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From the 6/4/2021 release of VAERS data:

Found 323,133 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 171 out of 3,232

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VAERS ID: 1310770 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EW0167 / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Hyperhidrosis, Pallor, Presyncope
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: At clinic for first pfizer dose became pale and diaphoretic vaso vagel . Assisted to stretcher Legs elevated. Ice pack applied Seen by Dr . BP 102/60 Observed x 30 min then d/ c home with parents.


VAERS ID: 1310900 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Pallor, Presyncope
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient came for second dose Pfizer COVID vaccine at location. He got his vaccine at 315pm. Immediately following the immunization he had a vaso-vagal reaction. He became light-headed, diaphoretic and pale. Dr. examined him and he was walked to a litter to lay down. He was given an ice pack and water. His legs were lifted. He felt better after laying down. He left for home at 235pm after the symptoms resolved.


VAERS ID: 1310908 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Presyncope
SMQs:, Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient came to location with her twin sister to get her first Pfizer COVID vaccine. She had a vasovagal response at the same time as her sister. She was laid down and recovered in 20 minutes.


VAERS ID: 1310921 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Hyperhidrosis, Pallor, Presyncope
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Came to location for Pfizer vaccine on 5/4/21. She had a vasovagal reaction immediately after the vaccine. Her B/P was 122/62. She was pale and diaphoretic. She was seen by Dr. She recovered after a brief period and went home.


VAERS ID: 1310929 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-19
Onset:2021-05-04
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

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

Write-up: About 2 weeks after Pfizer COVID 19 vaccine 1st shot, I developed significant tinnitus in both ears which still persists to this date. I have some hearing loss too. I?m not getting the second shot.


VAERS ID: 1311528 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-15
Onset:2021-05-04
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Anticoagulant therapy, Arthralgia, Back pain, Blood test, Chest pain, Computerised tomogram thorax abnormal, Cough, Pulmonary embolism, Ultrasound scan, X-ray
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Lutera
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ran a CT scan, X-rays and an ultra sound on Monday 5/10 as well as many blood tests
CDC Split Type:

Write-up: Pulmonary embolisms. Many clots in the lungs. Currently being treated with blood thinners. Developed a major cough and pain in my back, shoulder and chest. About 6 days of experiencing this I went to the ER and they found I had clotting in my lungs.


VAERS ID: 1312187 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-03
Onset:2021-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Blood test, Cerebrovascular accident, Computerised tomogram, Echocardiogram, Magnetic resonance imaging head abnormal, Scan with contrast
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Gabapentin,lisinopril,rosuvastatin,hydrochloroquin,methotrexate, folic acid,baby aspirin,amlodipin,humolog
Current Illness: Diabetes
Preexisting Conditions: Diabetes type 1
Allergies: Augmentin
Diagnostic Lab Data: Ct scan with dye,blood work,mri of brain,heart doppler
CDC Split Type:

Write-up: A stroke


VAERS ID: 1312625 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Lymphadenopathy, 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? 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: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever for two days, swollen lymph node under arm pit on left arm for six days


VAERS ID: 1312765 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-05-04
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210507927

Write-up: VACCINE DRAWN UP IN SYRINGE POSSIBLY ADMINISTERED PAST THE 6 HOUR EXPIRATION; This spontaneous report received from a pharmacist . The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 04-MAY-2021, the subject experienced vaccine drawn up in syringe possibly administered past the 6 hour expiration. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of vaccine drawn up in syringe possibly administered past the 6 hour expiration was not reported. This report was non-serious.


VAERS ID: 1312881 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-03-29
Onset:2021-05-04
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Gait inability, Hallucination, Hypokinesia, Pyrexia, Vaccination complication
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: hallucinating; Couln''t walk; Can barely move; feels awful; chills; fever; This spontaneous case was reported by an other caregiver and describes the occurrence of HALLUCINATION (hallucinating) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Chronic lymphocytic leukemia. On 29-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 04-May-2021, the patient experienced HALLUCINATION (hallucinating) (seriousness criterion medically significant), GAIT INABILITY (Couln''t walk), HYPOKINESIA (Can barely move), VACCINATION COMPLICATION (feels awful), CHILLS (chills) and PYREXIA (fever). At the time of the report, HALLUCINATION (hallucinating), GAIT INABILITY (Couln''t walk), HYPOKINESIA (Can barely move), VACCINATION COMPLICATION (feels awful), CHILLS (chills) and PYREXIA (fever) outcome was unknown. Concomitant medication was not reported. Treatment of these events were not reported. 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. The past medical history of Chronic lymphocytic leukemia is a likely confounder the events described This case was linked to MOD-2021-104070 (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. The past medical history of Chronic lymphocytic leukemia is a likely confounder the events described


VAERS ID: 1313589 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-27
Onset:2021-05-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Lymph node pain, Lymphadenopathy
SMQs:, 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: GARDASIL
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma, seasonal allergies
Allergies: Amoxicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Painful and swollen lymph nodes under both armpits. Right side was significantly more painful. Pain spread into the right breast. Lasted for 5 days with strong symptoms, mild pain (right side only) continued for additional 3 days. Patient is a nursing mother.


VAERS ID: 1313665 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Body temperature increased, Burning sensation, Chills, Disorientation, Dyspnoea, Feeling abnormal, Gait disturbance, Headache, Incontinence, Injection site reaction, Injection site swelling, Injection site warmth, Insomnia, Muscle spasms, Pain, Pulmonary pain, Somnolence
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: To the first Moderna shot on 04/06/2021
Other Medications: Metoprolol, Lisinipril, Allopurinol, vitamin D, Fish Oil
Current Illness:
Preexisting Conditions: COVID related asthma and COVID related SVT
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Starting around 9 PM, I had chills and felt my temperature going up. By 10:30, I had more than full body chills. They were like full body spasms that made it hard to breathe. My fever went to 103 degrees. I tried to sleep, but it was extremely difficult. I did finally sleep, I woke up and I had difficulty managing my body, hands, and brain. I lost bladder control. I took my temperature and it was 104. Went back to bed with difficulty. I woke up a couple more times with the same result. However, I didn''t have the brain power to take my temperature again. I could barely find the light switches and almost went into the closet instead of the bathroom. (That''s what my husband told me) 8 or 9 am, my fever was down to 102 degrees, my head felt like someone was splitting it open and my body felt like I had bruises from head to toe. I was awake MAYBE an hour all day that day. My lungs were on fire and I was short of breath again. It was like I was recovering from COVID pneumonia again. My doctor prescribed prednisone for my lungs. My right arm had a reaction below the injection site. It was swollen and hot. My left arm that had gotten the first injection also started hurting again. It was also swollen and hot.


VAERS ID: 1314096 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-05-03
Onset:2021-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 2 RA / IM

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

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

Write-up: Patient has a history of occasional nose bleeds, however after receiving 2nd Moderna vaccine he is experiencing nose bleeds every other day lasting $g20 minutes.


VAERS ID: 1314285 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-03
Onset:2021-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Fatigue, Headache, Influenza like illness, Injection site pain, Neck pain, Pain, Pyrexia, Sinus congestion
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Procardia 60mg, Synthroid 150 mg, Vitamin D, Valsartin 160 mg, Celexa 40 mg
Current Illness:
Preexisting Conditions: Kidney disease, Hypo-thyroid
Allergies: Penecillin, Tetrocyclene, Mangos, Fish,
Diagnostic Lab Data:
CDC Split Type:

Write-up: 12 hours after injection, came down with flu like symptoms, major head congestion, fever, body aches, headache, severe fatigue, lasted about 36 hours. 24 hours after injection, severe pain in left side of neck radiating down to the injection site in my left arm. At first felt like a stiff neck, but then progressed to severe radiating pain starting at neck and radiating down to injection site and then spreading to shoulder area. Took Tylenol every 4 hours. Pain would subside, and then suddenly come back with in 3.5 to 4.0 hours. Gradually worsened to the point that I almost went to the hospital. Took hot showers and put heating pad on shoulder. Pain level about 8. Pain lasted about 18 hours. Woke up and pain was suddenly gone, but pain in my arm at injection site because severe. Had no pain until that happened. Did not seek medical assistance at any time. Pain in my left arm at injection site lasted 3 days. Stomach issues occured appoximately 72 hours after injection and lasted about 4 days. Did not feel better and complete until 8 days had passed.


VAERS ID: 1314346 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-15
Onset:2021-05-04
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Contusion, Full blood count abnormal, Immune thrombocytopenia, Platelet count decreased
SMQs:, Haematopoietic leukopenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: nka
Diagnostic Lab Data: CBC with platelets. Platelet count was 2,000 upon admission.
CDC Split Type:

Write-up: Onset diffuse bruising prior to presentation to emergency department. Platelets = 2,000. Acute ITP diagnosed.


VAERS ID: 1314736 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-20
Onset:2021-05-04
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Acute kidney failure, unspecified.


VAERS ID: 1315736 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-05-04
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dermatitis allergic, Hypersensitivity, Pruritus, Rash pruritic, Skin mass
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZYRTEC [CETIRIZINE HYDROCHLORIDE]
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210519633

Write-up: ALLERGY ON NECK, BACK AND LOWER WAIST; BUMP AND ITCHING; ITCHING ALL OVER THE BODY; THE ALLERGY AS VERY BIG RED COLOR; HARD BUMP; This spontaneous report received from a patient concerned a 74 year old female. The patient''s weight, height, and medical history were not reported . The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 206A21A expiry: UNKNOWN) dose was not reported, administered on 03-MAY-2021 for prophylactic vaccination. Concomitant medications included cetirizine hydrochloride for allergy. On 04-MAY-2021, the subject experienced hard bump. On an unspecified date, the subject experienced allergy on neck, back and lower waist, bump and itching, itching all over the body, and the allergy as very big red color. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from allergy on neck, back and lower waist, the allergy as very big red color, hard bump, itching all over the body, and bump and itching. This report was non-serious.


VAERS ID: 1315842 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-15
Onset:2021-05-04
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
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: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CTA, 5/5/21
CDC Split Type:

Write-up: pulmonary embolism


VAERS ID: 1315876 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-05
Onset:2021-05-04
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Fatigue, Generalised tonic-clonic seizure, Hyperhidrosis, Memory impairment, Muscle spasms, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Generalised convulsive seizures following immunisation (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ONFI; APTIOM; TOPAMAX; MIDAZOLAM
Current Illness: Drug allergy (aspirin); Epilepsy (The patient has a history of grand mal, petit mal and stress seizures. Patient stated that he has at least one minor seizure once a month and the last seizure he had with this great intensity was about 3 to 4 months ago.)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210505; Test Name: blood work; Test Result: Inconclusive ; Result Unstructured Data: Result not provided
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: doesn''t remember anything; muscle spasms in back and legs; very tired; very sore; fever; grand mal seizures; sweating and being soak and wet; This spontaneous case was reported by a patient (subsequently medically confirmed) and describes the occurrence of GENERALISED TONIC-CLONIC SEIZURE (grand mal seizures) in a 42-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 037B21A and 006B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Epilepsy (The patient has a history of grand mal, petit mal and stress seizures. Patient stated that he has at least one minor seizure once a month and the last seizure he had with this great intensity was about 3 to 4 months ago.) and Drug allergy (aspirin). Concomitant products included MIDAZOLAM for Seizure, CLOBAZAM (ONFI), ESLICARBAZEPINE ACETATE (APTIOM) and TOPIRAMATE (TOPAMAX) for an unknown indication. On 05-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 04-May-2021, the patient experienced GENERALISED TONIC-CLONIC SEIZURE (grand mal seizures) (seriousness criterion medically significant). 04-May-2021, the patient experienced HYPERHIDROSIS (sweating and being soak and wet) and PYREXIA (fever). On 05-May-2021, the patient experienced MEMORY IMPAIRMENT (doesn''t remember anything), MUSCLE SPASMS (muscle spasms in back and legs), FATIGUE (very tired) and MYALGIA (very sore). On 05-May-2021, GENERALISED TONIC-CLONIC SEIZURE (grand mal seizures) had resolved. At the time of the report, HYPERHIDROSIS (sweating and being soak and wet), MEMORY IMPAIRMENT (doesn''t remember anything), MUSCLE SPASMS (muscle spasms in back and legs), FATIGUE (very tired), MYALGIA (very sore) and PYREXIA (fever) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 05-May-2021, Blood test: unknown (Inconclusive) Result not provided. It was reported that the patient took midazolam and swiped his magnet across his vagus nerve stimulator (VNS) for treatment. Action taken with mRNA-1273 in response to the event was Not Applicable It was reported that the patient was asymptomatic after first dose and experienced symptoms on 04May2021 at midnight after second dose of vaccine. 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. The medical history of epilepsy was assessed as strong cofounder.; 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. The medical history of epilepsy was assessed as strong cofounder.


VAERS ID: 1315963 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature abnormal
SMQs:

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

Write-up: temperature excursion with vaccine administration


VAERS ID: 1315978 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 LA / IM

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

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

Write-up: temperature excursion with vaccine administered


VAERS ID: 1316296 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-03
Onset:2021-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Chills, Cough, Dyspnoea, Fatigue, Influenza virus test negative, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test negative, Streptococcus test negative, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Every flu vaccine - fever, aches, chills, fatigue
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: 05/10/2021: COVID Test - negative; Strep Test - negative; Flu Test - negative
CDC Split Type:

Write-up: 05/04/2021 4:30am - 05/05/2021 9:00 - aches, chills 05/04/2021 - 5/13/2021 - fatigue 05/04/2021 12:00pm - vomited 05/04/2021 7:00pm - fever 100.6?F - took fever reducer (ibuprofen) 05/05/2021 4:00am - 05/11/2021 9:00am - sore throat, coughing, congestion, heavy breathing (hard to breathe)


VAERS ID: 1316297 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-03
Onset:2021-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gingival bleeding, Headache, Myalgia, Pyrexia, Stomatitis
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gingival disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, muscle ache, fever, gum bleeding, oral sore


VAERS ID: 1316529 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-16
Onset:2021-05-04
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       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: Ringing in left side ear


VAERS ID: 1316561 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Medical counselling, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Mild, Additional Details: Counseled patient. She said she ate very little before the vaccination. She fainted for a couple minutes and had to lie down. She informed pharmacy staff. I went over to her and offered her a bottle of water and stayed with her for approximately 10 minutes until she felt fine. She said after a couple minutes and drinking some water she felt fine. She stayed sitting in the vaccination/observation area for 10 more minutes. She was at the store for approximately 45 mins and waited 30 min after shot


VAERS ID: 1316800 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-03-27
Onset:2021-05-04
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Atrioventricular block, Cardiac arrest, Cardiac pacemaker insertion
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Not sure
Current Illness: None
Preexisting Conditions: Kidney disease and hypertension
Allergies: Sulfa drugs
Diagnostic Lab Data: May 4th 2021
CDC Split Type:

Write-up: Heart block - cardiac arrest - permanent pacemaker


VAERS ID: 1316820 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-16
Onset:2021-05-04
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram head normal, Drooling, Eye patch application, Eyelid function disorder, Facial paralysis
SMQs:, Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)

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: aspirin 81mg, biotin 5000mcg, fish oil x 3, Glucotrol xl 10mg, inderol160mg, multivitamin 1000mg, Prozac hcl 20mg, vitamin C 1000mg, D3 2000IU, Wellbutrin xl 300mg,
Current Illness:
Preexisting Conditions: diabetes, depression, rapid heartbeat, anxiety, issues w/ kidney stones, arthritis in hands and feet
Allergies: avelox, azithromycin, clindamycin, codeine, Zpac, dobutamine, fragrances, glipizide er, iodine, Keflex, Lipitor, metformin hcl, methylprednisolone, penicillin, surgical tape, medication intolerances: Biaxin, diazepam, Flagel, hydrocodone, Levaquin, metronidazole, Relafen, topiramate,
Diagnostic Lab Data: CT
CDC Split Type:

Write-up: pt states on 5/4/21 her mouth was drooping and she couldn''t shut her left eye. When she would drink, she would drool. Her condition did not improve so on 5/8/21 she went to Hospital. She had a CT, no stroke detected. No lab work. She was diagnosed w/ Bells Palsy. She was prescribed a valacyclovir hcl 1gm, 1 tab every 12rs. She was released to FU w/ PCP. She saw her PCP, on 5/12/21. She was evaluated and told to continue her meds and come back on 6/1/21. Pt still has these symptoms, wears a patch on her at night and is using artificial tears. The right side of her face is stronger than her left now.


VAERS ID: 1316875 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral normal, Aphasia, Arteriogram carotid normal, Cerebral infarction, Cerebral small vessel ischaemic disease, Cerebrovascular accident, Chest pain, Computerised tomogram head normal, Echocardiogram normal, Headache, Hemiparesis, Hypoaesthesia, Magnetic resonance imaging head abnormal, Muscular weakness, Musculoskeletal discomfort, Paraesthesia, Vitamin D deficiency
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: cholecalciferol 75 mcg Oral Daily ? insulin lispro 20 Units Subcutaneous TID AC ? insulin glargine 36 Units Subcutaneous 2 times per day ? rivaroxaban 20 mg Oral Daily with breakfast atorvastatin 80 mg Oral Nightly ? famotidine 20 m
Current Illness: Has been on blood thinners for acute PE 3 months prior Patient was having a left SI injection on 5/11 and "Per NP from pre-op, the pt received the injection without issue. After the injection she was developed groin numbness, which progressed into a headache, and chest pain. She then became aphasic, with left sided weakness and numbness- brought to ED for eval"
Preexisting Conditions: PMHx of atrerial ischemic stroke, DM2, HTN, HLD, PE, RAD, scoliosis
Allergies: Bee sting Losartan Meloxicam Topamax Codeine
Diagnostic Lab Data: TTE, 5/12/2021: Normal left ventricular size, systolic function and wall thickness, with no regional wall motion abnormalities.Normal diastolic filling pattern. No major valvular abnormalities Agitated saline was injected through a peripheral vein and did not show evidence of a shunt. 05/11/21 MRI Brain WO Contrast Narrative MRI BRAIN WO CONTRAST... Impression IMPRESSION: No acute intracranial abnormality, specifically no acute ischemia. Microangiopathic changes of aging. Small chronic infarcts in the left cerebellar hemisphe 05/11/21 CT Angio Head and Neck Level 1 Narrative CT ANGIOGRAM HEAD AND NECK W CONTRAST LEVEL 1... Impression IMPRESSION: 1. CTA neck: No evidence of significant extracranial vascular stenosis or occlusion. 2. CTA head: No evidence of hemodynamically significant intracranial stenosis, aneurysm, or vascular malformation 05/11/21 CT Head Level 1 Narrative CT HEAD LEVEL 1 - LEVEL 1... Impression IMPRESSION: No acute intracranial abnormality.
CDC Split Type:

Write-up: ED Note: "presents to the ED via RRT from pre-op after having a left SI injection with complaints of a stroke alert. at 1132 this morning. Per NP from pre-op, the pt received the injection without issue. After the injection she was developed groin numbness, which progressed into a headache, and chest pain. She then became aphasic, with left sided weakness and numbness. BS was 154 at that time. Per husband at bedside, the pt had numbness and tingling after injection but was otherwise at baseline. While the pt was getting dressed, the husband went to get the car. He notes the pt is on Xarelto secondary to PE and has taken it as prescribed. He denies any missed doses but states he is unsure of what time the last dose was. He states that the pt has no lasting deficits from her prior stroke. Of note, the pt is able to respond by nodding yes or no but is unable to speak. Pt able to write on a white board. She states she was taken off the Xarelto 3 months ago. The pt states she is unable to talk. She endorses left arm and leg weakness. The pt states she has a prior stoke years ago with weakness but has no lasting deficits. " Admitted to the hospital Diagnoses: -Dysphasia -Small vessel cerebrovascular disease -Bereavement -Vitamin-D deficiency


VAERS ID: 1316898 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 1 LA / IM

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

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

Write-up: Temperature excursion with vaccine administration


VAERS ID: 1316954 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 1 LA / IM

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

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

Write-up: NONE


VAERS ID: 1317031 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Atelectasis, Chest pain, Dyspnoea, Fatigue, Headache, Hiatus hernia
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Unknown
Preexisting Conditions: Asthma Discoid lupus Hurthle cell neoplasm of thyroid Post-surgical hypothyroidism
Allergies: Ampicillin, penicillin
Diagnostic Lab Data: CT Angio Pulmonary w/ contrast 05/12/21 14:32:08 IMPRESSION: 1. No CT evidence of major pulmonary embolus, thoracic aortic dissection, or thoracic aortic aneurysm. 2. Basilar subsegmental atelectasis. 3. Small hiatal hernia.
CDC Split Type:

Write-up: This is a 49 Years old Female with asthma, discoid lupus and post-surgical hypothyroidism with Hurthle cell neoplasm of thyroid presenting with 1 weeks of moderate shortness of breath without cough, which began gradually. Patient states that her symptoms first started after she received the first Moderna COVID-19 vaccine on 4/6/2021 and they lasted approximately 6 days. Patient was doing well until she received the second dose of the vaccine on 5/4/2021. Since then, she has been having shortness of breath, fatigue and headaches. Patient also complains of chest pain that is worse with inspiration, and she denies any abdominal pain, no nausea, no vomiting, no swelling to the legs, and no leg pain. Symptoms are worse with exertion


VAERS ID: 1317032 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 1 LA / IM

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

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

Write-up: temperature excursion with vaccine administered


VAERS ID: 1317250 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-03
Onset:2021-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Rash maculo-papular
SMQs:, 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: none
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: maculopapular rash on arms, legs and trunk when evaluated on 5/11/21 and 5/14/21 Symptomatic treatment started 5/12/21 with benadryl and hydrocortisone no improvement per patient when seen on 5/14/21, so was started on medrol dose pack and vistaril


VAERS ID: 1317478 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-16
Onset:2021-05-04
   Days after vaccination:49
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044A21A / 1 UN / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038A21A / 2 UN / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Pain
SMQs:, Anaphylactic reaction (broad)

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

Write-up: She started experiencing symptoms on 04/24/2021. Had body aches and cough. No Pneumonia or underlying health conditions. Patient was hospitalized and travelled from 04/21/2021- 04/24/2021. She drove back on 04/24/2021. No info about close contacts.


VAERS ID: 1317692 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-03
Onset:2021-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / IM

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

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

Write-up: She began experiencing regular arm numbess on the 3rd when she received the vaccine and it became fully developed by the next day. Over the next week or so the arm numbness became arm and hand numbness. The arm and numbness was intermittent, but the finger numbness has continued to persist. No treatments performed.


VAERS ID: 1317965 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-27
Onset:2021-05-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chills, Fatigue, Hypersomnia, Motor dysfunction, Musculoskeletal stiffness, Pain, Peripheral swelling, SARS-CoV-2 test negative
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad), Arthritis (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 5-10 days after "flu" shots has flu like systems for 1-2 days.
Other Medications: Losartan, Inderal LA, Testosterone cream, and OTC vitamins
Current Illness:
Preexisting Conditions: BP is a little high for the past year.
Allergies: NKANone
Diagnostic Lab Data: NEG for the virus, 10 days after the injection.
CDC Split Type:

Write-up: 6 days after injection woke with soreness in all joints, stiffness, fatigue. Now on day 10, the S/S are getting worst. Fingers are swollen,. I can''t grasp or pinch things. I must use both hands to hold a glass or cup. Very weak, sleeping 16-18 hours a day. At times I get very chilled and start to shiver. Never have had a fever, loss of taste, or smell. I tested NEG for the virus on day 3 (10 days after receiving the vaccine). Soreness is turned into pain. Feels like full-blown RA and if I was black I would be thinking sickle-cell because of the general pain.


VAERS ID: 1318612 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-03
Onset:2021-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Hypoaesthesia, Lumbar puncture, Magnetic resonance imaging head, Magnetic resonance imaging spinal, Paraesthesia, Vaccination complication
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vyvanse, spitonolactone
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ct scans, spinal mri, cranial mri, spinal tap, blood work
CDC Split Type:

Write-up: Woke up the next day with tingling in my body and numbness. The next morning I was completely numb on the left side of my body. Went to the emergency room and spent 5 days in the hospital being administered steroids and undergoing tests. Doctors thought it could have possibly resulted from ms but neurologist deemed it as a horrible covid vaccine reaction. Ms is not present- spinal tap results confirmed. Still numb on left side of my body. Neurologist believes it will last a couple months.


VAERS ID: 1319002 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN0151 / 2 AR / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: temperature excursion with vaccine administered


VAERS ID: 1319278 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 AR / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: temperature excursion with vaccine administered


VAERS ID: 1319791 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Maryland  
Vaccinated:0000-00-00
Onset:2021-05-04
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Penicillin allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210504; Test Name: COVID-19 virus test; Result Unstructured Data: POSITIVE; Test Date: 20210504; Test Name: COVID-19 antibody test; Result Unstructured Data: Positive for antibodies
CDC Split Type: USJNJFOC20210518529

Write-up: CONFIRMED CLINICAL VACCINATION FAILURE; CONFIRMED COVID-19 INFECTION; This spontaneous report received from a patient concerned a 53-year-old female. The patient''s height, and weight were not reported. The patient''s current conditions included penicillin allergy. The patient experienced drug allergy when treated with ciprofloxacin, and vancomycin. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A and expiry: unknown) dose was 0.5 ml, 1 total administered on 06-APR-2021 at right arm for prophylactic vaccination. No concomitant medications were reported. On 04-MAY-2021, the patient experienced confirmed clinical vaccination failure and confirmed COVID-19 infection. Laboratory data included: Rapid test and antibody testing for COVID-19 (NR: not provided) was positive for antibodies, and COVID-19 virus test (NR: not provided) positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from confirmed clinical vaccination failure and confirmed COVID-19 infection. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000179016. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. A manufacturing related root cause could not be identified. Additional live follow up information was received from Product Quality Vigilance on 11-MAY-2021.; Sender''s Comments: V0: 20210518529-covid-19 vaccine ad26.cov2.s-confirmed clinical vaccination failure. 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: SPECIAL SITUATIONS


VAERS ID: 1320329 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-03
Onset:2021-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure systolic, Blood pressure systolic increased, Cerebral haemorrhage, Hemiparesis, Platelet count, Platelet count decreased, Sensory loss, Unresponsive to stimuli
SMQs:, Haematopoietic thrombocytopenia (narrow), Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Medical History/Concurrent Conditions: Hypertension
Allergies:
Diagnostic Lab Data: Test Name: systolic blood pressure; Result Unstructured Data: Test Result:220; Test Name: platelets; Result Unstructured Data: Test Result:46
CDC Split Type: USPFIZER INC2021509103

Write-up: Left intracerebral brain hemorrhage; Right hemiparesis; His platelets were 46; Systolic blood pressure 220; only responsive to touch and pain; Unresponsive; This is a spontaneous report from a non-contactable healthcare professional. A 65-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), via an unspecified route of administration on 03May2021 (Batch/Lot number was not reported) as 2nd dose, single for Covid-19 immunisation. Medical history included hypertension. Concomitant medications were not reported. Historical vaccine included first dose of BNT162B2 for COVID-19 immunization. On 04May2021, the patient was found unresponsive by family, taken to Emergency department where left intracerebral brain hemorrhage was diagnosed. His platelets were 46 and systolic blood pressure 220. He has right hemiparesis and is only responsive to touch and pain. He is currently on hospice. The patient was hospitalized for 3 days and received platelet transfusion. The outcome of the events was not recovered. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Sender''s Comments: Based on available information and known drug profile it is unlikely that the reported events were causally related to bnt162b2 . The patient''s history of hypertension is a risk factor for the reported left intracerebral brain hemorrhage and. blood pressure systolic increased. Case will be reassessed if additional information is received


VAERS ID: 1320339 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-04
Onset:2021-05-04
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Atopic dermatitis; Pernicious anemia; Polycystic ovarian syndrome; Thyroiditis
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021511702

Write-up: Bell''s Palsy; This is a spontaneous report from a non-contactable consumer (patient). A 34-year-old female patient (not pregnant) received 2nd dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection) via an unspecified route of administration, administered in left arm at the age of 34-year-old on 04Apr2021 15:00 (Batch/Lot Number: Unknown) as single dose for covid-19 immunization. Medical history included asthma, pernicious anaemia, Polycystic ovarian syndrome, Hashimots thyroiditis, Atopic dermatitis. The patient''s concomitant medications were not reported. The patient previous took first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) at the age of 34-year-old on 07Mar2021 15:00 at left arm for COVID-19 Immunization. The most recent COVID-19 vaccine was administered at Hospital. No other vaccines within 4 weeks prior to the COVID vaccine received by patient, other medications the patient received within 2 weeks of vaccination confirmed yes but not specified and stated more than there was room for here. The patient experienced bell''s palsy on 04May2021 12:00. The event resulted in Emergency room/department or urgent and Doctor or other healthcare professional office/clinic visit, no treatment received. The patient was not diagnosed with COVID-19 prior to vaccination and has not been tested for COVID-19 since the vaccination. The outcome of the event was recovering. No follow-up attempts are possible. Information about batch/lot number can not be requested.


VAERS ID: 1320360 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-23
Onset:2021-05-04
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021516994

Write-up: Diagnosed with Bells Palsy; This is a spontaneous report from a contactable consumer (patient). A 46-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration, administered in arm right on 23Apr2021 18:00 (at the age of 46-year-old) (Lot Number: EW0170) as single dose for covid-19 immunisation. The patient''s medical history was not reported. Concomitant medications was none. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. No other medications the patient received within 2 weeks of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient was diagnosed with bells palsy on 04May2021 08:00. The event resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measures were taken as a result of diagnosed with bells palsy, medication steroid and antiviral were used. Event outcome was not recovered.


VAERS ID: 1320928 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dizziness, Dyspnoea, Feeling hot, Pain, Somnolence, Vertigo
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypoglycaemia (broad)

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

Write-up: Systemic: Body Aches Generalized-Severe, Systemic: Chest Tightness / Heaviness / Pain-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: delayed but quick onset of feeling of warmth-Severe, Additional Details: Patient came to me 5/13/21 to describe that later in the day, after receiving the Janssen vaccine, pt was driving and had a sudden feeling of body warmth and vertigo. Patient further described chest tightness and difficulty breathing, as well as all over body pain. He reported that he was able to safely get to where he was going and the next day had more "expected" grogginess and aches.


VAERS ID: 1321430 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-27
Onset:2021-05-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood test, Chest X-ray, Computerised tomogram, Echocardiogram, Electrocardiogram, Pulmonary embolism, Pulmonary infarction, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Chest X-rays, EKG, multiple blood tests, ct scan, Doppler ok legs and echo cardio gram. All tests conducted 5/5-5/8/21 during ER and hospitalization
CDC Split Type:

Write-up: Developed multiple pulmonary embolisms in both lungs and left lung infarction. Resulted in hospitalization for 4 days and treatment in hospital and blood thinners for post discharge


VAERS ID: 1321674 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-03
Onset:2021-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 2 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine (10 mg)
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Dr. performed various neurological exercises in office.
CDC Split Type:

Write-up: While sitting in class, suddenly passed out and vomited at the same time. Came to about 30 seconds later. No additional adverse affects after the episode.


VAERS ID: 1322111 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA O30B21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Complication associated with device, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: lipitor, lasix, zyrtec,insulin,metoprolol, phoslo, hydraziline
Current Illness: Covid+ 2/10/21 requiring hosp, neg Covid pcr 3/17, 4/5. positive covid 5/12(Ct 40.40 Covid + 5/16 (Ct 38.5)
Preexisting Conditions: hemodialysis, diabetes, ESRD, MGUS
Allergies: n/a
Diagnostic Lab Data: positive covid pcr 5/12,5/17
CDC Split Type:

Write-up: hospitalized 5/12 because unable to dialyze in his unit


VAERS ID: 1322232 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-30
Onset:2021-05-04
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NOT KNOWN / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute myocardial infarction, Chest pain, Computerised tomogram coronary artery normal, Dyspnoea, Magnetic resonance imaging heart, Myocarditis, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Elevated troponin: peak 5.95 (normal range for lab 0.00 - 0.03) Cardiac MRI was consistent with acute myocarditis. Cardiac CT scan showed normal coronary arteries.
CDC Split Type:

Write-up: Presented with chest pain and dyspnea. Admitted to the hospital. Initially, the diagnosis was NSTEMI. Further testing showed myocarditis.


VAERS ID: 1322464 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-26
Onset:2021-05-04
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Exposure during pregnancy, Premature labour
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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: G5P3 mother had moderna vaccine 1 week prior to going into preterm labor. Pregnancy was complicated by gestational diabetes. Mom also intermittently takes atenolol for heart palpitations. Preterm labor and delivery occurred at 33 0/7 weeks (previous children were not delivered preterm). Infant''s weight at birth was 1670g.


VAERS ID: 1322473 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-04-26
Onset:2021-05-04
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multiple vitamin, calcium , Zolpidem( 5mg)
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Since Day 8 after the vaccine, started tinnitus and headache . Tinnitus is non-stop 24 hours, headache come everyday, sometimes morning A little less


VAERS ID: 1322592 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-04
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN Q07AQ1A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Decreased appetite, Dizziness exertional, Fatigue, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pulmonary hypertension (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210505; Test Name: Body temperature; Result Unstructured Data: 99.1 F
CDC Split Type: USJNJFOC20210526721

Write-up: EXTREME DIZZINESS UPON EXERTION; LOSS OF APPETITE; HEADACHE; FEVER; FATIGUE; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Q07AQ1A expiry: UNKNOWN) dose was not reported, administered on 04-MAY-2021 13:00 for prophylactic vaccination. No concomitant medications were reported. On 04-MAY-2021, the subject experienced fatigue. On 05-MAY-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 99.1 F. On 07-MAY-2021, the subject experienced extreme dizziness upon exertion. On 07-MAY-2021, the subject experienced loss of appetite. On 07-MAY-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever, and had not recovered from fatigue, headache, loss of appetite, and extreme dizziness upon exertion. This report was non-serious.


VAERS ID: 1323501 (history)  
Form: Version 2.0  
Age: 98.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-06
Onset:2021-05-04
   Days after vaccination:59
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Mental status changes
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: N17.9 - Acute kidney failure, unspecified Altered Mental Status


VAERS ID: 1323625 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Anticoagulant therapy, Dyspnoea, Muscle spasms, Muscle tightness, Pain in extremity, Panic attack, Pulmonary embolism, Rash
SMQs:, Anaphylactic reaction (narrow), Embolic and thrombotic events, venous (narrow), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: metformin, pantoprazole, fluoxetine, aspirin, metoprolol tartrate, simvastatin, pramipexole, glimepiride, meloxicam, isosorbide mononitrate, carbidopa/levodopa
Current Illness:
Preexisting Conditions: Diabetes, hypercholesterolemia, congenital heart valve defect
Allergies: Gapabentin ("stroke episode" ~ 2019)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine on tuesday 5/4. Patient developed a rash surrounding both ankles. Patient and wife dismissed this as possible side effect of vaccine. The patient had difficulty breathing and dismissed it as a panic attack on 5/10. Symptoms continued for several days, went to walk-in clinic on Wednesday 5/12 for tests and inconclusive. Thursday 5/13 the patient continued to experience these symptoms and elevated pain, tightness and cramping in legs and went to the ER where he was diagnosed with bilateral pulmonary emboli. Patient was admitted for 2 days and treated for clots. Upon discharge the patient was instructed to discontiue meloxicam, carbidopa/levodopa and started on eliquis for 6 months. After 6 months the patient will follow-up with a hemotologist.


VAERS ID: 1323953 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-03
Onset:2021-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Peripheral swelling, Skin warm, Tenderness
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? 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: Patient called 5/17- 2 weeks post vaccine stating arm is still tender, swollen, and warm to the touch. Patient states it is not red


VAERS ID: 1323995 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-28
Onset:2021-05-04
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Anaesthesia oral, Bell's palsy, CSF protein increased, CSF white blood cell count, Enthesopathy, Facet joint syndrome, Facial paralysis, Guillain-Barre syndrome, Immunoglobulin therapy, Lumbar puncture abnormal, Magnetic resonance imaging head abnormal, Magnetic resonance imaging spinal abnormal, Nerve conduction studies abnormal, Paraesthesia, Vertebral foraminal stenosis
SMQs:, Peripheral neuropathy (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Demyelination (narrow), Hearing impairment (broad), Arthritis (narrow), Tendinopathies and ligament disorders (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Armour Thyroid, 60 mg, Oral, Daily Tri-Linyah 35 mcg oral tablet, 1 tab, Oral, Daily Vitamin D2 50,000 intl units (1.25 mg) oral capsule, 50000 IntlUnit= 1 cap, Oral
Current Illness: unknown
Preexisting Conditions: hypothyroidism
Allergies: milk, penicillins, shrimp
Diagnostic Lab Data:
CDC Split Type:

Write-up: 54-year-old female with past medical history of hypothyroidism, vitamin D deficiency presenting to the emergency room with bilateral paresthesias of foot and hand. Patient had received her first more Darner vaccine 3 weeks prior to presentation. Patient was also noted to have left facial droop and loss of sensation on the anterior tongue. Patient does report a prior history of cold sores on her mouth. She was seen by neurologist outpatient where she underwent nerve conduction studies which showed delayed and prolonged F waves consistent with a diagnosis of Guillain Barre room. Patient underwent a lumbar puncture which revealed markedly elevated protein with very few WBCs consistent with albumin cytologic dissociation. Patient was started on IVIG for 5 days per neurology''s recommendations. Patient reported improvement in her paresthesias prior to discharge. Patient was also diagnosed with having Bell''s palsy and started on valacyclovir and prednisone per infectious disease consultation recommendations. Patient underwent an MRI brain which revealed prior trauma/cortical contusion, and mild multiple nonspecific periventricular deep white matter foci of abnormal signal intensity, and no MR evidence of acute infarct. Also underwent an MRI cervical spine which revealed multilevel cervical enthesopathy with moderate to severe right C4-C5, left C5-C6 and left C6-7 foraminal stenoses. MRI lumbar spine also reviewed revealed moderate bilateral facet arthropathy at L4-L5 and L5-S1. Thoracic spine MRI was unremarkable. Patient''s paresthesias improved. Per neurology''s recommendations, patient was discharged home to follow-up with neurology in 2 weeks outpatient. Patient was also instructed to follow-up with her primary care doctor in 2 to 3 days for hospital discharge follow-up.


VAERS ID: 1325854 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-04
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 test, Suspected COVID-19
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: Premenstrual syndrome
Preexisting Conditions: Comments: The patient never had a reaction to a vaccine. She takes flu shot every year.
Allergies:
Diagnostic Lab Data: Test Date: 20210511; Test Name: COVID-19 virus test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210523464

Write-up: SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient via a company representative concerned a female of unspecified age. The patient''s height, and weight were not reported. The patient''s concurrent conditions included premenstrual syndrome, and other pre-existing medical conditions included the patient never had a reaction to a vaccine. she takes flu shot every year. The patient was previously treated with influenza vaccine for prophylactic vaccination. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 04-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 04-MAY-2021, the subject experienced suspected covid-19 infection. On 11-MAY-2021, Laboratory data included: COVID-19 virus test (NR: not provided) Positive. The action taken with covid-19 vaccine was not applicable. The outcome of suspected covid-19 infection was not reported. This report was non-serious. The suspected product quality complaint has been confirmed to be management approval - confirmed no PQC was identified within the reported complaint reported. complaint is approved for void. void: yes based on the PQC evaluation/investigation performed.; Sender''s Comments: V0: Medical assessment comments not required as per standard procedure as the case is assessed non serious.


VAERS ID: 1326245 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-12
Onset:2021-05-04
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9867 / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210503; Test Name: SARS-CoV-2 test; Result Unstructured Data: Test Result:Positive; Comments: Two instant tests prior to the one at NYU that were positive; Test Date: 20210503; Test Name: SARS-CoV-2 test; Result Unstructured Data: Test Result:Positive; Test Date: 20210504; Test Name: SARS-CoV-2 test; Result Unstructured Data: Test Result:Positive; Comments: full COVID test at NYU
CDC Split Type: USPFIZER INC2021517280

Write-up: she was fully vaccinated with the Pfizer COVID vaccine at the end of FEB2021 and she still got COVID; she was fully vaccinated with the Pfizer COVID vaccine at the end of FEB2021 and she still got COVID; This is a spontaneous report from a contactable consumer (Patient). A 68-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, lot number: EL8982) on 21Jan2021 (afternoon), and second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, lot number: EL9867) on 12Feb2021 (morning), both via an unspecified route of administration, administered in left arm, as single dose for COVID-19 immunization. The patient medical history was none. Concomitant medications were not reported. Patient did not receive any other vaccine four weeks prior the vaccination. On 03May2021, patient had two instant tests prior to the full one that were positive for COVID-19. On 04May2021, the patient has done three tests and COVID-19 was confirmed. Patient stated that she was fully vaccinated with the Pfizer COVID vaccine at the end of FEB2021 and she still got COVID. The patient underwent lab tests which included two times instant SARS-CoV-2 test on 03May2021 and full one for SARS-CoV-2 test on 04May2021, all the tests with Positive results, also patient described that NYU did some unspecified extensive test. Patient had the full test because her doctor was so shocked that she tested Positive, and doctor wanted to let Pfizer know. Patient thought that it was going to protect her from getting COVID. Patient has gone all of the time and never got COVID and then she gets the COVID vaccines and gets freaking COVID. Patient thinks that she has no predisposing factors for getting COVID but that the only thing that she was worrying about was that she lives in an apartment building and they had parties going on in her building and was trying to track that down. Patient did not go to the party though, but she wonders if COVID can be in the air in the building. Patient only concern was that this COVID vaccine was a bummer, got vaccinated and then got COVID. The outcome of the events was unknown. Follow up attempts are needed. Further information has been requested.


VAERS ID: 1326527 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Iowa  
Vaccinated:2020-12-30
Onset:2021-05-04
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042L20A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Photopsia
SMQs:, Retinal disorders (narrow)

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

Write-up: patient has had dull headaches ever since receive the vaccine which she previously had not. She also has complaints of seeing flashing of lights.


VAERS ID: 1326598 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear pain, Headache
SMQs:

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

Write-up: Patient stated that he has had a headache and ear pain ever since receiving his vaccine


VAERS ID: 1326600 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-21
Onset:2021-05-04
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

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

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

Write-up: Bell''s Palsy


VAERS ID: 1326849 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-03
Onset:2021-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Dry skin, Peripheral swelling, Sticky skin
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: None at this time.
CDC Split Type:

Write-up: Swelling of fingers and feet the next day after receiving the vaccine. It has been over 2 weeks and I still have swelling of my fingertips, hands, and feet. I also have excessive dryness on both hands and feet. My fingers feel like they are secreateing sticky moisture. Fingers feel sticky like they have glue on them.


VAERS ID: 1327147 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-28
Onset:2021-05-04
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Dyspnoea, Electrocardiogram, Pruritus, Skin hypertrophy, Ultrasound scan
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Losartan, Amlodepine,
Current Illness: N/A
Preexisting Conditions: Hypertension
Allergies: Any Cillians...
Diagnostic Lab Data: blood drawn, CT- Scan, EKG, Ultrsound of legs and heart. Hospitalization.
CDC Split Type:

Write-up: Uncontrolable itch and elephant type skin in mid section. Trouble breathing..


VAERS ID: 1327221 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-11
Onset:2021-05-04
   Days after vaccination:54
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: none
Allergies: unknown
Diagnostic Lab Data: 05/04/2121 positive Covid19 PCR test
CDC Split Type:

Write-up: 2nd covid vaccine received 03/11/2021. Tested positive for covid19 on a routine HCW screen after being fully vaccinated. Asymptomatic.


VAERS ID: 1327326 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Georgia  
Vaccinated:2020-12-29
Onset:2021-05-04
   Days after vaccination:126
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0141 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 2 UN / IM

Administered by: Pharmacy       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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: CARDIAVASCULAR DISEASE AND IMMUNOCOMPROMISED. DISABILITY: paralyzed from C5 down in June 2019
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization


VAERS ID: 1327509 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood magnesium, Blood thyroid stimulating hormone, Cardiac function test, Chest X-ray, Dizziness, Electrocardiogram, Full blood count, Glycosylated haemoglobin, Headache, Hypertension, Influenza virus test, International normalised ratio, Lipids, Metabolic function test, Prothrombin time, SARS-CoV-2 test, Thyroxine free, Troponin, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Vestibular disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Ibuprofen, PCN class
Diagnostic Lab Data: Lipid panel, UA, FLu and COVID swabs, CMP, PT/INR, CBC w/diff, Mg, A1C, T4 Free, Troponin, TSH, CXR, EKG, Cardian Panel
CDC Split Type:

Write-up: member complained of dizziness and headache after vaccine administration. Patient brought to lay down on a gurney. Headache resolved after patient in supine position. Vitals stable with noted hypertension: 194/129 that remained elevated for 30 minutes. Dizziness and headache resolved. Dr encouraged member ED assessment of continued hypertension. Member agreed to have wife (at bedside) drive him immediately to the ED. Per EMR, member went to emergency and was admitted 5/4- 5/6/2021 and placed on antihypertensives and hypothyroid meds.


VAERS ID: 1327577 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-04-21
Onset:2021-05-04
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Erythema, Feeding disorder, Stomatitis, Swelling
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metoprolol, Synthroid
Current Illness:
Preexisting Conditions: HTN, Thyroid disease
Allergies: none
Diagnostic Lab Data: none available
CDC Split Type:

Write-up: Pt started on 5/4/2021 with generalized erythema and swelling. This progressed for which he visited his PCP who recommended benadryl. Condition worsened until irritation affected the inside of his mouth, causing him difficulty eating. He wento to ER at Hospital on 5/13/2021 and was admitted for IV treatment (steoids??). He was treated by an Internist and ID Specialist (unknown names) who explained that this was secondary to the Moderna vaccine. He was discharged home on 5/16/2021 to continue on PO steoids. He denies exposure to any other potential allergen after his vaccine was administered (no new medications, or allergy-prone foods). Currently, patient is slowly improving.


VAERS ID: 1329483 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-04-27
Onset:2021-05-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO171 / 1 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hearing decreased (Started 10 years ago when he was 51)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021498995

Write-up: experienced hearing loss in his left ear/hearing loss on both ears; his right ear seems like there is water in there or it is underwater/left ear sounds like everything is echoing; immediately things were muffled; This is a spontaneous report from a contactable consumer (patient). A 61-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in right upper arm on 27Apr2021 11:00 (Batch/Lot Number: EWO171; Expiration Date: Aug2021) as 1st dose, single for covid-19 immunization. Medical history including hearing was about 80 percent in the left ear/loss of 20-30 percent which started 10 years ago when the patient was 51. The patient has no concomitant medications. No additional vaccines administered on same date of the Pfizer suspect and no prior vaccinations within 4 weeks. After receiving a dose of Pfizer Covid-19 vaccine on 27Apr2021, the patient experienced hearing loss in his left ear, it was barely noticeable but today (04May2021 12:00) there was a dramatic shift and he experienced hearing loss on both ears, it was instantaneous. The patient wanted to know if there are any reports of hearing loss and when could it go away. He has a hearing issue in his left ear that he has had, his hearing was about 80 percent in the left ear and in the right ear it was a 100 percent. Today, at noon he has almost lost his hearing in his left ear and his right ear seems like there is water in there or it is underwater. His left ear sounds like everything is echoing but, he can hear the call handler just fine. His right ear was perfect and now it is messed up. He is worried about that. The patient wonders why that happened and why did they both go. He reported that the shot may have had something to do with it and if it does, what should he do or maybe he is just getting old. He cannot hear in the left ear much; he was just testing it while on hold listening to the music to see how much he had. He felt like there is water in it, not a little, a lot of water and it echoes a little bit and seemed like it''s underwater. Started 10 years ago when he was 51, he lost 20-30 percent and it stopped as far as he could tell. He did not get checked out then because he could hear clearly. Today at 12 pm, and it was not gradual, it was like turning a light on, immediately things were muffled. Even when he was putting his hands over his ears, there was like an echo. He was on the phone with his wife at the time. He did not know what happened, so, he went to work, and nothing is changed. He told her something just happened to his ears. He thought of doing something in the meantime and not trying to wait for it to get better. Right ear feels like it is underwater, maybe the left ear is affecting the right the or the weaker ear is being affected more. The right ear is the stronger ear over the left ear. That is what bothering him. His weaker ear is being affected more than his good ear, which his right ear has always been the stronger ear and he never had problems before with his right ear. It was a dramatic switch today at 12pm and his ears have been that way ever since. The left ear feels like its underwater, so much even if he blocks that ear with his finger or his palm. Still there is something going on in both ears. He did not notice the right ear because the other ear was such a shock and he was just dealing with that. He noticed the right side too after trying to see if he could hear out of the left. He had no baseline to go off of for sure or a history. No baseline to go from other than this hearing change of event, which may be totally him. He wanted to see if there is anything related to this because it was so dramatic. The events were not treated. The outcome of the event "experienced hearing loss in his left ear/hearing loss on both ears" was not recovered while the other events were unknown. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1329491 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Fatigue, 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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021499419

Write-up: Woke up feeling weak and tired; Woke up feeling weak and tired; Lost consciousness/passed out for several minutes; This is a spontaneous report from a non-contactable consumer (patient). A 26 years-old male patient received the first dose of BNT162B2 (Pfizer-Biontech Covid-19 Vaccine, Lot. EW0173) in the left arm, at single dose, on 04May2021, at 08:45 AM, for COVID-19 immunisation. COVID-19 vaccine was administered at Pharmacy or Drug Store. The patient had not received any other vaccines within 4 weeks prior to the BNT162B2 vaccine. The patient had not received any other medications within 2 weeks of vaccination. Prior to vaccination, was not the patient diagnosed with COVID-19. Relevant medical history and concomitant medications were unknown. It was reported that the patient received the first dose of vaccine in left arm, then 5 minutes later, on 04May2021, lost consciousness/passed out for several minutes. Woke up feeling weak and tired on an unspecified date. Emergency Room Visit /department or urgent care required. Post the vaccination, the patient has not been tested for COVID-19. Clinical outcome of the events was unknown at time of this report. No follow-up attempts possible. No further information expected.


VAERS ID: 1329502 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-03
Onset:2021-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Diarrhoea, Lip swelling, Periorbital swelling, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021502448

Write-up: After 12 hours from vaccine I had diarrhea; chill; swelling all my body; puffy both eyes and lips; puffy both eyes and lips; This is a spontaneous report from a contactable consumer (patient). A 31-year-old female patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration, administered in arm left on 03May2021 14:00 (Batch/Lot number was not reported) as single dose at the age of 31-year-old for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. Patient was not pregnant. No other vaccine in four weeks. No COVID prior vaccination. No known allergies. Other medical history: she never had any reaction. On 04May2021 04:00 after 12 hours from vaccine she had diarrhea, chill, swelling all her body, puffy both eyes and lips. Events resulted in Emergency room/department or urgent care and Hospitalization. Therapeutic measures were taken as a result of events. COVID was not tested post vaccination. The outcome of events was recovered with sequelae. Information on the Lot/Batch number has been requested.


VAERS ID: 1329543 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-04-28
Onset:2021-05-04
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Postmenopausal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19; Postmenopause
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021515479

Write-up: I am post menopausal, I am bleeding and have period like symptoms; This is a spontaneous report from a contactable consumer (patient). A 52-year-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Lot number was not reported), at 52 years old via an unspecified route of administration, administered in Arm Left on 28Apr2021 10:30 as 2nd dose, single for COVID-19 immunization in a public health department. Medical history included diagnosed with COVID-19 and post menopausal both from an unknown date. Concomitant medications include an unspecified medication taken within two weeks of vaccination. The patient received the first dose of bnt162b2 on 07Apr2021 11:00 AM for COVID-19 immunization. On 04May2021 08:30, the patient reported that she is post menopausal, was bleeding and have period like symptoms. The reporter considered the event as non-serious. No treatment was given. The outcome of the event was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1329580 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-03
Onset:2021-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Multiple sclerosis, SARS-CoV-2 test
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Optic nerve disorders (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210505; Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC2021535948

Write-up: left side of body went numb; they thought she had MS (multiple sclerosis); This is a spontaneous report from a contactable consumer (patient). A 32-year-old female patient received bnt162b2 (BNT162B2), dose 2 via an unspecified route of administration, administered in arm left on 03May2021 15:30 (Lot Number: EW0167) as single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient was not pregnant. 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 previously administered first dose of bnt162b2 in left arm on 12Apr2021 14:30 (Lot Number: EW0162) for COVID-19 immunisation. The patient experienced left side of body went numb. Spent a week in the hospital- they thought she had MS (multiple sclerosis) but it was all from the covid vaccine. There''s documentation that the prognosis was from the vaccine. The events onset date and time was 04May2021 09:30. The adverse events result in any of the following doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Treatment steroids received for the adverse events. But she was still numb on the left side. The events were reported as serious, due to hospitalization and life threatening. Hospitalized for 5 days. The patient underwent lab tests and procedures which included nasal swab: negative on 05May2021. The outcome of events was not recovered.


VAERS ID: 1329590 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-23
Onset:2021-05-04
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Ectopic pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021542837

Write-up: ectopic pregnancy; This is a spontaneous report from a contactable consumer (patient). A 30-years-old female patient (not pregnant at the vaccination) received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 23Mar2021 (Batch/Lot number was not reported) as UNKNOWN, SINGLE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient previously took biaxin and experienced allergies. It was reported the Pfizer covid shot caused the patient to have an ectopic pregnancy. She ovulated the day before her shot while trying to get pregnant and just found out due to the shot she had an ectopic pregnancy on 04May2021. Event resulted in Doctor or other healthcare professional office/clinic visit, Emergency room/department or urgent care, Hospitalization, Life threatening illness (immediate risk of death from the event). No treatment received. Since the vaccination, the patient has not been tested for COVID-19. The outcome was recovering. Information on batch number has been requested


VAERS ID: 1330104 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, Peripheral swelling, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
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 inhaler, amitriptyline, flexeril, voltaren gel, flonase, ibuprofen, sildenafil, cialis, b vitamin, vitamin d, testosterone topical solution
Current Illness: unknown
Preexisting Conditions: hypogonadism, knee pain, erectile dysfunction
Allergies: no known allergies
Diagnostic Lab Data: right lower extremity venous ultrasound on 5/10 which showed DVT in the right common femoral, femoral, popliteal, and peroneal veins.
CDC Split Type:

Write-up: Patient had onset of right calf pain and swelling several hours after receiving vaccine. Was seen on 5/10 and diagnosed with right lower extremity DVT.


VAERS ID: 1332011 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-04-06
Onset:2021-05-04
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Cardiac function test, Computerised tomogram, Dizziness, Dysstasia, Intensive care, Nausea, Orthostatic hypotension, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Xaretel Flecainide aspirin Metropol amlodipine / benazepril crestor
Current Illness: Afib ... Had Web Sl implant for brain aneurysm last July ... might of had some type of infection
Preexisting Conditions: Same
Allergies: None
Diagnostic Lab Data: CT Scan lower body ...blood test ...a lot of heart test
CDC Split Type:

Write-up: Wasn?t able to stand up at all... nausea fainting dizziness etc... had to take rescue twice within 5 days... was in the ICCU unit at one point.. diagnosed with orthostatic hypotension


VAERS ID: 1332462 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-05-04
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Ear pain, Headache, Mastication disorder, Pain in jaw, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Osteonecrosis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210532841

Write-up: REALLY HARD TO CHEW AND NOT REALLY TO TALK BUT TO CHEW FOOD; EARACHE ON THE RIGHT SIDE OF MY FACE; PUFFY FACE; JAW PAIN; HEADACHE; This spontaneous report received from a patient concerned a 52 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 041A21A expiry: UNKNOWN) dose was not reported, administered on 04-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 04-MAY-2021, the subject experienced headache. On 05-MAY-2021, the subject experienced jaw pain. On 05-MAY-2021, the subject experienced earache on the right side of my face. On 05-MAY-2021, the subject experienced puffy face. On an unspecified date, the subject experienced really hard to chew and not really to talk but to chew food. The action taken with covid-19 vaccine was not applicable. The patient recovered from headache on 05-MAY-2021, had not recovered from jaw pain, earache on the right side of my face, and puffy face, and the outcome of really hard to chew and not really to talk but to chew food was not reported. This report was non-serious.


VAERS ID: 1332489 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-05-04
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210534744

Write-up: SORE ARM; This spontaneous report received from a patient concerned a 62 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: UNKNOWN) dose was not reported, administered on 04-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 04-MAY-2021, the subject experienced sore arm. The action taken with covid-19 vaccine was not applicable. The patient recovered from sore arm on 05-MAY-2021. This report was non-serious.


VAERS ID: 1332503 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-05-03
Onset:2021-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Oxygen saturation decreased
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: COPD; Emphysema
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19; Liver transplant
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: More breathing problems than normal/gasping; Oxygen level down to 80 after 1st dose; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (More breathing problems than normal/gasping) and OXYGEN SATURATION DECREASED (Oxygen level down to 80 after 1st dose) in a 68-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included COVID-19 in January 2021 and Liver transplant. Concurrent medical conditions included COPD and Emphysema. On 03-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-May-2021, the patient experienced DYSPNOEA (More breathing problems than normal/gasping) (seriousness criterion hospitalization) and OXYGEN SATURATION DECREASED (Oxygen level down to 80 after 1st dose) (seriousness criterion hospitalization). At the time of the report, DYSPNOEA (More breathing problems than normal/gasping) and OXYGEN SATURATION DECREASED (Oxygen level down to 80 after 1st dose) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. Treatment included oxygen. 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. The patient''s medical history of COPD and COVID-19 infection are confounders; 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. The patient''s medical history of COPD and COVID-19 infection are confounders


VAERS ID: 1332505 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-06
Onset:2021-05-04
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006BZ1A / 1 - / OT

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: EPIPEN; CELEXA [CELECOXIB]; SINGULAIR; NEXPLANON; OMEPRAZOLE; FLUTICASONE; ALBUTEROL [SALBUTAMOL]
Current Illness: Allergy to animal (Report mentions allergy to Cat dancer); Allergy to metals (No details); Allergy to vaccine; Asthma; Drug allergy (Risperdal); Drug allergy (Neomycin); Drug allergy (Depakote); Drug allergy (Ativan); Environmental allergy (No details); Latex allergy (No details)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Allergic Reaction following her second Moderna covid 19 vaccine; This case was received via VAERS (Reference number: 496918) on 05-May-2021 and was forwarded to Moderna on 05-May-2021. This spontaneous case was reported by a health care professional (subsequently medically confirmed) and describes the occurrence of HYPERSENSITIVITY (Allergic Reaction following her second Moderna Covid 19 vaccine) in a 19-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 0210Z1A and 006BZ1A) for COVID-19 vaccination. Concurrent medical conditions included Asthma, Allergy to animal (Report mentions allergy to Cat dancer), Allergy to metals (No details), Latex allergy (No details), Drug allergy (Neomycin), Drug allergy (Ativan), Environmental allergy (No details), Drug allergy (Risperdal), Drug allergy (Depakote) and Allergy to vaccine. Concomitant products included EPINEPHRINE (EPIPEN), CELECOXIB (CELEXA [CELECOXIB]), MONTELUKAST SODIUM (SINGULAIR), ETONOGESTREL (NEXPLANON), OMEPRAZOLE, FLUTICASONE and ALBUTEROL [SALBUTAMOL] for an unknown indication. On 06-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 04-May-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced HYPERSENSITIVITY (Allergic Reaction following her second Moderna covid 19 vaccine) (seriousness criterion life threatening). At the time of the report, HYPERSENSITIVITY (Allergic Reaction following her second Moderna covid 19 vaccine) had resolved. Patient presented to the emergency room by EMS for allergic reaction following her second Moderna covid 19 vaccine. She received her shot and began to feel her tongue swelling and she developed body wide itching. Patient received an injection of her Epi-pen at the facility and transferred to the emergency room. She was observed on a cardiac monitor for several hours and discharged home. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment for the events included administration of the patient''s prescribed Epi-pen. This was administered at the vaccine facility. The patient was subsequently transferred to the emergency room. The patient was on a cardiac monitoring in the emergency room for several hours and was ultimately discharged home. It was noted per source that COVID vaccination will now be listed as an allergy for the patient. Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 1332514 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-14
Onset:2021-05-04
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Small intestinal obstruction
SMQs:, Anaphylactic reaction (broad), Gastrointestinal obstruction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: small bowel obstruction; shortness of breath; This spontaneous case was reported by an other caregiver and describes the occurrence of SMALL INTESTINAL OBSTRUCTION (small bowel obstruction) in an 86-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Small bowel obstruction. Concurrent medical conditions included Emphysema. On 14-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-May-2021, the patient experienced DYSPNOEA (shortness of breath). On an unknown date, the patient experienced SMALL INTESTINAL OBSTRUCTION (small bowel obstruction) (seriousness criteria hospitalization and medically significant). The patient was hospitalized on 04-May-2021 due to SMALL INTESTINAL OBSTRUCTION. At the time of the report, SMALL INTESTINAL OBSTRUCTION (small bowel obstruction) and DYSPNOEA (shortness of breath) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications included an unspecified inhaler for emphysema. Treatment for the events included use of a tube and relive the pressure of the small bowel obstruction without surgery and an unspecified steroid medication to treat the shortness of breath. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1332709 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Vermont  
Vaccinated:2021-04-01
Onset:2021-05-04
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dysphagia, Ear discomfort, Oropharyngeal blistering, Oropharyngeal pain, Pharyngeal erythema, Pharyngeal ulceration, Throat lesion, Tongue ulceration
SMQs:, Severe cutaneous adverse reactions (broad), Agranulocytosis (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021503786

Write-up: redness in the back of the patient''s throat and blisters or ulcers; Redness in the back of the patient''s throat; He can talk a little bit better, but it''s still sore; Throat lesions; He developed this ulcer on his tongue and throat; He developed this ulcer on his tongue and throat; Difficulty swallowing; Ear feels plugged; This is a spontaneous report from contactable consumer (patient). A 67-year-old-male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date were not provided), via an unspecified route of administration on Apr2021 at 1st dose, single for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient experienced throat lesions on an unspecified date in 2021 which got worse over the weekend. He was able to speak to his healthcare professional (HCP) and recommended the second dose. He was prescribed amoxicillin for throat lesions and mentioned that he was on the way to the appointment for second dose. He asked if he could receive the second dose. The patient had his first vaccine about 1 month ago (Apr2021) and is due to get second dose today (05May2021) in about 30 minutes. The last few days (2021), he developed ulcer on his tongue and throat, difficulty swallowing, and his ear felt plugged. He went to the doctor on 04May2021 and the doctor said he saw redness in the back of the patient''s throat and blisters or ulcers and put him on an antibiotic. As the patient has been reading up more, he saw that was one of the symptoms being reported after the vaccine. He was wondering if he should or shouldn''t get the second dose as scheduled today relative to these events. It did seem like today he could talk a little bit better, but it''s still sore (2021). The outcome of the event throat lesion and throat ulcer was not recovered and unknown for all other events. No follow-up attempts are needed; information about lot/batch number cannot be obtained.


VAERS ID: 1332752 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-29
Onset:2021-05-04
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose, Blood glucose increased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SYMBICORT
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma
Allergies:
Diagnostic Lab Data: Test Name: Blood sugar test; Result Unstructured Data: Test Result:between 100 to 129; Comments: between 100 to 129 before the shot; Test Date: 20210504; Test Name: Blood sugar test; Result Unstructured Data: Test Result:266; Comments: around 266
CDC Split Type: USPFIZER INC2021508781

Write-up: My sugar level used to be between 100 to 129 before the shot. after taking covid 19 vaccine when i got my blood test it came around 266.; This is a spontaneous report received from a contactable consumer (patient). A 48-year-old male patient received BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration administered in left arm on 29Mar2021 13:30 (Batch/Lot Number: EP7534) (age at vaccination: 48 years old) as single dose for COVID-19 immunisation. Medical history included asthma from an unknown date and unknown if ongoing. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient had previously received the first dose of BNT162b2 on 10Mar2021 07:30 (Batch/Lot Number: EN6206) for COVID-19 immunisation. Concomitant medication(s) included budesonide, formoterol fumarate (SYMBICORT) taken for an unspecified indication, start and stop date were not reported. The patient''s sugar level used to be between 100 to 129 before the shot. After taking the COVID-19 vaccine, he got blood test it came around 266, on 04May2021 07:45. No treatment was received for the event. The event resulted in doctor or other healthcare professional office/clinic visit. The outcome of the event was unknown.


VAERS ID: 1332763 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-01-21
Onset:2021-05-04
   Days after vaccination:103
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Atelectasis, Bronchitis, Chest X-ray, Computerised tomogram thorax, Fibrin D dimer, Fibrin D dimer increased, Oxygen saturation, Pulmonary embolism, Respiratory disorder
SMQs:, Haemorrhage laboratory terms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Respiratory failure (broad), Infective pneumonia (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: COSENTYX
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19; Psoriatic arthritis (from 10 years; he started Cosentyx three or four weeks before reporting)
Allergies:
Diagnostic Lab Data: Test Date: 20210504; Test Name: Chest X-ray; Result Unstructured Data: Test Result:left lower lobecatelectasis; Test Date: 20210504; Test Name: chest CT; Result Unstructured Data: Test Result:bilateral pulmonary embolism; Comments: at 1:00PM; Test Date: 20210504; Test Name: D Dimer; Result Unstructured Data: Test Result:1.95; Test Date: 20210504; Test Name: Pulse oximetry; Test Result: 92 %
CDC Split Type: USPFIZER INC2021509823

Write-up: Upper respiratory tract something going on; possible bronchitis; Left lower lobe atelectasis; D Dimer that was positive, reading 1.95; Pulmonary embolism; This is a spontaneous report from a contactable consumer (patient). A 62-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, batch/lot number and expiration date unknown) via an unspecified route of administration at left arm on 21Jan2021 07:30 (62-year-old at time of vaccination), at single dose, for COVID-19 immunization. The patient''s medical history included psoriatic arthritis from 10 years (he started Cosentyx three or four weeks before reporting) and COVID virus from Nov2020. Concomitant medications included secukinumab (COSENTYX) from three or four weeks before reporting for psoriatic arthritis. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL1284) via an unspecified route of administration at left arm on 31Dec2020 07:30 (62-year-old at time of vaccination), at single dose, for COVID-19 immunization. Prior vaccinations within 4 weeks was none. Patient states he just wanted to report; and he didn''t know if this is significant. Patient reports now he has bilateral pulmonary embolism (from 04May2021) along with an upper respiratory tract something going on. Adds he never had this before. The doctor for his possible bronchitis has him on Omnicef and started Xarelto. Adds they were lucky to find the pulmonary embolism. Mentions the doctor tried a different antibiotic first, Keflex (NDC 68180 0122 02), and it was not helping. The doctor noticed his pulse oximeter (on 04May2021) reading was 92% and did a chest x ray. The chest x ray (on 04May2021) showed left lower lobe atelectasis. The doctor said that would not account for the low pulse oximeter of 92%. She sent him for a D Dimer (on 04May2021) that was positive, reading 1.95; and then had a chest CT at 1:00PM on Tuesday (04May2021), that showed the bilateral pulmonary embolism. Adverse events required a visit to physician office (received outpatient tests). Therapeutic measures were taken as a result of the event possible bronchitis and included Omnicef and Xarelto. The outcome of the events was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1332764 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-13
Onset:2021-05-04
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWD162 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Gait inability, SARS-CoV-2 test
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre 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? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Knee replacement; Liver transplant (Verbatim:Liver transplant recipient)
Allergies:
Diagnostic Lab Data: Test Date: 20210505; Test Name: COVID-19; Result Unstructured Data: Test Result:Unknown result
CDC Split Type: USPFIZER INC2021510131

Write-up: Tired; Could not walk; This is a spontaneous report from a contactable consumer (patient). A 70-year-old female patient (not pregnant) received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) 1st dose (lot number EWD162 ) on 13Apr2021 13:00, 2nd dose (lot number EWD150) on 04May2021 12:15, both via an unknown route in left arm for Covid-19 immunization. Medical history included liver transplant recipient, and knee replacement, allergies with torvastatin (LIPITOR) and simvastatin. Concomitant drug was not provided. Patient received other medications within 2 weeks of vaccination. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Serious adverse event was reported as tired and could not walk with onset date of 04May2021 21:00 and seriousness criterion of hospitalizing of 5 days. The clinical course was reported as follows: In the evening of the same date as vaccinated, the patient became tired and could not walk. She was transported to the Emergency Room of Hospital for treatment and was admitted for further testing, observation and treatment; she remained in that hospital. Prior to vaccination, the patient was not diagnosed with COVID-19. Nasal Swab on 5May2021 result was unknown. Outcome of the events was resolving. Information on lot/batch number has been requested.


VAERS ID: 1332782 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-05-04
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021514588

Write-up: fully vaccinated and they still got sick/COVID vaccine inefficacy; fully vaccinated and they still got sick/COVID vaccine inefficacy; This is a spontaneous report from a contactable other HCP. A 62-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as UNKNOWN, SINGLE for covid-19 immunisation. The patient medical history was not reported. The patient''s concomitant medications were not reported. The patient was fully vaccinated and still got sick/COVID vaccine inefficacy (medically significant) on 04May2021 with outcome of unknown. Causality was reported as Related. No follow-up attempts are needed; information about lot/batch number cannot be obtained.; Sender''s Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events of COVID-19 and suspected LOE. There is limited information provided in this report. This case will be reassessed once additional information is available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.


VAERS ID: 1332855 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-27
Onset:2021-05-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Pulmonary embolism, Pulmonary infarction, SARS-CoV-2 test
SMQs:, Embolic and thrombotic events, venous (narrow), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? 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: 20210505; Test Name: COVID-19 virus test (nasal swab); Test Result: Negative
CDC Split Type: USPFIZER INC2021548233

Write-up: multiple pulmonary embolisms in both lungs; Lung infarction occurred in left lung; This is a spontaneous report from a contactable consumer (patient). A 30-year-old female patient received the 2nd dose of bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), via an unspecified route of administration in arm left, on 27Apr2021 at 08:00 AM at 30 years (Lot# EW0169) as single dose, for COVID-19 immunisation. The patient was not pregnant and was not pregnant at time of vaccination. Medical history was none. Patient had no known allergies. It was unknown if patient experienced COVID-19 prior to vaccination. Concomitant medication in two weeks included multivitamin. The patient did not receive any other vaccine in four weeks. Previously the patient received the 1st dose of bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech) for COVID-19 immunisation on 06Apr2021 at 01:30 PM in left arm (Lot# ER8734) at 30 years. The patient experienced multiple pulmonary embolisms in both lungs (caused hospitalization, life threatening) on 04May2021 at 03:00 PM with outcome of recovering, lung infarction occurred in left lung (caused hospitalization, life threatening) on 04May2021 at 03:00 PM with outcome of recovering. The patient was hospitalized from 05May2021 to 08May2021. The events also required emergency room visit. Patient was tested for COVID-19 post vaccination (nasal swab): negative on 05May2021. Therapeutic measures were taken as a result of the events and included treatment with Lovenox injections, pain management, oral blood thinner.


VAERS ID: 1332875 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-27
Onset:2021-05-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Feeling hot, Hypoaesthesia, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (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: none
CDC Split Type:

Write-up: "Covid arm" Moderate left arm swelling, itching, warmth, and numbness that appeared approximately 1 week after vaccination. Symptoms resolved on its own over the course of 6 days after initial onset.


VAERS ID: 1333240 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-27
Onset:2021-05-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Full blood count, Inflammation, Metabolic function test, Myalgia, Urine analysis
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: asa, azelastine, cialsis, testosterone, propranolol, b-complex, zinc, copper
Current Illness: none
Preexisting Conditions: htn.
Allergies: none
Diagnostic Lab Data: cmp, cbc, ua (all done at the er)
CDC Split Type:

Write-up: beginning on 05/04/21 developed severe and disabling polymyalgia and poly arthralgia : was seen at urgent care twice and a local er once. we all agree this is likely an autoimmune inflammatory response to the vaccine. the patient has been placed on steroids with good response and pain reduction.


VAERS ID: 1333603 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-18
Onset:2021-05-04
   Days after vaccination:47
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Diarrhoea, Pyrexia, SARS-CoV-2 test positive, Tachypnoea
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ascorbic acid, aspirin 81 mg, carbamazepine, carvedilol, cefepime injection, escitalopram, ferrous sulfate, isosorbide mononitrate, megestrol, pantoprazole, pregabalin, sucralfate, tamoxifen, torsemide.
Current Illness:
Preexisting Conditions: Malnutrition, chronic anemia, pancreatic adenoma, GERD, neuropathy, stage IV CKD, CHF, HTN, cancer hx below.
Allergies: NKA
Diagnostic Lab Data: Novel coronavirus PCR- SARS-COV-2 detected (5/4/2021)
CDC Split Type:

Write-up: Pt is a 61 yo female with recurrent granulosa cell tumor (s/p secondary debulking/whipple in 2019), stage II colon cancer, and stage IA cancer s/p radiation on tamoxifen/megage, with history of short gut on chronic TPN. On admission (5/4) she presented with weakness, diarrhea, and fever. Pt was tachypnic to 40s, 1L NC with O2 sat $g 90% on admission. RR improved and she was eventually weaned to room air. The COVID PCR on admission resulted positive. She is s/p full Pfizer vaccination: first dose on 2/25 and second dose on 3/18. Pt remained stable on room air for the rest of her stay and received remdesivir for 5 total days.


VAERS ID: 1333833 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Amnesia, Aphasia, Confusional state, Dialysis, Feeling hot, General physical condition abnormal, Intensive care, Life support, Memory impairment, Multi-organ disorder, Ocular hyperaemia, Pyrexia, Tremor
SMQs:, Acute renal failure (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Chronic kidney disease (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: They do a lot of test every day
CDC Split Type:

Write-up: After vaccine by 6pm husband had high fever all night long, we woke up he took Tylenol and fever went down. He went out side for a little bit, his body temperature was still hot without chills and this lasted for 3 days and night. I talked to the pharmacist and he recommended Ibuprofen and I gave it to him for two days but he kept the fever. He started shaking and by the 5th day I took him to the clinic and both his eyes were red and hands and feet were hot. I was told to take him home because all vital signs were ok, but I took him back to the ER on day 8 because he was not getting better, they said he had multi organ issues and now he''s confused and he doesn''t know who I am or where he is and cannot remember and confused. He is now on dialysis and he was on life support, he was never hospitalized or taken prescription drugs and now he''s in this condition. He is still in ICU and his body looks so weird. He don''t remember words or when I talk to him.


VAERS ID: 1333901 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-29
Onset:2021-05-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0612 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal distension, Angiogram pulmonary abnormal, Arteriosclerosis coronary artery, Atelectasis, Atrial fibrillation, Back pain, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chest discomfort, Chills, Computerised tomogram abdomen abnormal, Computerised tomogram pelvis abnormal, Cough, Diarrhoea, Diverticulum, Dyspnoea, Fatigue, Fibrin D dimer increased, Fibrosis, Hepatic steatosis, Hiatus hernia, Lung infiltration, Lung opacity, Malaise, Mitral valve calcification, Oesophageal stenosis, Oesophagitis, Pain, Palpitations, Platelet count decreased, Pyrexia, SARS-CoV-2 test positive, Scan with contrast abnormal, Spleen disorder, Thrombocytopenia, Wheezing
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal obstruction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol 2.5 mg /3 mL (0.083 %) nebulizer solution amLODIPine (NORVASC) 2.5 mg tablet apixaban (ELIQUIS) 5 mg tablet calcitonin, salmon, (MIACALCIN) 200 unit/actuation nasal spray calcium carbonate-vitamin D3 (CALTRATE 600 PLUS D) 600 mg (
Current Illness:
Preexisting Conditions: Respiratory Asthma without status asthmaticus Allergic rhinitis Pneumonia due to COVID-19 virus Circulatory Essential hypertension Paroxysmal atrial fibrillation Atrial fibrillation with RVR Digestive Gastroesophageal reflux disease Esophageal stricture Genitourinary Stage 3 chronic kidney disease Musculoskeletal Generalized osteoarthritis Osteochondropathy Degeneration of intervertebral disc Endocrine/Metabolic Hyperlipidemia Hematologic Macrocytic anemia Thrombocytopenia Immune Systemic lupus erythematosus Sjogren''s syndrome Other Insomnia
Allergies: Meloxicam PenicillinsHives / Urticaria TramadolNausea and Vomiting Duloxetine Gabapentin Omeprazole Statins-hmg-coa Reductase Inhibitors
Diagnostic Lab Data: 05/05/21 0450 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 05/04/21 1110 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical Procedure Component Value Ref Range Date/Time X-ray chest 1 view, Portable [3282535447] Resulted: 05/14/21 1306 Order Status: Completed Updated: 05/14/21 1306 Narrative: XR CHEST 1 VW PORT IMPRESSION: There are bilateral patchy interstitial and airspace opacities as well as small bibasilar effusions for which developing pneumonia is suspected. END OF IMPRESSION: INDICATION: High fever rule out bacterial pneumonia in the setting of COVID-19. 81 years TECHNIQUE: AP chest COMPARISON: 5/10/2021 FINDINGS: The heart is normal in size. There are bilateral interstitial and patchy airspace opacities. There is a blunted configuration of the costophrenic angles bilaterally. There is no pneumothorax. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. Fluoroscopy esophagram complete [3281995185] Resulted: 05/10/21 1643 Order Status: Completed Updated: 05/10/21 1644 Narrative: FL ESOPHAGRAM COMPLETE IMPRESSION: Study limited due to patient''s inability to swallow appropriate amount of effervescent and barium. Within this limitation, there is suggestion of stricturing in the distal esophagus. END OF IMPRESSION: INDICATION: Abnormal CT. 81 female TECHNIQUE: A PA image of the chest was obtained for preliminary purposes. Barium products and effervescent agent were administered to the patient. Fluoroscopy and plain film evaluation were performed. FLUOROSCOPY TIME: 1.9 minutes COMPARISON: 4/3/2013 FINDINGS: Study limited by patient''s mobility. There was passage of barium into the esophagus. However there is some narrowing of the esophagus distally near the gastroesophageal junction. There is moderate tertiary wave contractions distally. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view [3282317380] Resulted: 05/10/21 1146 Order Status: Completed Updated: 05/10/21 1146 Narrative: XR CHEST 1 VW PORT IMPRESSION: 1. Small focal area of increased density in the left costophrenic angle likely representing scarring, volume loss or infectious consolidation such as pneumonia. 2. No other significant interval change. END OF IMPRESSION: INDICATION: fever. TECHNIQUE: Portable view(s) of the chest are provided. COMPARISON: 9/4/2019 FINDINGS: The lungs are adequately inflated. Increased density is noted in the left costophrenic angle. This may represent scarring, volume loss or infectious consolidation such as pneumonia. No pneumothorax seen. The cardiac silhouette, pulmonary vasculature and bony thorax are without significant interval change. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. CT angiogram chest pulmonary embolism with and without contrast [3281802645] (Abnormal) Resulted: 05/06/21 0216 Order Status: Completed Updated: 05/06/21 0216 Narrative: PROCEDURE INFORMATION: Exam: CTA Chest Without And With Contrast Exam date and time: 5/6/2021 1:01 AM Age: 81 years old Clinical indication: Cough; Additional info: Shortness of breath with covid TECHNIQUE: Imaging protocol: Computed tomographic angiography of the chest without and with contrast. 3D rendering (Not supervised by radiologist): MIP and/or 3D reconstructed images were created by the technologist. Radiation optimization: All CT scans at this facility use at least one of these dose optimization techniques: automated exposure control; mA and/or kV adjustment per patient size (includes targeted exams where dose is matched to clinical indication); or iterative reconstruction. Contrast material: OMNI 350; Contrast volume: 75 ml; Contrast route: INTRAVENOUS (IV); COMPARISON: DX RAD RIBS LT 9/4/2019 11:59 AM FINDINGS: Pulmonary arteries: Normal. No pulmonary emboli. Aorta: Atherosclerosis. No aortic aneurysm. No aortic dissection. Lungs: There are mild alveolar infiltrates identified bilaterally in the perihilar and lower lobe regions in a pattern which is nonspecific but suggests a pneumonia which may be viral. Pleural spaces: Unremarkable. No pneumothorax. No pleural effusion. Heart: Vascular calcifications including coronary artery calcifications. Mediastinal space: Wall thickening of the thoracic esophagus is noted with some filling defect proximally correlate for esophagitis with debris. The oral contrast may be helpful as indicated clinically. Lymph nodes: Unremarkable. No enlarged lymph nodes. Bones/joints: Degenerative change in the spine. Soft tissues: Unremarkable. IMPRESSION: 1. There are mild alveolar infiltrates identified bilaterally in the perihilar and lower lobe regions in a pattern which is nonspecific but suggests a pneumonia which may be viral. 2. Wall thickening of the thoracic esophagus is noted with some filling defect proximally correlate for esophagitis with debris. Oral contrast may be helpful as indicated clinically. 3.Vascular calcifications including coronary artery calcifications. CT abdomen pelvis with contrast [3281802646] (Abnormal) Resulted: 05/06/21 0213 Order Status: Completed Updated: 05/06/21 0213 Narrative: PROCEDURE INFORMATION: Exam: CT Abdomen And Pelvis With Contrast Exam date and time: 5/6/2021 1:01 AM Age: 81 years old Clinical indication: Abdominal pain; Generalized TECHNIQUE: Imaging protocol: Computed tomography of the abdomen and pelvis with contrast. Radiation optimization: All CT scans at this facility use at least one of these dose optimization techniques: automated exposure control; mA and/or kV adjustment per patient size (includes targeted exams where dose is matched to clinical indication); or iterative reconstruction. Contrast material: OMNI 350; Contrast volume: 75 ml; Contrast route: INTRAVENOUS (IV); COMPARISON: CT ABD PEL WWO 2/13/2015 2:22 PM FINDINGS: Lungs: Atelectasis or fibrosis is noted in the bases. Heart: Mitral annular calcifications Mediastinal space: Small hiatal hernia Liver: fatty liver Gallbladder and bile ducts: cholecystectomy The bile ducts are prominent which are probably reflective of the cholecystectomy reservoir effect. Pancreas: Normal. No ductal dilation. Spleen: Known numerous lesions have developed in the spleen which are indeterminate. Correlate for infection or neoplasm. Adrenal glands: Normal. No mass. Kidneys and ureters: Normal. No hydronephrosis. Stomach and bowel: There is colonic diverticulosis identified which appears to be most prominent in the sigmoid. A few air-fluid levels in the colon with liquid stool and equivocal enhancement correlate for any sign of colitis particularly transverse colonic segments. In addition, some of the small bowel in the deep pelvis is somewhat thick-walled. Possible enterocolitis. Appendix: No evidence of appendicitis. Intraperitoneal space: Trace fluid in the pelvis. Vasculature: Unremarkable. No abdominal aortic aneurysm. Lymph nodes: Unremarkable. No enlarged lymph nodes. Urinary bladder: Diffuse urinary bladder wall thickening is noted correlate for lack of distention or cystitis. Reproductive: Unremarkable as visualized. Bones/joints: Degenerative change in the spine. Soft tissues: Unremarkable. IMPRESSION: 1. Diffuse urinary bladder wall thickening is noted correlate for lack of distention or cystitis. 2. A few air-fluid levels in the colon with liquid stool and equivocal enhancement correlate for any sign of colitis particularly transverse colonic segments. In addition, some of the small bowel in the deep pelvis is somewhat thick-walled. Possible enterocolitis. 3. Known numerous lesions have developed in the spleen which are indeterminate. Correlate for infection or neoplasm.
CDC Split Type:

Write-up: Office Visit 5/4/2021 screening laboratory testing for COVID-19 virus +1 more Dx Cough ? Diarrhea ? Fatigue Reason for Visit ED to Hosp-Admission Discharged 5/5/2021 - 5/17/2021 (12 days) Last attending Treatment team Pneumonia due to COVID-19 virus Principal problem Hospital Problems POA * (Principal) Pneumonia due to COVID-19 virus Yes Asthma without status asthmaticus Yes Systemic lupus erythematosus (CMS/HCC) Yes Overview Signed 12/1/2020 7:46 AM Note: Document: 08/22/19 - Consults Rheumatology Paroxysmal atrial fibrillation (CMS/HCC) Yes Atrial fibrillation with RVR (CMS/HCC) Yes Esophageal stricture Yes Hospital Course HPI: patient is an 81 y.o. female with pmh of COPD and HTN presented to the ER with complaint of palpitations. She reports since her second covid short on 4/29, she''s been feeling "ill." she states she''s been having diarrhea, chills, fatigue, and cough. In the ER, she was found to be in afib with RVR. She was given a one time dose of cardizem but then spontaneously converted to NSR. She is not hypoxic but admits to increased cough and occasional dyspnea. CTA was done in the ER due to elevated D dimer. Pulm embolism was ruled out, however, she was found to have bilateral infiltrates concerning for viral pna Hospital Course: Please send details from consultation note from hematology gastroenterology 81-year-old Caucasian female she had a history of COPD hypertension she was admitted through the emergency room on May 6 with a chief complaint of palpitation chest discomfort. She was found to have A. fib with RVR with underlying history of paroxysmal atrial fibrillation. Patient was admitted and atrial fibrillation is rate controlled in maintain with increase his Lopressor. ACS is ruled out by cardiac enzyme patient was found to have a COVID-19 pneumonia fortunately patient oxygen saturation remained good continue having mild cough. And initially she was not started any dexamethasone or any antiviral remdesivir. But over the time patient actually having mild wheezing shortness of breath but oxygen saturation remained stable so then dexamethasone was started. Heart rate was pretty controlled with current medication Lopressor anticoagulation did not start since patient was found to have a severe thrombocytopenia. Patient was seen by hematologist recommend to bone marrow biopsy thought that the sudden drop possible from infectious source. So then that point Heparin Olympic Eliquis was not started. Over the time patient platelet count back to normal platelet count 1 75,000 Eliquis started 2 days ago. Since she looked tolerating Eliquis heart rate is well controlled after adding dexamethasone she is underlying history of COPD her wheezing is much improved and she is currently on DuoNeb. In the history of asthma without status asthmaticus patient will be discharged home with continue current medication Decadron for 5 more days started Eliquis 5 mg 2 times daily since she is tolerating and platelet count is normal I recommend to check CBC for platelet count in 5 days. This patient will benefit to see hematologist outpatient although she refused to do a bone marrow biopsy. She is having chronic low back pain and currently on narcotics recommend to follow-up with PCP to change his narcotic medication.. Initially she had a CTA chest done which was normal although D-dimer was mildly elevated negative for pulmonary embolism and a mild infiltration concerning viral pneumonia so bacterial antibiotic was not started. Stable to be discharged home she was having intermittent low-grade fever for almost like 5 to 10 days. The fever is totally gone now. She is clinically stable new medication is adjusting increase Lopressor 50 mg 2 times daily. Eliquis 5 mg p.o. twice daily and she is going to go home with Decadron only for 5 days.. Patient also have underlying history of chronic dysphagia patient was seen by gastroenterology recommend to follow-up outpatient in 2 to 3 weeks Follow-up PCP in 5 days, follow-up with hematology as scheduled


VAERS ID: 1333925 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-23
Onset:2021-05-04
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Adenovirus test, Atypical pneumonia, COVID-19, Chest X-ray abnormal, Coronavirus test negative, Cough, Diarrhoea, Human metapneumovirus test, Hypokalaemia, Hypoxia, Influenza A virus test negative, Influenza B virus test, Lung infiltration, Lung opacity, Pneumonia mycoplasmal, Pneumonia viral, Respiratory syncytial virus test negative, SARS-CoV-2 test positive, Sepsis, Tachycardia, Tachypnoea
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 mg tablet albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler benzonatate (TESSALON) 100 mg capsule multivitamin 400 mcg tablet predniSONE (DELTASONE) 10 mg tablet
Current Illness:
Preexisting Conditions: Respiratory Persistent dry cough Digestive Diarrhea Obesity Musculoskeletal Hidradenitis suppurativa Pes anserinus bursitis of left knee Primary osteoarthritis of left knee Endocrine/Metabolic Hypokalemia Infectious/Inflammatory COVID-19 virus infection Other Abnormal mammogram Multiple allergies Breast mass, left
Allergies: NKA
Diagnostic Lab Data: 05/07/21 0232 Respiratory virus detection panel Collected: 05/07/21 0123 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Synctial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected Pertinent Test Results: XR CHEST 1 VW PORT IMPRESSION: Patchy bilateral opacities consistent with atypical pneumonia. This nonspecific imaging pattern can be seen with Covid-19. Other considerations include but are not limited to other infectious etiologies or noninfectious etiologies. END OF IMPRESSION: INDICATION: cough cp sob.Rule out SARS-CoV-2( related to COVID-19) contact, Droplet isolation. TECHNIQUE: Portable AP view of the chest was obtained. COMPARISON: None available. FINDINGS: The cardiac silhouette is normal in size.
CDC Split Type:

Write-up: Clinical Support, 5/4/2021, Family Medicine - LPN, Close exposure to COVID-19 virus, Dx, Covid-19 Screening Reason for Visit. ED to Hosp-Admission Discharged 5/6/2021 - 5/8/2021 (2 days), Hospital, DO, Last attending, Treatment team COVID-19 virus infection, Principal problem, Medical Problems , Hospital Problems, POA, (Principal) COVID-19 virus infection- Yes, Hypokalemia- Yes, Diarrhea- Yes. Presenting Problem/History of Present Illness/Reason for Admission Hypoxia [R09.02] COVID-19 virus infection [U07.1] Severe sepsis Hospital Course, Pleasant 55-year-old female admitted to the hospital with signs of severe sepsis with associated acute hypoxic respiratory failure. Was found to be febrile, tachycardia, tachypneic, hypoxic on admission. Chest imaging did reveal patchy infiltrates consistent with viral pneumonia. Was diagnosed with COVID-19. Started on antiviral, corticosteroid, and received antibiotic therapies while in hospital. Improved significantly over the course of 2 days and was able to titrate back to room air. I recommended discharge home, she will continue to isolate until 14 days from initial diagnosis. Recommended the use of albuterol as needed, and she will continue a taper of prednisone. She will follow-up with PCP in 7 to 10 days


VAERS ID: 1334809 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-01-01
Onset:2021-05-04
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Eye haemorrhage, Ocular hyperaemia, Swelling of eyelid
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Glaucoma (broad), Retinal disorders (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Burst blood vessel hemorrhage and is small; eyelids were a little bit swollen; Right eye is red; This spontaneous case was reported by a consumer and describes the occurrence of EYE HAEMORRHAGE (Burst blood vessel hemorrhage and is small) in a 67-year-old female patient 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. In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In February 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1. On 04-May-2021, the patient experienced EYE HAEMORRHAGE (Burst blood vessel hemorrhage and is small) (seriousness criterion medically significant), SWELLING OF EYELID (eyelids were a little bit swollen) and OCULAR HYPERAEMIA (Right eye is red). At the time of the report, EYE HAEMORRHAGE (Burst blood vessel hemorrhage and is small), SWELLING OF EYELID (eyelids were a little bit swollen) and OCULAR HYPERAEMIA (Right eye is red) outcome was unknown. Not Provided Concomitant product use was not provided by the reporter. Treatment information was not provided. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. This case was linked to MOD-2021-109540, MOD-2021-109560 (E2B Linked Report).; 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. MOD-2021-109540: MOD-2021-109560:


VAERS ID: 1334898 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-20
Onset:2021-05-04
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Exposure during pregnancy, Haemorrhage, Sleep disorder, Transfusion, Uterine contractions during pregnancy, Vacuum extractor delivery
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prenatal vitamin
Current Illness: small infection on my toe - course of antibiotics - was finished by the time of vaccine
Preexisting Conditions: no
Allergies: penicillin; Neosporin; bacitracin
Diagnostic Lab Data: Hospital - any relating to the delivery etc.
CDC Split Type: vsafe

Write-up: May 4th - Therapeutic rest - had been having contractions for a couple of days and hadn''t had sleep- admitted to hospital. May 6 baby was born. I was full term - 40 weeks and six days. I was in labor and admitted for labor and delivery. Baby was born with a vacuum assist and had some risk for jaundice but didn''t get a jaundice diagnosis. Small for gestation age - Baby''s size - 6 lbs and 9 oz. I had some blood loss and did have a blood transfusion after deliver. It was my first pregnancy.


VAERS ID: 1334901 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-03
Onset:2021-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Hot flush, Neurological examination, Night sweats, 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: herbal suppliment-St. Johns Wort-just started this a day or two prior-very small dose.
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Biaxin-Form of antibiotic-not sure if that is the correct name.
Diagnostic Lab Data: I visited with my Family doctor on 5/12. A simple neurological exam was performed to weed out possible blood clots.
CDC Split Type:

Write-up: Dull head pain located at the front of the head to the temples, almost like when you have a fever but without a temperature. Severe night sweats, and have had hot flashes around the ears a few times. This has been going on since the evening of my vaccine. The head pain is constant and the night sweats have occurred almost every night. On night one the head pain was moderate.


VAERS ID: 1334942 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-29
Onset:2021-05-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

Administered by: Other       Purchased by: ?
Symptoms: Inflammation, Sudden hearing loss
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: LO LOESTRIN FE; ZYRTEC [CETIRIZINE HYDROCHLORIDE]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Meniere''s disease
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021504756

Write-up: Sudden hearing loss in both ears 5 days after 2nd vaccination.; inflammation; This is a spontaneous report from a non-contactable consumer (patient). A 46-year-old non-pregnant female patient received bnt162b2 (BNT162B2 reported as PFIZER COVID-19 VACCINE), dose 2 at vaccination age of 46-year-old via an unspecified route of administration in the right arm on 29Apr2021 09:30 (Batch/Lot number was not reported) as 2nd dose, single for covid-19 immunisation. Medical history included meniere''s disease. The patient has no known allergies. The patient was not diagnosed with Covid-19 prior to vaccination. The patient received the first dose of bnt162b2 (BNT162B2 reported as PFIZER COVID-19 VACCINE) at vaccination age of 46-year-old on 09Apr2021 at 10:30 AM in the left arm for Covid-19 immunisation. Concomitant medications included cetirizine hydrochloride (ZYRTEC); and ethinylestradiol, ferrous fumarate, norethisterone acetate (LO LOESTRIN FE), both indications and therapy dates were not reported. The patient did not have other vaccine in four weeks. The patient received the vaccine in a doctor''s office/urgent care. On 04May2021 07:30 AM, the patient experienced sudden hearing loss in both ears 5 days after 2nd vaccination. The event resulted in doctor or other healthcare professional office/clinic visit and received the treatment of steroid to relieve inflammation (04May2021 07:30 AM). The patient has not been tested post vaccination. The outcome of the event sudden hearing loss was recovering while the outcome of the other event was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1337279 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Malaise
SMQs:

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

Write-up: Patient stated " I don''t feel ok'' EMS came by patient side. Lead staff been aware of it. Patient vitals took by EMS BP 118/86, HR 61, O2 96. After 10 minutes lay flat and vitals taken. Patient Stated I feel good. Patient refused to go to the hospital.


VAERS ID: 1337315 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 a seizure.


VAERS ID: 1337461 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood smear test, Differential white blood cell count, Full blood count, Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: APAP 650mg PO Q4-6H PRN, Imbruvica 420mg PO QD, losartan 100mg PO QD, melatonin 10mg PO QHS, tamsulosin 0.4mg PO QPM,
Current Illness: UTI
Preexisting Conditions: Anemia, hereditary motor/sensory neuropathy, non-Hodgkins''s lymphoma, obstructive and reflux uropathy, OSA, enlarged prostate with LUTS, prediabetes, hypertension,
Allergies: Adhesive tape
Diagnostic Lab Data: CBC w/diff and peripheral blood smear, pending
CDC Split Type:

Write-up: Pt developed petechiae on BLEs the same day he was given the vaccine (5/4/2021) and the petechiae started to improve 3-4 days later. No other adverse symptoms reported.


VAERS ID: 1337716 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816025 / 1 - / 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient received Janssen vaccine and was under age 18. Patient did well no issues post vaccination


VAERS ID: 1337882 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Paranoia, Schizophrenia
SMQs:, Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (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, 17 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Presented to the ED by her son for paranoia related to schizophrenia; no medical complaints


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