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From the 9/3/2021 release of VAERS data:

Found 661,087 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 182 out of 6,611

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VAERS ID: 1644587 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Fatigue, Feeling abnormal, Malaise, Mobility decreased, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: AMLODIPINE; ATORVASTATIN; CITALOPRAM HBR; CIMETIDINE; VALSARTAN HCTZ; LEVOTHYROXINE; TYLENOL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Patient was hospitalized but completely recovered.)
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: body temperature; Result Unstructured Data: high; Test Date: 20210810; Test Name: body temperature; Result Unstructured Data: low grade fever from 99 to 100 degrees F (higher temperature close to 100 towards night time)
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: felt a little weird after the shot and felt like she had covid all over again; could not lift her arm for about 7 days / could not stand on feet for 2-3 days; sore arm / had extreme body aches / still had extreme body aches; high fever of 103 degrees F while she was on Tylenol / still experiencing low grade fever from 99 to 100 degrees F (higher temperature close to 100 towards night time); extreme tiredness / very tired at times and have to lay down; started feeling very sick and lasted for 3 days; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (started feeling very sick and lasted for 3 days), FEELING ABNORMAL (felt a little weird after the shot and felt like she had covid all over again), MOBILITY DECREASED (could not lift her arm for about 7 days / could not stand on feet for 2-3 days), PAIN (sore arm / had extreme body aches / still had extreme body aches) and PYREXIA (high fever of 103 degrees F while she was on Tylenol / still experiencing low grade fever from 99 to 100 degrees F (higher temperature close to 100 towards night time)) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 051C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 (Patient was hospitalized but completely recovered.) in March 2021. Concomitant products included AMLODIPINE, ATORVASTATIN, CITALOPRAM HYDROBROMIDE (CITALOPRAM HBR), CIMETIDINE, HYDROCHLOROTHIAZIDE, VALSARTAN (VALSARTAN HCTZ), LEVOTHYROXINE and PARACETAMOL (TYLENOL) for an unknown indication. On 28-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Jul-2021, the patient experienced MALAISE (started feeling very sick and lasted for 3 days). On an unknown date, the patient experienced FEELING ABNORMAL (felt a little weird after the shot and felt like she had covid all over again), MOBILITY DECREASED (could not lift her arm for about 7 days / could not stand on feet for 2-3 days), PAIN (sore arm / had extreme body aches / still had extreme body aches), PYREXIA (high fever of 103 degrees F while she was on Tylenol / still experiencing low grade fever from 99 to 100 degrees F (higher temperature close to 100 towards night time)) and FATIGUE (extreme tiredness / very tired at times and have to lay down). At the time of the report, MALAISE (started feeling very sick and lasted for 3 days) and MOBILITY DECREASED (could not lift her arm for about 7 days / could not stand on feet for 2-3 days) had resolved, FEELING ABNORMAL (felt a little weird after the shot and felt like she had covid all over again) and FATIGUE (extreme tiredness / very tired at times and have to lay down) outcome was unknown and PAIN (sore arm / had extreme body aches / still had extreme body aches) and PYREXIA (high fever of 103 degrees F while she was on Tylenol / still experiencing low grade fever from 99 to 100 degrees F (higher temperature close to 100 towards night time)) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In 2021, Body temperature: 103 (High) high. On 10-Aug-2021, Body temperature: 99-100 (Low) low grade fever from 99 to 100 degrees F (higher temperature close to 100 towards night time). The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. She had high fever of 103 degrees Fahrenheit (F) while she was on Tylenol. 13 days later she is still experiencing low grade fever from 99 to 100 degrees F (higher temperature close to 100 towards night time), still has extreme body aches, very tired at times and have to lay down. No treatment information was provided.


VAERS ID: 1644879 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-07-22
Onset:2021-07-29
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 1 RA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: patient experienced SARS-CoV2 infection; This spontaneous case was reported by an other health care professional and describes the occurrence of COVID-19 (patient experienced SARS-CoV2 infection) in a 48-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 017C21A) for COVID-19 vaccination. No Medical History information was reported. On 22-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Jul-2021, the patient experienced COVID-19 (patient experienced SARS-CoV2 infection). At the time of the report, COVID-19 (patient experienced SARS-CoV2 infection) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No Concomitant medication information was reported. No treatment medications were provided.


VAERS ID: 1644985 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008021A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspepsia, Heart rate increased, Hot flush
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific dysfunction (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Immediately after the injection she felt a hot flash; Then an hour later she had a rapid heart rate; Then an hour later she had a rapid heart rate and heartburn; This spontaneous case was reported by a consumer and describes the occurrence of HOT FLUSH (Immediately after the injection she felt a hot flash), HEART RATE INCREASED (Then an hour later she had a rapid heart rate) and DYSPEPSIA (Then an hour later she had a rapid heart rate and heartburn) in a 48-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008021A) for COVID-19 vaccination. No Medical History information was reported. On 29-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Jul-2021, the patient experienced HOT FLUSH (Immediately after the injection she felt a hot flash), HEART RATE INCREASED (Then an hour later she had a rapid heart rate) and DYSPEPSIA (Then an hour later she had a rapid heart rate and heartburn). On 29-Jul-2021, HOT FLUSH (Immediately after the injection she felt a hot flash), HEART RATE INCREASED (Then an hour later she had a rapid heart rate) and DYSPEPSIA (Then an hour later she had a rapid heart rate and heartburn) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided. Treatment information was not provided.


VAERS ID: 1645114 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Unknown  
Location: Michigan  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 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.MOD20212

Write-up: For this patient, the number of days that have passed were 26. Patient received second dose on 29Jul2021; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (For this patient, the number of days that have passed were 26. Patient received second dose on 29Jul2021) in a 35-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 29-Jul-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 29-Jul-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (For this patient, the number of days that have passed were 26. Patient received second dose on 29Jul2021). At the time of the report, EXPIRED PRODUCT ADMINISTERED (For this patient, the number of days that have passed were 26. Patient received second dose on 29Jul2021) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant and treatment medications were provided by reporter.


VAERS ID: 1645142 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Unknown  
Location: Michigan  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 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.MOD20212

Write-up: all the patients who received a vaccine which was more than 30 days in the refrigerator; all the patients who received a vaccine which was more than 30 days in the refrigerator; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (all the patients who received a vaccine which was more than 30 days in the refrigerator) and PRODUCT STORAGE ERROR (all the patients who received a vaccine which was more than 30 days in the refrigerator) in a 31-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 29-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 29-Jul-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (all the patients who received a vaccine which was more than 30 days in the refrigerator) and PRODUCT STORAGE ERROR (all the patients who received a vaccine which was more than 30 days in the refrigerator). On 29-Jul-2021, EXPIRED PRODUCT ADMINISTERED (all the patients who received a vaccine which was more than 30 days in the refrigerator) and PRODUCT STORAGE ERROR (all the patients who received a vaccine which was more than 30 days in the refrigerator) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.; Sender''s Comments: This report refers to a case of EXPIRED PRODUCT ADMINISTERED, and PRODUCT STORAGE ERROR, in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination with no associated Adverse events.


VAERS ID: 1645884 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dysphonia
SMQs:, Parkinson-like events (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100969718

Write-up: started losing her voice; This is a spontaneous report received from a contactable consumer or other non hcp. A female patient of an unspecified age received 1st dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE,Batch/Lot number was not reported), via an unspecified route of administration on 28Jul2021 as Dose 1,single for covid-19 immunization.The patient medical history and concomitant medications were not reported.The patient experienced that she started losing her voice on 29Jul2021.Patient was the first person at the phone but could not speak clearly as she was losing her voice.The patient didn''t receive any treatment for the event. The outcome of the event was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1645918 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / UNK LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Iodine allergy; Shellfish allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100970715

Write-up: Splotchy pink rash starting at left collarbone, covers left side of torso and left thigh; Rash is hot to the touch.; This is a spontaneous report from a non-contactable consumer (patient). A 25-year-old female patient received BNT162B2 (Pfizer-BIONTECH COVID-19 Vaccine), via an unspecified route of administration, administered in the left arm on 29Jul2021 at 10:15 AM (at the age of 25-years-old) (Batch/Lot Number: EW0177) dose number unknown, single, for COVID-19 immunization. Medical history included allergies to iodine and shellfish. The patient did not have COVID prior to the vaccination, was not pregnant, and did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient''s concomitant medications were not reported. On 29Jul2021 at 21:15, the patient experienced a splotchy pink rash starting at the left collarbone, which covered the left side of her torso and left thigh. There was no pain, itchiness, or discomfort. The rash was hot to the touch. The patient was not tested for COVID post vaccination. As treatment, the patient took 25mg of Benadryl. Outcome of the events was recovering.


VAERS ID: 1645973 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FAT484 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Headache, Oropharyngeal pain, Rhinorrhoea
SMQs:, Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Environmental allergy; Food allergy; Fruit allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100973634

Write-up: Severe headache; Diarrhoea; sore throat; runny nose; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 12-year-old non-pregnant female patient received bnt162b2 (BNT162B2 PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Batch/Lot number: FAT484), via an unspecified route of administration in arm right on 29Jul2021 (at the age of 12-years-old) as dose 1, single for COVID-19 immunisation. The medical history of the patient included asthma. The patient known allergies were reported as antibiotic bactrim, pears, corn, environment allergies. The other medications in two weeks were reported as yes. The patient was not pregnant at the time of vaccination. 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 not been tested with covid-19. The patient previously took bactrim and experienced drug hypersensitivity. On 29Jul2021, the patient experienced severe headache, diarrhoea, sore throat and runny nose. The patient received no treatment for the events. The outcome of the events was reported as unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1645974 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dysphagia, Dyspnoea, Headache, Lymph node pain, Tracheal pain
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100973685

Write-up: can not swallow or sip water; shortness of breath/difficulty breathing; pain in the trachea; pain in the gland; pain goes to the back of the brain; This is a spontaneous report from a contactable consumer (patient). A 57-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; solution for injection) via an unspecified route of administration on 28Jul2021 (at the age of 57-years-old) as a single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; solution for injection) via an unspecified route of administration on 25Jun2021 (at the age of 57-years-old) as a single dose for COVID-19 immunization and experienced a lot of pain in the joints, the shoulder and the neck. On 29Jul2021, the patient experienced cannot swallow or sip water, shortness of breath/difficulty breathing, pain in the trachea, pain in the gland and pain goes to the back of the brain. The course of events was reported as follows: About 3 hours ago, in the morning, the patient started to experience some shortness of breath, difficulty breathing, pain in the trachea, pain in the gland, which was quite strong and the patient could not swallow or sip water. The pain went to the back of the brain. The patient wanted to know if these symptoms were normal. He was 100% sure that these were due to the vaccine, because he had never experienced anything like this. When he went to see his PCP the day before yesterday he told him that after the first dose of the vaccine he had a lot of pain in the joints, the shoulder and the neck, and the PCP stated that several of his patients also had those symptoms. The clinical outcomes of the events cannot swallow or sip water, shortness of breath/difficulty breathing, pain in the trachea, pain in the gland and pain goes to the back of the brain were unknown. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.


VAERS ID: 1645981 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Insomnia
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: TYLENOL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Fibromyalgia
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100974845

Write-up: Can''t sleep or stay sleep; This is a spontaneous report from a contactable consumer, the patient. A 47-year-old, non-pregnant female patient received an unknown dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the arm left on 29Jul2021 at 16:15 (at the age of 47-year-old) as a single dose for COVID-19 immunisation. Medical history included fibromyalgia. Concomitant medications included paracetamol (TYLENOL) for unknown indication from an unknown date. The patient previously received morphine (MANUFACTURER UNKNOWN) and linaclotide (LINZESS) for unknown indication on an unknown date and experienced drug allergy. 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 vaccination. On 29Jul2021, the patient could not sleep or stay sleep. The event 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 event. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event could not sleep or stay sleep was unknown at the time of this report. The lot number for BNT162b2, were not provided and will be requested during follow up.


VAERS ID: 1646022 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Headache, Loss of personal independence in daily activities, Pain, Pain in extremity, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100976174

Write-up: SOB; Heart palpations; arm hurt; headache; hurt all over; Had trouble doing my regular exercise class this morning; This is a spontaneous report from a contactable consumer. A 64-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Expiration date: Not reported, Batch/Lot Number: FA7485), via an unspecified route of administration, administered in Arm Left on 29Jul2021 16:30 (Age at vaccination 64-year-old) as DOSE NUMBER UNKNOWN, SINGLE for covid-19 immunisation. The patient medical history was not reported. Concomitant medication included pneumococcal vaccine (PNEUMONIA SHOT) taken for pneumococcal immunisation from 23Jul2021 to 23Jul2021. Prior to vaccination, was the patient diagnosed with COVID-19 was No. On 29Jul2021 the patient experienced SoB, Heart palpations, arm hurt, headache, hurt all over. Had trouble doing my regular exercise class this morning. Since the vaccination, has the patient been tested for COVID-19 was No. Treatment received was no for all events. Outcome of event was not recovered. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1646041 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Muscular weakness, Oropharyngeal pain, Pain, Pain in extremity, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anemic; Barrett''s esophagus; Major depression; Restless leg syndrome
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100976570

Write-up: Very sore and weak arm that got the injection; Weak arm that got the injection; Body aches; Sniffles; Sore throat; Tired; This is a spontaneous report from a contactable consumer, the patient. A 50-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FA6780), via an unspecified route of administration in the left arm on 29Jul2021 at 15:00 (at the age of 50-years-old), as a single dose for COVID-19 immunisation. Medical history included barrett''s esophagus, anemic, restless leg syndrome and major depression. 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 unspecified medications from an unknown date for unknown indications. The patient previously took metronidazole (FLAGYL) on unknown date for an unspecified indication and experienced drug allergy. On 29Jul2021 at 17:00, the patient experienced very sore and weak arm that got the injection, body aches, sniffles, sore throat and tired. 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 the events very sore and weak arm that got the injection, body aches, sniffles, sore throat and tired were resolving at the time of reporting.


VAERS ID: 1646057 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac disorder, Chest discomfort, Malaise
SMQs:, Anaphylactic reaction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100978155

Write-up: I feel not so good in my heart area; I feel like a pressure in the chest area; I do not feel good; This is a spontaneous report from a contactable consumer or other non hcp. A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: unknown), via an unspecified route of administration on 29Jul2021 as dose number unknown, single for covid-19 immunization. The patient medical history was not reported. The patient''s concomitant medications were not reported. The patient stated I got the vaccine couple of hours ago (Like two hours ago) and i feel not so good in my heart area, i feel like a pressure in the chest area, i do not feel good on 29Jul2021. Patient stated tell me if it is normal or if it could be bad you know because I was afraid to get the vaccine and now I feel bad you know. Consumer wanted to know what to do if it would get worse whether to go to the hospital or something. The clinical outcome of event was not recovered. The lot number for the vaccine BNT162B2 was not provided and will be requested during follow up.


VAERS ID: 1646068 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Heart rate, Heart rate increased, Hypoaesthesia, Swelling, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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: CLARITIN-D; B-12; VITAMIN D COMPLEX
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Celiac disease (Verbatim: Celiac disease)
Allergies:
Diagnostic Lab Data: Test Name: heart rate; Result Unstructured Data: Test Result:110; Test Name: heart rate; Result Unstructured Data: Test Result:120; Test Name: heart rate; Result Unstructured Data: Test Result:125
CDC Split Type: USPFIZER INC202100978807

Write-up: Increased heart rate; Facial swelling; some swelling in my neck right underneath my chin; Shortness of breath and difficulty in breathing when my heart rate spikes; Numbness down my right arm; This is a spontaneous report from a contactable consumer. This 36-years old female consumer (patient) reported for herself. A 36-year-old female patient received second dose of BNT162B2 (BNT162B2, Formulation: Solution for injection, Lot Number: EW0180, Expiration date: unknown), via unspecified route, administered in right arm on 29Jul2021 (at the age of 36-year-old) as dose 2, single for COVID-19 immunization. The patient medical history includes Coeliac disease from an unspecified date to unknown ongoing and concomitant medications includes loratadine, pseudoephedrine sulphate (CLARITIN-D) for an unknown indication, cyanocobalamin (B-12) for unknown indication, cholecalciferol, menaquinone-7, Phyto menadione, retinol palmitate, tocopherol, tocotrienols nos (VITAMIN D COMPLEX) for unknown indication. No vaccine was taken within four weeks prior to vaccinations. On 29Jul2021, immediately after the vaccination, the patient experienced increased heart rate that went down on its own within 15-to-20-minute, patient noticed that her heart rate was experiencing spikes even when she was sitting completely still. Her heart rate was increased to 110, 120 and 125. she wears a heart monitor, a watch that monitors her heart rate. Patient also experienced facial swelling and some swelling in the neck right underneath her chin, which was noticeable externally. Patient also started to experience some shortness of breath and difficulty in breathing when her heart rate spikes. patient also experienced numbness down the right arm, the same arm that she got the shot, not at the injection site its down the higher length of her arm. The patient lab data includes heart rate readings on unspecified dates which showed 110, 120, and 125. The outcome of the events was unknown. No follow-up attempts possible. No further information expected.


VAERS ID: 1646128 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Chest pain, Electrocardiogram, Heart rate, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: IBUPROFEN
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None, Comment: known allergies: No
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: blood work; Result Unstructured Data: Test Result:Clear; Test Date: 202108; Test Name: EKG; Result Unstructured Data: Test Result:Clear; Test Date: 20210729; Test Name: heart rate; Result Unstructured Data: Test Result:faster than normal
CDC Split Type: USPFIZER INC202100985598

Write-up: chest pains; heart rate has been faster than normal; This is a spontaneous report from a contactable consumer or other non-health care professional (Patient). A 19-year-old female patient (Non-pregnant) received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EW0175 and expiration date was not reported), first dose via an unspecified route of administration, administered in Arm Left on 29Jul2021 14:15 (at the age of 19 years) as dose 1, single for covid-19 immunisation. Patient Medical history was not included. Concomitant medication(s) included ibuprofen (UNKNOWN MANUFACTURER) taken for an unspecified indication, start and stop date were not reported. Patient had no reported allergies. Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient was not diagnosed with COVID-19, prior vaccination and Since the vaccination, patient was not tested for COVID-19. The patient received Ibuprofen within 2 weeks of vaccination. Patient had been having chest pains and heart rate has been faster than normal. Patient went to the hospital on august 1st and EKG, and blood work came back clear. Patient stated "They didn''t give me an MRI and I''ve started feeling this way since the day I got my vaccine which was 29Jul2021. The adverse led to Hospitalization. On 29Jul2021 the patient underwent lab tests and procedures which included heart rate found to be faster than normal. On unspecified date of Aug2021 the patient underwent lab tests and procedures which included blood test and electrocardiogram found to be clear. Patient did not receive any treatment for events. The outcome of the event was not recovered.


VAERS ID: 1646150 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Dizziness, Feeling hot, Loss of consciousness, Nervousness, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100985884

Write-up: Felt like she was going to black out; Felt like she was dying; Generalized hotness / whole body was super hot; Lightheadedness/dizziness; Vision troubles/ couldn''t see; Nervous; This is a spontaneous report from a contactable consumer (patient). A 42-year-old female patient received the first dose of BNT162B2 (PFIZER BIONTECH COVID-19 VACCINE, solution for injection) via an unspecified route of administration on 29Jul2021 (at the age of 42 years old) (Lot number was not reported) as dose 1, single for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. On 29Jul2021, patient got the vaccine, and was driving she felt generalized hotness (whole body was super hot), dizziness, lightheadedness, vision troubles (couldn''t see), nervous, felt like she was dying and felt like she was going to black out. She had these complaints for five minutes and denied the events at the time of reporting. The outcome of the events was recovered on 29Jul2021. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1646152 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Flushing, Heart rate, Heart rate increased, Nasal discomfort, Paraesthesia, Paraesthesia oral, Pharyngeal paraesthesia, Presyncope, Throat irritation, Tongue discomfort
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ASPIRIN [ACETYLSALICYLIC ACID]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: AFib (One isolated event); Cardiac ablation; Penicillin allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210729; Test Name: heart/beat; Result Unstructured Data: Test Result:heart was beating fast and hard; Comments: heart was beating fast and hard
CDC Split Type: USPFIZER INC202100985927

Write-up: Felt she was going to pass out; Began experiencing a hot, flushed and tingly sensation to her whole arm/whole body went completely hot and flush and tingly; Began experiencing a hot, flushed and tingly sensation to her whole arm/whole body went completely hot and flush and tingly; Began experiencing a hot, flushed and tingly sensation to her whole arm/whole body went completely hot and flush and tingly; Heart was beating fast and hard; The back of her nose, throat, and tongue was tingly and hot; The back of her nose, throat, and tongue was tingly and hot; The back of her nose, throat, and tongue was tingly and hot; The back of her nose, throat, and tongue was tingly and hot; The back of her nose, throat, and tongue was tingly and hot; This is a spontaneous report from a contactable consumer (patient, reported for herself). A 48-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Solution for injection, lot number and expiry date not reported), via an unspecified route of administration, administered in left arm on 29Jul2021 12:45 (at the age of 48 years old) as dose 1, single for covid-19 immunization. Medical history included a fib (atrial fibrillation as one isolated event) from an unknown date to an unknown date; patient had a cardiac ablation in 2018; and allergy to penicillin from an unknown date and unknown if ongoing. The patient had no family history. Concomitant medication included aspirin [acetylsalicylic acid] at 81 mg taken for an unspecified indication, start and stop date were not reported. Patient had no prior vaccinations (within 4 weeks). The patient had no history of all previous immunization with the Pfizer vaccine suspect product. Most recent vaccine was administered at military facility. Patient received her first dose of the Pfizer Covid-19 Vaccine on 29Jul2021. As soon as it was injected, she began experiencing a hot, flushed and tingly sensation to her whole arm. She went and sat down and the feeling went to her entire body, then to her nose, throat, and tongue. Her heart was beating fast and hard. She felt she was going to pass out. Everything subsided after 10 minutes and went away. Patient further reported that when the lady put the needle in the patient''s arm and pushed the medicine the patient''s arm went hot and tingly. The patient sat down for a minute and then her whole body went completely hot and flush and tingly. The back of the patient''s nose, throat, and tongue was tingly. Then it felt like the patient''s heart started beating fast and hard. Patient asked if this was normal. These events happened within 5 minutes of the patient getting the shot. Behind the patient''s nose, throat and tongue was also hot. Patient asked if she could get the second dose. The events were non-serious as per reporter. The events did not require emergency room or physician office visits. The outcome of the events was reported as recovered on 29Jul2021. The lot number for the vaccine BNT162B2 was not provided and will be requested during follow up.


VAERS ID: 1646184 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-06-07
Onset:2021-07-29
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210729; Test Name: tested positive for COVID; Test Result: Positive
CDC Split Type: USPFIZER INC202100986922

Write-up: COVID positive; COVID positive; This is a spontaneous report from a contactable consumer or other non hcp. This consumer (patient''s Wife) reported for a 48-year-old male patient (reporter''s husband). A 48-years-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: ER8735) via an unspecified route of administration, administered in Arm Left on 17May2021 (48-years-old at the time of vaccination), as dose 1, single, dose 2 via an unspecified route of administration, administered in arm left on 07jun2021 (batch/lot number: er8729) as dose 2, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. Prior to the vaccination, the patient was not diagnosed with COVID-19. Consumer stated there are six people in her house, and they all got COVID. Her and her husband both got COVID and were both vaccinated, on 29Jul2021 her husband (patient) experienced covid positive. He did not have a prescribing doctor. The patient underwent lab tests and procedures which included sars-cov-2 test positive: positive on 29Jul2021. Follow-Up (05Aug2021): Follow-up attempts are completed. No further information is expected.


VAERS ID: 1646205 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-05
Onset:2021-07-29
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7583 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Near death experience, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100988980

Write-up: Acute pericarditis; he thought he was died, that he had an out of body experience at the hospital, like he was watching himself and his wife hold his hand; This is a spontaneous report from a Pfizer-sponsored program COVAX Support from a contactable consumer (patient). A 73 years old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), at the age of 72 years old, via an unspecified route of administration, administered in Arm Left on 05Apr2021 (Lot Number: EP7583) as single doses for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient previous took first dose of BNT162B2 at the age of 72 years old, on 15Mar2021 (Lot Number: EN6204) as single dose for covid-19 immunisation. The patient experienced acute pericarditis on 29Jul2021. He thought he was died, that he had an out of body experience at the hospital, like he was watching himself and his wife hold his hand. The patient was hospitalized for acute pericarditis from 29Jul2021 to 31Jul2021. Therapeutic measures were taken as a result of acute pericarditis including nitroglycerin and anti-inflammatory drugs. The outcome of acute pericarditis was recovering, of other event was unknown. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1646226 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Insomnia, Vaccination site pain
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MELATONIN GUMMIES
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 INC202100991813

Write-up: soreness on injection site; insomnia; minor headache; This is a spontaneous report from a non-contactable consumer, the patient. A 31-year-old non-pregnant female patient received the unknown dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 29Jul2021 at 14:00 (at the age of 31-years-old) as a single dose for COVID-19 immunisation. The patient did not have any medical history. 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 melatonin (MELATONIN GUMMIES) for unknown indication from an unknown date. The patient did not have any allergies to medications, food or other products. On 29Jul2021 at 14:00, the patient experienced soreness on injection site, insomnia and minor headache. 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 the events soreness on injection site, insomnia and minor headache were recovered with sequelae on an unknown date in 2021 at the time of this report. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1646262 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100993039

Write-up: A Puffy swelling filling on both sides of head.; This is a spontaneous report from a contactable consumer, the patient. A 36-year-old male patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FA7484) via an unspecified route of administration in the arm left on 28Jul2021 at 10:00 (at the age of 36-year-old) as a single dose for COVID-19 immunisation. Medical history was reported as no. Concomitant medications were not reported. The patient had no known allergies to medications, food or other products. 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 vaccination. On 29Jul2021 at 00:45, the patient experienced a puffy swelling filling on both sides of head. The event resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measures were not taken as a result of the event. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event a puffy swelling filling on both sides of head was not recovered at the time of this report.


VAERS ID: 1646275 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-02-08
Onset:2021-07-29
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Migraine
Allergies:
Diagnostic Lab Data: Test Date: 20210729; Test Name: Nasal Swab (rRT-PCR) (Aptima); Test Result: Positive.
CDC Split Type: USPFIZER INC202100993187

Write-up: Positive COVID-19 test on 29Jul2021; Positive COVID-19 test on 29Jul2021; This is a spontaneous report from a contactable consumer or other non hcp.A 43-year-old non-pregnant female patient received bnt162b2 (BNT162B2, Batch/Lot Number: EL3247) via intramuscular route of administration, administered in Arm Left (Age at time of vaccination: 43 years old) on 19Jan2021 as DOSE 1, SINGLE, dose 2 via intramuscular route of administration, administered in Arm Left on 08Feb2021 (Batch/Lot Number: EL3247) as DOSE 2,SINGLE for covid-19 immunisation at clinic. Medical history included migraine. There were no concomitant medications. The patient previously took sesame oil and experienced drug hypersensitivity. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had tested for COVID-19.The patient didn''t receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient did not received any other medications within 2 weeks of vaccination. The patient experienced positive covid-19 test on 29Jul2021. The patient did not received treatment. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 29Jul2021.The outcome of the events were recovering on unspecified date. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1646303 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Aphasia, Asthenia, Asthma, Dysphagia, Dyspnoea, Ear discomfort, Ear infection, Nasal congestion, Oropharyngeal pain, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Asthma/bronchospasm (narrow), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Bronchitis (10 years ago)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100994132

Write-up: felt very weak and winded; felt very weak and winded; an immense amount of pressure in her ears; congestion in her nose; throat began to hurt; throat began to swell; swallowing and speaking became close to impossible; swallowing and speaking became close to impossible; asthma flare up; ear infection; This is a spontaneous report from a contactable consumer (patient). An 18-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), via an unspecified route of administration, administered in left arm on 29Jul2021 at 10:15 am (Batch/Lot Number: EW0186) (at the age of 18-yrs-old) as dose 1, single for COVID-19 immunisation. The patient was not pregnant at time of vaccination. Facility where the most recent COVID-19 vaccine was administered was at the Doctor office/urgent care. Medical history included bronchitis in 2011. The patient has no past drug history and concurrent conditions. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient received birth control within 2 weeks of vaccination. On 29Jul2021 at 14:00 (4 hours after receiving the vaccine), the patient''s throat began to hurt. As more hours passed, her throat began to swell and swallowing and speaking became close to impossible. It was like this for three days following. On the third day (on 01Aug2021) of her throat swelling, she developed an immense amount of pressure in her ears as well as congestion in her nose. The fourth day after receiving the vaccine (on 02Aug2021), she felt very weak and winded. The fifth day after (on 03Aug2021), she went to urgent care as she was still experiencing these symptoms and was informed that she had an asthma flare up. For context, she hasn''t had an asthma flare up since she had bronchitis 10 years ago. She was also informed that she had an ear infection. The adverse events resulted in Doctor or other healthcare professional office/clinic visit. The patient received treatment which included Amoxicillin, Benzonatate, Inhaler, and Pseudoephedrine. The patient was not diagnosed with COVID-19 prior to vaccination and the patient has not been tested for COVID-19 Since the vaccination. The outcome of the events was recovering/resolving. No follow-up attempts are needed. No further information is expected.~


VAERS ID: 1646364 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Contusion, Dysphonia, Dyspnoea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lupus syndrome; Raynaud''s syndrome
Allergies:
Diagnostic Lab Data: Test Date: 20210729; Test Name: body temperature; Result Unstructured Data: Test Result:between 99.4 and 100.1; Comments: fever
CDC Split Type: USPFIZER INC202100997855

Write-up: bruising; bad breathing; hoarse voice; fever/between 99.4 and 100.1; This is a spontaneous report from a contactable consumer (patient). A 52-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number was not reported), via an unspecified route of administration, administered on arm left on 28Jul2021 (at the age of 52-years-old) as dose 1, single for covid-19 immunisation. The patient medical history included mild lupus and Raynaud''s syndrome both from an unknown date. The patient''s concomitant medications were not reported. The fever started the next day (29Jul2021), and it hasn''t broken, it was still between 99.4 and 100.1 constantly. Last night (03Aug2021), the patient realized, she have a severe bruising on her leg, on her upper leg and it was severe, she did not bumped to anything, and her voice was very harsh/hoarse and it''s bad breathing. The patient also asked if it was normal to be bruising like that or even having a fever for a week. The patient received ibuprofen as treatment for the events. The outcome of the events was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1646374 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: IRON; VITAMIN B12 NOS; VITAMIN D NOS
Current Illness: Shellfish allergy (Known allergies: Shellfish)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100998174

Write-up: Bumpy rash breakout on the head of penis; This is a spontaneous report from a contactable consumer, the patient. A 45-year-old male patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FA7485) via an unspecified route of administration in the left arm on 29Jul2021 at 18:30 (at the age of 45-years-old) as a single dose for COVID-19 immunisation. Medical history included shellfish allergy. Concomitant medications included iron (MANUFACTURER UNKNOWN), vitamin B12 (MANUFACTURER UNKNOWN) and vitamin D (MANUFACTURER UNKNOWN). Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 29Jul2021 at 21:00, the patient experienced bumpy rash breakout on the head of penis. The event resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measures were not taken as a result of the event. The clinical outcome of the event bumpy rash breakout on the head of penis was unknown at the time of this report.


VAERS ID: 1646459 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Iowa  
Vaccinated:2021-04-01
Onset:2021-07-29
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, COVID-19, Drug ineffective, Infection, Pyrexia, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: Body temperature; Result Unstructured Data: Test Result:fever; Comments: Ran a fever and miserable for three days; Test Date: 20210729; Test Name: Covid 19; Result Unstructured Data: Test Result:diagnosed with Covid 19
CDC Split Type: USPFIZER INC202101000397

Write-up: Diagnosed with Covid 19; Diagnosed with Covid 19; Ran a fever and miserable for three days; Infections; This is a spontaneous report from a contactable consumer (patient). A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/Lot Number: unknown) via an unspecified route of administration on Apr2021 as dose 2, single and bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/Lot Number: unknown) via an unspecified route of administration on Apr2021 as dose 1, single both for covid-19 immunisation. The patient medical history and concomitant medications were not reported. Patient received the Pfizer two shots in April of 2021. On 29Jul2021, the patient experienced diagnosed with Covid 19. Ran a fever and miserable for three days in 2021. Patient thought breakthrough infections was higher than being reported in 2021. Should be tracked. The patient underwent lab tests and procedures which included body temperature: fever in 2021 and sars-cov-2 test: diagnosed with covid 19 on 29Jul2021. Outcome of the events was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1646587 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Body temperature, Chest pain, Dyspnoea, Fatigue, Hypersensitivity, Lymph node pain, Malaise, Nasal congestion, Pain, Pain in extremity, Pyrexia, Somnolence
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cleft palate (he was born with cleft palate); Deviated nasal septum (he also has a lot of nasal congestion and a deviated septum); Immunocompromised (somewhat of compromise he could have a little bit of compromised system); Nasal congestion (he also has a lot of nasal congestion and a deviated septum); Surgery (several surgeries over the years)
Allergies:
Diagnostic Lab Data: Test Date: 20210803; Test Name: Body temperature; Result Unstructured Data: Test Result:did not have a temperature; Test Date: 20210803; Test Name: Body temperature; Result Unstructured Data: Test Result:did not have a temperature; Test Date: 20210804; Test Name: Body temperature; Result Unstructured Data: Test Result:99.5; Comments: at 10 in the morning; Test Date: 20210804; Test Name: Body temperature; Result Unstructured Data: Test Result:99.6; Comments: it went up after 11 o''clock; Test Date: 20210804; Test Name: Body temperature; Result Unstructured Data: Test Result:99.7; Comments: 1:30; Test Date: 20210804; Test Name: Body temperature; Result Unstructured Data: Test Result:100.7; Comments: at 6:30
CDC Split Type: USPFIZER INC202101008467

Write-up: he did not had a temperature but today I took it like four or five times and it started to go up/fever; allergy; lot of congestion / very congestive; difficulty in breathing / hard time breathing; chest hurt a little bit; arms were sore and may be his lymph nodes a little; arms were sore and may be his lymph nodes a little; tired; slept a little more than normal; does not feel well / he just not feel right; achy; This is a spontaneous report from a contactable consumer (parent). A 13-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 29Jul2021 12:00 (Batch/Lot Number: EW0181) (at the age of 13 years old) as single dose for covid-19 immunisation. Medical history included: he was born with cleft palate, he also has a lot of nasal congestion and a deviated septum, somewhat of compromised he could have a little bit of compromised system, and had several surgeries over the years. The patient''s concomitant medications were not reported. The patient received the vaccine last 29Jul2021 at 12:00, and he just didn''t had any side effect other than his arms was sore and may be his lymph nodes a little and he was tired, like he slept a little more than normal but today (04Aug2021) and yesterday (03Aug2021), the parent didn''t know if it has anything to do with vaccine or not, the patient has been experiencing with lot of congestion, difficulty in breathing and his chest hurt a little bit. Yesterday (03Aug2021), the parent took his (patient) temperature twice and he did not have a temperature but today (04Aug2021) the parent took it like four or five times and it started to go up/fever at 10 in the morning it''s 99.5 and then it went up after 11 o''clock at 99.6, 1:30 at 99.7 then the parent just did it again at 6:30 it was 100.7 and in between patient was given Claritin because the parent thought it was allergy related and then also the parent had just given him some Ibuprofen too to try to get the fever down. The patient was very congestive the last two days and he has hard time breathing. On an unknown date in 2021, he does not feel well and he was saying he was achy, he was saying that he just not feel right but the parent didn''t know if it''s allergy related or if it''s around somebody after or before the shot if it has anything to do with the shot. The parent stated that the patient can''t get a doctor''s appointment tomorrow however he/she wants to know if he/she should be concerned because the patient did not seem well and did not want him to suffer in any way. The patient underwent lab tests which included body temperature: he did not have a temperature on 03Aug2021, he did not have a temperature on 03Aug2021, 99.5 on 04Aug2021 at 10 in the morning, 99.6 on 04Aug2021 (it went up after 11 o''clock), 99.7 on 04Aug2021 at 1:30, 100.7 on 04Aug2021 at 6:30. The adverse events were considered important medical events and resulted in physician''s office visit. Outcome of the events was unknown. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1646643 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: School       Purchased by: ?
Symptoms: Back pain, Dyspnoea, Gait disturbance, Pain in extremity, Paralysis, X-ray
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: x-rays; Result Unstructured Data: Test Result:Unknown results
CDC Split Type: USPFIZER INC202101013169

Write-up: Felt like she had no breath; couldn''t walk; felt paralyzed; the pain moved from the arm to her back; Pain in left arm; This is a spontaneous report from a contactable consumer. A 51-year-old female patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration, administered in Arm Left on 29Jul2021 (Batch/Lot number was not reported) as DOSE 1, SINGLE for covid-19 immunisation . The patient medical history was not reported. There were no concomitant medications. The patient experienced the pain moved from the arm to her back (back pain) (non-serious) on 31Jul2021 with outcome of not recovered , couldn''t walk (gait disturbance) (non-serious) on 04Aug2021 12:00 with outcome of not recovered , felt paralyzed (paralysis) (non-serious) on 04Aug2021 with outcome of recovered , pain in left arm (pain in extremity) (non-serious) on 29Jul2021 16:00 with outcome of unknown , felt like she had no breath (dyspnoea) (non-serious) on 04Aug2021 12:30 with outcome of recovered. The patient underwent lab tests and procedures which included x-ray: unknown results on 2021 . The action taken in response to the event(s) for bnt162b2 was not applicable. Therapeutic measures were taken as a result of the pain moved from the arm to her back (back pain), felt like she had no breath (dyspnoea).


VAERS ID: 1646657 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Glossodynia, Migraine, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: IBUPROFEN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Prior to vaccination, was the patient diagnosed with COVID-19?: Yes)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101013418

Write-up: Sores on the back of tongue; High fever; Migraine; Fatigued beyond comprehension; Body aches so bad nothing helps.; This is a spontaneous report from a contactable consumer, the patient. A 26-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 28Jul2021 at 15:45 (at the age of 26-years-old) as a single dose for COVID-19 immunisation. Medical history included COVID-19. The patient had known allergies to azithromycin (ZITHROMAX). Prior to the vaccination, the patient was diagnosed with COVID-19. Concomitant medications included ibuprofen (MANUFACTURER UNKNOWN) from an unknown date for an unknown indication and unknown if ongoing. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 29Jul2021 at 06:00, the patient experienced every symptom severely over a week. The patient experienced sores on the back of tongue, high fever and migraine that won''t let up. The patient stated she would not be getting the second dose as she was fatigued beyond comprehension and her body ached so bad nothing helped. The events resulted in emergency room/department visit 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 the events sores on the back of tongue, high fever, migraine, fatigued beyond comprehension and body ached so bad nothing helped was not resolved at the time of this report. The batch/lot numbers for, BNT162b2, were not provided and will be requested during follow up.


VAERS ID: 1646698 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Condition aggravated, Influenza like illness, Pain, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210807; Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC202101015049

Write-up: Severe chest tightness and severe pain; Severe chest tightness and severe pain; flu like symptoms; chest pains have gotten worse; This is a spontaneous report from a contactable consumer or other non hcp (patient herself). A 28-years-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch Number/Lot Number: EW0185), via an unspecified route of administration, administered in Arm Left on 28Jul2021 15:00 (at the age of 28-Years-old) as dose 1, single for COVID-19 immunisation. Facility where the most recent COVID-19 vaccine was administered was reported as other. Medical history was reported as none. There were no concomitant medications. No known allergies were reported. The patient didn''t receive any other vaccines within 4 weeks prior to the COVID vaccine (prior vaccination was none). No other medications the patient received within 2 weeks of vaccination. The patient experienced severe chest tightness and severe pain, flu like symptoms and chest pains have gotten worse on 29Jul2021. The patient was hospitalized for severe chest tightness and severe pain, flu like symptoms and chest pains have gotten worse for 1 day. The adverse event resulted in visiting of emergency room/ department or urgent care. The adverse events were considered as serious with seriousness criteria of hospitalization. Patient went to the emergency room for pain and chest pain was worse over 9 days. Prior to vaccination, the patient was diagnosed with COVID-19. Since the vaccination, the patient has been tested for COVID-19. The patient underwent lab tests and procedures which included sars-cov-2 test: negative on 07Aug2021. No treatment was received for the reported events. The outcome of the events was reported as not recovered.


VAERS ID: 1646900 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram, Diarrhoea, Diverticulitis, Dyspnoea, Haematochezia, Hyperhidrosis, Nausea, Pyrexia, SARS-CoV-2 test, Vertigo
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific inflammation (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Cardiomyopathy (broad), Vestibular disorders (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LISINOPRIL; OMEPRAZOLE; IBUPROFEN; MULTIVITAMIN [ASCORBIC ACID;BIOTIN;CALCIUM PANTOTHENATE;CYANOCOBALAMIN;FOLIC ACID;NICOTINIC ACID;PYR
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Chronic pain; Diverticulitis; GERD; Hyperlipidemia; Hypertension
Allergies:
Diagnostic Lab Data: Test Name: CT scan with dye contrast; Result Unstructured Data: Test Result:Unknown results; Test Date: 20210729; Test Name: covid test (nasal swab); Test Result: Negative
CDC Split Type: USPFIZER INC202101028882

Write-up: severe diverticulitis attack; bloody stool; diarrhea; fever; nausea; severe vertigo; difficulty breathing; profuse sweating; intense abdominal pain; This is a spontaneous report from a contactable consumer (patient). A 43-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), via unspecified route of administration, administered in the left arm on 28Jul2021 08:15 (batch/lot number EW0187 and expiry date unknown) at 43 years of age as dose 1, single for covid-19 immunization in an urgent care center. Medical history included asthma, hyperlipidemia, hypertension, chronic pain, GERD, diverticulitis. The patient was not diagnosed with COVID-19 prior to vaccination. Concomitant medications included lisinopril, omeprazole, ibuprofen, ascorbic acid, biotin, calcium pantothenate, cyanocobalamin, folic acid, nicotinic acid, pyridoxine hydrochloride, riboflavin, thiamine hydrochloride, tocopheryl acetate (MULTIVITAMIN); all taken for an unspecified indication, start and stop date were not reported. The patient previously took codeine and experienced allergies. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient informed that within 24 hours of vaccine being administered (approximately midnight on 29Jul2021), he had severe diverticulitis attack to include bloody stool and diarrhea, experienced fever, nausea, severe vertigo, difficulty breathing, profuse sweating, and intense abdominal pain. The patient informed that he required ER visit via paramedics. He had CT scan with dye contrast administered and was then admitted to the hospital for four days on high IV antibiotic regimen plus IV narcotic pain meds. The patient informed that the adverse event resulted in doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care. The events were reported serious as caused hospitalization (hospitalization not prolonged). The patient underwent lab tests and procedures which included covid test (nasal swab): negative on 29Jul2021. The outcome of the events was recovering.


VAERS ID: 1647108 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood pressure measurement, Chills, Fatigue, Headache, Hypertension, Malaise, Myalgia, Nausea, Pain in extremity, Palpitations, Pyrexia, Vaccination site erythema, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210729; Test Name: Blood pressure; Result Unstructured Data: Test Result:High
CDC Split Type: USPFIZER INC202101041586

Write-up: Pounding heart; Arm pain; Vomiting; Feeling unwell; Nausea; Injection site redness; Fever; Joint pain; Chills; Muscle pain/pain in calf muscle; Headache; Tiredness; high blood pressure; This is a spontaneous report from a contactable consumer (patient). A non-pregnant 46-years-old female patient received the first dose of BNT162B2 Pfizer-BioNTech COVID-19 mRNA Vaccine, at Pharmacy or Drug Store, administered via an unspecified route in left arm on 29Jul2021 15:00, at 46 years of age, (Batch/Lot Number: FA7485) as single dose for COVID-19 immunization. The patient''s medical history was not reported. There were no concomitant medications. The patient was not diagnosed with COVID-19 prior to vaccination and has not been tested for COVID-19 since the vaccination. The patient didn''t receive any other vaccines within 4 weeks prior to the COVID vaccine. On 29Jul2021 22:00 the patient experienced pounding heart, assessed as medically significant, arm pain, vomiting, feeling unwell, nausea, injection site redness, fever, joint pain, chills, muscle pain/pain in calf muscle, headache, tiredness and high blood pressure. The events resulted in doctor or other healthcare professional office/clinic visit. The patient underwent lab tests and procedures on 29Jul2021 which included blood pressure measurement which was high. The patient didn''t receive any treatment. At the time of the report the reported events were resolving.


VAERS ID: 1647261 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Ear discomfort, Nausea, Tinnitus
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy (Known allergies: Penicillin)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101050702

Write-up: tinnitus; ear fullness; nausea; This is a spontaneous report from a contactable consumer (patient). A 54-year-old non-pregnant female patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/lot number: FA6780), via unspecified route of administration, administered in left arm, on 29Jul2021 17:00 (age at the time of vaccination 54-year-old) as single dose for COVID-19 immunization. The patient was not a pregnant at the time of vaccination. Medical history and concomitant medications were not reported. The patient was allergic to penicillin. On 29Jul2021 at 19:00, the patient experienced horrible non-stop tinnitus, ear fullness and nausea. The patient visited emergency room and physician office. The patient had not received any treatment for the events. 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 had not been tested for COVID-19. The seriousness was reported as disability. Device Date was reported as 15Aug2021. The outcome of the events was not resolved. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1653885 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Anxiety, Blood pressure fluctuation, Blood thyroid stimulating hormone decreased, Condition aggravated, Diarrhoea, Electric shock sensation, Feeling jittery, Feeling of body temperature change, Flushing, Heart rate abnormal, Impaired work ability, Nausea, Palpitations, Paraesthesia, Weight decreased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (broad), Cardiomyopathy (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, singular, allegra, buspar, atenolol, magnesium, Vitamin D, vitamin B12,
Current Illness: none.
Preexisting Conditions: asthma Hypothyroidism (total thyroidectomy in 2010 multiple environmental allergies
Allergies: levaquin Tequin Epinephrine
Diagnostic Lab Data: TSH July 9 was 2.6 TSH Aug 10 was 1.5 TSH Aug 14 was 2.3
CDC Split Type:

Write-up: About an hour after I got it I felt an odd shock all over my body, then a cold and hot flushing sensation all over. I was jittery the rest of the day. Five days later I had more of the cold shot flushes and realized they were adrenaline surges, accompanied by severe anxiety. It has progressively worsened and I am having loose stools, a 10 lb weight loss, and have been increasingly unable to work (I am a Public Health RN). I am having symptoms of POTS syndrome. I wish I had never taken the vaccine. This is absolutely horrible. My heart pounds when I get up and move about. My BP and heart rate are fluctuating wildly. I am nauseated. Having flushing. Went to the ER because my arms and legs were tingling so badly and the adrenaline surges.


VAERS ID: 1655073 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-12
Onset:2021-07-29
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Congestive heart failure; COPD.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: BMI; Result Unstructured Data: Test Result:28.7; Test Date: 20210729; Test Name: NAAT Covid test; Test Result: Positive.
CDC Split Type: USPFIZER INC202101076354

Write-up: Tested positive for Covid virus, after being fully vaccinated; Tested positive for Covid virus, after being fully vaccinated; This is a spontaneous report from a contactable consumer reporting same event(s) under the same suspect product(s) for 37 patients. This is 1 of 37 reports. A 65-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: EN5318), via an unspecified route of administration on 23Jan2021 as dose 1, single and BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: EL9266), via an unspecified route of administration on 12Feb2021 as dose 2, single for COVID-19 immunisation at health department. Medical history included ongoing chronic obstructive pulmonary disease (COPD) AND ongoing congestive heart failure (CHF). The patient''s concomitant medications were not reported. After being fully vaccinated, on 29Jul2021, patient tested positive for COVID virus. The patient underwent lab tests and procedures which included body mass index (BMI): 28.7 and NAAT COVID test: positive on 29Jul2021. Outcome of the event was unknown. Follow-Up (23Aug2021): Follow-up attempts are completed. No further information is expected.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101075254 Same reporter/drug/AE, different patients


VAERS ID: 1657802 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: 17-year-old patient received the first dose of Moderna COVID-19 vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (17-year-old patient received the first dose of Moderna COVID-19 vaccine) in a 17-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027C21A) for COVID-19 vaccination. No Medical History information was reported. On 29-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Jul-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (17-year-old patient received the first dose of Moderna COVID-19 vaccine). On 29-Jul-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (17-year-old patient received the first dose of Moderna COVID-19 vaccine) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. It was reported that, patient accidently received the Moderna vaccine while he was meant to be administered with the Pfizer vaccine. Treatment information was not provided.


VAERS ID: 1661136 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure measurement, Hypoaesthesia, Hypotension, Lumbar puncture, Paralysis, Rash, Speech disorder, Syncope, Vaccination site rash
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy; Sulfonamide allergy.
Allergies:
Diagnostic Lab Data: Test Date: 20210729; Test Name: blood pressure; Result Unstructured Data: Test Result: 60/90; Test Date: 2021; Test Name: spinal tap; Result Unstructured Data: Test Result: unknown results.
CDC Split Type: USPFIZER INC202101065511

Write-up: one of her sides was paralyzed/did not feel left side of body - face, arms and legs were numb; one of her sides was paralyzed/did not feel left side of body - face, arms and legs were numb; very bad rash/she had a rash everywhere/ rash on her whole body; she can''t speak; She got a bad rash around the injection site; fainted 4 hours later/collapsed 5 times; Blood pressure went low/it was 60/90; This is a spontaneous report from two contactable consumers. A 29-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Batch/Lot number was not reported), via an unspecified route of administration, administered in left arm on 29Jul2021 (at the age of 29-year-old) as dose 2, single for COVID-19 immunization. Medical history included allergies to sulfa and penicillin. There were no concomitant medications. The reporter stated her landlord''s daughter (patient) got her second shot of the Pfizer Covid-19 Vaccine and she fainted 4 hours later on 29Jul2021, she got a very bad rash, and had been in the hospital for 10 days now. She had to have a spinal tap, she couldn''t speak and one of her sides was paralyzed. She said that the patient''s mother told her that the patient was allergic penicillin and sulfa. She got a bad rash around the injection site in 2021. She said that the patient was going to be traveling, but got really sick from the second dose. The patient''s mother later reported the patient took second dose of the Pfizer vaccine and she collapsed, clarifying she collapsed 5 times. They called ambulance and went to the hospital. She was still in the hospital and they were trying to remove her from the hospital because they were not doing anything for her. She said the patient worked for a doctor for 2 years. She did not know the name of patient''s primary care provider or the doctor treating her now, clarifying there were so many doctors that she was seeing while in the hospital. The patient''s mother said the patient had a rash on her whole body 4 hours after she took the 2nd dose of the vaccine on 29Jul2021. She went to the hospital because her blood pressure was too low. She said it was 60/90. The patient had allergies with other mediations, and the patient''s mother said that maybe Pfizer''s COVID vaccine had some product inside the vaccine that she was allergic to. She later stated she was allergic to Sulfa and Penicillin. She did not have a manufacturer and did not have a lot or expiration. She was a baby when it was discovered and said she would not drink that medication now because she knew it was not good for her. The patient was carried by ambulance and was admitted to hospital on 29Jul2021. Two days after this, she was discharged. They said she had nothing and she was ok and can walk now. The doctor said for her to follow up for neurologic and heart doctor. He was supposed to give shot for allergies while in the hospital and he did not, even though she had a rash everywhere. Now the patient was very bad. She did not feel left side of body-face, arms and legs were numb. She cannot speak very well. She had no control of movements on left side. She was hospitalized for all of this on 08Aug2021 and she had more rash that was back on her body. She remained hospitalized and the doctor never gave shot for allergies. She said the patient was very healthy. The patient''s mother wanted to find out what can be done for her daughter and if there was anything in the vaccine that would be the same as Sulfa or Penicillin, since she was allergic to them. The outcome of the events "very bad rash/she had a rash everywhere/ rash on her whole body" and "one of her sides was paralyzed/did not feel left side of body - face, arms and legs were numb" was not recovered, of the other events was unknown. The lot number for BNT162B2, was not provided and will be requested during follow up.


VAERS ID: 1661196 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-28
Onset:2021-07-29
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Dizziness, Dyspnoea, Feeling abnormal, Fibrin D dimer increased, Malaise, Palpitations, Thrombosis, Vertigo
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Inflammation
Allergies:
Diagnostic Lab Data: Test Date: 20210729; Test Name: D-Dimer; Result Unstructured Data: Test Result:elevated
CDC Split Type: USPFIZER INC202101076625

Write-up: this means that she has tiny blood clots all in her body; has not been feeling well lately; very dizzy; vertigo; shortness of breath; her heart felt like it was racing; she felt really weird like out of body and did not feel right and her body did not feel right.; D-Dimer elevated; This is a spontaneous report from a contactable consumer (Patient). A 41-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, lot number: ER8736), via an unspecified route of administration, administered in Arm Left on 28Apr2021 10:00 (at the age of 41-years-old) as dose 2, single for covid-19 immunization. Medical history included inflammation. The patient''s concomitant medications were not reported. Historical vaccine included bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, lot number: ER8737), via unspecified route of administration, administered on 01Apr2021 (at the age of 41-years-old) as dose1, single for Covid-19 immunization. It was reported that Prior Vaccinations (within 4 weeks) was None. Family medical history relevant to adverse event was none. The patient experienced this means that she has tiny blood clots all in her body, has not been feeling well lately, very dizzy, vertigo, shortness of breath, her heart felt like it was racing, she felt really weird like out of body and did not feel right and her body did not feel right on Aug2021 and d-dimer elevated on 29Jul2021. Caller states she is calling about the Pfizer Covid-19 vaccine and states she has not been feeling well lately for three days of being very dizzy and her HCP did a test on her blood to see if she had elevated D-dimer enzymes or something like that and said this could be from the Pfizer Covid-19 vaccine. Caller states this means that she has tiny blood clots all in her body and she just wanted to report this. Caller states on her patient card it is written that she had the 1st dose of the Pfizer Covid-19 vaccine administered on 01Apr2022 and the 2nd dose administered on 28Apr2022; caller states this may be written incorrectly as she had the 1st dose on 01Apr2021 with lot ER8737 and the 2nd dose administered on 28Apr2021 with lot ER8736; states she does not see expiry dates or NDC numbers written on her patient card. Caller states the not feeling well began recently a couple of weeks ago around 04Aug2021 or 03Aug2021 and she went into urgent care on 07Aug2021 and was not feeling well and her symptoms were that she was very dizzy like vertigo, shortness of breath and her heart felt like it was racing and she felt really weird like out of body and did not feel right and her body did not feel right. States she still feels a little shortness of breath and she does not really know but knows something is wrong with her and does not know what it is but she is a pretty healthy person and does not have medical conditions or anything healthwise but feels like something is off and her shortness of breath is ongoing and is about the same as when it began. Caller states she had gone to her HCP previously before the urgent care visit and the HCP wanted to do the blood test on her knowing she had had the Pfizer COVID Vaccine after reading an article about the D-dimer enzyme being elevated and wanted to do this blood test on her and ended up saying that the caller was the HCP''s first person ever that had the elevated D-dimer and the HCP just told the caller this yesterday. States she does not know what the next step will be and she guesses right now her HCP prescribed her low dose Aspirin to take care of the blood clots and it is 81mg a day and told her to start with that and she guesses in another month or so she will have another test to test the D-dimer; states she began taking the Aspirin yesterday. States she is also taking some anti-inflammation supplements at the moment and has not started taking Serration yet and did start taking Tumeric supplements with black pepper because that is supposed to be good for inflammation and the HCP said that is fine and she began taking the Tumeric yesterday. Emergency room visit was no. Therapeutic measures were taken with Lunesta one pill of 3mg a night and began taking that back in the beginning of Jun2021; states she takes Zoloft 1.5 to 2mg and increased that dose recently and right now takes 2mg and anti-inflammation supplements (Tumeric supplements with black pepper)as a result of event this means that she has tiny blood clots all in her body has not been feeling well lately, very dizzy, d-dimer elevated, vertigo, shortness of breath, her heart felt like it was racing, she felt really weird like out of body and did not feel right and her body did not feel right. The patient underwent lab tests and procedures which included D-Dimer (blood test): elevated on 29Jul2021. The outcome of event shortness of breath was not resolved and for rest of all events outcome was unknown. Follow-Up (23Aug2021): Follow-up attempts are completed. No further information is expected.


VAERS ID: 1662044 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-31
Onset:2021-07-29
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Ageusia, Chest X-ray, Cough, Painful respiration, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Taste and smell disorders (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Afib, CHF, COPD, GERD, HTN, hypercholesterolemia, DVT, osteoporosis, PE.
Allergies: ACE inhibitors, Demerol.
Diagnostic Lab Data: CXR, covid test
CDC Split Type:

Write-up: Pt came to ER c/o pain with deep breaths, dry cough, loss of taste, abdominal pain.


VAERS ID: 1662049 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-05
Onset:2021-07-29
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Exposure to SARS-CoV-2, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Pt came to ER with cough and exposure to Covid, onset 1 day prior.


VAERS ID: 1512409 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 213C21A / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Headache, Hyperhidrosis, Vaccination site pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Pain at vaccination site, severe headache, dizziness, profuse sweating, feeling hot


VAERS ID: 1515749 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Seguril sporadically, Vitamin C 1000 mg daily, Iron, Vitamin D
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever since administration, swollen glands.


VAERS ID: 1524519 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 29125BA / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Discomfort, Inflammation, Myocarditis, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Diabetes
Preexisting Conditions: Diabetes
Allergies: NO
Diagnostic Lab Data: None yet, only the pulse is elevated and inflammation and discomfort are felt in the affected area.
CDC Split Type: A30-56773054

Write-up: Myocarditis and mild pericarditis.


VAERS ID: 1525260 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Chills, Fatigue, Injection site pain, Myalgia, Pyrexia, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pregnancy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210727; Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: No - Negative COVID-19 test
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Axillary pain; Muscle ache; Chills; Fatigue; Fever; Injection site pain; This regulatory authority prospective pregnancy case was reported by a consumer and describes the occurrence of INJECTION SITE PAIN (Injection site pain), FATIGUE (Fatigue), PYREXIA (Fever), AXILLARY PAIN (Axillary pain), MYALGIA (Muscle ache) and CHILLS (Chills) in a 32-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Pregnancy. On 29-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. Last menstrual period and estimated date of delivery were not provided. On 29-Jul-2021, the patient experienced INJECTION SITE PAIN (Injection site pain) (seriousness criterion medically significant). On 30-Jul-2021, the patient experienced FATIGUE (Fatigue) (seriousness criterion medically significant), PYREXIA (Fever) (seriousness criterion medically significant), MYALGIA (Muscle ache) (seriousness criterion medically significant) and CHILLS (Chills) (seriousness criterion medically significant). On 31-Jul-2021, the patient experienced AXILLARY PAIN (Axillary pain) (seriousness criterion medically significant). On 31-Jul-2021, CHILLS (Chills) had resolved. At the time of the report, INJECTION SITE PAIN (Injection site pain) and FATIGUE (Fatigue) had not resolved and PYREXIA (Fever), AXILLARY PAIN (Axillary pain) and MYALGIA (Muscle ache) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 27-Jul-2021, SARS-CoV-2 test: negative (Negative) No - Negative COVID-19 test. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. Concomitant medications were not reported. Treatment information was not provided. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1527242 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3003608 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Feeling cold, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: AMITRIPTYLINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Fatigue; Insomnia; Lactation decreased; Suspected COVID-19 (Unsure when symptoms started Unsure when symptoms stopped)
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Feverish; feel cold; Muscular pain; Slight temperature; Fatigue; This regulatory authority case was reported by a consumer and describes the occurrence of PYREXIA (Feverish), MYALGIA (Muscular pain), PYREXIA (Slight temperature), FATIGUE (Fatigue) and FEELING COLD (feel cold) in an 18-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3003608) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased, Fatigue, Suspected COVID-19 (Unsure when symptoms started Unsure when symptoms stopped) and Insomnia. Concomitant products included AMITRIPTYLINE from 15-Apr-2021 to an unknown date for Insomnia. On 29-Jul-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 29-Jul-2021, the patient experienced FATIGUE (Fatigue) (seriousness criterion medically significant). On 30-Jul-2021, after starting mRNA-1273 (Moderna CoviD-19 Vaccine), the patient experienced MYALGIA (Muscular pain) (seriousness criterion medically significant) and PYREXIA (Slight temperature) (seriousness criterion medically significant). On an unknown date, the patient experienced PYREXIA (Feverish) (seriousness criterion medically significant) and FEELING COLD (feel cold) (seriousness criterion medically significant). At the time of the report, PYREXIA (Feverish) was resolving, MYALGIA (Muscular pain), PYREXIA (Slight temperature) and FATIGUE (Fatigue) had not resolved and FEELING COLD (feel cold) outcome was unknown. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. No treatment information was provided. The patient reported that due to fatigue they went to bed early and woke up in early morning with very serious muscular pain. The patient''s temperature was high, but they felt cold-feverish. Reportedly, the patient has not tested positive for COVID-19 since having the vaccine and was not enrolled in clinical trial. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. No further information is expected.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. No further information is expected.


VAERS ID: 1527245 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3003607 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal, Nausea, Pain, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Swollen arm; Dizziness; Foggy feeling in head; Ache; Fever; Nausea; This regulatory authority case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Swollen arm), DIZZINESS (Dizziness), FEELING ABNORMAL (Foggy feeling in head), PAIN (Ache), PYREXIA (Fever) and NAUSEA (Nausea) in a 35-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3003607) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased. On 28-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 29-Jul-2021, the patient experienced PERIPHERAL SWELLING (Swollen arm) (seriousness criterion medically significant), DIZZINESS (Dizziness) (seriousness criterion medically significant), FEELING ABNORMAL (Foggy feeling in head) (seriousness criterion medically significant), PAIN (Ache) (seriousness criterion medically significant), PYREXIA (Fever) (seriousness criterion medically significant) and NAUSEA (Nausea) (seriousness criterion medically significant). At the time of the report, PERIPHERAL SWELLING (Swollen arm) and PAIN (Ache) had not resolved, DIZZINESS (Dizziness), FEELING ABNORMAL (Foggy feeling in head) and PYREXIA (Fever) was resolving and NAUSEA (Nausea) had resolved. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. No concomitant medication information was provided. The patient was not tested positive for COVID-19 since having the vaccine. No treatment product information was provided. For mRNA-1273 (Moderna COVID-19 Vaccine) (unknown), the reporter did not provide any causality assessments. Company Comment Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1527247 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3003608 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Headache, Lymphadenopathy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Psoriasis
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Joint pain; Lymphadenopathy; Fever; Occipital headache; Shivers; This regulatory authority case was reported by a consumer and describes the occurrence of ARTHRALGIA (Joint pain), LYMPHADENOPATHY (Lymphadenopathy), PYREXIA (Fever), HEADACHE (Occipital headache) and CHILLS (Shivers) in a 35-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3003608) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased. Concurrent medical conditions included Psoriasis. On 29-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 29-Jul-2021, the patient experienced ARTHRALGIA (Joint pain) (seriousness criterion medically significant), LYMPHADENOPATHY (Lymphadenopathy) (seriousness criterion medically significant), PYREXIA (Fever) (seriousness criterion medically significant), HEADACHE (Occipital headache) (seriousness criterion medically significant) and CHILLS (Shivers) (seriousness criterion medically significant). At the time of the report, ARTHRALGIA (Joint pain), LYMPHADENOPATHY (Lymphadenopathy), PYREXIA (Fever), HEADACHE (Occipital headache) and CHILLS (Shivers) had not resolved. Concomitant product use was not provided by the reporter. No treatment information was provided. The reactions started 1.5 to 2 hours after the vaccination. Patient has not tested positive for COVID-19 since having the vaccine. Patient was not enrolled in clinical trial. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. No further information is expected at this time.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. No further information is expected at this time.


VAERS ID: 1527256 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3003608 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Myalgia, Oropharyngeal discomfort, Pyrexia, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data: Test Date: 20210728; Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: No - Negative COVID-19 test
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Throat discomfort; Fever; Muscle ache; This regulatory authority case was reported by a consumer and describes the occurrence of OROPHARYNGEAL DISCOMFORT (Throat discomfort), PYREXIA (Fever) and MYALGIA (Muscle ache) in a 33-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3003608) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased. On 28-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 29-Jul-2021, the patient experienced PYREXIA (Fever) (seriousness criterion medically significant) and MYALGIA (Muscle ache) (seriousness criterion medically significant). On 30-Jul-2021, the patient experienced OROPHARYNGEAL DISCOMFORT (Throat discomfort) (seriousness criterion medically significant). On 30-Jul-2021, MYALGIA (Muscle ache) had resolved. At the time of the report, OROPHARYNGEAL DISCOMFORT (Throat discomfort) had not resolved and PYREXIA (Fever) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 28-Jul-2021, SARS-CoV-2 test: negative (Negative) No - Negative COVID-19 test. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported. Patient had not tested positive for COVID-19 since having the vaccine. Patient was not enrolled in clinical trial. No treatment information was provided For mRNA-1273 (Moderna COVID-19 Vaccine) (unknown), the reporter did not provide any causality assessments. Company Comment Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1528343 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Fatigue, Headache, Photophobia, SARS-CoV-2 test
SMQs:, Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthmatic
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: No - Negative COVID-19 test
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: zero energy; Exhaustion; Headache; Light sensitivity to eye; This regulatory authority case was reported by a consumer and describes the occurrence of ASTHENIA (zero energy), FATIGUE (Exhaustion), HEADACHE (Headache) and PHOTOPHOBIA (Light sensitivity to eye) in a 42-year-old male patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Asthmatic. On 29-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 29-Jul-2021, the patient experienced FATIGUE (Exhaustion) (seriousness criterion medically significant), HEADACHE (Headache) (seriousness criterion medically significant) and PHOTOPHOBIA (Light sensitivity to eye) (seriousness criterion medically significant). On an unknown date, the patient experienced ASTHENIA (zero energy) (seriousness criterion medically significant). At the time of the report, ASTHENIA (zero energy), FATIGUE (Exhaustion), HEADACHE (Headache) and PHOTOPHOBIA (Light sensitivity to eye) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: negative (Negative) No - Negative COVID-19 test. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. No concomitant products was provided by the reporter. No treatment information was provided by the reporter. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Seriousness criteria for the events was captured by regulatory authority, however based on medical judgement the case is non serious. No further information is expected at this time.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Seriousness criteria for the events was captured by regulatory authority, however based on medical judgement the case is non serious. No further information is expected at this time.


VAERS ID: 1528349 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-27
Onset:2021-07-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Oropharyngeal pain, SARS-CoV-2 test, Tonsillitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data: Test Date: 20210730; Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: Negative
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: tonsillitis; headache; Sore throat; This regulatory authority case was reported by a consumer and describes the occurrence of TONSILLITIS (tonsillitis), HEADACHE (headache) and OROPHARYNGEAL PAIN (Sore throat) in a 34-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased. On 27-Jul-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Jul-2021, the patient experienced OROPHARYNGEAL PAIN (Sore throat) (seriousness criterion medically significant). On an unknown date, the patient experienced TONSILLITIS (tonsillitis) (seriousness criterion medically significant) and HEADACHE (headache) (seriousness criterion medically significant). At the time of the report, TONSILLITIS (tonsillitis) and HEADACHE (headache) outcome was unknown and OROPHARYNGEAL PAIN (Sore throat) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 30-Jul-2021, SARS-CoV-2 test: negative (Negative) Negative. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) was unknown. Concomitant product information was not provided by reporter. No treatment information was provided. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1529645 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-27
Onset:2021-07-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Pain in extremity, Pyrexia, Rash, Swelling, Swelling face, Vision blurred
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: blurred vision; fatigue; swelling; hight temperature; headache; chills; rash on arm; legs aching; Swelling face; This regulatory authority case was reported by a consumer and describes the occurrence of VISION BLURRED (blurred vision), FATIGUE (fatigue), SWELLING (swelling), PYREXIA (hight temperature), HEADACHE (headache), CHILLS (chills) and SWELLING FACE (Swelling face) in a 39-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Lactation decreased. On 27-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 29-Jul-2021, the patient experienced SWELLING FACE (Swelling face) (seriousness criterion medically significant). On an unknown date, the patient experienced VISION BLURRED (blurred vision) (seriousness criterion medically significant), FATIGUE (fatigue) (seriousness criterion medically significant), SWELLING (swelling) (seriousness criterion medically significant), PYREXIA (hight temperature) (seriousness criterion medically significant), HEADACHE (headache) (seriousness criterion medically significant), CHILLS (chills) (seriousness criterion medically significant), RASH (rash on arm) and PAIN IN EXTREMITY (legs aching). At the time of the report, VISION BLURRED (blurred vision), FATIGUE (fatigue), SWELLING (swelling), PYREXIA (hight temperature), HEADACHE (headache), CHILLS (chills), RASH (rash on arm) and PAIN IN EXTREMITY (legs aching) outcome was unknown and SWELLING FACE (Swelling face) had not resolved. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. No treatment information was provided. Patient experience Rash on arm, Left side of face swollen, Leg aching. Company comment Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Events seriousness captured as per Regulatory Authority assessment; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Events seriousness captured as per Regulatory Authority assessment


VAERS ID: 1529836 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3003608 / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Pain, Pain in extremity, Seizure, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: convulsion; fainting; shaking; pain; sore arm; Faint; This regulatory authority case was reported by an other health care professional and describes the occurrence of SEIZURE (convulsion), SYNCOPE (fainting) and SYNCOPE (Faint) in a 35-year-old male patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3003608) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 29-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Jul-2021, the patient experienced SYNCOPE (Faint) (seriousness criterion medically significant). On an unknown date, the patient experienced SEIZURE (convulsion) (seriousness criterion medically significant), SYNCOPE (fainting) (seriousness criterion medically significant), TREMOR (shaking), PAIN (pain) and PAIN IN EXTREMITY (sore arm). The patient was treated with PARACETAMOL for Adverse event, at an unspecified dose and frequency. On 29-Jul-2021, SYNCOPE (Faint) had resolved. At the time of the report, SEIZURE (convulsion), SYNCOPE (fainting), TREMOR (shaking), PAIN (pain) and PAIN IN EXTREMITY (sore arm) was resolving. For mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medications were not reported. Patient had a nose bleed and a bruise on the right hand side of his forehead due to the impact of fainting. When the patient had his first dose, he experienced sore arm. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1529882 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Myalgia, Oropharyngeal pain, Pyrexia, Sinus headache
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: GBMODERNATX, INC.MOD20212

Write-up: Headache sinus; Sore throat; Fever; Generalised muscle aches; This regulatory authority case was reported by a consumer and describes the occurrence of SINUS HEADACHE (Headache sinus), OROPHARYNGEAL PAIN (Sore throat), PYREXIA (Fever) and MYALGIA (Generalised muscle aches) in a 33-year-old male patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 29-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 29-Jul-2021, the patient experienced SINUS HEADACHE (Headache sinus) (seriousness criterion medically significant), OROPHARYNGEAL PAIN (Sore throat) (seriousness criterion medically significant), PYREXIA (Fever) (seriousness criterion medically significant) and MYALGIA (Generalised muscle aches) (seriousness criterion medically significant). At the time of the report, SINUS HEADACHE (Headache sinus), OROPHARYNGEAL PAIN (Sore throat), PYREXIA (Fever) and MYALGIA (Generalised muscle aches) had not resolved. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided. Patient was not tested positive for COVID-19 since having the vaccine. Patient was not enrolled in clinical trial. Company Comment - Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Very limited information regarding these events has been provided at this time. No further information is expected at this time.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Very limited information regarding these events has been provided at this time. No further information is expected at this time.


VAERS ID: 1529883 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3003651 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Cough, Heart rate increased, Insomnia, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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: ADRENALINE [EPINEPHRINE]; PARACETAMOL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Norovirus infection (Patient had 24hours with suspected norovirus 7 working days before, but completely clear for 6 days)
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Trembling; Heart rate was up; cough; Sleep loss; Chills; Fever; This regulatory authority case was reported by a consumer and describes the occurrence of TREMOR (Trembling), HEART RATE INCREASED (Heart rate was up), COUGH (cough), INSOMNIA (Sleep loss), CHILLS (Chills) and PYREXIA (Fever) in a 35-year-old male patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3003651) for COVID-19 vaccination. The patient''s past medical history included Norovirus infection (Patient had 24hours with suspected norovirus 7 working days before, but completely clear for 6 days). Concomitant products included ADRENALINE [EPINEPHRINE] from 22-Jul-2021 to 23-Jul-2021 for Diarrhea, PARACETAMOL for an unknown indication. On 29-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Jul-2021, the patient experienced TREMOR (Trembling) (seriousness criterion medically significant), HEART RATE INCREASED (Heart rate was up) (seriousness criterion medically significant), COUGH (cough) (seriousness criterion medically significant), INSOMNIA (Sleep loss) (seriousness criterion medically significant), CHILLS (Chills) (seriousness criterion medically significant) and PYREXIA (Fever) (seriousness criterion medically significant). At the time of the report, TREMOR (Trembling), HEART RATE INCREASED (Heart rate was up) and COUGH (cough) was resolving and INSOMNIA (Sleep loss), CHILLS (Chills) and PYREXIA (Fever) had not resolved. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) was unknown. The patient had chills first with trembling, felt like patient did just run a race (adrenaline up, felt like heart rate was up but not sure it was). The patient had not slept at all. The symptoms started at around 10am.. The patient still felt very hot. No treatment medication were provided. Company comment Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1529902 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-02
Onset:2021-07-29
   Days after vaccination:57
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA LOT3002332 / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Decreased appetite, Fatigue, Insomnia, Myalgia, Pyrexia, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data: Test Date: 20210617; Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: No - Negative COVID-19 test
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: joint pain; muscle pain; feel very tired; under arm gland pain; couldn''t sleep the whole night; no appetite; Fever; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 01-Aug-2021 and was forwarded to Moderna on 01-Aug-2021. This regulatory authority case was reported by a consumer and describes the occurrence of ARTHRALGIA (joint pain), MYALGIA (muscle pain), FATIGUE (feel very tired) and PYREXIA (Fever) in a 30-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch nos. LOT3002332 and LOT3003651) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased. On 02-Jun-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 28-Jul-2021, received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 29-Jul-2021, the patient experienced PYREXIA (Fever) (seriousness criterion disability). On an unknown date, the patient experienced ARTHRALGIA (joint pain) (seriousness criterion disability), MYALGIA (muscle pain) (seriousness criterion disability) and FATIGUE (feel very tired) (seriousness criterion disability). At the time of the report, ARTHRALGIA (joint pain), MYALGIA (muscle pain), FATIGUE (feel very tired) and PYREXIA (Fever) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 17-Jun-2021, SARS-CoV-2 test: negative (Negative) No - Negative COVID-19 test. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. No concomitant medication were reported. Patient experienced high fever reaching 40 degree Celsius, muscle pain, joint pain, under arm gland pain, could not sleep the whole night. felt very tired, no appetite. Patient was not enrolled in clinical trial. No treatment medication were reported.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event Pyrexia, a causal relationship cannot be excluded. Very limited information regarding the events Arthralgia, Myalgia, Fatigue, Axillary pain, Insomnia and Decreased appetite have been provided at this time. No further information is expected at this time.


VAERS ID: 1529905 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Shivers; Fever chills; Period pains; Migraine; This regulatory authority case was reported by a consumer and describes the occurrence of CHILLS (Shivers), PYREXIA (Fever chills), DYSMENORRHOEA (Period pains) and MIGRAINE (Migraine) in a female patient of an unknown age who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 29-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 29-Jul-2021, the patient experienced CHILLS (Shivers) (seriousness criterion medically significant), PYREXIA (Fever chills) (seriousness criterion medically significant), DYSMENORRHOEA (Period pains) (seriousness criterion medically significant) and MIGRAINE (Migraine) (seriousness criterion medically significant). At the time of the report, CHILLS (Shivers) and DYSMENORRHOEA (Period pains) was resolving and PYREXIA (Fever chills) and MIGRAINE (Migraine) had resolved. Concomitant medications were not provided. Treatment medications was not given. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Seriousness of the events are based on the Regulatory Report received, as per medical judgement the events for this case are non serious.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Seriousness of the events are based on the Regulatory Report received, as per medical judgement the events for this case are non serious.


VAERS ID: 1529909 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3003608 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Headache, Nausea, SARS-CoV-2 test
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CERAZETTE [DESOGESTREL]; FLUTICASONE FUROATE; OMEPRAZOLE
Current Illness: Acid reflux (esophageal); Deviated nasal septum
Preexisting Conditions: Medical History/Concurrent Conditions: Suspected COVID-19 (Unsure when symptoms stopped)
Allergies:
Diagnostic Lab Data: Test Date: 20201105; Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: Negative
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: Nausea; Diarrhea; Headache; Diarrhoea; Throbbing headache; This regulatory authority case was reported by a consumer and describes the occurrence of NAUSEA (Nausea), DIARRHOEA (Diarrhea), HEADACHE (Headache), DIARRHOEA (Diarrhoea) and HEADACHE (Throbbing headache) in a female patient of an unknown age who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3003608) for COVID-19 vaccination. The patient''s past medical history included Suspected COVID-19 (Unsure when symptoms stopped) on 11-Mar-2020. Concurrent medical conditions included Deviated nasal septum and Acid reflux (esophageal). Concomitant products included OMEPRAZOLE for Acid reflux (esophageal), FLUTICASONE FUROATE for Deviated nasal septum, DESOGESTREL (CERAZETTE [DESOGESTREL]) for an unknown indication. On 28-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Jul-2021, the patient experienced HEADACHE (Throbbing headache) (seriousness criterion medically significant). On 30-Jul-2021, the patient experienced DIARRHOEA (Diarrhoea) (seriousness criterion medically significant). On an unknown date, the patient experienced NAUSEA (Nausea) (seriousness criterion medically significant), DIARRHOEA (Diarrhea) (seriousness criterion medically significant) and HEADACHE (Headache) (seriousness criterion medically significant). The patient was treated with PARACETAMOL for Headache, at an unspecified dose and frequency. On 29-Jul-2021, HEADACHE (Throbbing headache) had resolved. On 30-Jul-2021, DIARRHOEA (Diarrhoea) had resolved. At the time of the report, NAUSEA (Nausea), DIARRHOEA (Diarrhea) and HEADACHE (Headache) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 05-Nov-2020, SARS-CoV-2 test: negative (Negative) Negative. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Intramuscular) was unknown. Patient had the vaccine at 3.40pm and woke up the next morning with a headache which was helped by paracetam. By 3pm, paracetamol no longer worked and had a throbbing headache and nausea. The following day, had a mild headache. Diarrhoea and stomach pains started in the afternoon. Patient has not tested positive for COVID-19 since having the vaccine. Patient is not enrolled in clinical trial. Company comment- Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1529919 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-02
Onset:2021-07-29
   Days after vaccination:57
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Influenza like illness, Myalgia, Pyrexia, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: The value was 39-50 celcius.; Test Date: 20210730; Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: No-Negative COVID-19 test
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: flu like symptoms; strong muscle aches; Fever; This regulatory authority case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (flu like symptoms), MYALGIA (strong muscle aches) and PYREXIA (Fever) in a 34-year-old male patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 02-Jun-2021, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 28-Jul-2021, received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 2 dosage form. On 29-Jul-2021, the patient experienced PYREXIA (Fever) (seriousness criterion medically significant). On an unknown date, the patient experienced INFLUENZA LIKE ILLNESS (flu like symptoms) (seriousness criterion medically significant) and MYALGIA (strong muscle aches) (seriousness criterion medically significant). At the time of the report, INFLUENZA LIKE ILLNESS (flu like symptoms) and MYALGIA (strong muscle aches) outcome was unknown and PYREXIA (Fever) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 30-Jul-2021, SARS-CoV-2 test: negative (Negative) No-Negative COVID-19 test. On an unknown date, Body temperature: high (High) The value was 39-50 celcius.. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. The concomitant medication was not reported. Treatment medication was not provided. The patient was not enrolled in the clinical trial. The patient was not tested positive for COVID-19 nor had any symptoms associated with COVID-19. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1529939 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3003607 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Chest pain, Chills, Decreased appetite, Diarrhoea, Dizziness, Dyspepsia, Fatigue, Headache, Lymphadenopathy, Malaise, Myalgia, Nausea, Pain in extremity, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: chills; as of midnight 2 days after vaccination; Nausea; Armpit pain; Swollen lymph nodes; Vomiting; Appetite lost; Chest pain; Muscle ache; Diarrhoea; Indigestion; Fatigue; Malaise; Dizzy; Headache; Fever; This regulatory authority case was reported by a consumer and describes the occurrence of CHILLS (chills), PAIN IN EXTREMITY (as of midnight 2 days after vaccination), HEADACHE (Headache), NAUSEA (Nausea), DIZZINESS (Dizzy), PYREXIA (Fever), AXILLARY PAIN (Armpit pain), LYMPHADENOPATHY (Swollen lymph nodes), DIARRHOEA (Diarrhoea), DYSPEPSIA (Indigestion), FATIGUE (Fatigue), MALAISE (Malaise), VOMITING (Vomiting), MYALGIA (Muscle ache), DECREASED APPETITE (Appetite lost) and CHEST PAIN (Chest pain) in a 30-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) (batch no. 3003607) for COVID-19 vaccination. The patient''s past medical history included Lactation decreased. On 29-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 29-Jul-2021, the patient experienced PYREXIA (Fever) (seriousness criterion medically significant). On 30-Jul-2021, the patient experienced HEADACHE (Headache) (seriousness criterion medically significant), DIZZINESS (Dizzy) (seriousness criterion medically significant), DIARRHOEA (Diarrhoea) (seriousness criterion medically significant), DYSPEPSIA (Indigestion) (seriousness criterion medically significant), FATIGUE (Fatigue) (seriousness criterion medically significant), MALAISE (Malaise) (seriousness criterion medically significant) and MYALGIA (Muscle ache) (seriousness criterion medically significant). On 31-Jul-2021, the patient experienced NAUSEA (Nausea) (seriousness criterion medically significant), AXILLARY PAIN (Armpit pain) (seriousness criterion medically significant), LYMPHADENOPATHY (Swollen lymph nodes) (seriousness criterion medically significant), VOMITING (Vomiting) (seriousness criterion medically significant), DECREASED APPETITE (Appetite lost) (seriousness criterion medically significant) and CHEST PAIN (Chest pain) (seriousness criterion medically significant). On an unknown date, the patient experienced CHILLS (chills) (seriousness criterion medically significant) and PAIN IN EXTREMITY (as of midnight 2 days after vaccination) (seriousness criterion medically significant). At the time of the report, CHILLS (chills), PAIN IN EXTREMITY (as of midnight 2 days after vaccination), PYREXIA (Fever), AXILLARY PAIN (Armpit pain), VOMITING (Vomiting) and MYALGIA (Muscle ache) was resolving and HEADACHE (Headache), NAUSEA (Nausea), DIZZINESS (Dizzy), LYMPHADENOPATHY (Swollen lymph nodes), DIARRHOEA (Diarrhoea), DYSPEPSIA (Indigestion), FATIGUE (Fatigue), MALAISE (Malaise), DECREASED APPETITE (Appetite lost) and CHEST PAIN (Chest pain) had not resolved. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. Concomitant medications was not provided by the reporter. Treatment information was not provided. After vaccination patient overall discomfort and inability to concentrate and become very tearful. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1529943 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Fatigue, Groin pain, Headache, Myalgia, Nausea, Pain, Pyrexia, SARS-CoV-2 test, Vaccination site joint pain
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Negative ; Result Unstructured Data: No - Negative COVID-19 test
CDC Split Type: GBMODERNATX, INC.MOD20212

Write-up: electric shock type pain in groin; pain in joint of arm; Muscle pain; Nausea; Stomach ache; Shooting pain; Feverish; Joint pain; Headache; Fatigue; This regulatory authority case was reported by a consumer and describes the occurrence of ABDOMINAL PAIN UPPER (Stomach ache), PAIN (Shooting pain), PYREXIA (Feverish), HEADACHE (Headache), MYALGIA (Muscle pain), NAUSEA (Nausea), FATIGUE (Fatigue) and ARTHRALGIA (Joint pain) in a 43-year-old female patient who received mRNA-1273 (Moderna CoviD-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Lactation decreased. On 29-Jul-2021, the patient received second dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna CoviD-19 Vaccine) (unknown route) 1 dosage form. On 29-Jul-2021, the patient experienced HEADACHE (Headache) (seriousness criterion medically significant) and FATIGUE (Fatigue) (seriousness criterion medically significant). On 30-Jul-2021, the patient experienced ABDOMINAL PAIN UPPER (Stomach ache) (seriousness criterion medically significant), PAIN (Shooting pain) (seriousness criterion medically significant), PYREXIA (Feverish) (seriousness criterion medically significant), MYALGIA (Muscle pain) (seriousness criterion medically significant), NAUSEA (Nausea) (seriousness criterion medically significant) and ARTHRALGIA (Joint pain) (seriousness criterion medically significant). On an unknown date, the patient experienced GROIN PAIN (electric shock type pain in groin) and VACCINATION SITE JOINT PAIN (pain in joint of arm). At the time of the report, ABDOMINAL PAIN UPPER (Stomach ache), HEADACHE (Headache), MYALGIA (Muscle pain), NAUSEA (Nausea), FATIGUE (Fatigue) and ARTHRALGIA (Joint pain) had not resolved, PAIN (Shooting pain) and PYREXIA (Feverish) was resolving and GROIN PAIN (electric shock type pain in groin) and VACCINATION SITE JOINT PAIN (pain in joint of arm) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: negative (Negative) No - Negative COVID-19 test. The action taken with mRNA-1273 (Moderna CoviD-19 Vaccine) (Unknown) was unknown. Patient has not had symptoms associated with COVID-19. Patient is not pregnant. Patient is not currently breastfeeding. No concomitant medication reported. Patient keep getting electric shock type pain in groin and especially in joint of arm, that lasts seconds but extremely painful. Patient has not tested positive for COVID-19 since having the vaccine. Patient is not enrolled in clinical trial. No treatment information was provided. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. The events don?t seem to be serious by medical judgement, but they were assessed serious as per regulatory authority report.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. The events don?t seem to be serious by medical judgement, but they were assessed serious as per regulatory authority report.


VAERS ID: 1535806 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 213C21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: PHJNJFOC20210809115

Write-up: SEIZURE; This spontaneous report received from a health care professional via a Regulatory Authority [PHIFDA-PH-PHFDA-300095330] concerned a 53 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 213C21A, and expiry: UNKNOWN) dose was not reported, 1 total administered on 28-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 29-JUL-2021 at 12:30, the patient experienced seizure, and was hospitalized (date unspecified). No of days of hospitalization was not reported and it was unsure the patient has discharged from the hospital. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of seizure was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments:20210809115-Covid-19 vaccine ad26.cov2.s-Seizure. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1544809 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD7208 / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: CAPFIZER INC202100970057

Write-up: fainting; This is a spontaneous report from a contactable consumer (patient). A 16-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 at the age of 16-years-old via an unspecified route of administration, administered in Arm Left on 28Jul2021 (Batch/Lot Number: Fd7208) as dose 2, single for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient has no known allergies. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient received the vaccine in a Public Health Clinic. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE) administered in arm left on 05Jun2021 16:00 (Batch/Lot Number: EW0221) for covid-19 immunisation. The patient experienced fainting on 29Jul2021 10:15. The patient has not been tested for COVID-19 since the vaccination. The patient was recovering from the event.


VAERS ID: 1547168 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 212C12A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: PHJNJFOC20210809978

Write-up: FAINTING; This spontaneous report received from a health care professional via a Regulatory Authority [PHIFDA, PH-PHFDA-300094939] concerned an 18 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 212C12A, expiry: UNKNOWN) dose was not reported, 1 total administered on 29-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 29-JUL-2021 08:58 hours, the patient experienced fainting. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fainting. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210809978-COVID-19 VACCINE AD26.COV2.S-Fainting. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1624837 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest pain, Echocardiogram abnormal, Left ventricular dysfunction, Magnetic resonance imaging heart, Myocarditis, Pyrexia, Troponin increased
SMQs:, Cardiac failure (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Blood test showed high value of hs-troponin I, and the LV contractility was mildly reduced on echocardiography. Cardiac MRI did not show anything specific.
CDC Split Type:

Write-up: The patient got the second dose of Modern vaccine on July 28, started to have fever on 29, then started to have a chest pain on 30. He was transferred to our hospital. Blood test showed high value of hs-troponin I, and the LV contractility was mildly reduced on echocardiography. We diagnosed him with post-vaccine myocarditis and admitted him to our hospital. We treated him with ibuprofen and ACEi. The blood test showed gradual decrease in hs-troponin I, and LV contractility also normalized over days. We discharged him on 8th day after hospitalization.


VAERS ID: 1509445 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-02-01
Onset:2021-07-28
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

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

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

Write-up: Muscle soreness & pain 6 months after I received vaccine. Have had for about 2 weeks.


VAERS ID: 1509465 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Public       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: dietery supplements - like Maca/Ginko/ and some protein for weight lifting
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: ringing in my ears Tintinaites


VAERS ID: 1509471 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939676 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, 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: atenalol 12.5mg. Vitamin C&D, Multi-Vitamin
Current Illness: Borderline low platelets
Preexisting Conditions: Tinnitus
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received vaccine 3PM. 3AM woke with raging Tinnitus. I have had Tinnitus for many year but this spike is overwhelming and extremely loud. There are no treatments. May not return for second shot if Tinnitus does not calm down. Will not risk Tinnitus spike with second shot as this could be permanent damage.


VAERS ID: 1509530 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-17
Onset:2021-07-28
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Exposure during pregnancy, Fatigue, Gait disturbance, Lethargy, Mobility decreased
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamin
Current Illness:
Preexisting Conditions: Lupus and Primary Biliary Cholangitis
Allergies: Penicillin and shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pregnant and due January 19, 2022, so far no effect on pregnancy. Adverse effect was bed ridden exhaustion for three days. Lethargy. Hard to walk or move.


VAERS ID: 1509563 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-07-21
Onset:2021-07-28
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 1 LA / IM

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

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

Write-up: PATIENT REPRESENTED AS NOT HAVE HAD ANY COVID VACCINE AS OF 07/21/2021, AFTER ADMINSTERING VACCINE IT WAS DISCOVERED THAT PATIENT HAD RECEIVE JOHNSON SINGLE DOSE VACCINE ON 07/15/2021


VAERS ID: 1509649 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Dizziness, Fatigue, Headache, Pain
SMQs:, Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (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: multivitamin, C, B, D, Zinc
Current Illness: none
Preexisting Conditions: osteoporosis (non-medicated)
Allergies: flagyl
Diagnostic Lab Data:
CDC Split Type:

Write-up: terrible body aches headache dizzy fatigue diarrhea


VAERS ID: 1509663 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-26
Onset:2021-07-28
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Swollen supraclavicle lymph node on the same side as my shot was given


VAERS ID: 1509673 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Lethargy, Somnolence
SMQs:, 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: Prediabetes
Preexisting Conditions: hypothyroidism Thyroid nodule hyperlipemia
Allergies: No Known Allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient appears to be sleepy and lethargic after 15 minutes post vaccines. Patient responsive to command and alert but sleepy.


VAERS ID: 1509679 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none (but he was tired after staying up until 3am)
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fainted on bathroom floor at 10:30am, his head hitting the floor. He then regained consciousness, and has since been resting in bed.


VAERS ID: 1509774 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad)

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

Write-up: patient was nauseous; but did not vomit , looked pale and weak , patient denied bp check and 911. administered water to the patient and monitored the patient for 20 minutes. after that amount of time patient was fine. pharmacist followed up and called her . told patient to stay hydrated and rest. patient was called at 115pm was home and is fine .


VAERS ID: 1509783 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: no
Preexisting Conditions: no
Allergies: not known
Diagnostic Lab Data:
CDC Split Type:

Write-up: I made an appointment to get my first Dose of Covid Vaccine. Being Needle phobic, I had to really meditate and get myself in the right head space to get this vaccine. When I arrived I was told that my schedualed appoinmtnet did not matter and that I needed to come back a differnt day. I told the Pharmasist that I had a conformation number and that the store was welcoming walk-ins. He then said "I''m sure you do. I can give you the Vaccine but I''m going to make you make the choice. There are people dieing in India wanting this Vaccine, as soon as I open this vial 8 does will have to be thrown away so that YOU can have your shot. I dont want that on my conscience. Can you?" I felt incredible uncomftorble and like I was being turned away. I never heard of any one going to get the vaccine and being threated that they will harm others or that its my resposablity. I am tramatized.


VAERS ID: 1509784 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Joint lock, Nervousness, Palpitations, Vertigo
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient did not disclose any prescriptions, over-the-counter medications, dietary supplements, or herbal remedies being taken before and at the time of vaccination. He disclosed that he had gotten off of Wellbutrin two months ago, after he
Current Illness: Patient did not disclose any illnesses at the time of vaccination or up to one month prior.
Preexisting Conditions: Patient did not disclose he was hypoglycemic until after he had received the vaccine and started to feel ill/lightheaded 10 minutes after vaccination.
Allergies: Patient did not disclose any allergies.
Diagnostic Lab Data: Nurse took his vitals.
CDC Split Type:

Write-up: Patient felt light headed and dizzy "as if the room was spinning." Patient did not disclose that he was hypoglycemic until after he was vaccinated and 10 minutes into observation. He said he had only eaten a "sausage and egg thing and a Body Armor" to eat. He said he was starting to feel shaky. He was given a water, a fruit snack, and a protein drink. He was told to go eat a good meal. He was observed for an additional 5 minutes. He then said his legs and then knees started to lock up, and said his heart started to race. Staff put the patient in a wheelchair and took him to the University health clinic. The Head Nurse took patients vitals. Patients father then showed up. Nurse said patients vitals were stable. Patient and his father left prior to EMS arriving, which was Against Medical Advise.


VAERS ID: 1509808 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NA
Preexisting Conditions: BRAIN INJURY AS A CHILD, MIGRAINES
Allergies: NA
Diagnostic Lab Data: BP 140/90 P 52 02 SAT 99% ON RA RR 22 1109 BP 120/ 80 RR 16 P72 BGL 113
CDC Split Type:

Write-up: C/O BEING CLAMMY, SYNCOPE EPISODE HEADACHE. MOTHER CAME TO THE SCENE AND TOOK THE CHILD HOME


VAERS ID: 1509809 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-30
Onset:2021-07-28
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hypoaesthesia, Inflammation, Mobility decreased, Pain, Pain in extremity, Paraesthesia, Paraesthesia oral, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (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: Bupropion
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Within a few minutes of receiving injection, my arm went numb from site of injection to the tips of my fingers. Experienced severe swelling, inflammation and pain in whole arm. Fingertips were numb and tingled with the sensation of pins and needles on them. Arm remained inflammed, swollen and in severe pain for two weeks weeks and then decided to see a doctor. Doctor said it should go away fully in two more weeks and that if it did not to come back and see her. It had been the two weeks since I have seen the doctor and full use of my arm is still not fully restored and still feels pain when I try to resume full normal use of it. Also had some slight dizziness and sensation on tongue after two weeks of shot.


VAERS ID: 1509814 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Aphasia, Dysphagia, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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: Denied
Preexisting Conditions:
Allergies: Known allergy to Morphine--states had an anaphylactic reaction while in the hospital (although never given Epi)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Presented to COVID Vaccine Clinic with known history of allergic reaction to MSO4-stated it was anaphylactic in nature, happened while in the hospital. Approx 10 min after vaccine administration patient began to complain of being unable to swallow, unable to take a breath, unable to speak. Treated with EpiPen x 1 with improvement. Taken via EMS to local hospital where she was observed/monitored and discharged home.


VAERS ID: 1509819 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Food allergy, Hypersensitivity, Hypoaesthesia oral, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient, who used to frequently consume seafood/shellfish, developed an allergy to seafood and shellfish 1 day after vaccine administration. Patient reports to have consumed shrimp 1 day after receiving the vaccine. After eating the shrimp, the patient then developed a skin rash on her upper and lower extremities as well as numbness in the lips. The origin of the rash is unknown, but the patient exclaims the rash did not start on the arm in which the vaccine was injected. The patient also reports trying saltwater fish and shrimp flavored ramen soup after the vaccine on future unknown dates. She experienced the same allergic reaction (skin rash and numbness in the lips) from the seafood thereafter. Benadryl was used to combat the allergic reaction. The patient has consumed seafood/shellfish for all of her life and has never experienced any allergic reaction before vaccine administration. The patient was advised to contact an allergy specialist before consuming any seafood/shellfish in the future. Patient also reported having a son with seafood/shellfish allergy.


VAERS ID: 1509824 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Lip swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), 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? 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: Right side of jaw area started to feel numb and then bottom lip started to swell.


VAERS ID: 1509830 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Gaze palsy, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: About 3 minutes after the vaccination was administered patient fell off their chair and began seizing. The seizure lasted about 20 seconds. Patient was on the floor in the fetal position, eyes rolled back and seizing. After the patient was alert and oriented. No history of seizures or diabetes. Paramedics arrived and took patient from there.


VAERS ID: 1509833 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Influenza like illness, Nasopharyngitis
SMQs:, Anaphylactic reaction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Welbutrin, Omeprazole, Clonazepam, Metoprolol, Gabapentin.
Current Illness: Fibromyalgia
Preexisting Conditions: Fibromyalgia, Anxiety.
Allergies: Penicillin, Passion Fruit, Opiates
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dry, intermittent cough and Cold/Flu-like symptoms


VAERS ID: 1509854 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / IM

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

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

Write-up: Welts on back and around eyes. Began about 1 1/2 to 2 hours after vaccination


VAERS ID: 1509887 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

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

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

Write-up: Administered a vaccine that was diluted incorrectly


VAERS ID: 1509893 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-24
Onset:2021-07-28
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Petechiae, Purpura
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Small petechiae/purpura like (not professionally diagnosed) lesions on upper thigh below buttocks. The small purple/red dots are clustered together in an area roughly 2" by 2" in the same spot on each leg.


VAERS ID: 1509908 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

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

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

Write-up: Pfizer covid-19 vaccine diluted incorrectly and administered to patient


VAERS ID: 1509911 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

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

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

Write-up: Pt lied and said she had never received any covid vaccine and was administered Pfizer. B/c we had a system outage, we cannot verify her statement. Later we found out pt had received J&J in March 2021. Pt did not have a reaction following vaccination.


VAERS ID: 1509921 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

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

Write-up: The Patient got the Janssen shot and Passed out several minuets later. After coming to He was provided a bottle of water. He drank the water and said that he mainly just felt really hot. We asked that he stay in the store an additional 30 minuets, his mother was with him and kept a constant eye on him with the pharmacist checking in in 5 minuet increments. Patient was feeling better and left, at the end of the additional 30 minuet waiting period.


VAERS ID: 1509935 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Confusional state, Dry mouth
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Systemic: Allergic: Anaphylaxis-Mild, Systemic: Confusion-Mild, Systemic: DRY MOUTH-Mild


VAERS ID: 1509947 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 066D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Dysphagia, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (broad)

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

Write-up: Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Systemic: Cough-Medium, Additional Details: Patient received vaccine, started coughing but said she felt okay, coughing got a little bit worse so patient took a benadryl that she had brought with her. coughing not resolved so we called EMS to assist her and check her out.


VAERS ID: 1509953 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 3 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Extra dose 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: Carbamaepine 200mg TID diclofenac 75 BID Gabapentin 300 qhs Hydroclorithiazide 12.5 qd potassium 10 meq qd pravastatin 80mg qd
Current Illness: none
Preexisting Conditions: ANEMIA CHRONIC BACK PAIN CROHN''S COLITIS HEMIPLAGIA AND HEMIPARESIS FROLLOWING CEREBROVASCULAR DISEASE HYPERLIPIDEMIA SEIZURE TOBACCO ABUSE
Allergies: No known allergies
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: No reaction. Patient recieved a 3rd dose of Moderna.


VAERS ID: 1509957 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-23
Onset:2021-07-28
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

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

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

Write-up: After the Pfizer vaccination, the patient started to sweat and became pale. The patient passed out for 5 seconds. His mother was present. The patient was given water and remained seated for 15 minutes . He walked out of the pharmacy


VAERS ID: 1509974 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-25
Onset:2021-07-28
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Defaecation urgency, Dysarthria, Fatigue, Feeling cold, Hyperhidrosis, Inflammation, Limb discomfort, Lip swelling, Motor dysfunction, Muscle spasms, Muscular weakness, Peripheral swelling, Postpartum anxiety, Pruritus, Tinnitus, Tremor, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Green tea extract, beets chewable, prescription adderall 10mg x 2 day, prozac 40 MG 1 x day
Current Illness: None
Preexisting Conditions: Mental health conditions: adhd, postpartum depression, and postpartum anxiety
Allergies: None
Diagnostic Lab Data: Hospital was contacted for medical advise and was told they were unable to help due to full beds for covid patients. As long as I was not having trouble breathing, I would have to ride it out at home.
CDC Split Type:

Write-up: Symptoms began at 12:30AM Symptoms began as itchy, inflamed hands and feet Next swelling of lips began When seated on the toilet, began to sweat uncontrollably as itchy and inflammation increase Called for partner to check in on me at this time. Tried to get into the bathtub to help with itching but was unable to due to sudden urge to use restroom. Had one bowel movement after returning to toilet Proceeded to continue to sweat and ears began to ring. Vision became blurred, seeing purple spots. Speech was slurred and limbs were heavy and weak. Could think clearly but unable to do simple tasks such as grasp a cup of water without effort. Vision completely blackout at this point. I did not faint and still able to communicate but could not see anything other than blackness. This happened twice between 10 minute span. Once I was able to lie down, Vision and hearing cleared. Chills began then and itching continued. I was wrapped in three blankets unable to stop chills and shakes. Eventually I was able to relax and stop the chills and fall back to sleep at 3AM. It is now 2:05PM and I am experiencing some itching, fatigue, and cramping


VAERS ID: 1509977 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia, Head discomfort, Headache
SMQs:, Taste and smell disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Ended 5th IVF cycle on 7/16/21 (day of retrieval)
Preexisting Conditions: IBS
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: I got shot, spoke with pharmacist who injected for about 3 min, they didn?t behave me sit and wait 15min like my husband did (different location) this morning. I started to leave store and immediately had metallic taste & my head felt different. I knew something was off! The taste is still there, my head is achy but everything else is fine.


VAERS ID: 1509995 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

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

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

Write-up: Patient received vaccine at roughly 2:40 pm on 7/28/21. Was advised to stay at location for 15 minutes prior to leaving . Patient was shopping in store and fainted . Found patient lying on floor with her mother by her side . Patient was alert but shaken . Patient said she had hit her head and scraped her leg. patient was put into a chair and given some juice and an ice pack for back of neck . After about 10 to 15 minutes patient said she felt well enough to walk and was taken home by her mother .


VAERS ID: 1510005 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-02
Onset:2021-07-28
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Blood gases, Brain natriuretic peptide, Coagulation test, Computerised tomogram abdomen, Computerised tomogram thorax, Dehydration, Differential white blood cell count, Electrocardiogram, Full blood count, Melaena, Metabolic function test, Occult blood positive, Troponin, Urine analysis
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Gastrointestinal haemorrhage (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT abdomen and chest, EKG, fecal testing, urinalysis, blood gases, troponin, BNP, CBC with diff, BMP, coagulation testing
CDC Split Type:

Write-up: dehydration with acute kidney injury, melanotic stool that is hematest positive


VAERS ID: 1510006 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Zoloft, Zyertec
Current Illness:
Preexisting Conditions:
Allergies: NO
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt became nauseous and vomited minutes after receiving vaccine. Pt was given cold compress and water. VS were taken and WNL. Pt was allowed to rest until she felt better. No further adverse reaction was noted. Pt was advised to seek medical treatment if symptoms worsen over the course of time.


VAERS ID: 1510031 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Wrong 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:

Write-up: Pt was wanting her second shingles shot but received pfizer instead. Technician and Intern confirmed with pt that they were giving the covid vaccine. It was realized after her vaccine that she had already received both pfizer vaccines and it was actually the shingrix vaccine she was wanting.


VAERS ID: 1510042 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 AR / IM

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

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

Write-up: Patient was able to get scheduled for an appointment at age 11. No reaction at this time. Vaccine just given prior to age 12 as recommended.


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