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From the 11/12/2021 release of VAERS data:

Found 875,292 cases where Vaccine is COVID19 and Patient Did Not Die

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

This is page 178 out of 8,753

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VAERS ID: 1835531 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-10-10
Onset:2021-10-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OCREVUS; TEGRETAL; GABAPENTIN; ADDERALL; VITAMIN D [VITAMIN D NOS]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19; Multiple sclerosis; Sulfonamide allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101382391

Write-up: sever headache; This is a spontaneous report from a non-contactable consumer (nurse, patient). A 35-year-old female patient received second dose of BNT162B2 (Comirnaty, Solution for injection, lot/batch number: FF2590 and expiry date was not reported), via an unspecified route of administration in arm left, on 10Oct2021 at 01:30 PM (age at vaccination: 35 years), as a dose 2, single for COVID-19 immunization. The patient''s medical history includes allergies to sulfa and multiple Sclerosis. The concomitant medications include ocrelizumab (ocrevus), carbamazepine (tegretal), gabapentin, amfetamine aspartate, amfetamine sulfate, dexamfetamine saccharate, dexamfetamine sulfate (adderall), vitamin D[vitamin D nos] (vitamin D) all from an unknown date for an unknown indication. It was reported that the patient had covid prior vaccination and was not covid tested post vaccination. Reportedly the patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient historical vaccine includes BNT162B2 (Comirnaty, Solution for injection, lot/batch number: 301358A and expiry date was not reported), via an unspecified route of administration in arm left, on 19Sep2021 at 04:30 PM, as a dose 1, single for COVID-19 immunization. On 14Oct2021, 4 days after second dose a severe headache that was persisted for 4 days. The headache was constant and was located on the right side behind her right eye. It was reported that the headache was not responding to ibuprofen or Tylenol. Noticed hcp and as a treatment of adverse event the patient was prescribed with a steroid dose pack starting at 80mg. Outcome of the event was not recovered. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1835546 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 3 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: RIZATRIPTAN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Chronic kidney disease stage 1
Allergies:
Diagnostic Lab Data: Test Date: 20211014; Test Name: Body Temperature; Result Unstructured Data: Test Result:Slight fever
CDC Split Type: USPFIZER INC202101384426

Write-up: Slight fever; chills; diarrhea; swollen lymph nodes (left arm pit); low back pain; This is a spontaneous report from a contactable Consumer (patient) reported for herself. A 65-year-old non pregnant female received third dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot number: 301358A) via unknown route of administration in left arm on 14Oct2021 at 14:30 (at the age of 65 years old) as DOSE 3 (BOOSTER), SINGLE for covid-19 immunisation. The patient medical history included Kidney disease, Stage 1. The patient did not have allergies. The concomitant medication included rizatriptan for an unknown indication from an unknown date ( reported as other medication in two weeks). The patient historical vaccine included first dose of (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot number: EN6199) via unknown route in left arm on 08Mar2021 at 09:00 AM (at the age of 65 years old) as DOSE 1, SINGLE and second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot number: ER8737) via unknown route in left arm on 30Mar2021 at 08:30 AM (at the age of 65 years old) as DOSE 2, SINGLE for covid-19 immunisation. Patient did not receive other vaccine in 4 weeks. On 14Oct2021 at 21:00, the patient experienced slight fever, chills, diarrhea, swollen lymph nodes (left arm pit) and low back pain. It was reported that Fever, chills lasted 24 hours, but lymph nodes still swollen and back pain was persistent. Patient did not have covid prior vaccination and not tested for covid post vaccination. The lab data included body temperature was slight fever on 14Oct2021. It was also reported that the events were non-serious. Patient did not receive the treatment. The outcome of the events Fever and chills were recovered on 15Oct2021 and other events were not recovered. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1835562 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Headache, Immunisation, 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: Test Date: 20211015; Test Name: Body temperature; Result Unstructured Data: Test Result:101; Comments: Temperature peaked to 101 about 19 hours later
CDC Split Type: USPFIZER INC202101392308

Write-up: Temperature peaked to 101 about 19 hours later. By 48 hours there were no symptoms.; Headache within a hour.; Dose 3 administered; This is a spontaneous report from a contactable consumer. A male patient of age 41-year-old received third booster dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FF8841) via an unspecified route of administration in the left arm on 14Oct2021 at 08:45 (at the age of 41-year-old), as a single dose for COVID-19 immunisation. Medical history was not reported. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient received influenza vaccine (MANUFACTURER UNKNOWN) via an unspecified route of administration on 28Sep2021 for immunization within 4 weeks of vaccination. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EL3248) via an unspecified route of administration on 13Jan2021(at the age of 40-year-old) and received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EL3248) via an unspecified route of administration on 02Feb2021 (at the age of 41-year-old); both as a single dose for COVID-19 immunisation. On 14Oct2021 at 09:30, the patient experienced headache within an hour and temperature peaked to 101 (units unspecified) about 19 hours later. By 48 hours there were no symptoms. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of headache within an hour and temperature peaked to 101 was resolved on an unknown date in Oct2021.


VAERS ID: 1836720 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-04
Onset:2021-10-14
   Days after vaccination:224
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Anticoagulant therapy, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Fibrin D dimer increased, Lung opacity, Pneumonia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Interstitial lung disease (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), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), 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? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, aspirin, atorvastatin, baclofen, calcium, citalopram, clopidogrel, vitamin B12, isometheptene-dichloralphenazone-acetaminophen, lidocaine patch, lisinopril, omega-3 fatty acids, trazodone, white flower oil, diclofenac gel
Current Illness: back pain- left lumbar medial branch block performed
Preexisting Conditions: arthritis, asthma, CAD, diverticulitis, GERD, heart murmur, hyperlipidemia, hypertension, IBS, migraines, myocardial infarction, pseudocholinesterase deficiency, sleep apnea
Allergies: ADHESIVE,CODEINE,SUCCINYLCHOLINE CHLORIDE,SPIRONOLACTONE
Diagnostic Lab Data: D-dimer: 650 ng/mL SARS-COV-2: positive Chest x-ray: streaky scattered opacities in both lungs consistent with COVID-19 pneumonia CTA chest: no acute pulmonary embolism,; multifocal bilateral peribronchovascular and peripheral ground glass opacities, in keeping with COVID-19 pneumonia
CDC Split Type:

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA: hospitalized with pneumonia acute hypoxic respiratory failure seven months after vaccination. Received steroids, oxygen, and anticoagulation for elevated d-dimer. Discharged medically stable. Improving on outpatient follow-up.


VAERS ID: 1836923 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dysphagia, Erythema, Feeling abnormal, Pharyngeal swelling, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Employee felt foggy and lightheaded after vaccine. Nursing staff monitored her for 30 minutes and approved her to leave. She stated it was hard to swallow and her throat felt swollen. At 9PM she began having redness and hives on her arms and face. On Friday night she was seen at ER


VAERS ID: 1837000 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-10-12
Onset:2021-10-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Magnesium calcium zinc, Vitamin D3, B100 complex, 1200 mg fish oil, centrun adult 50+, Vitamin C , bio plasma Twelve Cell salt
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: On Thursday 10/21/21, From facility, after seeing the rash, they gave me hydrocortisone cream and benadril pills. Which did not work at all. From health department Monday 10/25/21 i was given triamcinolone acetonide to apply on itchy area with wet covers for 30 min twice a day and cetirizine hlc pill to take twice a day. Which works.
CDC Split Type:

Write-up: Started with left neck under armpit pain. When the pain disappeared the itchy rash started around the injection shot of thr 3rd covid19 booster, went down the left arm, left chest, tummy. It has been wakimg me up at night. And now it is on my spine gluts, and back of both legs and ankles.


VAERS ID: 1837004 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 2 LA / IM

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

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

Write-up: Systemic: Patient started to hear noises in his head after receiving covid19 2nd dose.-Medium, Additional Details: Patient started to hear noises in his head after receiving covid19 2nd dose on 10/14/2021. Patient claims he started to hear noises in his head the night of the day he got his 2nd dose. The symptom is going on constantly and it didn''t get any better. He said the noise is less when he is talking and gets louder when he is quite. He doesn''t have any other complaints bedside the noise in his head.


VAERS ID: 1837698 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-10-01
Onset:2021-10-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 11121301458A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine .75mg daily; amlodipine besylate 5 mg daily.
Current Illness: None.
Preexisting Conditions: High blood pressure being treated.
Allergies: Allergic to celebrex, codeine, valium
Diagnostic Lab Data: I will undergo a transvaginal ultrasound on 11/3/21.
CDC Split Type:

Write-up: On 10/14/21 I experienced an episode of vaginal bleeding. I have been post menopausal for 3years. I made an appointment with my doctor on 10/20/21, at that time it was only one event, but she had me schedule an ultrasound. Approximately 2 days later I started light vaginal bleeding and it has continued since. Not like having a period just a light bleeding. A couple of years ago I had benign polyps removed, and was thinking those had returned, although I?ve had no problems for 2 years, and hadn?t thought about reporting the bleeding. However, during my last VSafe check in, it recommended if you have seen a doctor for anything since your vaccination it should be reported, so I did. A person from the CDC contacted me and said that I should report this issue via VAERS.


VAERS ID: 1839950 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-10-10
Onset:2021-10-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Faeces discoloured, Metabolic function test, Parasite stool test, Parosmia, Stool analysis
SMQs:, Taste and smell disorders (narrow), Noninfectious diarrhoea (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: CYMBALTA MODANAFIL TADALAFIL LOSARTAN HCTZ VIT C VIT D ZINC
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: LATEX
Diagnostic Lab Data: ENTERIC PARASITE MOLECULAR DETECTION, ENTERIC STOOL PAHTOGENS, COMP METABOLIC PANEL, TSH SENSITIVE, HOMOGRAM/PLTS/DIFF
CDC Split Type:

Write-up: CHANGE IN SMELL, ALL THINGS SMELL SIMILARLY BAD. CHANGE IN STOOL COLOR. BLOOD TESTS SHOW NOTHING ABNORMAL. ALL WITHIN NORMAL RANGES.


VAERS ID: 1840056 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Discomfort, Dyspnoea, Head discomfort, Muscular weakness, Paraesthesia, Paranasal sinus discomfort
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: unknown
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Weakness in back muscles, pins and needles across arms and chest, difficulty breathing, increase in anxiety, sinuses and neck and head have extreme pressure at times.


VAERS ID: 1840184 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Neck pain, Pain
SMQs:, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: nkda
Diagnostic Lab Data: n''a
CDC Split Type:

Write-up: patient compalined about shooting pain at the time of administering the vaccine. she had neck pain. verified on 11/03/21 patient verbally admitted that she is feeling well now.


VAERS ID: 1840442 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-20
Onset:2021-10-14
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute sinusitis, Adenovirus test, Aortic dilatation, Asthenia, Atelectasis, Atrial flutter, Atrial pressure increased, Blood creatinine increased, Blood lactic acid, Bordetella test negative, Bradycardia, Brain natriuretic peptide increased, C-reactive protein increased, COVID-19, COVID-19 pneumonia, Cardiomegaly, Chest discomfort, Chlamydia test negative, Computerised tomogram thorax, Condition aggravated, Coronavirus test negative, Cough, Decreased appetite, Diarrhoea, Dilatation atrial, Electrocardiogram normal, Emphysema, Enterovirus test negative, Exposure to SARS-CoV-2, Fatigue, Gynaecomastia, Haematocrit decreased, Haemoglobin decreased, Human metapneumovirus test, Human rhinovirus test, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Lung opacity, Lymphadenopathy mediastinal, Mycoplasma test negative, Myelopathy, Nausea, Oxygen saturation decreased, Platelet count decreased, Pleural effusion, Pulmonary arterial hypertension, Respiratory syncytial virus test negative, Respiratory viral panel, Rib deformity, SARS-CoV-2 test positive, Scan with contrast abnormal, Secretion discharge, Vomiting, White blood cell count decreased, Wound
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Peripheral neuropathy (narrow), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Systemic lupus erythematosus (narrow), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Lipodystrophy (broad), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ARMOUR THYROID 60 mg tablet ascorbic acid, vitamin C, (VITAMIN C) 500 mg tablet CONTOUR NEXT TEST STRIPS strip felodipine (PLENDIL) 2.5 mg 24 hr tablet fluticasone propionate (FLONASE) 50 mcg/actuation nasal spray furosemide (LASIX) 20
Current Illness:
Preexisting Conditions: Nervous Idiopathic peripheral neuropathy Neuropathy, lumbosacral (radicular) Respiratory COPD (chronic obstructive pulmonary disease) Shortness of breath Cough Community acquired pneumonia Circulatory Atrial flutter AV heart block Congenital heart disease Cardiac pacemaker in situ Chronic congestive heart failure Essential hypertension TOF (tetralogy of Fallot) Type II diabetes mellitus with peripheral circulatory disorder Atrial flutter, unspecified type Digestive B12 deficiency Vitamin D deficiency Genitourinary CKD (chronic kidney disease) stage 3, GFR 30-59 ml/min Musculoskeletal Osteomyelitis of foot Chronic foot ulcer Closed fracture of proximal end of left humerus with routine healing Closed left hip fracture Pressure ulcer of left heel, stage 2 Dupuytren''s contracture Acquired hammer toe of left foot Pressure ulcer of toe of left foot, stage 3 Endocrine/Metabolic Hypokalemia Hypothyroidism Mixed hyperlipidemia Hematologic Subtherapeutic international normalized ratio (INR) Anemia Coagulopathy Iron deficiency anemia secondary to inadequate dietary iron intake Other Debility Depression Primary insomnia Spinal stenosis BMI 23.0-23.9, adult Low oxygen saturation Generalized weakness
Allergies: Niacin Sulfa (Sulfonamide Antibiotics) MoxifloxacinDiarrhea
Diagnostic Lab Data: 10/24/2021 1617 Respiratory virus detection panel Collected: 10/24/21 1617 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result Detected Critical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected 10/19/2021 1135 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 10/19/21 1135 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result Detected Critical 10/19/2021 1135 COVID-19 PCR Collected: 10/19/21 1135 | Final result | Specimen: Swab from Nasopharynx Procedure Component Value Ref Range Date/Time CT angiogram chest with and without contrast (Abnormal) Resulted: 10/24/21 1757 Order Status: Completed Updated: 10/24/21 1757 Narrative: PROCEDURE INFORMATION: Exam: CTA Chest With Contrast Exam date and time: 10/24/2021 16:38 Age: 75 years old Clinical indication: Shortness of breath; Prior surgery; Additional info: R/O pe, fatigue and SOB x 8 days per PT. HX of cardiac surgery. TECHNIQUE: Imaging protocol: Computed tomographic angiography of the chest with contrast. 3D rendering (Not supervised by radiologist): MIP and/or 3D reconstructed images were created by the technologist. Radiation optimization: All CT scans at this facility use at least one of these dose optimization techniques: automated exposure control; mA and/or kV adjustment per patient size (includes targeted exams where dose is matched to clinical indication); or iterative reconstruction. Contrast material: 350 OMNI; Contrast volume: 80 ml; Contrast route: INTRAVENOUS (IV); COMPARISON: CTA CHEST PULMONARY EMBOLISM W WO CONTRAST 01/04/2021 17:23 FINDINGS: Tubes, catheters and devices: Left chest wall pacemaker in the expected position. Pulmonary arteries: No pulmonary artery emboli. Dilated main PA at 39 mm similar to prior, likely chronic PA hypertension. Aorta: 39 mm dilation of the ascending aorta without rupture. Normal caliber of the descending aorta.. No aortic dissection. Lungs: Mild in severity predominantly lung base peripheral ground-glass opacities, which represent a slight change in morphology of pulmonary disease since the previous study with the finding today most suggestive of atypical infection. Most pronounced in the right lower lobe involving lingula, left lower lobe and right middle lobe as well. Mild dependent subsegmental atelectasis. Pleural spaces: Trace right pleural fluid, decreased in volume. No pneumothorax. Heart: Reflux of contrast into the IVC suggesting elevated right atrial pressures. Moderate to severe cardiomegaly with marked dilation of the right and left atrium. Lymph nodes: Mild mediastinal adenopathy appears likely commensurate to the degree of pulmonary disease. Bones/joints: Chronic left-sided rib deformities. Degenerative changes in the spine. Median sternotomy wires. No acute fracture or subluxation. Soft tissues: Gynecomastia. IMPRESSION: 1. Findings concerning for mild COVID-19 pneumonia. Consider pneumonitis in the right clinical setting. Pattern would be very unusual for pulmonary edema. 2. Moderate to severe cardiomegaly with marked dilation of the right and left atrium. 3. No pulmonary artery emboli. Chronic PA hypertension. 4. Trace right pleural fluid, decreased in volume. 5. Mild dependent subsegmental atelectasis. THIS DOCUMENT HAS BEEN ELECTRONICALLY SIGNED BY MD
CDC Split Type:

Write-up: 10/18/2021 Cough, Spitting up mucus, Diarrhea 10/19/2021 Pulmonary emphysema, unspecified emphysema type, Atrial flutter, unspecified type, Low oxygen saturation, Non-intractable vomiting with nausea, unspecified vomiting type, Acute recurrent maxillary sinusitis, Cough in adult, Exposure to COVID-19 virus ED to Hosp-Admission Discharged 10/24/2021 - 10/30/2021 (6 days) Hospital - Hospital Problems POA * (Principal) Generalized weakness Yes Anemia Yes Cardiac pacemaker in situ Yes Chronic congestive heart failure Yes Chronic foot ulcer Yes COPD (chronic obstructive pulmonary disease) Yes Essential hypertension Yes Type II diabetes mellitus with peripheral circulatory disorder Yes Subtherapeutic international normalized ratio (INR) Yes Presenting Problem/History of Present Illness/Reason for Admission Generalized weakness [R53.1] Profound fatigue [R53.83] COVID-19 virus infection [U07.1] Patient is an 75 y.o. male with past medical history of atrial fibrillation, CHF, cardiac pacemaker, chronic anticoagulation, diabetes mellitus, unhealing wound to left heel, CKD, COPD, hypertension, recent covid-19 infection (10/19), who presented to the ED with complaint of intermittent cough, chest pressure with cough, overwhelming fatigue, poor appetite and nausea. Patient states that his Covid symptoms started 16 days ago, him and his wife both tested positive on the 19th. Patient is afebrile on arrival with oxygen saturation of 96% on room air, B/P 126/60. Pertinent ED work up includes laboratory studies that shows WBC 4.5, H&H 11.0/33.3 (which appears to be his baseline labs) platelet 136, BNP 474, lactate 1.0 Respiratory viral panel positive for Covid. EKG A/V paced, no ectopy, no acute ST-T wave elevation or depression, similar to prior. CTA of chest shows mild COVID-19 pneumonia, Moderate to severe cardiomegaly with marked dilation of the right and left atrium, no pulmonary emboli. Patient referred to hospitalist service for admission. Hospital Course Patient admitted for generalized weakness, functional decline due to COVID-19 infection, patient CRP minimally elevated, no oxygen requirement, patient respiratory status did not change during hospitalization, so patient was not a candidate for steroids or remdesivir. Regarding left heel wound patient was seen and evaluated by wound care, dressing was changed daily, according recommendations. Patient had slight bump in creatinine, which improved after holding Lasix and starting on Flomax, due to bradycardia his metoprolol was decreased to 25 mg. Patient will discharged to Facility in stable condition.


VAERS ID: 1840470 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-22
Onset:2021-10-14
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Alopecia
SMQs:

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

Write-up: Increasingly losing hair. Started between doses and almost three weeks out from second dose is still happening


VAERS ID: 1840595 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-12
Onset:2021-10-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: School       Purchased by: ?
Symptoms: Alopecia, Blood test normal, Chest discomfort, Chest pain, Hypoaesthesia, Metabolic function test
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Sexual dysfunction (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: cyclosporine, atarax
Current Illness:
Preexisting Conditions: eczema
Allergies:
Diagnostic Lab Data: I got bloodwork done just to check and my CMP is normal
CDC Split Type:

Write-up: chest pain and tightness that has lasted 3 weeks, arm numbness on both sides (worse on injected arm), hair loss (brushing hair has been strange),


VAERS ID: 1841195 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-10-13
Onset:2021-10-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF884 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Fatigue, Headache, Hypoaesthesia, Parosmia, Poor quality sleep, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Depression (excl suicide and self injury) (broad), Sexual dysfunction (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: Valcyclovir, Busperin
Current Illness: None
Preexisting Conditions: None
Allergies: NA
Diagnostic Lab Data: Scheduling a doctor''s appointment in the next week since the effects have not subsided.
CDC Split Type:

Write-up: 3 continuous weeks of exhaustion, restless sleep, headaches, congestion, cough, random numbness in my left arm, and constant burnt plastic smell in my nose. Symptoms began the day after the 2nd dose and have not subsided 3 weeks after the injection.


VAERS ID: 1841208 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-18
Onset:2021-10-14
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A` / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Biopsy, Eczema, Erythema, Laboratory test, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: singulair, cymbalta, caduet , daily vitamin,
Current Illness: none
Preexisting Conditions: Very Good
Allergies: Flu Shot
Diagnostic Lab Data: Lab Results......Lab Results on 10/18/21 Biopsy was talken and result was Spongiotic Dermatitis from specimen
CDC Split Type:

Write-up: Spongiotic Dermatitis, all over entire body.Biopsy was taken to confirm. Condition present at this time for 2 weeks and still persists. Topical ointment daily treatments X2. Redness and raised welts so far for 2 weeks.


VAERS ID: 1842164 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 3 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Axillary pain, Immunisation, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: QUINAPRIL; CRESTOR
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high (High blood pressure)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101381852

Write-up: Pain under the left arm where shot was given; swelling under the left arm where shot was given; Patient received a third/booster dose; This is a spontaneous report from a contactable consumer, the patient. A 68-year-old non-pregnant female patient received third (booster) dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0179) via an unspecified route of administration in the left arm on 14Oct2021 (at the age of 68-years-old) as a single dose for COVID-19 immunisation. Medical history included high blood pressure and it was reported that the patient was not aware of the allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID-19 vaccine. Concomitant medications included quinapril (MANUFACTURER UNKNOWN) and rosuvastatin calcium (CRESTOR); both for unknown indication from an unknown date and unknown if ongoing. The patient previously received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot number: EN6206) via an unspecified route of administration in the left arm on 12Mar2021 (at the age of 67-years-old) as a single dose for COVID-19 immunisation and received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EN6201) via an unspecified route of administration in the left arm on 19Feb2021 (at the age of 67-years-old) as a single dose for COVID-19 immunisation. On 15Oct2021, the patient experienced pain and swelling under the left arm where shot was given. Therapeutic measures were not taken as a result of the events. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events pain and swelling under the left arm where shot was given was not resolved at the time of this report.


VAERS ID: 1842168 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-10-14
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac flutter, Chills, Muscle spasms
SMQs:, Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dystonia (broad), Tachyarrhythmia terms, nonspecific (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: Medical History/Concurrent Conditions: Fibromyalgia; Inflammatory bowel disease; Osteoporosis
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101403296

Write-up: Heart flutters; chest muscles cramping with chills; chills; This is a spontaneous report from a contactable consumer (patient). A 70-year-old female patient received third dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via unspecified route in left arm on an unspecified date single dose for covid-19 immunization at 70-year-old. Medical history included inflammatory bowel disease (IBS), osteoporosis, fibromyalgia. No known allergies or covid prior vaccination. The patient''s concomitant medications were not reported. No other vaccine in four weeks. The patient previously received first and second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) in right arm for covid-19 immunization at 70-year-old. The patient experienced heart flutters and chest muscles cramping with chills on 14Oct2021 04:00 with outcome of recovered, no treatment received. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1842222 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Choking, Feeling abnormal, Illness, Joint range of motion decreased, Malaise, Near death experience, Pain, Productive cough, Pruritus, Rhinorrhoea
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Dementia (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy (patient didn''t take medications because she was allergic to it); Drug allergy (patient didn''t take medications because she was allergic to it)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101482316

Write-up: feeling like she thought she was going to die; sick for 6 days, it was awful; she couldn''t come to herself; producing so much phlegm she choked when speaking; body aches; running nose; did not feel well; trouble lifting her arm from so much pain; producing so much phlegm she choked when speaking; itching; This is a spontaneous report from a contactable consumer (patient). A 79-year-old female patient received BNT162B2 (COMIRNATY, Batch/Lot number was not reported), via an unspecified route of administration, administered in left arm on 14Oct2021 (at 79-year-old) as dose 3 (booster), single for COVID-19 immunisation. Medical history included allergic to a lot of things and patient didn''t take medications because she was allergic to it. The patient''s concomitant medications were not reported. The patient previously received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose1 and dose 2, both via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as single dose for COVID-19 immunization. The patient reported feeling like she thought she was going to die on an unspecified date and several adverse events after the dose on 14Oct2021 including: running nose, body aches, trouble lifting her arm from so much pain, producing so much phlegm she choked when speaking, and itching. She did not feel well for six days and has taken cold/flu medications to help. She was not too thrilled about it. She asked if these symptoms have been reported before. She took the Pfizer 1 and 2 shot no problem and took the booster and she thought she was going to die. 3 hours later her nose was running, her body was aching, when she tried to speak she was choking on so much phlegm. She was sick for 6 days, it was awful. She knew people that have taken it without any effects but for some reason she did. She wound up having itching since she took the shot and went to her dermatologist. She was allergic to a lot of things and they didn''t ask questions or say they need to know anything about anything. She didn''t know if she would take another one, it was like 6 days like that and she couldn''t come to herself. She couldn''t lift her arm to put on clothes she was in so much pain, it was weird. Patient thought it must be something in the shot. She said this was 6 days. She took some medication to try to ward it off and that took time and she was getting better and better. She was fine before the vaccine and was sick as a dog after. Her neighbor has been checking on her and she talked to her doctor and he told her to take cold and flu medication and that helped. Other than for itching her doctor gave her some allergy pills, she tooke allergy pills every day but he gave her something else for morning and evening. She didn''t like to take medications, vitamins were ok. The outcome of the events was recovering. The lot number for BNT162B2, was not provided and will be requested during follow up.


VAERS ID: 1842581 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-10-14
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 3 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Patient was administered a dose from an expired vial; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient was administered a dose from an expired vial) in a 31-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 049E21A) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient was administered a dose from an expired vial). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (Patient was administered a dose from an expired vial) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Concomitant and Treatment medication were reported.


VAERS ID: 1842603 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / UNK - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Dose administered to patient after 30 day Use By Date; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Dose administered to patient after 30 day Use By Date) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 005C21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Oct-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Dose administered to patient after 30 day Use By Date). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (Dose administered to patient after 30 day Use By Date) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant information was not provided. It was reported that the officer received Moderna vaccine on 2-Sep-2021 but was unaware that the vial should have been discarded on 02-Oct-2021.They are not sure that the vail was thawed on 2-Sep-2021.The vial didn''t undergo any temperature excursions. Treatment information was not provided. This case was linked to MOD-2021-366199 (Patient Link).


VAERS ID: 1842770 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-10-13
Onset:2021-10-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF841 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Inflammatory pain, Neck pain, Pain, Pyrexia, Skin discolouration
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I woke up on October 15 in the early hours of the morning with pain on the left side of the neck , fever and pain on my whole body. Have marks on the neck and painful inflammation.


VAERS ID: 1842991 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-01
Onset:2021-10-14
   Days after vaccination:105
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Magnetic resonance imaging head, Vertigo
SMQs:, Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 10/25/21 Mri of the brain, Imaging contrast agent, Imaging contrast agent
CDC Split Type:

Write-up: Vertigo onset, required dr care and referral to neurologist as well as mri referral


VAERS ID: 1843316 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 1 LA / IM

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

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1843331 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 1 LA / IM

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

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1843336 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 1 RA / IM

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

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1843352 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 2 LA / IM

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

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1843389 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 3 RA / IM

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

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

Write-up: Error: Improper storage (temperature).


VAERS ID: 1843425 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 3 LA / IM

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

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1843482 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-13
Onset:2021-10-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Blood test normal, Headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zofran - for nausea
Current Illness: no
Preexisting Conditions: GERD
Allergies: no
Diagnostic Lab Data: I went to the doctor this past Monday for something else - they did bloodwork and that was fine.
CDC Split Type: vsafe

Write-up: I get a headache every day - I notice it in the morning periodically throughout the day. I have a persistent headache every single day since this second shot. OTC - Tylenol when need be. I notice the headache in the morning and then I''ll have it all day.


VAERS ID: 1843887 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-10-01
Onset:2021-10-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 2 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Electrocardiogram normal, Headache, Hypoaesthesia, Liver function test abnormal, Migraine, Pain, Pain in extremity, Paraesthesia, Pyrexia, Ultrasound Doppler normal
SMQs:, Liver related investigations, signs and symptoms (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Phenobarbital, phenegren
Diagnostic Lab Data: I had ultrasound in legs , chest xray, blood test, and ekg. On 10.21 in the emergency room at hospital. Liver results bit nothing too high slightlu elevated and they said everything looked ok and that it appeared I had paresthesia, but they never check my head, my head pain will not subside and now seeking other doctors to determine what is going on
CDC Split Type:

Write-up: After the fever for 24hrs straight, I now have paresthesia the my ER visit indicated, shooting pain through out my legs, numbness in my arms, and I have extreme migranes that have not gone away and shooting pain in my head all day. No medications will elevate it. I have always been healthy and this is not going away, this does not appear to be temporary.


VAERS ID: 1844538 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-13
Onset:2021-10-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood calcium increased, Blood uric acid increased, Joint swelling, Laboratory test, Nasal congestion
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tumour lysis syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Chlorthalidone, estradiol patch, lisinopril, Metformin, progesterone oral capsules, sertraline, levothyroxine
Current Illness: None
Preexisting Conditions: Recurrent Bell''s palsy, hypertension, Chronic major depression, migraines, obesity BMI 32, thyroid nodule
Allergies: No known
Diagnostic Lab Data: Labs pending but so far ? Abnormals: Elevated calcium 10.9, uric acid 7.3 Normal: Rest of CMP, CK, CBC, CRP, rheumatoid factor
CDC Split Type:

Write-up: 3 weeks of nasal congestion and multiple joint pain and swelling (bilateral wrists, lateral hips, knees, ankles) Exam with joint tenderness but otherwise normal


VAERS ID: 1845300 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Dose administered to patient after 30-day Use By Date; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Dose administered to patient after 30-day Use By Date) in an 85-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 005C21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Oct-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Dose administered to patient after 30-day Use By Date). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (Dose administered to patient after 30-day Use By Date) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications information was reported. No treatment medications were provided. This case was linked to MOD-2021-366127 (Patient Link).


VAERS ID: 1845302 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-09-16
Onset:2021-10-14
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blood oestrogen, Confusional state, Dysgeusia, Fear of disease, Progesterone, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Dysgeusia (Sour taste/ Metallic taste); Pregnancy (Patient had the same taste( sour taste and metallic taste) in her mouth during her pregnancy when she had high estrogen and low progesterone)
Allergies:
Diagnostic Lab Data: Test Name: Estrogen; Result Unstructured Data: During her pregnancy she had high estrogen; Test Date: 20211020; Test Name: Estrogen; Result Unstructured Data: she had high estrogen; Test Name: Progesterone; Result Unstructured Data: During her pregnancy she had low progesterone; Test Date: 20211020; Test Name: Progesterone; Result Unstructured Data: low progesterone
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: She also had vaginal spotting just one time/ Later she stated streaks of vaginal blood for a few days; She kept changing her story; scared that she might have uterine cancer; sour taste in her mouth and metallic taste in the mouth; This spontaneous case was reported by a nurse and describes the occurrence of DYSGEUSIA (sour taste in her mouth and metallic taste in the mouth), CONFUSIONAL STATE (She kept changing her story), FEAR OF DISEASE (scared that she might have uterine cancer) and VAGINAL HAEMORRHAGE (She also had vaginal spotting just one time/ Later she stated streaks of vaginal blood for a few days) in a 52-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 040021A and 048F21A) for COVID-19 vaccination. The patient''s past medical history included Pregnancy (Patient had the same taste( sour taste and metallic taste) in her mouth during her pregnancy when she had high estrogen and low progesterone) and Dysgeusia (Sour taste/ Metallic taste). On 16-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Oct-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Oct-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced DYSGEUSIA (sour taste in her mouth and metallic taste in the mouth). On 27-Oct-2021, the patient experienced CONFUSIONAL STATE (She kept changing her story) and FEAR OF DISEASE (scared that she might have uterine cancer). On an unknown date, the patient experienced VAGINAL HAEMORRHAGE (She also had vaginal spotting just one time/ Later she stated streaks of vaginal blood for a few days). At the time of the report, DYSGEUSIA (sour taste in her mouth and metallic taste in the mouth), CONFUSIONAL STATE (She kept changing her story) and FEAR OF DISEASE (scared that she might have uterine cancer) outcome was unknown and VAGINAL HAEMORRHAGE (She also had vaginal spotting just one time/ Later she stated streaks of vaginal blood for a few days) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 20-Oct-2021, Blood oestrogen: 287 (High) she had high estrogen. On 20-Oct-2021, Progesterone: 0.5 (Low) low progesterone. On an unknown date, Blood oestrogen: high (High) During her pregnancy she had high estrogen. On an unknown date, Progesterone: low (Low) During her pregnancy she had low progesterone. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment details were reported. This case was linked to MOD-2021-365563 (Patient Link).


VAERS ID: 1845359 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-10-13
Onset:2021-10-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Blood pressure increased, Blood pressure measurement, Eye irritation, Heart rate, Heart rate increased, Pharyngeal swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypertension (narrow), Corneal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: Test Date: 20211014; Test Name: Blood pressure; Result Unstructured Data: Test Result:167/132; Comments: 17:00; Test Date: 20211014; Test Name: resting heart rate; Result Unstructured Data: Test Result:131; Comments: 17:00
CDC Split Type: USPFIZER INC202101418243

Write-up: Anaphylaxis; Blood pressure 167/132; resting heart rate 131; swelling of the throat; irritation of the eyes; This is a spontaneous report from a contactable consumer (patient). A 33-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER BIONTECH COVID-19 VACCINE, solution for injection, lot number/expiry date unknown), via an unspecified route of administration administered in arm left on 13Oct2021 17:00 as dose 2, single for covid-19 immunization. Medical history included allergies: PCN (penicillin). The patient was previously vaccinated with the first dose of BNT162b2 (PFIZER BIONTECH COVID-19 VACCINE, lot number unknown) on 22Sep2021 17:00 in the left arm for covid-19 immunization at the age of 32 years old. The patient previously received cefalexin (KEFLEX), ciprofloxacin (CIPRO) and, azithromycin - all on unspecified dates for unknown indications and experienced allergies. The patient''s concomitant medications were not reported. The vaccine was given in a pharmacy or drug store. There were no other vaccines received in four weeks. The patient did not have covid-19 prior vaccination. On 14Oct2021 17:00 the patient experienced anaphylaxis, blood pressure 167/132, resting heart rate 131, swelling of the throat, and irritation of the eyes. Treatment received included IV antihistamine, fluids, and prednisone. The events resulted in doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care. The patient was recovering from all the adverse events at the time of the report. The patient was not tested for covid-19 post-vaccination. The lot number for BNT162B2 was not provided and will be requested during follow-up.


VAERS ID: 1845367 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-11
Onset:2021-10-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Chorioretinopathy, Metamorphopsia, Xanthopsia
SMQs:, Retinal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VITAMIN C [ASCORBIC ACID]
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 INC202101425378

Write-up: central serous chorioretinopathy; distorted far sight vision, distorted central sight; yellowish vision; This is a spontaneous report from a contactable consumer (patient). A 33-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration in left arm on 11Oct2021 at 13:15 (Lot Number: EW0179, unknown expiration) as dose 2, single at the age of 33 years old for COVID-19 immunization. Medical history reported as none. Concomitant medication included vitamin c (ascorbic acid). The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot number: EW0179) on 20Sep2021 at 13:15 in the left arm at the age of 33 years old for COVID-19 immunization. No other vaccine in four weeks. No COVID prior to vaccination and has not been tested for COVID post vaccination. The patient experienced distorted far sight vision, distorted central sight, and yellowish vision on 14Oct2021 at 05:30 am. The patient saw an eye specialist and was diagnosed with central serous chorioretinopathy. The events resulted in doctor or other healthcare professional office/clinic visit. The patient did not receive treatment for the events. The patient has not yet recovered from the events. Information on the lot/batch number has been requested.


VAERS ID: 1845400 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-10-12
Onset:2021-10-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH CUS 295 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Cough, Dyspnoea, Feeling abnormal, Otitis externa, Panic attack, Vertigo
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LAMICTAL; LIPITOR; NORVASC.
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Bipolar disorder; Cholesterol; Hypertension.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101458543

Write-up: Swimmers ear; Vertigo; brain fog; Shortness of breath trouble breathing; coughing; panic attacks; Anxiety; This a spontaneous report from a contactable consumer (patient). A 46-years-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; solution for injection, Batch/Lot number: CUS 295) dose 1 via an unspecified route of administration, administered in left arm on 12Oct2021 at 12:00 hours as DOSE 1, SINGLE (at the age of 46-years-old) for COVID-19 immunization. The patient''s medical history included bipolar disorder, hypertension, and cholesterol. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient''s concomitant medications within 2 weeks of vaccination included Lamotrigine (LAMICTAL); Atorvastatin calcium (LIPITOR); and Amlodipine besilate (NORVASC). The patient had no known allergies. 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. Since the vaccination, the patient has not been tested for COVID-19. On 14Oct2021, the patient experienced swimmers'' ear, vertigo, brain fog, shortness of breath trouble breathing, Anxiety, panic attacks, and coughing. The events were resulted in doctor/other health care professional office/clinic visit. Therapeutic measures were taken as a result of the events. Treatment received included ear drops and ibuprofen. The clinical outcome of the events was not recovered. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1846240 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 2 RA / IM

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

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

Write-up: Expired vaccine administered.


VAERS ID: 1846254 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: No adverse event; patient received expired Moderna Booster Dose Vaccine expired on 10/13/2021 and patient received it on 10/14/2021.


VAERS ID: 1846272 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 3 RA / IM

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

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

Write-up: Expired vaccine administered.


VAERS ID: 1846290 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 2 LA / IM

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

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

Write-up: Expired vaccine administered


VAERS ID: 1846293 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008CC21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: No adverse event Pt received expired dose. Expiration Date: 10/13/2021 Date of Administration: 10/14/2021


VAERS ID: 1846299 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Product storage 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:
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Expired vaccine administered


VAERS ID: 1846305 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Product storage 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:
Current Illness:
Preexisting Conditions:
Allergies: Iodine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Expired vaccine administered.


VAERS ID: 1846319 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: No adverse event Received expired Moderna Dose expired 10/13/2021 date administered 10/14/21


VAERS ID: 1846322 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Product storage 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: Levothyroxine, Albuterol, Spironolactone, Amiodarone, Ergocalciferol, Potassium Chloride, Metoprolol
Current Illness:
Preexisting Conditions: HTN, RA
Allergies: Iodine, NSAIDS, Iohexol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Expired vaccine administered.


VAERS ID: 1846353 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin, Lisinopril, Clopidogrel, Metoprolol
Current Illness:
Preexisting Conditions: CAD
Allergies: Latex, natural rubber
Diagnostic Lab Data:
CDC Split Type:

Write-up: Expired vaccine administered


VAERS ID: 1846372 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 3 LA / IM

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

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

Write-up: Expired vaccine adminstered


VAERS ID: 1846594 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-30
Onset:2021-10-14
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2598 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Chills, Ear discomfort, Ear infection, Exposure to SARS-CoV-2, Headache, Influenza like illness, Lethargy, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: COVID test - positive result Irrigation of my ear to get some of the wax out; no testing
CDC Split Type: vsafe

Write-up: Day after the vaccine- extremely lethargic; chills; flu-like symptoms; headache. Those symptoms lasted 24 hours. On the 14th of October, my wife and child were diagnosed and I went and got tested on the 15th. I had mild symptoms - sniffles for two days and then I was fine. I started getting a lot of ear wax around the 12th of October. It got really bad on the 2nd of November my ears were were blocked. On the 3rd of November, I was diagnosed with ear infection at Urgent Care. They gave me ear drop antibiotic with combination steroid for the inflammation. The ear infection is still ongoing. I got my flu vaccine maybe about 2 weeks before the dose 3 of COVID vaccine - at the same pharmacy where I got the booster. That was my left arm. On the 8th of September, 2021 I got my tetanus shot - I got that at Internal Medicine as part of my physical exam. Left arm.


VAERS ID: 1846733 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-09-30
Onset:2021-10-14
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA D21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac disorder
SMQs:

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: Yes
Current Illness:
Preexisting Conditions: Yes
Allergies: I am allergic to Codeine & Brimonidine
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I experienced heart trouble


VAERS ID: 1846834 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-07
Onset:2021-10-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: ekg showed some abnormalities in office pt was sent to ER for further eval
CDC Split Type:

Write-up: chest pain 1 week after receiving vaccination


VAERS ID: 1846895 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-10-13
Onset:2021-10-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011F21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Chest pain, Computerised tomogram, Dizziness, Fatigue, Headache, Heart rate increased, Heavy menstrual bleeding, Hot flush, Hyperhidrosis, Hypoaesthesia, Induration, Injection site pain, Loss of personal independence in daily activities, Lymphadenopathy, Menstrual disorder, Pain, Palpitations, Sleep disorder, Vasodilatation
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Cold
Preexisting Conditions: None
Allergies: Macrobid; Latex; Codeine
Diagnostic Lab Data: Blood work; CT scan.
CDC Split Type: vsafe

Write-up: I woke up in the middle of the night, my heart was beating very hard. I felt like my heart was going to explode. I was sweating excessively. My left arm hurt tremendously. My armpit swelled up and a swollen lymph node formed under my armpit. It was very hard. My joints, muscles, head, and skull hurt badly. I couldn''t go back to sleep. I had hot flashes. My period came two days after my 2nd dose, even though it wasn''t supposed to arrive around that time. My period was extremely heavy. Also, my veins in my arms are very pronounced and raised. Currently, I have frequent chest pains, I get light-headed, and my heart continues to beat really fast. Two fingers on my right hand has become numb and its painful. I still break out into full body sweats and I have a headache all the time. I feel dizzy a lot. I am extremely fatigued all the time. I still deal with muscle and joint pain. When I went to the Emergency Room, I would pass out whenever my blood was drawn. I''m not able to physically do a lot of things like I did before the vaccine.


VAERS ID: 1846898 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-13
Onset:2021-10-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

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

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

Write-up: Severe rash/hives over entire body


VAERS ID: 1846978 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-10-13
Onset:2021-10-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Headache, Immunodeficiency, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (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: Second dose of vaccine. Also Shingles vaccine.
Other Medications: singular 10mg 1xday, Fish oil 1xday, zinc 50 mg 1xday, vitamin C 500mg 1xday, Baby aspirin 81 mg 1xday, 5000 IU Vitamin D3 1xday, Advair 250/50 inhaler 2xday as needed
Current Illness: None
Preexisting Conditions: Asthma and Obesity
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: Woke up 3am with chills, body ache, joint aches, headache, nausea, and felt fatigued.


VAERS ID: 1847368 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-10-01
Onset:2021-10-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye injury, Photophobia, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Accidents and injuries (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tresibia, Ozempik
Current Illness: None
Preexisting Conditions: Diabetes
Allergies: Penicillin
Diagnostic Lab Data: 3 different eye exams before discovering the surface damage
CDC Split Type:

Write-up: On the evening of October 14th I started having trouble seeing and sensitivity to light. I went to the eye Dr and they believed it was a change in prescription. We tried new contacts over the course of two weeks. The vision in my left eye just became worse. Finally after putting dye in my eye the Dr discovered ?surface damage? to my eye. She said it is typically caused by an allergic reaction to a new medication. I haven?t been on any new medication. The only ?new? medication that I had recently was the Covid vaccine. I am now on neomycin & polymyxin eye drops to try and undo the damage. Outcome is to be determined


VAERS ID: 1847760 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-13
Onset:2021-10-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Bone pain, Chills, Dyspnoea, Fatigue, Gait disturbance, Headache, Heart rate increased, Injection site pain, Myalgia, Pain, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Extreme pain at injection site. Blood pressure shot up to 248/110, trouble breathing, walking, rapid pulse, 101.5 fever, vomiting, chills, bone+muscle pain, fatigue. No longer have fever and vomiting, but fatigue, elevated bp, headaches, and body aches linger. I was hospitalized in ICU with covid in December 2019 and tested positive for antibodies until recently. I was also diagnosed with Wegener''s Vasculitis in hospital.


VAERS ID: 1848187 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-15
Onset:2021-10-14
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939901 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: The HCP administered an expired Moderna Vaccine to the patient; This spontaneous case was reported by a health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient) in a 30-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 049E21A and 939901) for COVID-19 vaccination. No Medical History information was reported. On 15-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Oct-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Oct-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient). At the time of the report, EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were mentioned. No treatment details were reported.


VAERS ID: 1848243 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-01-11
Onset:2021-10-14
   Days after vaccination:276
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Patient received an expired dose; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received an expired dose) in a 68-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 008C21A, 025L20A and 030M20A) for COVID-19 vaccination. No Medical History information was reported. On 11-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Oct-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Oct-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received an expired dose). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (Patient received an expired dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant concomitant medications were reported. No treatment information was reported.


VAERS ID: 1848246 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Washington  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: An expired 2nd dose was given to a patient; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (An expired 2nd dose was given to a patient) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 049E21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Oct-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (An expired 2nd dose was given to a patient). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (An expired 2nd dose was given to a patient) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was mentioned. No treatment medication was mentioned.


VAERS ID: 1848279 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-24
Onset:2021-10-14
   Days after vaccination:51
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: The HCP administered an expired Moderna Vaccine to the patient; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 049E21A and 026C21A) for COVID-19 vaccination. No Medical History information was reported. On 24-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Oct-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Oct-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant and treatment medication was not provided.


VAERS ID: 1848280 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, Fatigue, Headache, Vaccination site pain
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Fatigue; Headache; Pain at the injection site; Expired vaccine administered; This spontaneous case was reported by a consumer and describes the occurrence of FATIGUE (Fatigue), HEADACHE (Headache), VACCINATION SITE PAIN (Pain at the injection site) and EXPIRED PRODUCT ADMINISTERED (Expired vaccine administered) in a 39-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 050E21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Oct-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Oct-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXPIRED PRODUCT ADMINISTERED (Expired vaccine administered). On an unknown date, the patient experienced FATIGUE (Fatigue), HEADACHE (Headache) and VACCINATION SITE PAIN (Pain at the injection site). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (Expired vaccine administered) had resolved. At the time of the report, FATIGUE (Fatigue), HEADACHE (Headache) and VACCINATION SITE PAIN (Pain at the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was reported by reporter. No treatment medication was reported by reporter. This case was linked to MOD-2021-367477 (Patient Link).


VAERS ID: 1848284 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-16
Onset:2021-10-14
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 9399001 / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: The HCP administered an expired Moderna Vaccine to the patient; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient) in a 28-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 049E21A and 9399001) for COVID-19 vaccination. No Medical History information was reported. On 16-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Oct-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Oct-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant products were reported. No treatment information was reported by the reporter. This case was linked to MOD-2021-366988, MOD-2021-367774 (Patient Link).


VAERS ID: 1848290 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-03
Onset:2021-10-14
   Days after vaccination:225
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012A21A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: The HCP administered an expired Moderna Vaccine to the patient; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient) in a 46-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 049E21A, 016B21A and 012A21A) for COVID-19 vaccination. No Medical History information was reported. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 02-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Oct-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was provided. No treatment information was provided. Date the vial was initially stored in the refrigerator on 08-Sep-2021 o


VAERS ID: 1848291 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-15
Onset:2021-10-14
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939901 / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: The HCP administered an expired Moderna Vaccine to the patient; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient) in a 32-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 049E21A and 939901) for COVID-19 vaccination. No Medical History information was reported. On 15-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Oct-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was not applicable No concomitant medications reported. No treatment reported.


VAERS ID: 1848310 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / UNK - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: patient received an expired dose/ received a dose on 14Oct2021 of a vial that had expired on 13Oct2021; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 28-Oct-2021 and was forwarded to Moderna on 28-Oct-2021. This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (patient received an expired dose/ received a dose on 14Oct2021 of a vial that had expired on 13Oct2021) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008C21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Oct-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (patient received an expired dose/ received a dose on 14Oct2021 of a vial that had expired on 13Oct2021). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (patient received an expired dose/ received a dose on 14Oct2021 of a vial that had expired on 13Oct2021) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication was provided by the reporter. No treatment information was provided.


VAERS ID: 1848321 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-01-22
Onset:2021-10-14
   Days after vaccination:265
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: The HCP administered an expired Moderna Vaccine to the patient; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 049E21A, 041L20A and 012A21A) for COVID-19 vaccination. No Medical History information was reported. On 22-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Oct-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications information was reported. It was reported that the date the vial was initially stored in the refrigerator was Sep 8th 2021 the vial did not undergo any temperature excursions. This case was linked to MOD-2021-366988 (Patient Link).


VAERS ID: 1848323 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-01-25
Onset:2021-10-14
   Days after vaccination:262
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004M20A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: patient received an expired dose; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (patient received an expired dose) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 008C21A., 030M20A and 004M20A) for COVID-19 vaccination. No Medical History information was reported. On 25-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Oct-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Oct-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXPIRED PRODUCT ADMINISTERED (patient received an expired dose). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (patient received an expired dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No treatment information were reported. No concomitant medications were reported.


VAERS ID: 1848326 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / UNK - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: patient received an expired dose; This spontaneous case was reported by a health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (patient received an expired dose) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008C21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Oct-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (patient received an expired dose). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (patient received an expired dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication provided. No treatment information provided.


VAERS ID: 1848331 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-12
Onset:2021-10-14
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: The HCP administered an expired Moderna Vaccine to the patient; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient) in a 48-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 049E21A, 046A21A and 031A21A) for COVID-19 vaccination. No Medical History information was reported. On 12-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Oct-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (The HCP administered an expired Moderna Vaccine to the patient) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication information was provided by the reporter. No treatment information provided. Nurse administered an expired dose of the Moderna Vaccine to 8 patients. Lot number 049E21A, number of doses/vials 8 doses o The vial was initially stored in the refrigerator on 08 Sep 2021 and the vaccine was administered on 14 Oct 2021. The vial did not undergone any temperature excursions. This case was linked to MOD-2021-366988, MOD-2021-367143, MOD-2021-367474 (Patient Link).


VAERS ID: 1848361 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Washington  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: An expired 2nd dose was given to a patient; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (An expired 2nd dose was given to a patient) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 049E21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Oct-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) .5 ml. On 14-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (An expired 2nd dose was given to a patient). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (An expired 2nd dose was given to a patient) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were provided. No treatment medications were provided. The vial didn''t undergo any temperature excursions.


VAERS ID: 1848582 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 3 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chills, Diarrhoea, Fatigue, Headache, Herpes zoster, Immunisation, Malaise, Myalgia, Nausea, Pain in extremity, Pyrexia, SARS-CoV-2 test, Vaccination site erythema, Vaccination site pain
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ELIQUIS; OMEPRAZOLE; PRAVASTATIN; TAMSULOSIN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211029; Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC202101499913

Write-up: Broke out with shingles two days after injection; Severe headache; Joints aching; Chills; Nausea; Arm pain; Injection site pain; Redness at injection site; Fever; Diarrhea; Feeling unwell; Tiredness; Muscle pain; The patient received the third/booster dose of BNT162b2; This is a spontaneous report from a contactable consumer, the patient. A 65-year-old male patient received third (booster) dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FE3590) via an unspecified route of administration in the left arm on 14Oct2021 at 10:15 (at the age of 65-years-old) as a single dose for COVID-19 immunisation. Medical history was not reported. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. Concomitant medications included apixaban (ELIQUIS), omeprazole (MANUFACTURER UNKNOWN), pravastatin (MANUFACTURER UNKNOWN) and tamsulosin (MANUFACTURER UNKNOWN); all for unknown indication from an unknown date and unknown if ongoing. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EL8922) via an unspecified route of administration in the left arm on 29Jan2021 (at the age of 65-years-old) and also received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EL9276) via an unspecified route of administration in the left arm on 19Feb2021 (at the age of 65-years-old) as a single dose for COVID-19 immunisation. On 15Oct2021 at 18:00, the patient experienced severe headache, joints aching, chills, nausea, arm pain, injection site pain, redness at injection site, fever, diarrhea, feeling unwell, tiredness, muscle pain and on 16Oct2021, two days after injection, the patient broke out with shingles. The events resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measures were taken as a result of the event broke out with shingles two days after injection and included treatment with valacyclovir (VALTREX). Since the vaccination, the patient had been tested for COVID-19. On 29Oct2021, the patient underwent COVID-19 virus test via nasal swab and the result was negative. The clinical outcome of the events severe headache, joints aching, chills, nausea, arm pain, injection site pain, redness at injection site, fever, diarrhea, feeling unwell, tiredness, muscle pain and broke out with shingles two days after injection was resolving at the time of this report.


VAERS ID: 1848770 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-10-07
Onset:2021-10-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anxiety disorder, Palpitations, Panic disorder
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

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

Write-up: Heart palpitations that led to panic/anxiety disorder


VAERS ID: 1848997 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-10-05
Onset:2021-10-14
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dermatitis contact, Diarrhoea, Pruritus, Rash, Rhinorrhoea, Scrotal dermatitis
SMQs:, Anaphylactic reaction (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen, Adalimumab injection pen kit, Allopurinol, Azithromycin, Bupropion HCL, Carvedilol, Cetirizine HCL, Cholecalcif (vitamin D3-1) tablet, Clobetasol propionate ointment, Famotidine, hydrocodone/acetaminophen, Hydroxyzine HCL, Lo
Current Illness: None.
Preexisting Conditions: Type 2 diabetes mellitus, hyperlipidemia, hypertension, coronary artery disease, chronic obstructive pulmonary disease
Allergies: Penicillin, Niacin, Prazosin.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Vet received covid 19 booster 10/05/21, received flu vaccine 10/07/21 and began to experience diarrhea and the "sniffles". On 10/14/21 Vet had rash on neck, chest, back, extending down thighs and scrotal area. Vet went to ER 10/28/21 for continued rash, was diagnosed with allergic contact dermatitis, unspecified cause (L23.9) and pruritus, unspecified (L29.9) and received 125mg IM injection methylprednisonlone while in the ER. Vet was prescribed Dosepak as an outpatient, hydroxyzine 25mg by mouth every 6 hours as needed, Zyrtec 10mg by mouth daily and to continue Famotidine as prior (per ER provider). Vet was also prescribed Trazodone cream to apply as needed.


VAERS ID: 1849213 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-01
Onset:2021-10-14
   Days after vaccination:74
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bradyphrenia, Cerebrovascular accident, Computerised tomogram normal, Electroencephalogram, Extra dose administered, Full blood count, Hemiplegia, Hyperacusis, Hypoaesthesia, Magnetic resonance imaging normal, Metabolic function test, Monoplegia, Muscle twitching, Photophobia, Seizure, Slow speech, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (narrow), Generalised convulsive seizures following immunisation (narrow), Medication errors (narrow), Hypoglycaemia (broad), Sexual dysfunction (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CBC , BMP, Negative MRI and negative CT for stroke . eEG , repeat MRI
CDC Split Type:

Write-up: . Initiated with stroke / hemiplegia episode ,photophobia . Face twitching . And lead to complete bilateral leg paralysis and sensitivity to sound , lights and all stimulation , later evolved to left side paralysis and numbness and twitching and tremors on left side . Later evolved to full body convulsion and currently absent seizures type activity followed by paralysis of both legs . And slow speech and slow thinking process present in all stages .no treatment yet


VAERS ID: 1849346 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-10-13
Onset:2021-10-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF3590 / 2 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Woke up at 2:30 am with a high fever and bad headache. These symptoms steadily worsened until about 5:00 am. At that point, the fever plateaued for a short while and then slowly went back down. By about noon of that day the fever had completely subsided but the headache was still very bad. After a couple of days the headache finally went away.


VAERS ID: 1849396 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Hypoaesthesia, Immediate post-injection reaction, Injection site pain, Muscle twitching, Neck pain, Pain in extremity, Paraesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: prostate cancer
Allergies: n/a
Diagnostic Lab Data: Hoping symptoms subside. Had to take vaccine and return to work as vaccine is mandated as part of continued employment.
CDC Split Type:

Write-up: Immediate pain , twitching in upper left arm area. Onset of fever and extreme fatigue for several days. Continuing pain in lower neck and numbness/tingling/pain in fingers. Particularly left hand.


VAERS ID: 1850098 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-10-10
Onset:2021-10-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discomfort, Injection site bruising, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Menstrual disorder, Pruritus, Rash, Vaccination site reaction
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Bruising at Injection Site-Medium, Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: In addition to menstrual cycle irregularities listed above, patient experienced what she called "Covid Arm" 5 days after vaccination in right arm. Described rash, itchiness, and discomfort. Described the rash as similar to ringworm


VAERS ID: 1850363 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-16
Onset:2021-10-14
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthma, Blood test, Condition aggravated, Epistaxis, Feeling abnormal, Glycosylated haemoglobin, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Dementia (broad), Eosinophilic pneumonia (broad), Hypersensitivity (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: i used to have an issue with taking the flu shot and didn''t take another one since 1990 until 2018
Other Medications: I take daily Warfarin 5mg, Atorvastatin 40mg, Losartan Potassium 50mg, Verapamil HCIER 100mg 2xday, Vitamin D
Current Illness: NO
Preexisting Conditions: Lung cancer surgery, asthma, COPD, bronchitis, diabetes, on warfarin, hypertension, cholesterol,
Allergies: Lisinopril, tramadol, environmental allergies (which includes mold and mildew and dust, pollen, crabgrass)
Diagnostic Lab Data: bloodwork, Glycohemoglovin bloodwork
CDC Split Type: vsafe

Write-up: On the 14th of Oct, I started feeling bad because my asthma medication wasn''t working and I kept on for a few days because nothing was working. I went to the urgent care on the 17th and they gave me a zpack and 20mg prednisone. On the 18th, I went to the ER because my nose started running and when I wiped it, I found it was blood. They gave me albuterol treatments and prednisone 50mg and they put me on the nebulizer. I then followed up with my doctor and she told me to continue with the meds they gave me. Last week, I started feeling better and each day that goes on I started feeling better. DOCTOR''S SEEN. 1ST EVENT: URGENT CARE 10/17. 2ND EVENT: ER 10/18. FOLLOW UP: PCP''S VISIT 10/21


VAERS ID: 1850394 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-10-06
Onset:2021-10-14
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2529 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Eye disorder, Fatigue, Headache, Insomnia, Lymphadenopathy, Nausea
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Retinal disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flovent HFA Inhaler
Current Illness: None
Preexisting Conditions: Bronchitis and pneumonitis due to chemical vapors, gases, and fumes. Obese
Allergies: None
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Diarrhea- still present Insomnia - still present Headache- comes and goes Fatigue- 4 days Nausea- 6 days Swollen Lymph nodes- 2 weeks I have noticed that my right eye is now smaller than my left. I feel like I have a hard time opening it.


VAERS ID: 1850754 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-07
Onset:2021-10-14
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Oxygen saturation decreased, SARS-CoV-2 test positive
SMQs:, Acute central respiratory depression (broad), Respiratory failure (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: AMLODIPINE, ROSUVASTATIN, PANTOPRAZOLE, HYDROCHLOROTHIAZIDE, POTASSIUM, LEVOTHYROXINE, IMBRUVICA
Current Illness:
Preexisting Conditions:
Allergies: LEVAQUIN, LISINOPRIL, SULFA
Diagnostic Lab Data:
CDC Split Type:

Write-up: POSITIVE COVID 10/14/2021, LOW O2,


VAERS ID: 1850930 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-23
Onset:2021-10-14
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Dyspnoea, Endotracheal intubation, Hypoxia, Mechanical ventilation, SARS-CoV-2 test positive, Septic shock
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (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), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Sepsis (narrow), 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? Yes
Hospitalized? Yes, 22 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: Rapid COVID test positive on 10/14/2021
CDC Split Type:

Write-up: Patient was admitted to the hospital on 10/14/2021 with SOB and hypoxia. He was intubated and on a ventilator from 10/14/2021 to 10/18/2021. He received 5 days of remdesivir, glucocorticoids x 22 days. Patient was still on oxygen via heated high flow at the time of discharge to a long term acute care hospital. Discharge diagnosis was acute respiratory failure with hypoxia and septic shock due to COVID-19 pneumonia.


VAERS ID: 1851013 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-10-07
Onset:2021-10-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 930991 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Herpes virus infection, Pain in extremity, Pruritus, Skin reaction, Tinea infection
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: I had sore arm for about a day. I felt a little off for about 24 hours. A week later, I noticed my left hip, and chest around was ringworms. It was itchy and red. I had a herpes outbreak on my groin. I haven''t had an outbreak since about 4 years. I went to the urgent care. They just did a clinic exam.


VAERS ID: 1851602 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-15
Onset:2021-10-14
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Ageusia, Anosmia, Cough, Dizziness, Fatigue, Malaise, Oropharyngeal pain, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall Vyvanse
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Urgent Care Covid-19 Negative
CDC Split Type: vsafe

Write-up: Five months after I got the vaccine I developed a very sore throat. My family members had had a similar illness and tested negative for Covid-19. I felt more unwell the next day and I was very fatigued. I went to the Urgent care to get a Lung X-Ray because I have a history of Pneumonia. My cough was very severe. I have been experiencing dizziness currently and it has been two weeks since the symptoms started. I still have a cough. I tested Negative for Covid-19 on an at home. A lot of my family members had been sick with the same symptoms, and they all tested Negative. I have no sense of taste or smell and it started about a week in to the illness.


VAERS ID: 1853820 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Fatigue, Headache, Myalgia, Nausea, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Excused from flu shots due to similar severe side effects
Other Medications:
Current Illness:
Preexisting Conditions: spondylolisthesis dermatitis
Allergies: animal protein, dairy, almonds adverse reaction to flu shots
Diagnostic Lab Data:
CDC Split Type:

Write-up: High fever, gradually increased to as high as 102.6 F Severe body aches, muscle pain, joint pain, headache Nausea, fatigue, stomachache


VAERS ID: 1853952 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-12
Onset:2021-10-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC 3184 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Blood test, Confusional state, Dysarthria, Electroencephalogram, Headache, Magnetic resonance imaging, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (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), Hypoglycaemia (broad)

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

Write-up: Hand Tremors, Headaches, Confusion, Hard to Speak, Severe Anxiety


VAERS ID: 1855744 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-10-11
Onset:2021-10-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Neck pain, Neuralgia
SMQs:, Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Arthritis (broad)

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

Write-up: Pain in trapezius and sharp pain when pressing on neck near spine. Possible nerve issues.


VAERS ID: 1856683 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039C21A / 3 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: expired moderna vaccine mistakenly administered; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (expired moderna vaccine mistakenly administered) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039C21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Oct-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) .25 ml. On 14-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (expired moderna vaccine mistakenly administered). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (expired moderna vaccine mistakenly administered) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Concomitant medications were provided No treatment medications were provided.


VAERS ID: 1857052 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039C21A / 3 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: expired moderna vaccine mistakenly administered; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (expired moderna vaccine mistakenly administered) in a 67-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039C21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Oct-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) .25 ml. On 14-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (expired moderna vaccine mistakenly administered). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (expired moderna vaccine mistakenly administered) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication provided No treatment medication provided


VAERS ID: 1857366 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-10-12
Onset:2021-10-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dyspnoea, Dyspnoea exertional, Injection site reaction, Miliaria
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: During the first week I experienced prickly heat from the injection site through to the right half of my face. I experience this only the first week and it happened four times with each time the severity getting more noticeable. During the third week I experience episodes of chest pain or tightness of chest in the center of my chest. This only happened during week three and happened about four times with severity increasing with each episode. I experience shortness of breath the entire three weeks. When I walked up the stairs it was as if I had run up 10 flights of stairs.


VAERS ID: 1857971 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-10-11
Onset:2021-10-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF 2580 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Computerised tomogram thorax, Deep vein thrombosis, Echocardiogram, Fibrin D dimer, Malaise, Pain, Peripheral swelling, Pulmonary embolism, Pyrexia, Ultrasound Doppler, Vena cava filter insertion
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Gabapenten 300mg atorvastatin 10mg , levothyroxine 0.50mcg, protonix 40mg, monuclast 20mg, amitrptyline 20mg, valtrex 500mg,
Current Illness: None
Preexisting Conditions: Volvodynia, high cholesterol, hypothyroidism,
Allergies: Seasonal such as polen dust etc
Diagnostic Lab Data: CTA chest 10/24/2021. D diner, echocardiogram 10/25/2021, venous dopplers left leg 10/24/2021 10/25/2021 vena cava filter placed. Treated with iv heparin and started xaralto.
CDC Split Type:

Write-up: Developed general malaise, low grade fever, body aching which increased in severity until 10/24/2021. Seen in ER due to extreme swelling of left leg. Diagnosed with Massive dvt left leg, 2 pulmonary emboli right lung. Required placement of IVC filter on 10/25/2021


VAERS ID: 1858029 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-11
Onset:2021-10-14
   Days after vaccination:156
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Audiogram, Conjunctivitis, Ear infection, Oropharyngeal pain, Sinusitis, Upper respiratory tract infection
SMQs:, Severe cutaneous adverse reactions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (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: Sertraline 25 mg, Multi-vitamin, Annovera
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 10/26/2021 - Auditory Exams
CDC Split Type:

Write-up: Upper respiratory infection - sinus infection, sore throat, ear infection, conjunctivitis. 4 days of amoxicillin, 10 days of Augmentin, 3 weeks of Mucinex D, 6 days of oral steroids, 14 days of nasal steroids.


VAERS ID: 1858092 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dizziness, Headache, Muscle spasms, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: chest infection
Preexisting Conditions: diabetes, hemorrhoids, hernia
Allergies: aspirin, albuterol, mefloquine
Diagnostic Lab Data: i haven''t seen doctor yet.
CDC Split Type:

Write-up: dizziness, headache (still have 6 days after second dose (shot on 4 Nov 2021), Pain in left arm up to when i had second dose (feels like a typhoid shot). An hour after first dose had cramps/squeezing in my left testicle. I had chest pain after the second dose (felt like someone was standing on my chest, that happened twice within 4 hours after 2nd dose) i have not recovered from the headaches (feels like someone is squeezing the top of my head)


VAERS ID: 1858173 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: No adverse event
SMQs:

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

Write-up: Client presents for 2nd COVID Pfizer vaccine. Client reports she experienced numbness and tingling in lips after receiving first Pfizer COVID vaccine on 10/14/2021. Onset was 20 min after vaccination. Client reports it resolved on its own without intervention. Did not follow up with primary doctor for 2nd dose guidance. Client denies any chronic medical problems, not taking medications, denies allergies. Denies any shortness of breath, trouble breathing or throat tightening with 1st dose.


VAERS ID: 1858994 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-13
Onset:2021-10-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, Headache, Pain in extremity, Rash, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Pt called hospital call ceneter to report side effects. Complains of Small amount of itchiness in throat, headache arm pain. Also reports having a small amount of little red dots on arms and legs. Denies any emergency symptoms. Denies fever. Patient reports taking acetaminophen, 1000 mg earlier. Reports experiencing similar symptoms prior to Covid 19 (+) diagnosis 9/2021. Pt was advised to go to ER for evaluation


VAERS ID: 1860209 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039C21A / 3 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: expired moderna vaccine mistakenly administered; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (expired moderna vaccine mistakenly administered) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039C21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Oct-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) .25 ml. On 14-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (expired moderna vaccine mistakenly administered). On 14-Oct-2021, EXPIRED PRODUCT ADMINISTERED (expired moderna vaccine mistakenly administered) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were reported No treatment medications were reported. It was reported that on 14-Oct-2021, the vial was removed from refrigerator and was not opened before vaccination and temperature was not compromised.


VAERS ID: 1860971 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-13
Onset:2021-10-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011F21A / 1 - / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: TDAP/Tetanus/M1R1
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Currently doing lab work and chest xrays to determine affect on heart.
CDC Split Type:

Write-up: Heart Palpitations, Heavy chest, hard time breathing.


VAERS ID: 1861021 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019F21B / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (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: Influenza Vaccine
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 20 minutes after receiving moderna vaccine - patient noticed numbness to the left side of face. This lasted two hours. Event was similar to a reaction patient had "Years" ago where patient had numbess to arms, side, and legs unilaterally.


VAERS ID: 1862531 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-21
Onset:2021-10-14
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Breast swelling, Inflammation, Nipple enlargement, Nipple pain, Pain
SMQs:, Angioedema (broad), Arthritis (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Spironolactone 50mg qday, fish oil supplement, multivitamin, thiamine, vit d
Current Illness: None
Preexisting Conditions: None
Allergies: Watermelon, sulfa medications
Diagnostic Lab Data:
CDC Split Type:

Write-up: About one week after the vaccine I noticed my whole body feeling very inflamed. My joints were all achy and I began getting very sore after my work outs. Two-three weeks after I noticed that my left breast had swollen and was larger than usual, I know that can be a side effect and assumed it would pass. Over the following weeks I continued to monitor my over all inflammation and left breast and I have noticed my left nipple is now also getting larger. It is very sensitive and tender to the touch.


VAERS ID: 1863494 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Delaware  
Vaccinated:2021-10-14
Onset:2021-10-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, Product storage 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Dose administered after exposure to room temperature $g24 hours; Dose administered after exposure to room temperature $g24 hours; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a nurse and describes the occurrence of PRODUCT STORAGE ERROR (Dose administered after exposure to room temperature $g24 hours) and EXPIRED PRODUCT ADMINISTERED (Dose administered after exposure to room temperature $g24 hours) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 076C21A) for COVID-19 vaccination. No Medical History information was reported. On 14-Oct-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-Oct-2021, the patient experienced PRODUCT STORAGE ERROR (Dose administered after exposure to room temperature $g24 hours) and EXPIRED PRODUCT ADMINISTERED (Dose administered after exposure to room temperature $g24 hours). On 14-Oct-2021, PRODUCT STORAGE ERROR (Dose administered after exposure to room temperature $g24 hours) and EXPIRED PRODUCT ADMINISTERED (Dose administered after exposure to room temperature $g24 hours) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. no concomitant medication were reported no treatment medication were reported Fridge''s door was not closed all the way, and temperature was out of range for about 1 hour and 20 minutes, reaching a maximum of 10 degrees Celsius. This case was linked to MOD-2021-374037 (Patient Link).


VAERS ID: 1793919 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-10-06
Onset:2021-10-14
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30150BA / UNK - / IM

Administered by: School       Purchased by: ?
Symptoms: Sensory loss
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad)

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

Write-up: 2 days ago she started to have loss of sensation in the right side of the face.


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