National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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 177 out of 3,232

Result pages: prev   78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276   next


VAERS ID: 1311183 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-27
Onset:2021-05-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Interchange of vaccine products, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Medication errors (broad), 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? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Severe headache, fever and pain in both legs. Will need to be on Eliquis for 2 weeks. She also mentioned she got Pfizer 7 weeks ago but they ran out of the vaccine so she couldn''t get her second dose.


VAERS ID: 1311193 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Body temperature increased, Chest discomfort, Chills, Headache, Heart rate increased, Laboratory test, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: HCTZ, Lisinopril, Vitamin C, Vitamin D, Calcium, Osteobiflex with Turmeric
Current Illness: None
Preexisting Conditions: HTN
Allergies: PCN
Diagnostic Lab Data: Blood cultures (negative), COVID swab (negative), numerous labs done. Given 2L LR, Tylenol p.o., Potassium p.o., Tordol IV, Given option to be admitted for continued observation, or go home to return if symptoms return. Discharged aprox. 02:30 AM. Had follow up visit with Primary Care MD today.
CDC Split Type:

Write-up: Rigors, severe Headache, rapidly increasing temperature (102.5), pulse rose above 130, BP slightly elevated, chestbpressure (no pain). Went to ER at 09:15pm.


VAERS ID: 1311327 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-01
Onset:2021-05-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 RA / IM

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

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

Write-up: I63.9 - Acute CVA (cerebrovascular accident) (CMS/HCC)


VAERS ID: 1312769 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-05-03
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Cough, Dizziness, Feeling abnormal, Lower respiratory tract infection, Malaise, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210509350

Write-up: CHEST COLD; FEELING SICK; FEVER; PRESSURE IN CHEST; COUGHING ON AND OFF; DIZZINESS; NOT FEELING GREAT; SORE ARM; This spontaneous report received from a consumer concerned a 27 year old white, hispanic or latino male. 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: 203A21A, expiry: 23/JUN/2021) dose was not reported,1 total administered administered on 03-MAY-2021, 17:00 for prophylactic vaccination. No concomitant medications were reported. On 03-MAY-2021, after 30 to 50 minutes of vaccination, the patient started feeling not sober, dizzy, not feeling great and sore arm. On 04-MAY-2021, (Tuesday), the patient woke up feeling really sick, feeling feverish then felt better during the afternoon (around 5 pm). The patient felt like he had a chest cold, he was clearing his throat more often, feels a kind of pressure in his chest (but no shortness of breath) and was coughing on and off. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from dizziness, feeling sick, and fever on 04-MAY-2021, had not recovered from cough, and pressure in chest, and the outcome of sore arm, chest cold and feeling bad was not reported. This report was serious (Other Medically Important Condition). This case, from the same reporter is linked to 20210509097 (same reporter).; Sender''s Comments: V0;20210509350-covid-19 vaccine ad26.cov2.s-Chest Cold. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1312777 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Idaho  
Vaccinated:0000-00-00
Onset:2021-05-03
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Medication 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: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210513592

Write-up: VACCINE LEFT OUT OVER NIGHT ABOUT 12 HOURS BEFORE ADMINISTRATION; MEDICATION ERROR; This spontaneous report received from a pharmacist concerned a patient of unspecified age and sex. 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, and batch number were not reported) dose was not reported, administered on 03-MAY-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 03-MAY-2021, the subject experienced left out over night about 12 hours. On 03-MAY-2021, the subject experienced medication error. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the medication error and left out over night about 12 hours was not reported. This report was non-serious. This case, from the same reporter is linked to 20210512313.


VAERS ID: 1313532 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-03
Onset:2021-05-03
   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 ER8736 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Limb injury, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Arthritis (broad)

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

Write-up: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)


VAERS ID: 1313550 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-29
Onset:2021-05-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: shingles shortly after vaccine


VAERS ID: 1314039 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-02
Onset:2021-05-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Chills, Epistaxis, Malaise, Pain, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (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: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt. got sick in the middle of the night after receiving his second vaccine. He had a fever, chills, body aches. He is a very physically fit teenager who is active in weight lifting, football and wrestling. His blood pressure is now high, and he has had 9 nose bleeds in 11 days. Currently his pediatrician, Dr. is tracking his blood pressure. He has not fully recovered and still appears ill after his vaccine. Blood tests have been requested, but orders have not been issued yet.


VAERS ID: 1314211 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Interchange of vaccine products
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: NOT REPORTED
Current Illness: NOT REPORTED
Preexisting Conditions: NOT REPORTED
Allergies: NKA
Diagnostic Lab Data: NA
CDC Split Type: TX29

Write-up: RECIEVED MODERNA ON 2/7/2021 THEN RECEIVED J&J ON 5/3/2021.


VAERS ID: 1314320 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-26
Onset:2021-05-03
   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 EW0164 / 1 RA / IM

Administered by: School       Purchased by: ?
Symptoms: Deep vein thrombosis, Discomfort, Full blood count normal, Metabolic function test, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: CBC and CMP done at ER visit 5/4/21 - normal results, normal platelet count
CDC Split Type:

Write-up: Seven days after received Dose 1 of Pfizer Covid-19 vaccine, right arm was swollen and uncomfortable, the next day was purple. He want to urgent care center who thought he had "Covid arm" and was put on prednisone. Arm worsened, so he went to ER in middle of night on 5/4/21. He was given shot of Lovenox and sent home to return in am for ultrasound. Ultrasound next morning showed right subclavian vein DVT. He was put on Eliquis and told to follow up with hematologist. He is working on getting appointment with a hematologist before flying home, where he will do further work up with hematologist there.


VAERS ID: 1315187 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-01
Onset:2021-05-03
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram abnormal, Computerised tomogram thorax, Pulmonary embolism, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: docusate sodium, levetiracetam, memantine, mycophenolate, olanzapine, pantoprazole, prednisone, tarcrolimus
Current Illness:
Preexisting Conditions: stomach cancer
Allergies: NKDA
Diagnostic Lab Data: CT of chest showed small subsegmental branches peripheral emboli noted in lower lobes. No large central embolism demonstrated. Mild fibrotic changes of both lungs
CDC Split Type:

Write-up: Unknown date of vaccination, physician asked for this to be reported, possibly related to Covid vaccine. Patient admitted to hospital with syncope and bilateral pulmonary embolism. Patient treated and discharged home after after 2 days


VAERS ID: 1315642 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-01
Onset:2021-05-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Condition aggravated, Ear pain, Mastication disorder, Mobility decreased, Pain, Pain in jaw, Ultrasound scan normal
SMQs:, Parkinson-like events (broad), Osteonecrosis (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: Birth Control (mini pill) Prenatal
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin, Cephalexin
Diagnostic Lab Data: Went to ER on 5/7 due to the radiating leg pain, ultrasound to check for blood clot (none found at that time behind knee, nor in groin). ER doc also did physical exam on ear/jaw, pressing on the painful area, no definitive answer but believes the area is inflamed causing nerve pain/pressure.
CDC Split Type:

Write-up: Extreme pain in left jaw/ear area that continues to be present almost 2weeks post vaccine. Started approximately 48hrs post vaccination. Cannot open mouth fully or chew properly due to the pain. As well as: Joint Pain, more specifically, increased pain in areas with pre-existing nerve issues/concerns (carpal tunnel, damaged ulnar nerve in right arm, sciatic nerve pain in left hip). Radiating pain in left pain from hip to ankle


VAERS ID: 1315653 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-02
Onset:2021-05-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cardiac monitoring, Chest pain, Intensive care, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data: Elevated troponin- highest level was 11.6 on 5/7.
CDC Split Type:

Write-up: Myocarditis. Patient initially presented with chest pain 12 hours after vaccination. No other risk factors. Patient required to be in Pediatric ICU for treatment and cardiac monitoring.


VAERS ID: 1317085 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-05
Onset:2021-05-03
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

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

Write-up: Administration Error: Issued the Moderna vaccine at 17 years old.


VAERS ID: 1317137 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 1 RA / IM

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

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

Write-up: Patient was meant to be given the Pfizer vaccination based on current age. No adverse effects; infectious disease provider has reviewed case and has no imminent concerns. Patient''s second dose is scheduled for 6/1 and will be receiving the Pfizer formulation.


VAERS ID: 1317364 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-01
Onset:2021-05-03
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute hepatic failure, Alanine aminotransferase increased, Ammonia increased, Aspartate aminotransferase increased, Biopsy skin abnormal, Blood bilirubin increased, Blood creatinine increased, Embolism, Extremity necrosis, International normalised ratio decreased, Purpura
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Biliary system related investigations, signs and symptoms (narrow), Skin tumours of unspecified malignancy (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metoprolol, Excedrin PRN
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: Lisinopril (cough)
Diagnostic Lab Data: date of presentation to Medical facility (7/2021): AST $g 2600, ALT $g 2600, INR 3.0, Tbili 2.05, creatinine kinase 3226, ammonia 117
CDC Split Type:

Write-up: fulminant liver failure (INR 3.0, AST and ALT $g 2600, Tbili 2.0) without identifiable autoantibodies expected for autoimmune hepatitis, course complicated by retiform purpura and digital/acral lower extremity necrosis, dermatologic biopsy confirmed thromboembolic vaso-occlusion throughout the superficial and mid-dermal vessels without evidence for vasculitis, rheumatologic evaluation without cause, hereditary and acquired thrombophilia evaluation without cause


VAERS ID: 1317736 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-12
Onset:2021-05-03
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

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

Write-up: I21.4 - NSTEMI (non-ST elevated myocardial infarction) (CMS/HCC)


VAERS ID: 1317803 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen and ibuprofen as needed; Loestrin FE
Current Illness:
Preexisting Conditions: anxiety/depression
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Administration Error: this is a 16 year old that received the J&J vaccine (approved for ages 18 and over only). In this event, the patient attended a vaccine clinic with a family member and was added on to the schedule as a ''walk-in'' appointment at the parent''s request. The patient received the vaccination before they were processed in the computer. After administration during the electronic documentation, the patient''s age was flagged and the error discovered. The parent and patient were advised of the age-related error, and the patient had no adverse effects in the immediate observation period.


VAERS ID: 1317834 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-27
Onset:2021-05-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Confusional state, Electroencephalogram, Generalised tonic-clonic seizure, Headache, Lumbar puncture, Magnetic resonance imaging, Septic shock
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (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 (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lotrel, abilify, flexeril, cymbalta, nexium, amaryl, synthroid, mag ox, mobic, metformin, MS contin, percocet, actos, pravachol
Current Illness: None
Preexisting Conditions: low back pain, depression, HTN, HLD, DM, hypothyroidism, gout
Allergies: NKA
Diagnostic Lab Data: MRI (5/13) EEG (5/14) LP (5/14)
CDC Split Type:

Write-up: Presented to Hospital with HAs, confusion, septic shock, AKI. GTC on day of discharged, prompting transfer to hospital.


VAERS ID: 1319851 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-17
Onset:2021-05-03
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023M204 / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest X-ray, Echocardiogram, Electrocardiogram, Pulmonary fibrosis
SMQs:, Interstitial lung disease (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Date: 20210503; Test Name: Chest x-ray; Test Date: 20210503; Test Name: COVID-19; Test Result: Positive ; Result Unstructured Data: diagnosed with COVID-19 for second time; Test Date: 20210503; Test Name: Echocardiogram; Test Result: Negative ; Result Unstructured Data: Negative; Test Date: 20210503; Test Name: Electrocardiogram; Result Unstructured Data: no indication of heart attack
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Chest x-ray showed really bad scarring on both lungs; Diagnosed with COVID-19 for second time; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of PULMONARY FIBROSIS (Chest x-ray showed really bad scarring on both lungs) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 023M204 and 047A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 in November 2020. On 17-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 03-May-2021, the patient experienced PULMONARY FIBROSIS (Chest x-ray showed really bad scarring on both lungs) (seriousness criterion medically significant) and COVID-19 (Diagnosed with COVID-19 for second time). At the time of the report, PULMONARY FIBROSIS (Chest x-ray showed really bad scarring on both lungs) and COVID-19 (Diagnosed with COVID-19 for second time) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 03-May-2021, COVID-19: (Positive) diagnosed with COVID-19 for second time. On 03-May-2021, Chest X-ray: scarring on both lungs, really bad. On 03-May-2021, Echocardiogram: (Negative) Negative. On 03-May-2021, Electrocardiogram: no indication of heart attack. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications provided. . No treatment information provided. Action taken with mRNA-1273 in response to the drug was not applicable.; 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: 1320211 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-03
Onset:2021-05-03
   Days after vaccination:89
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: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 antibody 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: IRBESARTAN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy to chemicals; Blood pressure high
Allergies:
Diagnostic Lab Data: Test Date: 20210503; Test Name: SARS CoV Antigen; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC2021496398

Write-up: Tested positive for COVID19 on 5/3/2021; Tested positive for COVID19 on 5/3/2021; This is a spontaneous report from a contactable consumer (patient). A 58-years-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; Batch/Lot number was not reported ), via an unspecified route of administration, administered in Arm Left on 03Feb2021 (at the age of 58-year-old) as single dose, and first dose via an unspecified route of administration, administered in Arm Left on 13Jan2021 (Batch/Lot number was not reported) as single dose for covid-19 immunisation. Medical history included hypertension from an unknown date and unknown if ongoing, allergy to chemicals (Nickel) from an unknown date and unknown if ongoing. Concomitant medication included irbesartan (IRBESARTAN) taken for an unspecified indication, start and stop date were not reported. The patient experienced cold-like symptoms (nasopharyngitis) on 28Apr2021 with outcome of recovering, loss of smell (anosmia) on 02May2021 with outcome of recovering. The patient tested positive for Covid-19 on 03May2021. The patient underwent lab tests and procedures which included Sars-Cov-2 antibody test: positive on 03May2021 (Nasal Swab). Adverse events result in Emergency room/department or urgent care. Information on the lot/batch number has been requested


VAERS ID: 1320262 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-01-21
Onset:2021-05-03
   Days after vaccination:102
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 2 - / -

Administered by: Unknown       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: LO LOESTRIN FE; PROBIOTICS; TYLENOL; LEXAPRO
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data: Test Date: 20210503; Test Name: Lumiradx Sars-Cov-2 AG; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: PFIZER INC2021503162

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This is a spontaneous report from a contactable consumer (patient). A 34-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), 1st dose via an unspecified route of administration, administered in arm left on 21Jan2021 (Batch/Lot Number: EL3302) at the age of 34-year-old as single dose, 2nd dose via an unspecified route of administration, administered in arm left on 10Feb2021 12:00 (Batch/Lot Number: EM9810) at the age of 34-year-old as single dose for COVID-19 immunization. Relevant medical history and relevant past drug history was none. The patient was not pregnant. Concomitant medications included escitalopram oxalate (LEXAPRO); ethinylestradiol, ferrous fumarate, norethisterone acetate (LO LOESTRIN FE); probiotics; paracetamol (TYLENOL). 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. Reported event was tested positive for COVID on 03May2021. Treatment received for the adverse event was medicines and rest. The patient underwent lab tests and procedures which included Lumiradx Sars-Cov-2 AG: positive on 03May2021 (Nasal Swab). The outcome of event was recovering. Follow-up attempts are needed. Further information is expected.


VAERS ID: 1320311 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-27
Onset:2021-05-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210503; Test Name: COVID-19; Test Result: Positive
CDC Split Type: USPFIZER INC2021505999

Write-up: He was positive for COVID 19; This is a spontaneous report received from a contactable consumer (patient). A 56-year-old male consumer received first dose of BNT162B2 (BNT162B2, PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection) via an unspecified route of administration in left arm on 27Apr2021 at 14.00 as first single dose 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. The patient did not receive any antipyretic drug around the date of vaccination. Product complaint was reported. The patient reported that he got first shot 27Apr2021 and he took a test on 03May2021 and he was positive for COVID 19. He only got the first dose, he goes for the second dose 14May2021, he says they did not give him a vaccine card. He did not know any lot number or expiration for the dose he received. The case was classified as serious. The outcome of event was unknown. Information on the Lot/Batch number has been requested.


VAERS ID: 1320332 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:2021-04-15
Onset:2021-05-03
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Streptobacillus infection, Streptococcus test
SMQs:, Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210503; Test Name: Strep test; Test Result: Positive ; Comments: she tested positive with her Strep test yesterday (03May2021)
CDC Split Type: USPFIZER INC2021509910

Write-up: however she tested positive with her Strep test yesterday (03May2021) and she also started to take Azithromycin yesterday.; This is a spontaneous report from a Pfizer Sponsored Program. A contactable consumer (mother) reported for a 16-year-old female patient reported that patient received first dose of BNT162B2 (Pfizer Covid-19 Vaccine, Batch/Lot number and expiration date were not reported), via unspecified route on 15Apr2021 at single dose for covid-19 immunization. The patient''s medical history was not reported. The patient''s concomitant medications were not reported. The patient was scheduled to get the 2nd dose of the vaccine on 06May2021, however she tested positive with her Strep test yesterday (03May2021) and she also started to took Azithromycin yesterday. (name) wanted to know if her daughter could still take the 2nd dose on the scheduled date. The outcome of the events was unknown Information on the lot/batch number has been requested.


VAERS ID: 1320333 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-08
Onset:2021-05-03
   Days after vaccination:25
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: Public       Purchased by: ?
Symptoms: Bell's palsy, SARS-CoV-2 test
SMQs:, Hearing impairment (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anxiety; Barrett''s esophagus; Blood cholesterol abnormal; Depression
Allergies:
Diagnostic Lab Data: Test Date: 20210504; Test Name: Covid test; Test Result: Negative
CDC Split Type: USPFIZER INC2021510116

Write-up: Bell''s palsy; This is a spontaneous report from a contactable consumer (patient). A 37-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported) via an unspecified route of administration, in arm left, on 08Apr2021 16:00 (at the age of 36-year-old), at single dose, for COVID-19 immunization. Medical history included cholesterol, anxiety, depression, and Barrera esophagus. No known allergies. Concomitant medications included unspecified medication (patient received other medications within 2 weeks of vaccination). The patient previously received 1st dose of BNT162B2 for Covid-19 immunization, in left arm. The patient experienced Bell''s palsy a month after 2nd shot on 03May2021, and received Steroids and antivirus medicine as treatment. The event caused Doctor or other healthcare professional office/clinic visit and Emergency room/department or urgent care. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient did not have Covid prior vaccination. On 04May2021, patient had negative Covid test post vaccination with Nasal swab. The outcome of the event was recovering. Information on the lot/batch number has been requested.


VAERS ID: 1320354 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-30
Onset:2021-05-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Dysstasia, Gait inability, Monoplegia
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ABILIFY; ZOLOFT; METFORMIN; WELLBUTRIN; SIMVASTATIN; LISINOPRIL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Mental disorder NOS; Obesity
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021514729

Write-up: Began to have pain in hip that progressed to severe pain and parlaying leg and foot; Unable at 2 nd week to stand or walk; Unable at 2 nd week to stand or walk; Began to have pain in hip that progressed to severe pain and parlaying leg and foot; This is a spontaneous report from a contactable consumer (parent). A 27-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number and expiration date were not reported), via an unspecified route of administration on 30Apr2021 at 15:30 (at the age of 27 years) as unknown dose, single for COVID-19 immunization. Medical history included obesity and mental illness. Concomitant medications included aripiprazole (ABLIFY), sertraline hydrochloride (ZOLOFT), metformin, bupropion hydrochloride (WELLBUTRIN), simvastatin and lisinopril. 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 and since the vaccination, it was unknown if the patient was tested for COVID-19. The patient was hospitalized on 27Apr2021 for an unknown reason and began to have pain in hip that progressed to severe pain and parlaying leg and foot on 03May2021. Unable at the second week to stand or walk. These adverse events result in emergency room (ER) or department or urgent care. The patient''s hospitalization was prolonged and the patient was disability as a result of these events. It was unknown if the treatment was received by the patient due to these events. It was reported that the duration of hospitalization was 10 days discharged on 07May2021 (also reported as continued, CLARIFICATION PENDING). The outcome of all these events was not recovered at the time of report. Information on the lot/batch number has been requested.


VAERS ID: 1320381 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-29
Onset:2021-05-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation
SMQs:, Supraventricular tachyarrhythmias (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LATUDA; METOPROLOL; LORAZEPAM; XARELTO; QUETIAPINE; BUPROPION; OXYBUTYNIN; ATORVASTATIN; DILTIAZEM; LOSARTAN; GABAPENTIN; FUROSEMIDE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Prior to vaccination)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021530781

Write-up: Patient was hospitalized for an episode of A-fib; This is a spontaneous report from a contactable Pharmacist. This Pharmacist reported for a 55-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTEC COVID-19 mRNA VACCINE, Solution for injection, lot number: EW0179 and expiry date was not reported), via intramuscularly, in Arm Left, on 29Apr2021, as a single dose for COVID-19 immunization. The patient was not pregnant at the time of vaccination. The patient medical history included that she was diagnosed with COVID-19 prior to the vaccination. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. Concomitant medications included lurasidone hydrochloride (LATUDA), Metoprolol, Lorazepam, rivaroxaban (XARELTO), Quetiapine, Bupropion, Oxybutynin, Atorvastatin, Diltiazem, Losartan, Gabapentin and Furosemide. Since the vaccination, the patient was not tested for COVID-19. It was reported that on 03May2021, the patient was hospitalized for an episode of A-fib which resulted in emergency room/department or urgent care. The patient was hospitalized due to the event from an unspecified date in May2021 to an unspecified date in May2021. Device date was reported as 11May2021. Outcome of the event was recovered with sequel. Information on Lot/Batch number was available. Additional information has been requested.; Sender''s Comments: Based on known drug safety profile, there is reasonable possibility of causal association between the event atrial fibrillation and the suspect drug. 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: 1320787 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test normal, Electrocardiogram normal, Exposure during pregnancy, Headache, Hypoaesthesia, Insomnia, Limb discomfort, Magnetic resonance imaging normal, Migraine, Urine analysis normal
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: prenatal
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: MRI urine sample blood panel EKG
CDC Split Type: VSAFE

Write-up: 5/3 vaccination By 10pm I had a HA and thought going to sleep it would go away. I woke up at 12AM and it had turned into a migraine. After that, I couldn''t sleep and then in the morning, I went to the daycare with my son. I waited for it to go away, rested (no medication; painful but bearable). Applied cold compress to forehead and it felt like it was easing, the pain. I did that all day long. The next day, when I woke up, the migraine was still there and decided to go to dr for medical advice. I have never had a migraine like that, not just a HA. Dr. and I didn''t know what caused it. If wasn''t gone by Friday, to call her back. On Wed, same symptoms. On Thursday, it was there but less intense. I felt like my left numb was slightly numb and the upper part of my arm, if felt like I had a tourniquet on it. I called my Dr and informed her of new symptom and didn''t know if linked to migraine. Advised to go to the ER and order some imaging. I went at 9:30, the Dr. told me she was going to order MRI, urine sample, blood panel, EKG. Everything was normal. *3 weeks prior, I had been having pain in my legs. Eco doppler on my legs. Localized pain. Appt scheduled 5/19/2021 *2nd pregnancy (''new things didnt have in first pregnancy like the pain in my legs''), EDD 09/14/2021


VAERS ID: 1320905 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-12
Onset:2021-05-03
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Ageusia, Anosmia, Arthralgia, COVID-19, Chest X-ray abnormal, Cough, Dyspnoea, Dyspnoea exertional, Exposure to SARS-CoV-2, Lung opacity, Pain, Respiratory failure, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Taste and smell disorders (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), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Respiratory failure (narrow), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (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? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin, omeprazole, melatonin, losartan, levothyroxine,...
Current Illness: HTN
Preexisting Conditions: CLL, HTN, hypthryoidism, bladder CA, seizures, CKD stage 3, obesity
Allergies: NKDA
Diagnostic Lab Data: 5/3 & 5/11: SARS CoV 2 RNA PCR- positive 5/10: CXR: Bilateral patchy ground-glass opacities may represent acute infectious or inflammatory process such as COVID PNA.
CDC Split Type:

Write-up: Pt w/hx of COVID positive (5/3) in the setting of an exposure and onset of symptoms including arthralgias, body aches, non-productive cough, loss of taste/smell sensations, shortness of breath upon exertion despite receiving Moderna vaccines (2/12 & 3/12/21). Pt presented to ED w/worsening SOB upon rest and was admitted for management of acute hypoxemic respiratory failure due to COVID-19. Was treated w/dexamethasone, remdesivir. She was ultimately discharged on 5/12 after significant improvement with follow-up.


VAERS ID: 1320924 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (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: not known
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: no known allergies
Diagnostic Lab Data: paramedics were called in and mr vital signs were taken and was asked to sit for another 30 to 60 minutes, all his vital signs were normal according to the paramedics
CDC Split Type:

Write-up: mr was sweating all over his body from head to toe and turned red


VAERS ID: 1321257 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-01-14
Onset:2021-05-03
   Days after vaccination:109
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram head, Headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: warfarin. Furosemide. LISINOPRIL LEVOTHYROXIN PRAVATATIN.
Current Illness: afib
Preexisting Conditions: afib
Allergies: none
Diagnostic Lab Data: head scans
CDC Split Type:

Write-up: diagnose with subdural Severe headaches


VAERS ID: 1322491 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-21
Onset:2021-05-03
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Migraine, Musculoskeletal stiffness, Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad)

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

Write-up: Severe migraines and stiffness in the back of the neck after receiving Botox injections for migraines 8 days after 2nd dose of Pfizer. The back of the neck where the injection site of the Botox occurred, locked up for for several days and swelling occurred. Shortness of breath also occurred over a four day period.


VAERS ID: 1322526 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-29
Onset:2021-05-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Epistaxis, Fatigue, Headache, Heavy menstrual bleeding, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omega 3 Multivitamin Turmeric
Current Illness: None
Preexisting Conditions: None
Allergies: Cephalosporins
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Transient moderate headaches and nose bleeds 3-7 days post-injection, including sneezing out blood clot Menstruation lasted longer than normal Mild fatigue 1-5 days post-injection


VAERS ID: 1322577 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-05-03
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: 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: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210525978

Write-up: HEADACHE; This spontaneous report received from a consumer 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: unknown) dose was not reported, administered on 03-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 03-MAY-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache. This report was non-serious.


VAERS ID: 1322805 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-20
Onset:2021-05-03
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Photosensitivity reaction, Pruritus, Rash, Sunburn
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Accidents and injuries (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: Atorvostatin , glucosamine, multi vitamin, AdvilPM
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe and persistent sensitivity to sun exposure on neck. Patient received a mild sunburn that broke out into a severe rash similar to sun poisoning. Rash is very itchy


VAERS ID: 1324315 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 1 LA / IM

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

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

Write-up: pharmacist accidently administered MODERNA COVID 19 vaccine to patient 16 years old.


VAERS ID: 1325392 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-28
Onset:2021-05-03
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Acoustic stimulation tests, Deafness, Exposure during pregnancy
SMQs:, Hearing impairment (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I?m taking prenatal vitamins and a daily baby aspirin.
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin and amoxicillin
Diagnostic Lab Data: Hearing test by an ENT on 05/17/2021
CDC Split Type:

Write-up: No known effect to baby since it is not due for a few more months. I am only aware of the hearing loss I experienced as the pregnant mother I?ve now had two separate bouts of hearing loss. The first started 5 days after the first vaccine and lasted around 36 hours. The second was almost two weeks after that and also lasted around 36 hours. Both times I felt a lot of pressure in my ears and had muffled hearing. I subsequently made an appointment with an ENT that alerted me this could be a vaccine side effect. I have not had my second dose of the vaccine yet.


VAERS ID: 1326061 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-30
Onset:2021-05-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

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

Write-up: Skipped historically regular period for the first time ever, with multiple negative pregnancy tests


VAERS ID: 1326104 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Montana  
Vaccinated:0000-00-00
Onset:2021-05-03
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Fatigue, Pain, Pain assessment
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (Moderate); Non-smoker
Preexisting Conditions: Comments: The patient had no pertinent medical history. The patient had no known allergies and no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 202105; Test Name: Pain scale; Result Unstructured Data: 4/10 (unit not reported)
CDC Split Type: USJNJFOC20210527044

Write-up: ABDOMINAL PAIN; SORENESS; TIREDNESS; This spontaneous report received from a patient concerned a 36 year old male. The patient''s weight was 190 pounds, and height was 175 centimeters. The patient''s concurrent conditions included alcohol user, and non-smoker, and other pre-existing medical conditions included the patient had no pertinent medical history. the patient had no known allergies and no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 203A21A, and expiry: UNKNOWN) dose was not reported, administered on 03-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On MAY-2021, Laboratory data included: Pain scale (NR: not provided) 4/10 (unit not reported). On 03-MAY-2021, the subject experienced abdominal pain. On 03-MAY-2021, the subject experienced soreness. On 03-MAY-2021, the subject experienced tiredness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from soreness, and tiredness on 06-MAY-2021, and had not recovered from abdominal pain. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure as case assessed as non-serious.


VAERS ID: 1326153 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-01
Onset:2021-05-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Burns third degree, Computerised tomogram, Condition aggravated, Dysstasia, Electrocardiogram, Hypoaesthesia, Loss of consciousness, Muscular weakness, Myocardial infarction, Neck pain, Pain, Pain in extremity, Sensitive skin, Swelling face, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Brain CT Scan; Result Unstructured Data: Test Result:No results; Test Name: EKG; Result Unstructured Data: Test Result:No results
CDC Split Type: USPFIZER INC2021494198

Write-up: fainted; lost consciousness for a couple of seconds; burning pain that felt like needles on his shoulder, left arm and a little on the right side/extremely, burning pains across his back/He had burning pain on his shoulders, very sensitive, felt like a 3rd degree burn; felt like he could not stand and had to go to the floor, struggled to get up; arms were numb; thought he was having a heart attack; left arm weak; skin is hypertensive: back of neck feels like a third degree burn: if he moves the hair on his arms it hurts; left side of face is swollen; left side of face is swollen was reported as worsened.; skin is hypertensive: back of neck feels like a third degree burn: if he moves the hair on his arms it hurts; skin is hypertensive: back of neck feels like a third degree burn: if he moves the hair on his arms it hurts; left arm pain; This is a spontaneous report from contactable consumers (patient reported for himself, patient''s mother). A 27-years-old male patient received bnt162b2 (BNT162B2; PFIZER-BIONTECH COVID-19 VACCINE), dose 1 intramuscular, administered in Arm Right on 01May2021 12:00 noon (Batch/Lot Number: EW0170; Expiration Date: 31Aug2021) as 1ST DOSE, 0.3 ML SINGLE for covid-19 immunization, at the age at vaccination of 27 years old. The patient''s medical history and concomitant medications were not reported. The patient experienced thought he was having a heart attack(medically significant) on 03May2021 01:00 with outcome of unknown, skin is hypertensive: back of neck feels like a third degree burn: if he moves the hair on his arms it hurts (medically significant) on 03May2021 with outcome of not recovered, fainted (medically significant) on an unspecified date with outcome of unknown, lost consciousness for a couple of seconds (medically significant) on 03May2021 01:00 with outcome of recovered with sequelae on 03May2021, burning pain that felt like needles on his shoulder, left arm and a little on the right side/extremely, burning pains across his back/he had burning pain on his shoulders, very sensitive, felt like a 3rd degree burn (non-serious) on 03May2021 01:00 with outcome of unknown, felt like he could not stand and had to go to the floor, struggled to get up (non-serious) on 03May2021 01:00 with outcome of recovered with sequelae on 03May2021, arms were numb (non-serious) on 03May2021 01:00 with outcome of recovering, left arm pain (non-serious) on 03May2021 with outcome of not recovered, left arm weak (non-serious) on 03May2021 01:00 with outcome of unknown, skin is hypertensive: back of neck feels like a third degree burn: if he moves the hair on his arms it hurts (non-serious) on 03May2021 01:00 with outcome of not recovered, skin is hypertensive: back of neck feels like a third degree burn: if he moves the hair on his arms it hurts (non-serious) on 03May2021 with outcome of not recovered, left side of face is swollen (non-serious) on 03May2021 01:00 with outcome of not recovered , left side of face is swollen was reported as worsened (non-serious) on 03May2021 with outcome of not recovered. The patient underwent lab tests which included computerised tomogram (brain CT): no results, electrocardiogram (EKG): no results, both on unknown date. Reported patient was in pain and his mom and dad didn''t know what to do. He had sharp pains. No bruises. He remember lowering myself to fall. He didn''t fall. It was a strange thing. When he went to the ER they didn''t fine anything. He was still in the same amount of pain. Caller stated her son took the vaccine on Saturday. Thirty six hours later around 1:00am he started getting extremely, burning pains across his back.The patient stated he was coming out of the bathroom and felt like he couldn''t stand and he had to go to the floor. He lost consciousness for a couple of seconds. Both arms were numb. He struggled to get up. He sat on the couch and then went upstairs after being in the basement. He had a burning pain that felt like needles on his shoulder, left arm and a little on right side. His skin was sensitive. The back of his neck feels like he has a third degree burn. This morning he went to the hospital. Initially said he fainted but clarified that he was speaking about losing consciousness. He had left arm pain. He thought he was having a hard attack. While at the emergency room today he had labs, a brain CT scan and an EKG. He does not have results to provide. Caller added that his skin was hypersensitive. It was like if he moves the hair on his arm it hurts. His parents noticed he has swelling on the left side of his face. The events require a visit to Emergency Room. No Prior Vaccinations (within 4 weeks). Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1326256 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-02-20
Onset:2021-05-03
   Days after vaccination:72
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 2 LA / -

Administered by: Unknown       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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ATORVASTATIN; METOPROLOL SUCCINATE; RAMIPRIL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Type 2 diabetes mellitus
Allergies:
Diagnostic Lab Data: Test Date: 20210503; Test Name: COVID antigen; Test Result: Positive ; Comments: Nasal Swab; Test Date: 20210503; Test Name: PCR; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC2021523894

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This is a spontaneous report from a contactable consumer (patient). This consumer reported similar events for 2 patients. This is 1st of 2 reports. A 73-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL9264) via an unspecified route of administration on 30Jan2021 13:00 (at the age of 73-year-old), received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EL9266) via an unspecified route of administration on 20Feb2021 12:45 (at the age of 73-year-old), both in arm left, at single dose, for COVID-19 immunisation. Medical history included Type 2 Diabetes. No Known allergies. Concomitant medications in two weeks included atorvastatin, metoprolol succinate, ramipril, and "H". The patient previously received first dose of BNT162B2 (lot number: EL9264) on 30Jan2021 01:00 PM (at the age of 73-year-old) in left arm for COVID-19 immunisation. Patient did not receive other vaccine in four weeks and did not have COVID prior vaccination. Patient tested positive for the COVID virus after receiving the 2nd dose on 03May2021 with positive result of COVID Antigen and PCR (Nasal Swab). AE resulted in Doctor or other healthcare professional office/clinic visit. Patient received treatment for AE. The outcome of the event was recovered in May2021.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-2021529304 Same reporter, event, vaccine/different patient


VAERS ID: 1326534 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-29
Onset:2021-05-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Alopecia, Menstruation delayed
SMQs:, Fertility disorders (broad)

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

Write-up: I have continued to lose lots of hair since my vaccine. I have not had a period since my vaccine, and am not pregnant.


VAERS ID: 1326540 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-28
Onset:2021-05-03
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Erythema, Pruritus, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: started with a small rash on top of R hand and then progressively moved up right arm and back of neck and then to the left wrist and arm. Red, raised bumps, very itchy .


VAERS ID: 1326547 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-17
Onset:2021-05-03
   Days after vaccination:47
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cerebral mass effect, Headache, Magnetic resonance imaging abnormal, Subdural haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Accidents and injuries (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Patient received J&J Covid vaccine on 3/17/21. She began experiencing daily headaches on 4/1/21. She initially presented to her PCP on 5/3/21. MRI was ordered and conducted on 5/6/21, revealing a large subdural hematoma with midline shift. Patient was referred to neurosurgery and ultimately opted for outpatient management with course of steroids and close follow up.


VAERS ID: 1326572 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Migraine, 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Injection date: 05/03/21 Reaction date: 05/03/21 LOT: EW0161 EXP: 07/31/2021 Headache starting 2 hours post injection. Hx of migraines. Severe HA with fevers and chills starting approx. 12 hours post injection and lasting only 8-12 hours. Followed up with patient 05/18/21 and she states she still has this persistent headache that started 2 hours post injection.


VAERS ID: 1326722 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Over the counter antihistamines.
Current Illness: None
Preexisting Conditions: Non-specific angioedema
Allergies: None
Diagnostic Lab Data: My immunologist referred me to GP, who referred me to ENT. Awaiting appointment.
CDC Split Type:

Write-up: The evening of the vaccine I noticed pulsatile tinnitus, which began as a low thudding sound in my head (with pulse). The next day the tone had changed to the high pitch, constant ringing of tinnitus. I also experienced persistent daily headaches for 8 days, which has resolved. The tinnitus has not resolved and ranges in intensity from so loud I cannot listen it focus to background noise.


VAERS ID: 1327735 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-02-15
Onset:2021-05-03
   Days after vaccination:77
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Pulmonary embolism, Vaccination complication
SMQs:, Embolic and thrombotic events, venous (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisenipril blood pressure medication
Current Illness: None
Preexisting Conditions: None
Allergies: sulfur; morphine
Diagnostic Lab Data: to be determined
CDC Split Type:

Write-up: The patient, began suffering from extreme fatigue about 4 weeks ago and has now been admitted on an emergency basis to Hospital. He has blood clots in his lungs and his heart rate is sustained at approximately 140 beats per minute. No cause for the clots has been determined as of yet and the possibility of the COVID 19 vaccine causing the clots as an adverse effect can not be ruled out. This case needs to be investigated. Patient is still in the hospital as of 5/18/2021.


VAERS ID: 1329471 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-29
Onset:2021-05-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Alanine aminotransferase, Alanine aminotransferase increased, Blood test, Headache, Hepatic enzyme increased, Nausea
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210503; Test Name: ALT; Result Unstructured Data: Test Result:165; Comments: liver enzymes became elevated 20 times what was normal; Test Date: 20210415; Test Name: Bloodwork; Result Unstructured Data: Test Result:normal; Test Date: 20210503; Test Name: Liver enzyme; Result Unstructured Data: Test Result:208; Comments: liver enzymes became elevated 20 times what was normal
CDC Split Type: USPFIZER INC2021498464

Write-up: headache; nausea; liver enzymes became elevated 20 times what was normal (liver enzymes was 208 and ALT 165); liver enzymes became elevated 20 times what was normal (liver enzymes was 208 and ALT 165); This is a spontaneous report from a contactable consumer (the patient). A 65-year-old female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, lot number EW0172), via an unspecified route of administration in the left arm on 29Apr2021 (age at vaccination unknown) as a single dose for COVID-19 immunization. There was no medical history or concomitant medications. The patient received the second dose of her Pfizer COVID vaccine on 29Apr2021 and reported headache and nausea (unspecified date). She also stated that her blood test done on 03May2021, showed her liver enzymes became elevated 20 times what was normal (liver enzymes was 208 and ALT (alanine aminotransferase) 165). She had the same bloodwork done on 15Apr2021, and everything was normal. She asked if these side effects were normal and how long should they last for? The outcome of headache and nausea was unknown. The outcome of other events was not recovered. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1329481 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-28
Onset:2021-05-03
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: METFORMIN; DIAZEPAM; LISINOPRIL
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021498915

Write-up: Bell''s Palsy - Left Side of Face; This is a spontaneous report from a contactable consumer (patient). A 50-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm left on 28Apr2021 (Batch/Lot Number: EW0171) as 2nd dose, single for covid-19 immunisation. The first dose was received on 03Apr2021 (lot number: ER8733). There were no medical history. Concomitant medications included metformin, diazepam and lisinopril. No other vaccine were received within 4 weeks. The patient experienced bell''s palsy - left side of face on 03May2021 10:00. Event resulted in physician''s clinic visit. Outcome of the event was not recovered. Patient was not diagnosed with covid-19 prior to vaccination and had not been tested post vaccination.


VAERS ID: 1329497 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-03
Onset:2021-05-03
   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 EW0176 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: 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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021501026

Write-up: I have barely hit my hands on something and they start bleeding on my knuckles; This is a spontaneous report from a contactable consumer (patient). This 39-year-old female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration in the left arm on 03May2021 (at the age of 39-year-old) (Lot Number: EW0176) as single dose for COVID-19 immunisation. Relevant medical history and concomitant medications were not reported. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on an unspecified date for COVID-19 immunisation and experienced heavy menstrual bleeding for 3 weeks following the first dose; very large clots. On 03May2021 at 15:00, after the second dose, the patient had barely hit her hands on something and they started bleeding on her knuckles. The patient had not recovered from the event. Prior to vaccination, the patient was not diagnosed with COVID-19; since the vaccination, the patient had not been tested for COVID-19.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-2021498328 same patient/drug, different vaccine dose/AE


VAERS ID: 1329974 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-23
Onset:2021-05-03
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Allergy to vaccine, Biopsy skin abnormal, Hypersensitivity, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Skin tumours of unspecified malignancy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Biopsy taken on the rash, results indicated an allergic reaction to the vaccine but did not indicate exactly what component.
CDC Split Type:

Write-up: Full body rash started ~10 days after the first dosage of the Moderna Vaccine, beginning in the mid section (thighs and lower stomach) on the first day and then spreading to the legs, chest/back and arms over the course of 2 more days. Treatment- appointments with primary care and a dermatologist, Prednisone and Lexette were prescribe to treat the rash. Rash has subsided 95% in the following 7-10 days.


VAERS ID: 1330247 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-29
Onset:2021-05-03
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Haemorrhage, Immune thrombocytopenia, Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), 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? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Digoxin 250 ?g by mouth daily Uloric 40 mg by mouth daily Finasteride 5 mg by mouth daily Warfarin 3 mg by mouth daily Torsemide 20 mg alternating with 40 mg daily K Dur 20 mEq by mouth daily Mirtaz
Current Illness: none
Preexisting Conditions: chronic atrial fibrillation prosthetic aortic valve replacement chronic diastolic congestive heart failure hypo-testosteronism
Allergies: none
Diagnostic Lab Data: PLATELETS FELL FROM 128,000 IN FEBRUARY 2021 TO 86,000 ON 5/7/21 AND FINALLY TO 2 ON 5/13/21 (ONE WEEK AFTER BEGINNING TO BLEED AT HOME)
CDC Split Type:

Write-up: IMMUNE THROMBOCYTOPENIA


VAERS ID: 1330684 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product use 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: VACCINE WAS ADMINISTERED 8 HOURS AFTER THE VIAL WAS PUNCTURED.


VAERS ID: 1331070 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-03
Onset:2021-05-03
   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 RA / IM

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

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

Write-up: No adverse event occurred. Janssen is not currently indicated for under 18. She is 17. Her mother was present at the vaccination. We saw her again on 5/17/21 and there were no adverse events.


VAERS ID: 1331170 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-05-03
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy, Full blood count normal, HIV test negative, Magnetic resonance imaging abnormal, Viral test
SMQs:, Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Underwent filling for a cavity on the same day, otherwise well.
Preexisting Conditions: None
Allergies: Cats Seasonal allergies
Diagnostic Lab Data: HIV negative. CBC normal. MRI demonstrates bilateral facial nerve enhancement. Additional viral tests pending. CSF analysis planned, pending.
CDC Split Type:

Write-up: Bilateral facial nerve palsy. Unrelenting to date (16 days after onset).


VAERS ID: 1331251 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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

Write-up: VACCINE ADMINISTRATION OCCURRED 8 +1/2 HOURS AFTER THE VIAL WAS PUNCTURED


VAERS ID: 1332385 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-30
Onset:2021-05-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Balance disorder, Burning sensation, Computerised tomogram normal, Dizziness, Headache, Neck pain, Photophobia, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (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: Childhood seizures (last episode was age 11)
Allergies: Phenobarbitol
Diagnostic Lab Data: CT scan shows no blood clot.
CDC Split Type:

Write-up: Monday-Feeling like ants crawling under my skin. Headache, present even with Tylenol Tuesday- Ant feeling subsided, headache and neckache. Lightheadedness and loss of balance. Went to ER Thursday 5/20- Lightheaded and loss of balance Since 5/4, lightheadedness comes and goes. Light and sound affect the ability to focus. I have never felt like this before.


VAERS ID: 1332711 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-04-21
Onset:2021-05-03
   Days after vaccination:12
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: Atrial fibrillation, Cardiac failure congestive
SMQs:, Cardiac failure (narrow), Supraventricular tachyarrhythmias (narrow), 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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021503879

Write-up: Congestive heart failure, in AFIB; Congestive heart failure, in AFIB; This is a spontaneous report from a contactable consumer (patient). A 59-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot and expiry were not reported), via an unspecified route of administration on 21Apr2021 (at the age of 59-years-old) as 1 st dose, single for covid-19 immunisation. Prior to vaccination, patient was not diagnosed with COVID-19 and since vaccination, patient was not tested for COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient''s medical history and concomitant medications were not reported. The reported Events were congestive heart failure, in AFib on 03May2021, hospitalization not prolonged. The events resulted to emergency room/department or urgent care. Received unspecified treatment for the events. The outcome of the events was not recovered. Information on the lot/batch number has been requested.


VAERS ID: 1332761 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
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: Asthenia, Chest discomfort, Chest pain, Dizziness, Dyspnoea, Hyperventilation, Lung disorder, Pulmonary pain
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Fibromyalgia; Latex allergy; Lupus syndrome; Lyme disease; Neuropathy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021509317

Write-up: Easily short of breath, winded; weak; Chest heaviness and mild pain with tightness; Chest heaviness and mild pain with tightness; Lung heaviness and mild pain with tightness; Lung heaviness and mild pain with tightness; breathing heavier; lightheaded; This is a spontaneous report from a contactable consumer (patient). A 39-year-old female patient (not pregnant) received the first dose BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, batch/lot number and expiration date unknown) via an unspecified route of administration on 03May2021 16:00 (39-year-old at time of vaccination), at single dose, for COVID-19 immunization. The patient''s medical history Lupus, fibromyalgia, Lyme, neuropathy, and allergies to Latex. Concomitant medications were not reported. Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 03May2021 19:00, patient experienced Chest/Lung heaviness and mild pain with tightness; Easily short of breath, winded and weak; unable to perform daily routine, breathing heavier is also making her lightheaded. Prior to vaccination, the patient was not diagnosed with COVID-19; since the vaccination, the patient has not been tested for COVID-19. No therapeutic measures were taken as a result of the events. The outcome of the events was not recovered. Information on the lot/batch number has been requested.


VAERS ID: 1332769 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Arthropathy, Gait disturbance, Inappropriate schedule of product administration, Joint swelling, Mobility decreased, Off label use, Pain, Peripheral swelling, Spinal cord disorder
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Medication errors (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: Rheumatoid arthritis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021510783

Write-up: His whole body ache, the spinal cord is he can''t even get up; His whole body ache, the spinal cord is he can''t even get up; His whole body ache, the spinal cord is he can''t even get up; He was in lot of pain with his knee, the both knees; hardly walk because his knees are very weak; He was in lot of pain with his knee, the both knees; hardly walk because his knees are very weak; He was in lot of pain with his knee, the both knees; hardly walk because his knees are very weak; he had swollen arm, hand and wrist; he had swollen arm, hand and wrist; first dose was administered on 14Mar2021 and the second dose was on 03May2021; first dose was administered on 14Mar2021 and the second dose was on 03May2021; This is a spontaneous report from two contactable consumers (patient and patient''s wife). A 57-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration on 03May2021 (at the age of 57-year-old) as 2nd dose, single for COVID-19 immunisation. Medical history included ongoing rheumatoid arthritis. There were no concomitant medications. Historical vaccine includes first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 14Mar2021 (at the age of 57-year-old) for COVID-19 immunization and experienced rheumatoid arthritis, like his arthritis more severe, Joints were swollen; painful; the joints were inflamed and his arm was swollen, his hands were swollen. It was reported that the patient''s first dose was administered on 14Mar2021 he was unable to take the second dose because he had to travel far from the country, and the second dose was administered on 03May2021. It was reported that his "whole body ache, the spinal cord is he can''t even get up", he was in lot of pain with his knee, the both knees; can hardly walk because his knees are very weak and he had swollen arm, hand and wrist on an unspecified date. The patient took anti-inflammatory and pain medication for the event "he was in lot of pain with his knee, the both knees; hardly walk because his knees are very weak". Outcome of events was unknown. Information on Lot/Batch number was not available. Additional information has been requested.


VAERS ID: 1332807 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Angina pectoris, Headache, Insomnia, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Other ischaemic heart disease (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021520652

Write-up: Heart pain; Fever; Headache; Stomach ache; Difficulty to sleep; This is a spontaneous report received from a contactable consumer (patient). A 28-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration (at the age of 28-years-old), administered in Arm Left on 03May2021 10:00 (Batch/Lot number was not reported) as 2nd dose, single for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient previously received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration (at the age of 28-years-old), administered in Arm Left on Apr2021 10:00 (Batch/Lot number was not reported) as 1st dose, single for COVID-19 immunization. The patient experienced the normal symptoms like fever but it was just a mild fever, headache, stomach ache, and difficulty to sleep but the reason he is calling is because he was experiencing heart pain. He received the vaccine for protection on 03May2021 and for all the symptoms he had all started the same day he got the vaccine which all the symptoms started that night. The heart pain was only 10 minutes to 15 minutes that the pain lasted and it was painful but he relaxed himself and the pain went away by itself and he was not scared. He just laid down until the pain relieved and he took no medication. The outcome of the event heart pain was recovered on 03May2021, while for the rest of the events was recovered on 04May2021. The events were considered as non-serious by reporter. No history of all previous immunization with the Pfizer vaccine considered as suspect. No additional administered vaccines. No prior vaccinations (within 4 weeks). Information on the lot/batch number has been requested.


VAERS ID: 1333217 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-02
Onset:2021-05-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039A21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chills, Dizziness, Fatigue, Headache, Influenza like illness, Lethargy, Myalgia, Nausea, Pain, Paraesthesia, Pyrexia, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Beginning approx 24 hours after 2nd vaccination- began to feel flu like symptoms, dizzy, nausea, fever. This progressed to pain in every part of my body. When I touched anything it was like needles. When I laid down it felt like a bed of nails. Severe pain in muscles, joints, head, everywhere. I was fatigued, lethargic, in pain, alternated between feverish and chills. I laid down and didn''t get up for 12 hours. I truly felt I would die from the pain. I was tired, but couldn''t sleep due to pain. 12 hours later, at approx. 3 a.m. the pain subsided. The next day, while still fatigued and drained I felt better. I''ve had headaches off an on since.


VAERS ID: 1333852 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Atrial fibrillation, Cardioversion, Vertigo
SMQs:, Supraventricular tachyarrhythmias (narrow), Vestibular 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None for One week
Current Illness: None
Preexisting Conditions: Hypo-Thyroid, Insulin Resistance
Allergies: Metformin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Atrial fibrillation started, one hour after vaccine. Rushed to ER, Electrical Cardioversion given Experienced Vertigo, 18 hours after vaccine.


VAERS ID: 1334101 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-02
Onset:2021-05-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Computerised tomogram head normal, Confusional state, Full blood count abnormal, Mycobacterium test positive, Platelet count increased, Protein urine present, Red blood cells urine positive, SARS-CoV-2 test negative, Tachycardia, Urinary sediment present, Urinary tract infection, Urine abnormality, Urine analysis abnormal, Urine ketone body present, Urine leukocyte esterase positive, White blood cells urine positive
SMQs:, Acute renal failure (broad), Haematopoietic leukopenia (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Chronic kidney disease (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine
Current Illness: COVID-19 infection
Preexisting Conditions: encephalopathy, deconditioning, falls, hypertension, CVA
Allergies: None reported
Diagnostic Lab Data: CBC: within normal ranges except platelets 466 10*9/L SARS-CoV-RNA: negative UA: cloudy, positive for protein, ketones, leukocyte esterase, WBC, RBC, bacteria, and epithelial cells CT brain: no acute intracranial hemorrhage
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA: one day after immunization patient admitted to hospital for weakness and confusion. Patient tachycardic but afebrile. Diagnosed with urinary tract infection, administered antibiotics and intravenous fluids, clinically improved and discharged home medically stable.


VAERS ID: 1334761 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-05-03
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chromaturia, Pollakiuria
SMQs:, Rhabdomyolysis/myopathy (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: Plaque psoriasis
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210532106

Write-up: BATHROOM FREQUENCY/WENT TO BATHROOM ABOUT FOUR TIMES; URINE WAS LIKE A LIGHT PINK COLOR; This spontaneous report received from a health care professional concerned a 30 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included moderate to severe chronic plaque psoriasis.The patient received covid-19 vaccine (suspension for injection, intramuscular, batch number: Unknown) dose was not reported, administered on 03-MAY-2021 for prophylactic vaccination. The batch number was not provided and it has been requested. Non-company suspect drugs included: adalimumab (solution for injection in pre-filled pen, subcutaneous, batch number was not reported) dose, frequency, and therapy dates were not reported for moderate to severe chronic plaque psoriasis. No concomitant medications were reported. On 03-MAY-2021, the subject experienced bathroom frequency/went to bathroom about four times. On 03-MAY-2021, the subject experienced urine was like a light pink color. The action taken with covid-19 vaccine was not applicable; and action taken with adalimumab was not reported. The outcome of the bathroom frequency/went to bathroom about four times and urine was like a light pink color was not reported. This report was non-serious.


VAERS ID: 1336027 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A LA / SYR

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

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

Write-up: Fever began approx 3 hours after shot was administered. Fever gradually increased despite regular doses of tylenol, according to directions. Fever reached 103.9 and would not come down, even after ibuprofen. 2nd day a 102 fever in the morning and 101 throughout the rest of the day with regular tylenol doses. 3rd day feverish symptoms with low grade (99.0) fever. 4th day normal.


VAERS ID: 1336133 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042AZ1A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Body temperature increased, Burning sensation, Chills, Dizziness, Dyspnoea, Fatigue, Feeling cold, Feeling hot, Hyperhidrosis, Injection site pain, Myalgia, Nausea, Pain in extremity, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu vaccine, severe lymphadenopathy, at age about 55, unknown date or vaccine brand
Other Medications: HCTZ, Tylenol
Current Illness:
Preexisting Conditions: Reactive airway, hypertension, obesity
Allergies: Tetanus toxoid, NSAID?s, Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5-3-2021: at 11:54 am got J&J Covid-19 vaccine at Pharmacy. No anaphylaxis or other severe reactions within first four hours. By 8:00 pm began feeling fatigued and generally warm. No nausea or vomiting. By 11:00 pm developed diffuse soreness of left deltoid at injection site, mild chilling, muscle aches, T 98.8. Then developed severe shaking chills and profuse sweating, generalized, systemic burning sensation, nausea, light-headedness. This reaction lasted through the night, about 8 hrs. I spent 5-4-2021 in bed, and started feeling a bit better by 7:00 pm. By the next day felt very weak, light-headed and tired, and a little short of breath with movement. By 5-8-2021 felt pretty much back to normal, but tired. Arm soreness resolved. Reported reaction to my MD.


VAERS ID: 1336459 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-06
Onset:2021-05-03
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest discomfort, Cough, Drainage, Head discomfort, Pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nervous Cervicalgia Chronic pain disorder Headache(784.0) Meningioma Other specified hemiplegia and hemiparesis affecting dominant side Atypical angina Respiratory Obstructive sleep apnea Circulatory Coronary artery disease Essential
Current Illness:
Preexisting Conditions: aspirin 81 mg tablet cal cit-mag-D3-Zn-cop-man-bor 250-40-125 mg-mg-unit tablet cholecalciferol, vitamin D3, 1,000 unit capsule coenzyme Q10 (CO Q-10) 10 mg capsule cranberry 400 mg capsule cyanocobalamin 1,000 mcg tablet escitalopram (LEXAPRO) 20 mg tablet ferrous sulfate 324 mg (65 mg iron) EC tablet furosemide (LASIX) 20 mg tablet gabapentin (NEURONTIN) 300 mg capsule KLOR-CON M20 20 mEq CR tablet losartan (COZAAR) 100 mg tablet meclizine (ANTIVERT) 25 mg tablet metoprolol tartrate (LOPRESSOR) 25 mg tablet topiramate (TOPAMAX) 25 mg tablet(Expired) traZODone (DESYREL) 100 mg tablet
Allergies: MorphineHives / Urticaria
Diagnostic Lab Data: 05/05/21 1906 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 05/05/21 0903 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: Coordination Progress Note RN (Registered Nurse) COVID 19 Initial Patient Assessment Ordering Prescriber has completed required FDA EUA elements. COVID-19 Positive Result Date (and on chart/file): 05/05/2021 Start of Symptoms Date: 05/03/2021 Meets Criteria: ANY AGE: ? Body mass index (BMI) ?35 ? Chronic kidney disease ? Diabetes ? Immunosuppressive disease AGE SPECIFIC: ? ? 65 years of age ? ?55 years of age AND had Cardiovascular Disease OR Hypertension OR COPD/other chronic respiratory disease Reviewed present symptoms with patient. Congestion in head and chest, drainage, body aches, cough Purpose of Infusion Assessment: Can you tell me why you are receiving this infusion? Reviewed by Physician 1. Date/Time of Infusion: 5/10/2021 . Location of Infusion: A city: Come to address and while in your car, contact the Center to register over the phone from your vehicle. Once you are registered, you will be directed to the entrance and a nurse will be down to meet and assist you to the suite and infusion room ead congestion, Sinus congestion, sore throat, Mild Cough


VAERS ID: 1336944 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-29
Onset:2021-05-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Chills, Headache, Nausea, Pain in extremity, Pyrexia, Rhabdomyolysis
SMQs:, Rhabdomyolysis/myopathy (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Low dose aspirin
Current Illness:
Preexisting Conditions: Asthma, Pacemaker
Allergies: Keflex, Sulfa, Shellfish
Diagnostic Lab Data: inpatient stay 05/12/21 to 05/14/2021
CDC Split Type:

Write-up: Fever, chills, headache, nausea, chest pain, leg pain, rhabdomyolysis


VAERS ID: 1337048 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-17
Onset:2021-05-03
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Fatigue, Headache, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROAIR HFA) 90 mcg/actuation inhaler amitriptyline (ELAVIL) 50 mg tablet busPIRone (BUSPAR) 10 mg tablet FLUoxetine (PROzac) 20 mg capsule MICROGESTIN FE 1.5/30, 28, 1.5 mg-30 mcg (21)/75 mg (7) per tablet montelukast (SINGUL
Current Illness:
Preexisting Conditions: Nervous Chronic migraine without aura with status migrainosus, not intractable Respiratory Mild intermittent asthma without complication Non-seasonal allergic rhinitis due to pollen Digestive Infectious gastroenteritis and colitis Genitourinary Menorrhagia with regular cycle Musculoskeletal Pes equinus, acquired, right Deliberate self-cutting Insect bite (nonvenomous) of right upper arm, initial encounter (CODE) Other GAD (generalized anxiety disorder) Adjustment disorder with mixed anxiety and depressed mood Lactose intolerance Depression, unspecified depression type
Allergies: AmoxicillinHives / Urticaria PenicillinsHives / Urticaria Zantac [Ranitidine Hcl]Rash
Diagnostic Lab Data: 05/04/21 0750 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 05/03/21 1422 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: SORE THROAT HEADACHE FATIGUE


VAERS ID: 1337257 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Angiogram cerebral normal, Arteriogram carotid normal, Chest X-ray normal, Computerised tomogram abnormal, Computerised tomogram head abnormal, Computerised tomogram thorax, Computerised tomogram thorax abnormal, Facial bones fracture, Fall, Headache, Loss of consciousness, Rib fracture, Subarachnoid haemorrhage, X-ray normal
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Haemorrhagic central nervous system vascular conditions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Osteoporosis/osteopenia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen, amlodipine-benazepril, ibuprofen
Current Illness: none reported
Preexisting Conditions: hypertension
Allergies: none reported
Diagnostic Lab Data: In emergency department: Chest x-ray: no radiographic evidence of acute cardiopulmonary process CT brain: moderate volume subarachnoid hemorrhage predominantly based in the right sylvian fissure, fracture-dislocation of the left mandible at the TMJ, comminuted bilateral nasal bone fractures involving the anterior septum, right periorbital soft tissue injury X-ray pelvis: no acute fracture or traumatic abnormality Chest CT: minimally displaced lateral fractures of the right sixth and seventh ribs CT face: extensive facial fractures CTA head/neck: unremarkable
CDC Split Type:

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA: shortly after post-vaccination 15 minute observation period patient experienced loss of conscioussness and a fall from standing. Patient transported by ambulance to emergency department alert and oriented with stable vital signs reporting headache. Patient found to have moderate right subarachnoid hemorrhage, extensive facial and mandibular fractures, bilateral nasal fractures, and right ribs six and seven fractures. Patient determined not to be a candidate for surgery and admitted for pain control, antibiotics, and monitoring. Discharged medically stable on antibiotics with neurology and oral maxillofacial surgery follow-up in place.


VAERS ID: 1337573 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Hot flush, Pain in extremity, Product administered to patient of inappropriate age
SMQs:, Tendinopathies and ligament disorders (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: escitalopram 20mg daily, losartan 100mg daily, tri-linyah daily
Current Illness: None
Preexisting Conditions: anxiety, high blood pressure, ventricular septal defect
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Mother called pharmacy on 5/21/21 and said she just took her daughter to the doctor and was informed that she should not have received the Moderna vaccine as a 16 year old. Patient''s mother reports patient had a sore arm, headache, some hot flashes after receiving the vaccine. Only lasted a few days after vaccination. Today she reports feeling fine.


VAERS ID: 1340375 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cellulitis, Diarrhoea, Fatigue, Headache, Hypersensitivity, Pruritus, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: WELLBUTRIN; LAMICTAL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Complex regional pain syndrome
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021515618

Write-up: Allergic reaction; Allergic reaction that developed into a bacterial infection of the lower leg (Cellulitis); itching; Heavy fatigue; vomiting; diarrhea; headache; This is a spontaneous report from a contactable consumer (patient). A 40-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), via an unspecified route of administration on 03May2021 at 08:45 AM (Batch/Lot Number: EW0173) at the age of 40-years-old as 2nd dose, single for COVID-19 immunization at a pharmacy or drug store. The patient had no other vaccines within 4 weeks prior to the COVID vaccine. The patient was not diagnosed with COVID-19 prior to vaccination. The patient''s medical history included complex regional pain syndrome (CRPS) from an unknown date and unknown if ongoing. The patient had no known allergies. Concomitant medications included bupropion hydrochloride (WELLBUTRIN) and lamotrigine (LAMICTAL); both taken for unspecified indications, start and stop dates were not reported (received within 2 weeks of vaccination). The patient previously received the first dose of BNT162B2 (Lot number: ER8729) on 15Apr2021 at 02:15 PM in the left arm for COVID-19 immunization. On 03May2021 at 11:00 AM, the patient experienced allergic reaction that developed into a bacterial infection of the lower leg (Cellulitis). There was extreme pain and burning in addition to itching, and the patient also experienced heavy fatigue, vomiting, diarrhea, and headache. The events resulted in doctor or other healthcare professional office/clinic visit and also emergency room/department or urgent care. The patient was treated with antibiotics for the events. Since the vaccination, the patient has not been tested for COVID-19. The outcome of the events was not recovered.


VAERS ID: 1340482 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-01
Onset:2021-05-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / -

Administered by: Pharmacy       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: High cholesterol
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021534644

Write-up: developed "Bell Palsy" between 48-72 hours after his second shot; This is a spontaneous report from a contactable consumer (patient). A 39-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration, administered in arm left on 01May2021 10:00 (at age of 39-year-old) (lot number: EW0167) as single dose for covid-19 immunisation. Medical history included high cholesterol. No known allergies. The patient''s concomitant medications were 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. Patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) in arm left on an unknown date in Apr2021 10:00 (lot number: EW0153) for covid-19 immunization. The patient developed "Bell Palsy" between 48-72 hours after his second shot. The event start date was on 03May2021 14:00. The event resulted in doctor or other healthcare professional office/clinic visit. The event resulted in Emergency room/department or urgent care. No covid prior vaccination, no covid tested post vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. Therapeutic measures were taken as a result of the event included prednisone and valacyclovir. Event outcome was not recovered.


VAERS ID: 1340493 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021548296

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the long term care facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : US-PFIZER INC-2021576911 same reporter, vaccine and AE, different patient;US-PFIZER INC-2021576917 same reporter, vaccine and AE, different patient;US-PFIZER INC-2021576919 same reporter, vaccine and AE, different patient;US-PFIZER INC-2021576926 same reporter, vaccine and AE, different patient;US-PFIZER INC-2021576920 same reporter, vaccine and AE, different patient;US-PFIZER INC-2021576916 same reporter, vaccine and AE, different patient;US-PFIZER INC-2021576921 same reporter, vaccine and AE, different patient;US-PFIZER INC-2021576914 same reporter, vaccine and AE, different patient;US-PFIZER INC-2021576924 same reporter, vaccine and AE, different patient;US-PFIZER INC-2021576912 same reporter, vaccine and AE, different patient;US-PFIZER INC-2021576923 same reporter, vaccine and AE, different patient;US-PFIZER INC-2021576915 same reporter, vaccine and AE, different patient;US-PFIZER INC-2021576918 same reporter, vaccine and AE, different patient;US-PFIZER INC-2021576913 same reporter, vaccine and AE, different patient;US-PFIZER INC-2021576925 same reporter, vaccine and AE, different patient;US-PFIZER INC-2021576922 same reporter, vaccine and AE, different patient;US-PFIZER INC-2021576910 same reporter, vaccine and AE, different patient;US-PFIZER INC-2021576684 same reporter, vaccine and AE, different patient


VAERS ID: 1340518 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576684

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the long term care facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : US-PFIZER INC-2021548296 same reporter, vaccine and AE, different patient


VAERS ID: 1340519 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576910

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the long term care facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : US-PFIZER INC-2021548296 same reporter, vaccine and AE, different patient


VAERS ID: 1340520 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576911

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the long term care facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : US-PFIZER INC-2021548296 same reporter, vaccine and AE, different patient


VAERS ID: 1340521 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576912

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the long term care facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : US-PFIZER INC-2021548296 same reporter, vaccine and AE, different patient


VAERS ID: 1340522 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576913

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the long term care facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : US-PFIZER INC-2021548296 same reporter, vaccine and AE, different patient


VAERS ID: 1340523 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576914

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : US-PFIZER INC-2021548296 same reporter, vaccine and AE, different patient


VAERS ID: 1340524 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576915

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the long term care facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : US-PFIZER INC-2021548296 same reporter, vaccine and AE, different patient


VAERS ID: 1340525 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576916

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the long term care facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : US-PFIZER INC-2021548296 same reporter, vaccine and AE, different patient


VAERS ID: 1340526 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576917

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the long term care facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : US-PFIZER INC-2021548296 same reporter, vaccine and AE, different patient


VAERS ID: 1340527 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576918

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the long term care facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : US-PFIZER INC-2021548296 same reporter, vaccine and AE, different patient


VAERS ID: 1340528 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576919

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the long term care facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : PFIZER INC-2021548296 same reporter, vaccine and AE, different patient


VAERS ID: 1340529 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576920

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the long term care facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : US-PFIZER INC-2021548296 same reporter, vaccine and AE, different patient


VAERS ID: 1340530 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576921

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the long term care facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : US-PFIZER INC-2021548296 same reporter, vaccine and AE, different patient


VAERS ID: 1340531 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576922

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the long term care facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : US-PFIZER INC-2021548296 same reporter, vaccine and AE, different patient


VAERS ID: 1340532 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576923

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the long term care facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : US-PFIZER INC-2021548296 same reporter, vaccine and AE, different patient


VAERS ID: 1340533 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576924

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the long term care facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : US-PFIZER INC-2021548296 same reporter, vaccine and AE, different patient


VAERS ID: 1340534 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576925

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the long term care facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : US-PFIZER INC-2021548296 same reporter, vaccine and AE, different patient


VAERS ID: 1340535 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-01-03
Onset:2021-05-03
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? Yes
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: Test Date: 20210503; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC2021576926

Write-up: COVID-19 confirmed by positive COVID-19 test; COVID-19 confirmed by positive COVID-19 test; This spontaneous report from a contactable nurse reporting same events under the same suspect product for 19 patients. This is one of 19 reports. An elderly patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jan2021 (Batch/Lot number was not reported) at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced positive with COVID-19 on 03May2021. It was reported that 19 residents in the long term care facility where the reporter work were fully vaccinated and are positive with COVID-19. Some were not doing well at all. The events was serious for being hospitalization, life threatening. The events result in Emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19 on 03May2021 with positive result. The outcome of the events was unknown. Information on the lot/batch number has been requested.; 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.,Linked Report(s) : PFIZER INC-2021548296 same reporter, vaccine and AE, different patient


VAERS ID: 1340983 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-02
Onset:2021-05-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Antiphospholipid antibodies negative, Antithrombin III, Blood homocysteine normal, Coagulation factor V level normal, Fluorescence angiogram normal, Fundus autofluorescence, Macular oedema, Optical coherence tomography normal, Photopsia, Protein C, Protein S normal, Retinal vein occlusion, Vision blurred, Vitreous floaters
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Fundus photos, Flurescein Angiography, OCT Macula. Antiphospholipid panel, Protein S, Protein C, Factor V, Homocysteine and Antithrombin all come back normal from lab testing.
CDC Split Type:

Write-up: Sudden appearance of significant amount of eye floaters, flashes and blurriness in the right eye about 20 hours after the 2nd shot of Pfizer Covid-19 vaccine. First started to notice sporadic floaters and mild blurriness during the 3-week period between the 1st and the 2nd shot of Pfizer vaccine. Diagnosed with Central Retinal Vein Occlusion (CRVO) with macular edema in the right eye within 48 hours of the 2nd shot of the vaccine. Confirmed by second opinion. Right eye vision is currently 20/50. Received Eylea injection in the right eye. Antiphospholipid panel, Protein S, Protein C, Factor V, Homocysteine and Antithrombin all come back normal from lab testing. Blood pressure normal, no diabetes, no known systematic disease. 34 year old female.


VAERS ID: 1342307 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-01
Onset:2021-05-03
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Catheterisation cardiac, Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: 05/06/2021 - heart catheterization Blood draws
CDC Split Type:

Write-up: Multiple mini heart attacks, with a three day stay in the hospital


VAERS ID: 1342992 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-30
Onset:2021-05-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Menstruation irregular, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa, Percocet
Current Illness: Osteoarthritis
Preexisting Conditions: Asthma
Allergies: Nka
Diagnostic Lab Data: Saw my gyn 5/6/2021 she ordered ultrasound, scheduled June 4
CDC Split Type:

Write-up: Period clots that resemble miscarriage every 20 minutes for 4+ days


VAERS ID: 1343159 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-12
Onset:2021-05-03
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Myalgia, Nausea, Night sweats, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: High fever, chills, muscle aches, night sweats, nausea, vomiting, headache. Persisted for 3 days.


VAERS ID: 1343167 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-04-28
Onset:2021-05-03
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pruritus to face, head and neck. Under arm pain to the injected side.
Current Illness: None
Preexisting Conditions: DM2, HTN
Allergies: Latex, lisinopril, Percocet
Diagnostic Lab Data:
CDC Split Type:

Write-up: Using antihistamines topical and oral.


VAERS ID: 1343454 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram thorax abnormal, Dyspnoea, Electrocardiogram, Electrocardiogram abnormal, Headache, Pain, Pericarditis, Ultrasound scan abnormal
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (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? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Meloxicam, montelukast, flexiril
Current Illness: No illness but being treated for whiplash
Preexisting Conditions: N/A
Allergies: Allergic to morphine
Diagnostic Lab Data: ECG, EKG, CT SCAN, SONOGRAM (5/8/2021).
CDC Split Type:

Write-up: Chest pain, shortness of breath, pain, headache. Diagnosed with pericarditis.


VAERS ID: 1343497 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-26
Onset:2021-05-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose increased, Dysstasia, Feeling abnormal, Gout, Incomplete course of vaccination, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Dementia (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), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Medication errors (narrow)

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

Write-up: patient had moderna covid vaccine on 4-26-21, administered in his left arm. He states that within a week he started having pain in his left foot that eventually moved up to just below his knee. This included swelling. He saw his physician, who began treating him for gout. His also said that he felt off and insisted that his doctor checks his blood sugar, although he had no previous issues with his blood sugars. He came back at a 241. He is now taking allopurinol and metformin. The pain and swelling in his left leg is subsiding now. He did go thru one period of 4 days where he said he could not stand on his left leg. He was due for his second shot today, 5/24/21, but chose not to out of caution, until his doctor figures out what is going on. Also, his dietician recommended he not get the vaccine at this time


Result pages: prev   78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=177&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


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