid-19 immunization at 22-year-old. Prior to vaccination, the patient was not diagnosed with COVID 19. Since the vaccination, the patient has been tested for COVID 19. The patient experienced Anaphylaxis, swollen closing throat,sob, wheezing, itching, dizziness on 14May2021 11:45. The adverse event result in Emergency room/department or urgent care. Therapeutic measures were taken as a result of all the events, treatment included Epi,Prednisone,Benedryl, IV. The outcome of the events was recovering. Information about lot/batch number cannot be obtained. Additional information has been requested.; Sender''s Comments: Based on the known safety profile of the drug and plausible temporal relationship, a causal association between the event of Anaphylactic reaction and suspect drug BNT162B2 cannot be excluded


VAERS ID: 1357320 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Pain, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021549989

Write-up: She fainted; Chills; Fever; Body ache; This is a spontaneous report from a contactable consumer. A female patient of unspecified age received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on an unspecified date (at unknown age) as single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient previously took first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported) as single dose for COVID-19 immunisation. Reporter stated, "One of my family members had the vaccine, her second dose of vaccine and she today (14May2021) at 4:00 in the morning she started having chills and fever and body ache and then took like, like in less than an hour she fainted. Is that normal or she has to go to the, her doctor or the emergency room?" Reporter confirmed it was the Pfizer Covid19 vaccine. The outcome of the events was unknown. information on the lot/batch number has been requested.


VAERS ID: 1357613 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
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: 102 degree F fever, aches, chills, fatigue


VAERS ID: 1357893 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE KNOWN
Current Illness: NONE KNOWN
Preexisting Conditions: NONE KNOWN
Allergies: NONE KNOWN
Diagnostic Lab Data: NONE KNOWN
CDC Split Type:

Write-up: AT THE TIME OF VACCINE, NO ADVERSE EVENT REPORTED DUE TO PATIENT AGE


VAERS ID: 1357952 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE KNOWN
Current Illness: NONE KNOWN
Preexisting Conditions: NONE KNOWN
Allergies: NONE KNOWN
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: NO ADVERSE EVENT AT TIME OF VACCINE REPORT DUE TO PATIENT AGE


VAERS ID: 1357963 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / -

Administered by: Other       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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Answered "No" to vaccine screening question "Have you had a serious or life-threatening allergic reaction, such as hives, or difficulty breathing to any vaccine shot?" Any other specific allergies unknown.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pfizer Vaccine administered to individual under 12 years old; vaccine is only authorized for 12+. No adverse event/outcomes noted. Parents of children misrepresented their age when making the children appointments to get the vaccine. Registration noticed the children were under 12 years old when they were looking at second dose scheduling and noticed duplicate accounts with same info but different ages.


VAERS ID: 1357984 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Other       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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Answered "No" to "Have you had a serious or life-threatening allergic reaction, such as hives, or difficulty breathing to any vaccine shot?" Any other allergies unknown.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pfizer Vaccine administered to individual under 12 years old; vaccine is only authorized for 12+. No adverse event/outcomes noted. Parents of children misrepresented their age when making the children appointments to get the vaccine. Registration noticed the children were under 12 years old when they were looking at second dose scheduling and noticed duplicate accounts with same info but different ages. Per CDC and OHA guidance, second dose will not be administered.


VAERS ID: 1358009 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dyspnoea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received J&J COVID vaccine on 5/13 at site. Admitted 5/14 with fever, rigors, dyspnea.


VAERS ID: 1358082 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Chest discomfort, Electrocardiogram, Fatigue, X-ray
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypertension (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: The symptoms started the day after the vaccine on Friday 5/14, but were mild at the time. By Monday the symptoms were getting worse but still kind of mild, and coincidentally on Monday, May 17th I had a dentist appointment and they told me that my blood pressure was high 136/95. May 18th I went into the Minute Clinic and they said everything looked okay. My symptoms continued to persist and were the worst on 5/20 when I went to Urgent Care to get an EKG. The EKG came back fine, but they sent me to a Radiologist to get an X-ray to check my stomach which I did on May 25th, but by then the symptoms were all done by then.
CDC Split Type:

Write-up: The day after the vaccine I started feeling tightness in the chest, tiredness, and higher than normal blood pressure ~130 - ~160. The symptoms persisted for a couple days and got progressively worst where it was uncomfortable to lie down or sleep without being propped up. It wasn''t painful but it felt like there was a lot of pressure right in the center of my chest below my rib cage as if someone was pressing on it. The symptoms lasted for about a week with the peak of the symptoms on 5/20.


VAERS ID: 1358132 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Fatigue, Injection site erythema, Injection site pruritus, Local reaction, Vaccination site swelling
SMQs:, Extravasation events (injections, infusions and implants) (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: patient reported SOB, throat tightening and itchy rash after 1st COVID 19 injection 04.08.21 and was advised on 05.13.21 2nd inj
Other Medications: unknown
Current Illness: Apparent fatigue per patient report
Preexisting Conditions: Unknown
Allergies: unknown
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: onset of redness, itchiness and a bump on her left arm where vaccination was given; size $g quarter. She did see her PCP Dr. Apparent localized reaction. She apparently presented to Dr.(unknown is VAERS filed per their office. She also states she continues to be fatigued however with further Hx it is apparent fatigue has been an apparent longstanding concern previously worked up by OB/GYN.


VAERS ID: 1358150 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-18
Onset:2021-05-14
   Days after vaccination:85
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Fatigue, Herpes zoster
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Opportunistic infections (broad)

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

Write-up: No significant event following vaccination except tired. However, started with pain on trunk and abdomen on 5/14/2021. Progressed into lesions on right side of stomach, under arm and on back. Diagnosed with shingles. Dr. Teledoc as part of my benefits.


VAERS ID: 1358241 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-30
Onset:2021-05-14
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 he experienced hives bilaterally on his forearms two weeks after receiving first dose of Pfizer vaccine. Patient states symptoms lasted "a few days" and resolved on their own without intervention. Patient did not seek medical care. Patient received dose #2 of Pfizer on 5/28/2021.


VAERS ID: 1358322 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Disturbance in attention, Epistaxis, Fatigue, Feeling abnormal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dementia (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (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 medications taken
Current Illness:
Preexisting Conditions:
Allergies: environmental
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: My daughter is experiencing periodically nose bleeds, brain fog and bit distracted and losing herself in her thoughts after her first dose Pfizer vaccine. This is new from the initial report. Her mother also states she feels fatigue and not active for a few days now. At this time I have not been able to get an appointment to see her doctor and I am very concerned about her symptoms. I would like more research or documentation to be released about this type of group to figure out why this happened to her. Also, I would like to see if they are going to be monitored after her vaccine. I do not know what other side effects will be coming after her vaccine and I am concerned.


VAERS ID: 1358328 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Feeling hot, Glassy eyes, Hyperhidrosis, Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (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: no
Current Illness: no
Preexisting Conditions: no
Allergies: allergic to amoxicillin
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: Within 3-5 minutes, she was asking for water and feeling hot. Her back was sweaty. Her eyes looked like they were glazed- not responding; didn''t look bright. She got some water and an ice pack on her back and removed her shoes and put her feet up. After drinking the water and keeping the ice pack on for the rest of those 15 minutes. Nurses were there watching her. And she was able to walk out of the clinic on her own power. It had looked like she maybe would have passed out without the intervention of water, ice pack and getting her feet up. She had muscle pain in her arm (of injection site) that day and into the next day. The muscle pain in her arm lasted for about 24 hours.


VAERS ID: 1358382 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-06
Onset:2021-05-14
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

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


VAERS ID: 1358452 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Erythema, Headache, Limb discomfort, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (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? 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: Around 7 pm on the night the vaccine was administered (5/14/21), I noticed my legs felt heavier and weird. When I looked at my legs, they were swollen and slightly red. This did concern me, but given that I can not afford health insurance, I laid in bed with my legs elevated and eventually went to sleep. When I woke up the next day around 9 am, my legs were no longer swollen, but my hands now were. The swelling went away by 5 pm that day(5/15/2021). Thus far, besides a headache that persisted for three days straight from 5/21/21 until 5/24/21, I haven?t experienced any other abnormal swelling and I currently feel fine today.


VAERS ID: 1358632 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Possible yellowjacket - broke out in hives 08/2020
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: 5/13 vaccination 5/14 Woke up with mild case of hives. Was on her elbows and knees. 5/15 She got up and the hives were all over. We gave her Benadryl. It took about 60-90 minutes to take affect. We took her to urgent care, the rash had started to fade (I do have pictures if needed). They prescribed Prednisone with ongoing Benadryl. *2-3 days where the rash was all over extremities; itchy. *Every morning when she wakes up, she has hives shortly after she gets up. *5/18 PCP appt. The dr. didn''t feel the prednisone was affective. The doctor stated to have full dose of Benadryl and to get over the counter Zyrtec. *She felt the Benadryl was enough but it has not made the hives stop occurring. **Appt with allergist; waiting for a cb for date & time. *2nd vaccination scheduled for 6/3/2021 *infectious disease doctor wants her to have appt with allergist before the 2nd vaccination


VAERS ID: 1358647 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-05-12
Onset:2021-05-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Cardiovascular symptom, Computerised tomogram, Electrocardiogram, SARS-CoV-2 test, Scan myocardial perfusion
SMQs:, 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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: GOUT.
Allergies: NONE
Diagnostic Lab Data: 05-18-2021 to 05-19-2021 Numerous Tests, including several blood panels, several EKG''s, a CT scan, and a nuclear stress test, a covid test, and more.
CDC Split Type:

Write-up: Two days after the vaccine, I had the common symptoms of a heart attack for several days. I went to Urgent Care on 05-18-2021, and they told me to go to the ER. I went to the ER, and they admitted me to the hospital in the cardiology department of Medical Center. Then I was there until the next day. The hospital ran numerous tests, including several blood panels, several EKG''s, a CT Scan, and a nuclear stress test. I will have many big hospital bills from this.


VAERS ID: 1358650 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-07
Onset:2021-05-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site reaction, Injection site warmth, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, Effexor, Hydrochlorothiazide, Simvastatin, Metformin XR, women''s multivitamin, iron, vitamin D3
Current Illness: None
Preexisting Conditions: polycystic ovarian syndrome, high blood pressure, high cholesterol, sleep apnea, overweight
Allergies: Amoxicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 7 days after 1st injection (5/14/21) , right arm started itching, was warm to the touch, and had a red welt approx. 2x2 inches. Each day thereafter, the redness continued to increase in diameter. 5 days after delayed reaction began (5/18/21), the redness/warmth/welt was approx. 7x7 inches. Had virtual appt with my doctor who prescribed triamcinolone cream 0.1% for the itching and inflammation. On day 6 of delayed reaction (5/20/21), there was no additional spread of the redness. Slowly the redness/warmth/welt faded. Today (5/28/21) it is resolved - you can barely see the outline of the redness. No other symptoms.


VAERS ID: 1358793 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-12
Onset:2021-05-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Automatic positive airway pressure, Blood bilirubin increased, HIV test negative, Hepatitis A virus test, Hepatitis B virus test, Hepatitis C virus test, Hepatitis viral test negative, Hypertransaminasaemia, Laboratory test, Liver function test normal, Nausea, Pregnancy test negative, Pruritus, SARS-CoV-2 test negative, Thyroid function test normal, Ultrasound biliary tract normal, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (narrow), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bupropion, larissia OCP
Current Illness: None
Preexisting Conditions: IBS, prior cholestasis of pregnancy (9 years ago), depression
Allergies: None
Diagnostic Lab Data: On 5/26 saw MD, got labs and noted to have a severe hepatocellular trasaminitis (AST = 250s, ALT = 960s, T bili 1.8, d bili 1.2, intact synthetic labs). Vital signs and physical examination compeltely normal. No other ingestions, no alcohol use, no illicits, negative pregnancy test, normal liver/biliary ultrasonography with doppler, negative APAP, normal thryoid tests, negative HIV, HAV, HBV, HCV, COVID, no environmental exposures, no recent travel. Autoimmune hepatitis labs pending.
CDC Split Type:

Write-up: First nausea starting on 5/14, then vomiting, then itching (5/23). Presented first to PCP, then to ER and subsequently admitted.


VAERS ID: 1359026 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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


VAERS ID: 1360481 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / -

Administered by: School       Purchased by: ?
Symptoms: Accident, Blindness, Dizziness, Feeling cold, Feeling hot, Hyperhidrosis, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (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? 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: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021547506

Write-up: I started to lose my sight, at first it was my entire peripheral vision and it looked like I was looking through a black holed telescope and then I completely lost sight; Crashed into a stand and passed out; I got really dizzy; I sat in a chair where I became incredibly hot; Sweat through all my clothes; Immediately extremely cold; crashed into a stand; This is a spontaneous report from a contactable consumer (the patient). A 21-year-old non-pregnant female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0173) via an unspecified route of administration in left arm on 13May2021 18:00 at age of 21-year-old at single dose for COVID-19 immunisation. Prior to vaccination, the patient diagnosed with COVID-19. No known allergies. No other medical history. Concomitant medication included: the patient received birth control medication within 2 weeks of vaccination. The patient previously took the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number EP7533) via an unspecified route of administration on 19Apr2021 01:15 PM at age of 21-year-old for COVID-19 immunization. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient had not been tested for COVID-19 since the vaccination. The patient got really dizzy, then as she tried to walk away she started to lose her sight, at first it was her entire peripheral vision and it looked like she was looking through a black holed telescope and then she completely lost sight. She became very dizzy and crashed into a stand and passed out. While she was passed out on the floor she uncontrollably defected. Once someone helped her up, she sat in a chair where she became incredibly hot, sweat through all her clothes and then immediately extremely cold. The events onset date reported as 14May2021 09:00AM. No treatment received for the events. The outcome of the events was recovering. The report was non-serious.


VAERS ID: 1360488 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angina pectoris, Heart rate, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Other ischaemic heart disease (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Sulfonamide allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210514; Test Name: heartbeat; Result Unstructured Data: Test Result:fast
CDC Split Type: USPFIZER INC2021548032

Write-up: This is a spontaneous report from a contactable consumer (patient). A 51-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on the left arm on 13May2021 (15:30) as a 1st dose, single dose, with route of administration unspecified, for COVID-19 immunization. Medical history included sulfa allergy. There were no concomitant medications. The patient was not pregnant at the time of vaccination. The patient previously took hydrocodone, acetaminophen (VICODIN), and had drug allergy. On 14May2021 (20:30), the patient had a feeling of heart pain; and heart was beating fast. The patient did not receive any treatment for the reported events. The outcome of the events was unknown. The patient was not diagnosed with COVID-19 prior to vaccination, and had not been tested for COVID-19 since the vaccination. Information on the lot/batch number has been requested.


VAERS ID: 1360501 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Haematemesis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021548964

Write-up: Thrown up once; it had blood in it; This is a spontaneous report from a contactable consumer (patient''s wife). A male patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE lot number: ER8736) via an unspecified route of administration on 14May2021 as 2nd dose, single for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient previously received first dose of BNT162B2 on an unknown date for COVID-19 immunization. The patient got his second shot on 14May2021 of the Pfizer and he just threw about 15-20 minutes ago, and it had blood in it. The wife was just wondering is this something that they should be concerned about. "Should I take him to the emergency room? He got his second shot yesterday. He has thrown up once. But it had blood in it." Outcome of the event was unknown.


VAERS ID: 1360506 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-03-09
Onset:2021-05-14
   Days after vaccination:66
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / UNK RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Heart rate, Heart rate increased, SARS-CoV-2 test
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (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; FLUTICASONE PROPIONATE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: CLL; Penicillin allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210514; Test Name: Heart rate; Result Unstructured Data: Test Result:Rapid heart rate up to 163 bpm; Test Date: 20210514; Test Name: Nasal Swab for COVID-19; Result Unstructured Data: Test Result:Pending result
CDC Split Type: USPFIZER INC2021549493

Write-up: Rapid heart rate up to 163 bpm. 2.5 hours, unable to reduce. Required emergency pharmaceutical intervention.; This is a spontaneous report from a contactable consumer (patient). A 75-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EN6204), via an unspecified route of administration in right arm on 09Mar2021 at 15:15 (at the age of 75-years-old) at unknown, single dose for COVID-19 immunization. Medical history included chronic lymphocytic leukaemia (CLL) and penicillin allergy. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included cetirizine and fluticasone propionate. The facility where the most recent COVID-19 vaccine was administered was reported as other. On 14May2021 at 09:00, the patient experienced rapid heart rate up to 163 bpm which has not reduced in 2.5 hours. The event required emergency pharmaceutical intervention with intravenous (IV) dialtiazem, diltiazem 120 mg, and ELIQUIS 5 mg 2x, doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care visit. The patient underwent lab tests and procedures which included heart rate: rapid heart rate up to 163 bpm and nasal swab for COVID-19: pending result, both on 14May2021. The outcome of the event was not recovered. The event was reported as non-serious.


VAERS ID: 1360527 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Blood pressure measurement, Chills, Hyperhidrosis, Hypoaesthesia, Hypotension, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (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: Medical History/Concurrent Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210514; Test Name: Blood pressure; Result Unstructured Data: Test Result:dangerously low
CDC Split Type: USPFIZER INC2021550147

Write-up: Fainting spell; Loss of feeling in hands and feet; Dangerously low blood pressure; Sweating profusely; Chills; Overall weakness; This is a spontaneous report from a contactable consumer. A 29-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in the left arm on 14May2021 08:00 (at the age of 29 years) (Batch/Lot number was not reported) as 2ND DOSE, SINGLE for covid-19 immunisation. Medical history included penicillin allergy. The patient previously received the 1ST DOSE of BNT162B2 administered on the left arm on 16Apr2021 at 08:00 (at the age of 29 years) for COVID-19 immunization. On 14May2021 08:00, the patient experienced fainting spell, loss of feeling in hands and feet, dangerously low blood pressure, sweating profusely, chills, overall weakness and "nautilus". The event fainting was assessed as serious (medically significant). Therapeutic measures were taken as a result of all the events. The outcome of the events was recovering. No follow-up attempts are possible, information about the batch number cannot be obtained.


VAERS ID: 1360556 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-11
Onset:2021-05-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210514; Test Name: shingles test; Test Result: Positive
CDC Split Type: USPFIZER INC2021560147

Write-up: positive shingles test; This is a spontaneous report from Pfizer-sponsored program, received from a contactable consumer (patient). A female patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 11May2021 (Batch/Lot number was not reported) as 2nd dose, single for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. On 14May2021, patient had a positive shingles test. Outcome of the event was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1360579 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Blood count, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: LEVOTHYROXINE SODIUM; AMLODIPINE BESILATE; BYSTOLIC
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Shingles (had the shingles shot 5 weeks before the Covid vaccine)
Allergies:
Diagnostic Lab Data: Test Name: Blood count; Result Unstructured Data: Test Result:Low; Comments: blood count go low
CDC Split Type: USPFIZER INC2021568938

Write-up: right arm pain all the way down her arm with swelling on her hand; swelling on her hand; This is a spontaneous report from a contactable consumer. A 75-year-old female patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration, administered in Arm Right on 14May2021 14:00 (Batch/Lot Number: EW0183) as 1ST DOSE, SINGLE for covid-19 immunisation administered in Hospital. Medical history included Singles shot (had the shingles shot 5 weeks before the Covid vaccine). Concomitant medication(s) included levothyroxine sodium at once a day; amlodipine besilate at once a day for hypertension; nebivolol hydrochloride (BYSTOLIC) for hypertension. The patient experienced significant right arm pain all the way down her arm, right after vaccine with swelling on her hand on 14May2021, about 6 hours after vaccine. She is very concerned and is asking if she should get the second dose with her 2nd dose due on 9Jun2021. She had blood work at the doctor''s office because he said she was bleeding on the inside, making her blood count go low. That was in March. Treatment was received as Tylenol for the events. Outcome of event for swelling on her hand was recovered on an unspecified date and for the other event it was recovering. Follow-up attempts are possible. further information is expected.


VAERS ID: 1360605 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:2021-05-07
Onset:2021-05-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210514; Test Name: SARS-COV-2 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576054

Write-up: her first dose on 07May2021. On 14May2021 the caller tested positive for the covid virus; This is a spontaneous report from a contactable consumer (patient). A 49-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on 07May2021 as SINGLE DOSE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. On 14May2021, the patient tested positive for covid-19. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 14May2021. The outcome of the event was unknown. Information about lot/batch number has been requested.


VAERS ID: 1360692 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Dizziness, Feeling abnormal, Headache, Herpes virus infection, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Opportunistic infections (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: tetanus
Other Medications: liothyronine, levothyroxine, zoloft
Current Illness:
Preexisting Conditions:
Allergies: dairy
Diagnostic Lab Data: none
CDC Split Type:

Write-up: nausea, sever stomach pain , dizziness, herpes outbreak, headache, muscle aches, chills, spaced out - cannot think - symptoms varied and were not all present at the same time


VAERS ID: 1360723 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Influenza like illness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Server joint pain,fatigue,fever,chills,flu like symptoms. Approx 48 hrs. Felt great after 48 hrs. I have RA and my RA symptoms almost completely disappeared for 4 days . Had an energy burst for those 44 days.


VAERS ID: 1360777 (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: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect product formulation 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)


VAERS ID: 1360887 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test, Cardiac monitoring, Chest X-ray normal, Chest discomfort, Computerised tomogram normal, Dyspnoea, Echocardiogram normal, Fatigue, Fibrin D dimer, Heart rate increased, Intra-abdominal pressure increased, Migraine, Palpitations
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: I did receive a vaccine about 10 years ago, before college. I cannot remember the name of the vaccine, but it was one that you n
Other Medications: I do not take any medications.
Current Illness: I have not had any other illnesses.
Preexisting Conditions: I have a condition called POTS. Postural orthostatic tachycardia syndrome.
Allergies: I am allergic to keflex, anything in the keflex family and penicillin. I am also allergic to peanuts, tree nuts, fish and shellfish.
Diagnostic Lab Data: They performed blood work, D-Dimer, echocardiogram, CT scan, an EKG and a chest x-ray.
CDC Split Type: vsafe

Write-up: The night/next morning after receiving the vaccine I was awoken by a racing heart rate that I measured at a resting heart rate of 200 bpm. After 5 minutes of trying to assess what was happening, I recognized that my heart rate was not slowing down. I woke my wife because I was worried and had difficulty breathing. It continued to be in the 180-190''s, I called an ambulance. On the way to the hospital my resting heart rate was 180. After I got to the hospital they ran blood work, a CT scan and a chest x-ray. I was in the hospital until 10 am. My heart rate steadily fell to about 110 beats per minute after 9 hours in the hospital. They released me because my tests had come back normal. Upon being released, I came home, had lots of fluids and rest. After 1 week, my heart rate went back up to 160''s. My chest started to feel tight again and I had difficulty breathing again. I called my PCP emergency number and they advised me to go back to the ER at 10 am on 05/15/2021. They did another EKG, a D-Dimer and I received saline. My heart rate dropped to 120 and they released me. I was given an all clear from all tests performed. Sunday-Wed that week, I had a slightly elevated resting heart rate, have had difficulty getting a full breath, general stomach pains and I had felt fatigued. Thurs-Sat, my resting heart rate returned to normal (60 bpm) minimal difficulty breathing, but continued pressure in my abdomen and chest. Saturday I fell asleep because I was having a migraine. I woke up at 10 pm and the cycle started again. My heart rate went back up into the 160''s. I called the emergency line for my PCP and was told to go back to the ER (05/22/2021). They performed a chest x-ray, an EKG and some blood work. My resting heart rate went to 90 bpm around 3 am and was sent back home. The rest of Sunday, I had difficulty getting a full breath and my resting heart was higher than usual. I had an echocardiogram on Wednesday and it came back normal. I wore a heart monitor for 24 hours, but I have not received the results yet from my doctor. I have never experienced any sort of cardiac episode in my life.


VAERS ID: 1360939 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Breast discomfort, Breast pain, Breast swelling, Butterfly rash, Dizziness, Fatigue, Feeling hot, Hyperacusis, Influenza like illness, Initial insomnia, Lymphadenopathy, Migraine, Myalgia, Nausea, Parosmia, Photophobia, Pruritus, Pyrexia, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Hearing impairment (narrow), Vestibular disorders (broad), Lipodystrophy (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall XR, Topamax, magnesium, Vit. D, probiotic, Vit. C, fish oil.
Current Illness: Lupus, Hashimoto?s Disease, Hypothyroidism, Raynaud''s syndrome, ADHD, Migraines
Preexisting Conditions: Lupus, Hashimoto?s Disease, Hypothyroidism, Raynaud''s syndrome, ADHD, Migraines
Allergies: Ceftin, gluten, dairy, egg.
Diagnostic Lab Data: Visit my primary physician who diagnosed me with an allergy to mRNA vaccines.
CDC Split Type:

Write-up: I received the vaccine on Friday at 12pm. Late afternoon: fatigue, joint pain, swollen lymph nodes on left side of upper body, swollen left breast with pain and heaviness feeling that lasted for 2-3 days, Lupus butterfly rash on face, flu-like symptoms, spike in temperature to 100?, dizziness, heat radiating off body, and migraine. I took my prescribed Meloxican (for Lupus joint/muscle pain) approx 2:30pm and then my prescribed Fioricet for the migraine. Friday evening: Approximately 8pm I broke out in hives on my trunk; stomach, chest, shoulders, and back. The migraine worsened to include nausea with sensitivity to light, sound and smell. I took my prescribed Zomeg with no relief. The migraine was so severe that it kept me in bed with pain for hours that once I had some relief to be able to stand to go look in the mirror at the hives, it was approximately 1am. I put hydrocortisone cream on the areas I could reach and took Benadryl. It took over an hour to fall asleep. Saturday: I took Allegra. The hives were still prominent and itchy. Sunday: The hives were still there but most were on my shoulders and back, while some still remained on my stomach but not as prominent. The hives were still itchy. The other symptoms have subsided except the migraine, which was dull, and fatigue. Monday: The hives were not as prominent but somewhat itchy. They were some remaining on my shoulders. They other symptoms subsided with the exception of a dull migraine which I managed with Fioricet. I made the first available appointment with my primary doctor. Tuesday: I saw my primary doctor. Per my physician I still have hives on my trunk. I was instructed to continue with interventions. As of 5/19/2021, I had been treating the hives, fatigue, and migraines which occurred unexpectedly. The hives have subsided completely by Thursday, 5/20/2021.


VAERS ID: 1361041 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-24
Onset:2021-05-14
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Exposure during pregnancy, Pathology test, Premature delivery, Preterm premature rupture of membranes
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft, prenatal, Synthroid
Current Illness:
Preexisting Conditions: Under active thyroid
Allergies: Penicillin
Diagnostic Lab Data: Pathology on placenta - 5/15/21
CDC Split Type:

Write-up: Preterm birth at 33 weeks and 5 days. Date of birth 5/15/21. Due date June 28, 2021. Water broke on 5/14. Birth weight 4 lbs 8oz. Only pregnancy complication was bleeding at 6 weeks. Baby in NICU for 12 days.


VAERS ID: 1361079 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Blood test, Magnetic resonance imaging abnormal, Meniscus injury, Mobility decreased, Muscle spasms, Muscle tightness, Pain in extremity, Swelling, Ultrasound Doppler normal, Walking aid user
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dystonia (broad), Parkinson-like events (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Clariton Prilosec
Current Illness: Allergies
Preexisting Conditions: Asthma (brought on by mold, mildew, dust, ragweed, etc.) Migraines since I was 25
Allergies: Morphine
Diagnostic Lab Data: Ultrasound Doppler on right leg May 21, 2021 after seeing primary care physician. Result, negative for DVT. Emergency Room May 21, 2021 after feeling a snap and excruciating pain in right leg. Blood draw. Result, referred for MRI. MRI without contrast May 26, 2021 of right leg and knee. Results on May 28, 2021, Full Thickness Tear in the Posterior Medial Meniscus. Referred to orthopedic surgeon.
CDC Split Type:

Write-up: Within 3 hours of getting the vaccine on May 14, 2021 I could not bend my right leg, could not squat down, and had terrible pain throughout the back of my right calf and surrounding my knee and upper right thigh. During the next 2 days the pain increased and the swelling increased to become very visible to others. The muscles in my calf and thigh were so tight and so bound up that it looked like balls under the skin, as if I was in a constant state of chronic, extreme charlie horse. And that is also what it felt like. So very painful that I could not bear my own weight without crying. By Tuesday, May 18, 4 days later, I was having to use a cane or have someone by my side because the pain was so extreme and my right leg would spasm and buckle without warning. I called my doctor and made an appt. Pain continued throughout the week. I had to switch to a walker. I saw my doctor on Friday May 21st at 11 a.m. He was concerned about the vaccine causing blood clotting and due to the swelling, binding of muscles, and pain that he noted, he ordered an ultrasound for later that day. I had the ultrasound at 2 p.m.. My results were negative for blood clots. I went home to ice my leg and elevate it until I could see a Dr again the next week as it was now after hours and the weekend. At or around 6:30 p.m. that same night, Friday, May 21, I was standing up at my dining room table and felt and heard a horrific snap or pop. It was so excruciating. I fell to the floor and landed on my bottom first and then my back and right shoulder. I had to be allowed to lay on the floor for at least 20 minutes before I could calm myself from the pain and fear of being lifted off of the floor. I required being carried to my chair because when I tried to walk, my right foot would just drag. I could not lift it at this time. My family decided I needed to go to the emergency room, as did the on-call after hours doctor at my doctor''s office whom I called. I was taken to the hospital because when we called they said they would do an MRI in the E.R. We had to use a wheelchair. After admitting me and going through all of the events, they informed me that they would not do MRI''s in the E.R. unless the patient met a certain criteria of trauma and I did not..in their opinion. They sent me home with crutches and prescriptions. That weekend was pure hell, although, the muscles seemed to be diminishing in hardness and tightness and swelling with each day after I felt the snap. Regardless, I called my niece on Sunday to ask her to come stay with me and help take care of me until someone would order an MRI because the horrific pain was still there at random moments of trying to maneuver myself to the bathroom and bed. Finally, an MRI was ordered and I had it done on Wednesday, May 26, at 4:00 p.m.. I did not get the results until Friday, May 28, at appx 4 p.m. Full Thickness Tear in the Posterior Horn Medial Meniscus. It is my own and my family''s absolute belief that the Phizer shot caused the binding of my leg muscles, of which they were relentlessly bound for almost 2 weeks, with the 1st week being the most painful and traumatic, subsequently causing my meniscus to snap. Even my Dr believed it was a possibility because of the stats on the vaccine and the fact that I had not injured myself previously or on the day of the vaccination. The pressure that was put on those muscles from the binding/balling and swelling were too much for my muscles and tendons to withstand. The Dr bills, the ultrasound, the E.R. bills, the crutches, the prescriptions, the MRI will all be coming out of my pocket because I am an uninsured, unemployed woman trying to protect herself and her community by getting a vaccination that was supposed to be a positive thing. Only, instead, it has crippled me and now...now, I have to figure out how to come up with money for surgery, rehab, etc. Where is the justice in this? The fairness? The peace of mind? The safety? I want a phone call, in the least, from someone of the highest rank to help me understand all of this and what anyone intends to do about it. This is not acceptable, nor is it my responsibility.


VAERS ID: 1361125 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Pain in extremity, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient had a headache and sore arm for 6 days. Her lower left arm broke out with a rash the same day and is still present. She did take a Benadryl for allergy related issues unrelated to the vaccine.


VAERS ID: 1361189 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Balance disorder, Blister, Feeling abnormal, Headache, Hypoaesthesia, Pain in extremity, Paraesthesia, Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ritalin, Clonazepam, Cyclobenzaprine, Clonidine, Doxepin, Risperidone, Bupropion, Lovastatin, Metoprolol, Vit.D, Oxycodone & Duloxetine
Current Illness: No illness except for diverticulosis
Preexisting Conditions: Chronic pain, Degenerative Disc Disease, in my back and neck, Anxiety, Depression, Diverticulosis, High Blood Pressure, High Cholesterol, Bladder Issues
Allergies: Keflex, cephalexin
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: The day after my second injection I began to feel Painful Numbness & Tingling in my hands/arms and my legs and feet. Swelling of my legs & feet, socks leaving big indents in my skin. Off and on headaches, an intense itch at times, all over, blisters on my butt(2) that "popped" and left the skin open and raw. I also just feel "off", do not feel like myself, a little bit unsure about my footing...


VAERS ID: 1361218 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FW0185 / 1 - / UN

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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: none
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient administered before vaccine before she is eligible. She is 11. Patient''s father took her to get vaccine and, according to her mother, "lied about her age". Patient subsequently administered 1st dose of Covid-19 vaccine before meeting age eligibility requirements. Patient has NOT suffered any physical S/S and/or other side-effects of vaccine.


VAERS ID: 1361267 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-16
Onset:2021-05-14
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram, Electrocardiogram, Facial paralysis, Pain in jaw
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Osteonecrosis (broad)

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

Write-up: Bell?s palsy. Started with pain in jaw and paralyzed right side of face a few days after pain began


VAERS ID: 1361335 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-04-22
Onset:2021-05-14
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0433214 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Herpes zoster, Neuralgia
SMQs:, Peripheral neuropathy (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol, Advair, Loratadine
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Sulfa Drugs
Diagnostic Lab Data: Consultation with Dr. on 5/17.
CDC Split Type:

Write-up: Shingles, Treated with Anti Viral Rx, Valacyclovir (per Dr.), for 7 days. Still have nerve sensitivity.


VAERS ID: 1361390 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Fatigue, Headache, Impaired work ability, Lymphadenopathy, Neck pain, Pallor, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever 37.5C, fatigue, headache, swollen lymph nodes, back of the neck pain, stomach ache, pale complexion. Missed school, stayed in bed at home until symptoms resolved.


VAERS ID: 1361398 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Bell's palsy, Eating disorder, Facial asymmetry, Hypoaesthesia, Ocular discomfort
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi vitamin, probiotics, omega-3 fish oil, calcium, Flonase.
Current Illness: None.
Preexisting Conditions: Sinus headaches.
Allergies: None.
Diagnostic Lab Data: No tests and labs for Bells Palsy.
CDC Split Type:

Write-up: One day after injection on 5/14/21, got intense painful ache under right ear. It went away after about a day. But then on the evening of 5/24, I found that my right eye was very scratchy. On 5/25, I realized it?s because the right eye would not close all the way. On the evening of 5/25, I found my food kept falling into my right cheek when I ate. On 5/26, I found that my right eye would not blink at all. And my right cheek was numb. My right eyebrow would not raise as high as the left and my smile was crooked. I went to urgent care and they diagnosed me with Bell?s Palsy.


VAERS ID: 1361584 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-05-07
Onset:2021-05-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anger, Depression, Dysstasia, Fungal infection, Gait disturbance
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (narrow), Depression (excl suicide and self injury) (narrow), Hypoglycaemia (broad), Opportunistic infections (broad)

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

Write-up: From the patient I participated in phase 3 randomized, Double-Blind, placebo controlled Center study for Clinical Research back in December of 2020 to determine the safety and efficacy of AstraZenecas, a combination of 2 of their monoclonal antibodies (AZD8895 and AZD1061) to preexposure prophylaxis in COVID-19 I was told to wait at 90 days before I got my vaccine and I think I should have waited much longer. Not long after I received the monoclonal antibody treatment I started to have really bad depression issues and anger problems that seemed to last up to around mid April of 2021. I also had my hepatitis viral load go from 180,000 to 580,000 in just a few months so a massive jump in hep c viral load. I reported all of this to them and they assured me that I was fine and the promised I?d be ok. I recently got the Pfizer vaccine with my second dose being on May the 7th 2021. My first dose on April the 16th was felt within minutes and I thought I was going to have to ask a staff worker with help getting out to the car. I was very sick for a day or so and it made me very frightened to get the second one. So much that I contacted The council about it. Everyone was extremely polite and very helpful. I got my second dose and it was not as bad to go through but now I have a constant fungal infection that I can not get rid of and if I eat sweets it gets really bad. My concern is not for anyone getting just the vaccine but for the people who have had the monoclonal antibodies and then getting the vaccine within 3 months. The second dose seemed to make me angry but it did not last as long. I?m worried about the effects other people may have had by combining the 2 or maybe not waiting longer before getting the actual vaccine. I don?t know but I can?t get rid of this fungus and I?m not sure else who to report it to. I?ve obviously shown it to my doctor. He gave me anti fungal creams but it turns out I have an allergy to fungal creams. I did let the drug trial site know what happened as well. I do not think it?s a Pfizer thing but a combination of it with the AstraZeneca monoclonal antibodies and the vaccine.


VAERS ID: 1361864 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025CZ1A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse reaction, Dizziness, Dry mouth, Dyspnoea, Insomnia, Palpitations, Pharyngeal paraesthesia, Sleep disorder, Throat tightness, Tremor
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: I received the Covid 19 Moderna vaccine on 5/14/2021; approximately at 6pm. I experienced about 5 hours later adverse reactions. I went to be around 11pm. Upon laying down I began to get dizzy and my heart began to pound rapidly. This strong heart pounding would last 5 hours straight. An hour later my throat started to get a tight feeling with tingling under the chin area and my saliva production began to slow drying out my mouth. Breathing became more labored and difficult. At this time my heart was still beating strong. I had intense Insomnia. The one time that I tried to lay down; when my body would try to doze off for a second; my body would suddenly jolt me awake with an intense shaking and heart pounding.


VAERS ID: 1362049 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-04
Onset:2021-05-14
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: Developed very mild tinnitus 10 days after injection


VAERS ID: 1362058 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-31
Onset:2021-05-14
   Days after vaccination:44
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: B complex, daily vitamin, zinc, d, biotin/keratin, maca, licorice root,
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Dermatologist visual inspection
CDC Split Type:

Write-up: Shingles


VAERS ID: 1362085 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Dysstasia, Headache, Hyponatraemia, Hypothyroidism, Immobile, Loss of personal independence in daily activities, Magnetic resonance imaging head normal, Magnetic resonance imaging spinal normal, Muscular weakness, Pain, Peroneal nerve palsy, Walking aid user
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (narrow), Hypothyroidism (narrow), Chronic kidney disease (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: "Admit Date: 5/14/2021 Discharge Date: 5/15/2021 The patient is a 74 y.o. female, history of MS, history of cerebellar ataxia and gait instability at baseline who presents for evaluation of lower extremity weakness. Patient received her second Covid vaccine yesterday. Patient reports baseline right lower extremity weakness with foot drop. She reports she awoke today and has had bilateral lower extremity weakness. Patient reports she normally walks with a cane but has been unable to stand up and get out of her chair. She typically uses a cane for ambulation but states she has been unable to complete her ADLs secondary to immobility. She reports mild headache throughout the course of the day but no thunderclap quality or maximal headache at onset. No neck pain. No chest pain or shortness of breath. She reports otherwise, ""feeling achy."" No fevers. No chills. At discharge: #left lower extremity weakness: resolved overnight. MRI brain and L spine without acute MS flare, no signs of acute stroke or cord impingement. ? Reaction to Pfizer vaccination. Now returned to baseline. Cleared by PT for return home. #Multiple sclerosis: chronic right upper and lower extremity weakness. Unchanged. No active MS lesions no MRI brain/L spine as above. Recommended routine follow up with her neurologist. No changes to medications at this time #Hyponatremia: very mild, resolved on day of discharge #Hypothyroid: continue synthroid"


VAERS ID: 1362089 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-26
Onset:2021-05-14
   Days after vaccination:49
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: General symptom
SMQs:

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: Estradiol, aspirin, pepcid, zyrtec, fish oil, multivitamin, propranolol, fenofibrate, n-acetyl cysteine, clonazepam
Current Illness: None
Preexisting Conditions: Orthostatic intolerance, sinus tachycardia, hypertriglyceridemia, peripheral neuropathy
Allergies:
Diagnostic Lab Data: Stethoscope examination in office.
CDC Split Type:

Write-up: Friction rub noted during examination by cardiologist on May 14 2021. Patient had a history of intermittent tachycardia and chest discomfort for weeks prior.


VAERS ID: 1362185 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-28
Onset:2021-05-14
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-31
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? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

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


VAERS ID: 1362189 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-22
Onset:2021-05-14
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / IM

Administered by: Unknown       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, 17 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

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


VAERS ID: 1362244 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-04-29
Onset:2021-05-14
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Feeling abnormal, Muscle spasms, Muscle tightness, Myalgia, Pain, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Dementia (broad), Dystonia (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I was taking 50mg of generic flonase,(pro-air HFA) albuterol sulfate 90mcg, rosuvastatin 20mg and montelukast sod (allergy pill) 10mg.
Current Illness: I did not have any other illnesses.
Preexisting Conditions: I do not have any chronic or long standing health conditions.
Allergies: I am allergic to oxycodine.
Diagnostic Lab Data: There were not any tests performed.
CDC Split Type: vsafe

Write-up: Approximately two weeks (05/12/2021) after receiving the vaccine, I started to experience tightening in my legs all around. It felt like every time I would massage the cramps out of my legs, an hour later the muscle tightness/pain would come back. It was interrupting my sleep. I also experienced knee and hip pain along with the tightness in my legs. I also experienced some brain fog on and off for about 3 weeks. I visited my PCP on 05/19, but by 05/17 my symptoms had improved. On 05/18 my pain/tightness had gone away completely. I had to do vigorous stretches and I took 4 tablets of 200mg per day for a couple days.


VAERS ID: 1362455 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Delirium, Migraine, Nausea, Pain, Pain in jaw, Palpitations, Pyrexia, Respiratory tract congestion, Tinnitus
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hearing impairment (narrow), Osteonecrosis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 10/13/2010 combo seasonal/H1N1 flu vaccine
Other Medications: Align probiotic, Phyto Multi vitamin, Selenium (200 mcg), Calcium (800 mg), Magnesium Citrate (420 mg), Lomatium root (1 tsp).
Current Illness: frontal fibrosing alopecia, leaky gut
Preexisting Conditions:
Allergies: Medications: Azithromycin, amoxicillin, naproxen, natural thyroid. Food: Gluten, tree nuts, eggs, cow dairy. Skin: Exima dermatitis. Environmental: seasonal hay fever
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Approximately 5 hours following the 2nd dose, I began to experience total body aches. Pain became acute from head to toe, with onset of chills with fever (6 degrees above normal), racing heart, congestion, migraine from aching jaw, delirious all night. Ringing in my ears and nausea. I was very well hydrated before/after vaccine. By morning, BP was back down to 113/61, but I could still hear/feel my heartbeat in my throat. Most symptoms resolved after 24 hours, other than temperature and jaw ache.


VAERS ID: 1362457 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Facial pain, Gait inability, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: R arm pain, R sided facial pain, after second shot, R sided leg pain/parasthesia. Unable to walk.


VAERS ID: 1362535 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-07
Onset:2021-05-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: I had the first dose of Moderna on Friday, May 7. A week later (May 14), I developed a red itchy rash on my upper right arm, on the site of the injection. It went away by May 21.


VAERS ID: 1362555 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-07
Onset:2021-05-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: swollen after a week of 1st dose vaccine


VAERS ID: 1362580 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / IM

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

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

Write-up: SWOLLEN RED ENLARGED LYMPH NODE UNDER LEFT ARM, LASTED 3 DAYS. AND SEVERE MENSTRUAL PAIN SINCE 2ND VACCINE


VAERS ID: 1362615 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-06
Onset:2021-05-14
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / SYR

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

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

Write-up: Rash all over body; appeared suddenly; unsightly and somewhat itchy; topical steroids were prescribed but did not solve the problem; dermatologist said the rash was a vaccine reaction that she had seen in several other patients approximately 10 days after the 2nd COVID shot


VAERS ID: 1362620 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia
SMQs:, Arthritis (broad)

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

Write-up: Pain in shoulder.


VAERS ID: 1362621 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-05-01
Onset:2021-05-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0391321A / 2 - / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0391321A / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Burning sensation, Fatigue, Musculoskeletal pain, Neuralgia, Pain, Pain in extremity, Rash papular
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall Hydrocodone Foliate Multivitamins Iron gummies
Current Illness: No
Preexisting Conditions: Fibromyalgia
Allergies: Penicillin Kiwi
Diagnostic Lab Data: Unsure
CDC Split Type:

Write-up: Severe pain in the back. Burning across top of back after 2nd shot with no relief, it has been over 2 weeks and I am seriously ready to just put myself down. Swollen bumps down spine painful to touch. Pain bump on lower back that throbs, pain in nerve bundle by tail bone, right buttocks and pain down legs. Extreme fatigue.


VAERS ID: 1362622 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-10
Onset:2021-05-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Anticoagulant therapy, Chest pain, Computerised tomogram thorax abnormal, Dyspnoea, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Sudden Cardiac Arrest @ 52 yrs, on 05/23/2021, 5 days after Pfizer COVID-19 1st vaccination on 05/18/2021. Separate VAERS report
Other Medications: Mexiletine
Current Illness: Recovering from sudden cardiac arrest that occurred 5 days after 1st round vaccination.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT showed pulmonary embolism, 05/21/2021
CDC Split Type:

Write-up: ? 5/21/21: Pulmonary Embolism o Presented with chest pain, abdominal pain, breathing problems o CT showed pulmonary embolism o Stable for outpatient anticoagulation. Started on 10 mg Eliquis BID x 7 days and then 5 mg BID thereafter.


VAERS ID: 1363813 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Blood test, Computerised tomogram, Echocardiogram, Fatigue, Gait disturbance, Pain, Pulmonary thrombosis, Thrombosis, Ultrasound Doppler, X-ray
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: B COMPLEX PLUS VITAMIN C; PREDNISONE
Current Illness: Alcohol use (drinks wine 1-2 times a week); Asthma; Chronic obstructive pulmonary disease; Non-smoker; Prostate cancer; Sulfonamide allergy
Preexisting Conditions: Medical History/Concurrent Conditions: Nasal polypectomy; Comments: no drug abuse or illicit drug usage
Allergies:
Diagnostic Lab Data: Test Date: 20210525; Test Name: X-ray; Result Unstructured Data: blood clots bilateral in lungs; Test Date: 20210525; Test Name: Blood test; Result Unstructured Data: blood clots bilateral lungs and both legs; Test Date: 20210525; Test Name: Venous Doppler; Result Unstructured Data: blood clots in legs; Test Date: 20210525; Test Name: CT scan; Result Unstructured Data: blood clots bilateral lungs and both legs; Test Date: 20210526; Test Name: Echocardiogram; Result Unstructured Data: clear
CDC Split Type: JNJFOC20210554302

Write-up: BLOOD CLOTS IN BOTH LUNGS; LEFT SIDE OF BODY HURTING; GENERALIZED WEAKNESS; TIREDNESS; BLOOD CLOT IN BOTH LEGS; TROUBLE WALKING; This spontaneous report received from a consumer concerned a 77- year old White Not Hispanic or Latino male. The patient''s height and weight were not reported. The patient''s past medical history included polyp removal on the nose, and concurrent conditions included prostate cancer, asthma, chronic obstructive pulmonary disease, allergic to sulfa drugs, alcohol user (drinks wine 1-2 times a week), and non-smoker, and other pre-existing medical conditions included no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A expiry: UNKNOWN) 1 total, the dose was not reported, administered on right arm on 09-MAY-2021 for prophylactic vaccination. Concomitant medications included prednisone for loss sense of taste, and ascorbic acid/biotin/cyanocobalamin/folic acid/nicotinamide/pantothenic acid/pyridoxine hydrochloride/riboflavin/thiamine hydrochloride, and vitamins and minerals. On 14-MAY-2021, the patient began experiencing symptoms of both legs hurting from hips to knees and generalized body weakness as well as tiredness. a Patient complained about legs that whole week stating was in a lot of pain, having trouble walking. Consumer stated pain level was around at a 7 or 8 and that patient had a lot of difficulties getting out of the car and not being able to walk from kitchen to the bedroom. They were concerned. On, Monday 24-May-2021, the patient stated whole left side of the body was hurting and could not put any pressure or sit on the left side of the body. the Patient also had shortness of breath and chest pain on Monday 24-May-2021. Patient was hospitalized on 25-May- 2021 and found multiple clots in bilateral lungs and both legs. The patient was hospitalized for 2 days. Laboratory data included: Blood test (NR: not provided) blood clots bilateral lungs and both legs, Computerised tomogram scan (NR: not provided) blood clots bilateral lungs and both legs, Venous Doppler (NR: not provided) blood clots in legs, and X-ray (NR: not provided) blood clots bilateral in lungs. On 26-MAY-2021, Laboratory data included: Echocardiogram (NR: not provided) clear. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from blood clots in both lungs, blood clot in both legs, trouble walking, left side of body hurting, generalized weakness, and tiredness. This report was serious (Hospitalization Caused / Prolonged ); Sender''s Comments: V0:20210554302- blood clots in both lungs, blood clot in both legs, trouble walking, left side of body hurting -This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY, UNDERLYING DISEASE V0:20210554302- generalized weakness, and tiredness.This event(s) is labeled per RSI and is therefore considered potentially related.


VAERS ID: 1363877 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Utah  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Eye haemorrhage, Headache, Injection site pain, Insomnia, Tremor
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Non-smoker; Social alcohol drinker (Only in holidays mostly)
Preexisting Conditions: Medical History/Concurrent Conditions: Gallbladder removal; Comments: The patient had no known allergies and did not have any drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210555889

Write-up: LEFT EYE WITH BLOOD SPOT IN THE EYEBALL; PAIN IN THE CENTRAL PART OF THE CHEST; DIFFICULTY BREATHING WHEN DOING ACTIVITIES; HEADACHE; LEFT ARM PAIN WHERE SHOT WAS ADMINISTERED; COULDNT SLEEP THE DAY OF THE VACCINE; BODY TREMBLING; This spontaneous report received from a 48-year-old, male patient The patient''s weight was 184 pounds, and height was 74 inches. The patient''s past medical history included gallbladder removal. The patient was non-smoker, social drinker (only in holidays mostly), and the patient had no known allergies. The patient did not have any drug abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 207A21A and expiry: 23-JUN-2021) dose was not reported, 1 total administered on 14-MAY-2021 around 13:15 to left arm for prophylactic vaccination. No concomitant medications were reported. On 14-MAY-2021, the patient experienced left arm pain where shot was administered, body trembling and couldn''t sleep on the day of vaccine. On 17-MAY-2021, the patient experienced headache which had diminished, but suddenly they were like stabbing, left eye with blood spot in the eyeball and pain in the central part of the chest, which on occasions varies from right to left with breathing difficulty when doing activities. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body trembling, couldn''t sleep, and left arm pain where shot was administered on 18-MAY-2021, was recovering from headache, and left eye with blood spot in the eyeball, and had not recovered from pain in the central part of the chest, and difficulty breathing when doing activities. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0 : 20210555889-COVID-19 VACCINE AD26.COV2.S -Left eye with blood spot in the eye ball. This event is considered unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.


VAERS ID: 1364639 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Lip swelling, Swelling face, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient endorsing throat tightness, difficulty talking deep breath, swelling of face and lips post #2 covid vaccine. Premedicated at home with singulair last night and this morning. VSS, 02 100%, slightly tachycardic, hypertensive with ongoing stressors of appointment. No chest pain or palpitations. Due to ongoing HSR symptoms and lack of response to premedications at home, administered EPIPEN in infusion room at 105pm in right lateral thigh. VSS monitored every 10 minutes remained stable. Continued to report mild throat tightness, slight improvement in breathing, improvement in facial edema. Administered Benadryl 25mg IM in clinic, referred to ED for continued monitoring due to incomplete resolution of symptoms. Of note, patient is able to tolerate low doses of benadryl, experiences pruritus with high dosing. Unable to obtain IV access to collect tryptase level in light of HSR, requested to obtain at ED in order to avoid delay in transit.


VAERS ID: 1364666 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-01
Onset:2021-05-14
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Abortion missed, Foetal cardiac arrest, Foetal heart rate abnormal, Full blood count abnormal, Haematocrit decreased, Haemoglobin decreased, Pregnancy test urine positive, Primiparous, Red blood cell count decreased, Retained products of conception, Ultrasound antenatal screen abnormal, Ultrasound scan vagina abnormal, Vaginal haemorrhage, White blood cell count decreased
SMQs:, Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Congenital and neonatal arrhythmias (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D drops - 1000 IU daily
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin allergy
Diagnostic Lab Data: 5/17/21 - ultrasound impression reported above; 5/25/21 - CBC (low WBC and RBC, reduced Hbg and Htc compared to patient baseline drawn on 3/5/21); 5/27/21 - ultrasound impression reported above
CDC Split Type:

Write-up: Patient''s first day of last menstrual period was 3/23/2021. Patient has a predictable monthly cycle with an average length of 30 days. Patient reports two positive at home urine pregnancy tests on 4/30/21 and 5/1/21. Conception likely occurred on or around 4/6/21. Patient reports vaginal bleeding that started on 5/14/21. Patient had transvaginal ultrasound on 5/17/21. Impression: FIRST TRIMESTER ULTRASOUND, SINGLETON An early intrauterine singleton pregnancy is visualized. A fetal pole is visualized but fetal cardiac activity is NOT present. The fetal biometry is appropriate for gestational age. Anatomic survey is precluded by early gestational age. As the CRL <7mm (measures 2.6mm) a definitive diagnosis of a missed miscarriage can not be made I would recommend a follow up ultrasound in 10-14d. Follow up ultrasound on 5/27/21 could not visualize pregnancy. Impression: The endometrium measures 14.39 mm, with heterogenous echotexture suggestive of retained products. The right and left ovaries appear normal.


VAERS ID: 1364674 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-12
Onset:2021-05-14
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, Ultrasound scan abnormal, Ultrasound scan normal
SMQs:, Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Loratadine, multivitamin, norgestimate/ethinyl estradiol (Tri-Sprintec)
Current Illness: None
Preexisting Conditions: Cerebral palsy, obesity, congenital nystagmus, vitreous detachment
Allergies: N/A
Diagnostic Lab Data: An ultrasound was obtained approximately 2 weeks after vaccination due to patient complaint of right calf pain, but this was negative. Another ultrasound was obtained on 5/14 and did show a DVT. Patient was started on apixaban for the treatment of this. Did not require hospitalization.
CDC Split Type:

Write-up: Patient developed a deep vein thrombosis approximately one month after receipt of vaccine. Of note, was on an oral contraceptive prior to this. No other history of VTE or smoking, or other coagulation disorders in family.


VAERS ID: 1364718 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-29
Onset:2021-05-14
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Menstrual disorder, Ultrasound scan vagina
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: vitamins, Aleve
Current Illness:
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: vaginal ultrasound
CDC Split Type:

Write-up: 2 weeks after vaccination-started bleeding clots


VAERS ID: 1364841 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Condition aggravated, Pain, Pain in extremity
SMQs:, Retroperitoneal fibrosis (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: 125 mcg levothyroxine 400 mg hydroroxychloroquine
Current Illness: Undifferentiated connective tissue disorder Hashimoto thyroiditis with hypothyroidism Lyme
Preexisting Conditions: Undifferentiated connective tissue disorder Hashimoto thyroiditis with hypothyroidism Lyme
Allergies: Cipro Cephalosporin Z-pack Possible allergies: (hives all over) Augmentin Bactrim
Diagnostic Lab Data: I thing at the moment.
CDC Split Type:

Write-up: It?s like one of my autoimmune is flaring up badly. I take hydroxychloroquine to manage the pain I used to feel in my shoulder, back, legs. But ever since the vaccine which the following day started with body aches and fever for 24 hours and another 24 hours of horrible bodily aches. On the third day I felt much better but my right leg had a slight ache. The ache here and grew until now which now if affecting my lower back. I thought to let you know because I haven?t had this much pain in years and it?s definitely the worse flare I have had since my diagnosis in 2017. I know you need more info about the effects on people who have autoimmune disease(s). And this was not a normal reaction. Its been nearly three weeks and the pain is only getting worse thus far.


VAERS ID: 1365008 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-07
Onset:2021-05-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 1 RA / SYR

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

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

Write-up: No side affects until 7 days after shot. Developed large red swollen and itchy lump at injection site. Took antihistamines for the itching. Went away after 5 days. On day 14, broke out in hives. Do not know if hives are related, but did/ate nothing out of the ordinary. Hives went away after a few hours.


VAERS ID: 1365138 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 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? 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: The parent put down on the patient''s form that the child''s birthdate was date, making the child 12 years old. The immunization records show the child''s birthdate is date, making the child 11 years old and not meeting the age limit per the FDA.


VAERS ID: 1365230 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / 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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: I report this adverse event due to potential safety and quality of Pfizer vaccine for beyond use date. Pharmacist at Pharmacy. I want to check with you for the quality and safety of the remaining Pfizer Vaccine we have left in stock (648 doses equals 108 vials). I received a shipment of Covid-19 Pfizer Vaccine product on April 20th, 2021 for 1176 doses. I transferred the shipment to a low freezer fridge at a temperature range from -13 celsius to -24 celsius. Per ACIP guidelines, Pfizer is good to use for 14 days after removing from ultra cold storage and additional 3 excursion days. Based on the guidelines, Pfizer doses are good to use until May 6th, 2021 (15 days from April 20th, 2021). However, 333 doses of Pfizer vaccine was continuously administered to patients until May 28th, 2021 beyond use expiration date on old recommendation (May 6th to May 28th, 2021). Can you advise me on the quality and safety of use in this scenario if there is any data to support this or not? What to do with those patients who received vaccines during this excursion period? Of note, FDA has authorized Pfizer vaccine to be kept up to 30 days at 2C to 8C on May 20th, 2021. Is there any extension beyond use date for this vaccine in this case?


VAERS ID: 1365372 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-07
Onset:2021-05-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 1 RA / SYR

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

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

Write-up: I developed a small itchy rash on my arm where the shot was injected.


VAERS ID: 1365420 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Immediate post-injection reaction, Pain, Pain in extremity
SMQs:, Hypersensitivity (narrow), 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: Vitamins
Current Illness: None
Preexisting Conditions: Non
Allergies: Sulfa eye drops
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Sore arm immediately. Headache, body aches and chills started within 3 hours. This lasted for 2 days. I had an off and on headache for a couple more days.


VAERS ID: 1365431 (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: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 NEW / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Angiogram, Computerised tomogram head, Computerised tomogram head normal, Concussion, Dehydration, Electrocardiogram abnormal, Fatigue, Headache, Loss of consciousness, Magnetic resonance imaging, Phonophobia, Sinus bradycardia, Sleep disorder, Syncope, X-ray limb
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), Disorders of sinus node function (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Advil Excedrin
Current Illness: Headaches 3 days prior Left knee torn ACL (complete) and tear posterior horn medial meniscus 28 April 2021 (Date of injury; MRI dx 17 May 2021)
Preexisting Conditions: HSV type 1
Allergies: no known allergies
Diagnostic Lab Data: 5/17/2021 - MRI L knee 5/14/2021 - ECG - sinus bradycardia o/w normal, CT Angio brain/head, CT Brain/head without contrast: normal 4/29/2021 - XR 3 view left knee
CDC Split Type:

Write-up: Syncope x 3 in the early morning hours (around 3am) about 14-15 hours after vaccine. She had had headaches that is intermittent, throbbing, phonophobia but no photophobia, from back of head to top of head and behind eyes, taking Advil or Excedrin intermittently with relief for a week prior to covid19 vaccine. Syncope, longest lapse was two minutes, her sister found her. She went to Medical Center ER at 0400, was assessed and scanned, neg CT scan of head, and was discharged home. Has felt some fatigue today due to not sleeping early the night before, has returned to school since concussion, with normal learning, and denies any exertional physical activity due to pre-existing torn ACL, torn medial meniscus L knee. After evaluation by ER, was given IV fluids, determined cause to be dehydration.


VAERS ID: 1365906 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-24
Onset:2021-05-14
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Cardiac monitoring, Computerised tomogram head normal, Dizziness, Echocardiogram normal, Fatigue, Feeling abnormal, Hypoaesthesia, Magnetic resonance imaging head normal
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, Seroquel, Vitamin D3.
Current Illness: None
Preexisting Conditions: N/A
Allergies: Codeine
Diagnostic Lab Data: On May 14/21, after I experienced numbness on my left side, I went to the ER. There I was given a head CT and an MRI of my brain along with blood work. Everything came back normal. I went home later that day and found I was extremely fatigued through the weekend. Then Tuesday morning (05/18) I felt light headed and very unstable. I went back to the ER and another CT scan and MRI were done. Again both came back normal. I am currently wearing a ZIO heart monitor and I had an echocardiogram May 27, which also was normal.
CDC Split Type:

Write-up: On the morning of May 14/21, I was walking and all of a sudden my left foot went numb and I couldn''t feel my foot stepping on the ground. The numbness went up my left leg while at the same time, my left hand started to go numb, starting at my baby finger and working over to my thumb. I thought I might be having a stroke so I called my PCP and they recommended I go to the ER. There I was given a head CT and an MRI of my brain along with blood work. Everything came back normal. I went home later that day and found I was extremely fatigued through the weekend. Then Tuesday morning (05/18) I felt light headed and very unstable. I went back to the ER and another CT scan and MRI were done. Again both came back normal . I am currently wearing a ZIO heart monitor and I had an echocardiogram May 27, which also was normal. None of the doctors I spoke with were able to offer an explanation for my symptoms.


VAERS ID: 1366156 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-05
Onset:2021-05-14
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Ear swelling, Fatigue, Neck mass, Swelling face, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Lump on left side of face near ear, Lump on left cheek, Lump on left side of neck, lump on right side of neck Dizziness and Lightheadedness Fatigue Seen by Dr. Ultrasound of impacted areas


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