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

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



Case Details (Reverse Sorted by Onset Date)

This is page 182 out of 3,232

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VAERS ID: 1344079 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-20
Onset:2021-05-02
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013A21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthropod bite, Asthenia, Back pain, Blood immunoglobulin G normal, Blood immunoglobulin M normal, Blood sodium decreased, Borrelia test negative, CSF protein increased, CSF test abnormal, Computerised tomogram abdomen normal, Condition aggravated, Confusional state, Fluid intake restriction, Gait inability, Guillain-Barre syndrome, Hypertension, Hypertensive urgency, Hyponatraemia, Hypotension, Immunoglobulin therapy, Impaired driving ability, Inappropriate antidiuretic hormone secretion, Intensive care, Labile hypertension, Limb discomfort, Loss of personal independence in daily activities, Lumbar puncture abnormal, Magnetic resonance imaging head normal, Magnetic resonance imaging spinal normal, Magnetic resonance imaging thoracic normal, Movement disorder, Spinal X-ray normal
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (narrow), Hypertension (narrow), Demyelination (narrow), Chronic kidney disease (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad), Immune-mediated/autoimmune 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? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 325 MG tablet Take 650 mg by mouth every 4 (four) hours as needed for Pain. acetaminophen (TYLENOL) 650 MG suppository Place 650 mg rectally every 4 (four) hours as needed for Fever. amLODIPine (NORVASC) 10 MG
Current Illness:
Preexisting Conditions: HTN, HLD, osteoporosis, stress incontinence, DM diet controlled, GERD
Allergies: diclofenac (swelling), cephalexin (rash), penicillin (rash), prednisone (anxiety), tetracycline (confusion)
Diagnostic Lab Data: See above
CDC Split Type:

Write-up: Covid-19 vaccine administrations (Moderna) 3/23/21 lot# 013A21A 4/20/21 lot# 013A21A Admission to Hospital (5/2/21 ? 5/10/21) for hypertension and acute on chronic back pain requiring ICU admission, hyponatremia thought to be due to SIADH. CT of abdomen done at hospital noting no significant lumbar abnormalities and a plain film of her lumbar spine with no obvious compression fracture. Outside hospital notes do not further outline why she could no longer ambulate. Brain MRI done and negative during that admission. Discharged to a rehab facility for ongoing weakness. On 5/13/21, patient?s son requested admission to hospital for further evaluation. She states that she feels confused and her legs are very heavy and she can barely move them. Notably she lives alone in her own home, used to drive, did not use any assistive device to walk, and paid her own bills until 2 weeks ago. The symptoms did occur approximately a week after receiving her last Covid vaccine. Pt also notes around April 1, 2021 having taken an engorged deer tick off her head. 5/14/21 Lyme serology IgM & IgG = negative. Neurology was consulted. She had an MRI of her thoracic and lumbar spine, as well as an LP. She had had an MRI brain at a hospital. Her MRIs did not reveal a source of her weakness and pain. Her CSF revealed albuminocytologic dissociation. Given this finding and the constellation of symptoms and LP findings, it was thought she had Guillain Barre Syndrome, presumably due to her COVID vaccine. She was given IVIG for 5 days. She improved with this. As above, she had a recent admission for hyponatremia and hypertensive urgency. Here, her blood pressure was somewhat labile, but at times was low. She was started back on amlodipine and carvedilol, but at much lower doses with plan for ongoing monitoring. In terms of her hyponatremia, her salt tabs were stopped, and eventually her fluid restriction was able to be lifted. Her sodium was 136 at discharge.


VAERS ID: 1344138 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Confusional state, Fatigue, Feeling abnormal, Joint stiffness, Musculoskeletal stiffness, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Clonazepam, Robaxin
Current Illness: N/A
Preexisting Conditions: Spinal stenosis, arthritis, pyofacial pain disorder, severe type 1 endplate modal changes of the lumbar, epilepsy, PTSD
Allergies: Depakote, penicillin, fabric starch
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Onset fever, then confusion, followed by stiff muscles at the 24hr mark. Confusion, brain fog, joint stiffness and severe arm pain continue through the 36 hour mark. By hour 72, most side effects have subsided, brain fog, confusion and extreme fatigue persist until day 5.


VAERS ID: 1344174 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-16
Onset:2021-05-02
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Appendicectomy, Appendicitis, Computerised tomogram abdomen abnormal, Fatigue, Malaise, Nausea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Buspirone HCL, Glucosamine Chondroitin, Multivitamin,Estrogen/progesterone menopause formula, Vit D, magnesium, asthma inhaler Albuterol
Current Illness: none
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data: In hospital from Sun, May 2- Tues, May 4.
CDC Split Type:

Write-up: appendicitis. Nausea for maybe the week prior, feeling tired, unwell. Sunday, May 2, 2021 at noon stomach pain. Moved into lower right side. Went to emergency department at 9 p.m. as pain was intense. CAT scan done. Inflamed appendix. Appendectomy done the next morning.


VAERS ID: 1345440 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood test normal, Heavy menstrual bleeding, Hormone level abnormal, Menstruation irregular, Pyrexia, Ultrasound scan normal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Fertility disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ultrasound came out good, blood as well. It messed up my hormones. I was prescribed progesterone.
CDC Split Type:

Write-up: I had a fever the second night after getting the second vaccine shot. I felt very very weak and my menstrual cycle is very irregular. I was bleedy heavily for the. next 3 days where I had to change every half hour. It was very bad. I went to the ER on the 3rd or 4th day.


VAERS ID: 1345601 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Depressed mood
SMQs:, Depression (excl suicide and self injury) (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: Citalopram 20mg
Current Illness: None
Preexisting Conditions: Anxiety and depression
Allergies: Penicillin Sulfa
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Within 24 hours of having my second dose of the COVID-19 vaccine, I became moderately depressed. Nothing had occurred in the days prior to trigger an episode nor had I suffered from a episode for a while. I have since encountered two other people who have had the same reaction and have encouraged them to retort it as well.


VAERS ID: 1345706 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-05-02
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Drug exposure before pregnancy, Pregnancy test
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Penicillin allergy
Preexisting Conditions: Medical History/Concurrent Conditions: Infertility
Allergies:
Diagnostic Lab Data: Test Date: 20210502; Test Name: Pregnancy test; Result Unstructured Data: Positive; Test Date: 20210505; Test Name: Blood test; Result Unstructured Data: pregnancy confirmed
CDC Split Type: USJNJFOC20210537553

Write-up: DRUG EXPOSURE PRIOR TO PREGNANCY; This spontaneous pregnancy report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. The patient''s past medical history included infertility, and concurrent conditions included penicillin allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 02-MAY-2021, the subject experienced drug exposure prior to pregnancy. Laboratory data included: Pregnancy test (NR: not provided) Positive. On 05-MAY-2021, Laboratory data included: Blood test (NR: not provided) pregnancy confirmed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of drug exposure prior to pregnancy was not reported. This report was non-serious.


VAERS ID: 1346622 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphagia, Flushing, Hyperhidrosis, Hypoaesthesia, Injection site pain, Pruritus, Throat irritation, Throat tightness, Tremor
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Site: Pain at Injection Site-Medium, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Flushed / Sweating-Mild, Systemic: Numbness (specify: facial area, extremities)-Medium, Systemic: Shakiness-Mild, Additional Details: Patient experienced numbness in the face along with difficult swallowing and an itching and closing sensation in the throat starting about 30 minutes after the injection. patient remained conscious and the symptoms subsided within an hour of the injection. no medications needed to be administered.


VAERS ID: 1346682 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Chest discomfort, Electrocardiogram
SMQs:, Anaphylactic reaction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Hospital blood tests, ekg 05/05/2021
CDC Split Type:

Write-up: Two days after receiving my first vaccine dose, I began to feel a tight, uncomfortable sensation in my chest. Over a few days it grew into pain that would become worse with physical activity or when lying down. I had pericarditis last year and recognized the symptoms but I chose to go to the hospital anyways to be safe. The doctors at the ER did not have a concrete answer for me but the cautiously assumed pericarditis.


VAERS ID: 1346737 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-25
Onset:2021-05-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / UNK - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Herpes zoster, Pain in extremity, Paraesthesia, Pruritus, Sensory loss
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: A week after I received the first dose of the COVID Vaccine, I experienced an odd tingle/loss of feeling on my right side. A few days later it became itchy and painful, then a bunch of painful sores appeared. I went to the doctor and was diagnosed with shingles. They prescribed me valacyclovir to ease the pain.


VAERS ID: 1346797 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-29
Onset:2021-05-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Catheterisation cardiac abnormal, Echocardiogram abnormal, Myocarditis
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Athletic greens
Current Illness:
Preexisting Conditions: Viral Myocarditis 01/27/2017
Allergies: peanuts
Diagnostic Lab Data: heart catheterization, blood work, echocardiogram
CDC Split Type:

Write-up: Hospitalized with myocarditis after the second shot


VAERS ID: 1347181 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-05-02
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: On chemotherapy
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Nasal swab PCR test on 5/7/2021 Cycle threshold: ORF1ab:19.66,N:22.74
CDC Split Type:

Write-up: Positive COVID-19 test with symptoms after being fully vaccinated


VAERS ID: 1347257 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-29
Onset:2021-05-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro, vitamin B complex, buspirone, allergy over the counter, vit c,
Current Illness: none
Preexisting Conditions: slight anemia
Allergies: sulfa n
Diagnostic Lab Data: nothing yet i have an appt on the 15th of June.
CDC Split Type:

Write-up: Daily bleeding not heavy but enough to have to wear a pad. Have had three half dollar size clots there has been no let up on the bleeding .


VAERS ID: 1347441 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-01-03
Onset:2021-05-02
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ3616 / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 2 UN / 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization


VAERS ID: 1347565 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-14
Onset:2021-05-02
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood iron increased, Cardiac stress test, Chest discomfort, Chest pain, Cough, Echocardiogram, Electrocardiogram ambulatory, Electrocardiogram normal, Fatigue, Heart rate increased, Pain in jaw, Sleep disorder, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Osteonecrosis (broad), Dehydration (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: Xyzal 24 hr 5mg, Supermom multivitamin, Kyleena IUD
Current Illness: None
Preexisting Conditions: Polycystic ovarian syndrome
Allergies: Many seasonal and environmental allergies including dust, pollen, Alder trees, dogs, cats, horses, rabbits. No food allergies but several intolerances including dairy, gluten and chocolate.
Diagnostic Lab Data: I called my doctors office the next day and saw my PCP, she did an EKG but saw no issues and diagnosed it as tachycardia and referred me for several tests. My only abnormal lab result was a higher than normal iron level, so my PCP asked me to stop taking my multivitamin. Since the event I was referred to a cardiologist and wore a 48 hour holter monitor. I have not received the results. I have two more heart related tests, a stress test and an echocardiogram at the end of June.
CDC Split Type:

Write-up: I woke up from a dead sleep and coughed, suddenly my heart rate jumped into high gear, my heart beat was over 120 beats per minute for one hour. I had chest pain and my jaw hurt and I could not lay down because it was very comfortable for my chest and felt like there was more pressure when I laid down. I came out of it by sitting upright, breathing deeply and drinking water. It took about 2 days for my chest to feel normal again, it felt like my lungs had been really overworked, I was exhausted and I started feeling normal again about the 4th day from the event.


VAERS ID: 1347679 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-27
Onset:2021-05-02
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO164 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Atrial fibrillation, Chest pain, Electrocardiogram
SMQs:, Supraventricular tachyarrhythmias (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Breo Ellipta
Current Illness: none
Preexisting Conditions: copd
Allergies: none
Diagnostic Lab Data: ER conducted EKG and chest xray. Was told it was Atrial Fibrillation, and should follow up with a cardiologist. First appointment with cardiologist will be June 2.
CDC Split Type:

Write-up: Severe chest pain extending into left collarbone, and shoulders began on May 2nd and 3rd. Thought it could be muscular from heavy lifting over the weekend. Self treated with steroids for 2 days, and the problem resolved. I did not seek medical care. On May 10 and May 11, the pain returned. This time I knew it was not muscular so sought medical treatment. After describing to my physicians office I was advised to go to the ER.


VAERS ID: 1347712 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Decreased appetite, Fatigue, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test negative
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), 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, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: UNKNOWN
Diagnostic Lab Data: Per the patient, a CT scan was done and she was given steroids, but no diagnosis and no improvement.
CDC Split Type:

Write-up: According to the patient (my mother), and my father, the patient had her 2nd shot on 4/30/21 and within 2 days began having a 102 fever. She continued to have that high fever off & on every other day and spoke to her primary care physician who told her he didn''t know why she had the fever, then finally advised her to go to the ER. She had already recovered from COVID prior to taking the 2nd shot, and tested negative for COVID by the time she went to the ER. She went to the ER on about 5/18/21, and in addition to fever, experienced sore throat, appetite loss and fatigue. She was admitted and the doctors told her they''re unsure if it''s related to the experimental shot, but they can''t rule it out at this time. They continue to give her drugs and run tests, with no real answers to speak of and she believes it''s likely an adverse reaction to the shot(s).


VAERS ID: 1348335 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Vaccine listed in Item 22, previously reported
Other Medications: Nexium, Allegra, hydroxychloroquine, Celebrex, Singular, metaxalone, citrical, magnesium, vitamin D, B complex, omega 3-6-9, multivitamin, restasis
Current Illness: None
Preexisting Conditions: Arthritis, GERD, environmental allergies, dry eye
Allergies: benzoyl peroxide, cyclobenzaprine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Increased joint pain over entire body for more than 3 weeks only relieved by whole body cortisone injection.


VAERS ID: 1348622 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Apathy, Arthralgia, Chest X-ray normal, Chest pain, Chills, Diarrhoea, Dyspnoea, Electrocardiogram normal, Fatigue, Feeling abnormal, Fibrin D dimer normal, Hypoaesthesia, Insomnia, Irritability, Laboratory test normal, Memory impairment, Muscular weakness, Myalgia, Pain, Paraesthesia, Pruritus, Rash, SARS-CoV-2 test, Troponin normal, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Dementia (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), 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? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A. However, in January/February, there was some suspected COVID. Test was taken but results never received. Not sure if county lost them? Was fine after about 2 days. However, noticed couldn''t run the same as prior to vaccine as felt like getting winded perhaps a bit easier. No other illnesses or anything at all. There was no issue after the first vaccine on 4/10. This started after second vaccine on 5/1
Preexisting Conditions: Some stomach issues (perhaps IBS) in terms of just a sensitive stomach (example, garlic makes stomach upset). Otherwise, very healthy and no issues at all.
Allergies: N/A
Diagnostic Lab Data: To note - everything is negative/unremarkable unless otherwise noted Urgent Care 5/3 - Chest X-Ray, EKG, Labs ER 5/5 - EKG, Chest X-Ray, CT Scan with Dye, Labs 5/6 - Echocardiogram Neg d-dimer Neg troponin 5/7 - EKG 5/21 - acetylcholine receptor antibodies (***STILL WAITING ON RESULTS) 5/22 - COVID test Again, everything negative/unremarkable but still waiting on the one antibodies lab results.
CDC Split Type:

Write-up: Timeline just provided to neurologist. 5/1 - 2nd COVID vaccine (Pfizer) 5/3 - Went to Urgent Care for primarily chest pains 5/5 - GP sent to ER after continued severe chest pains and getting very winded after only a few steps. Weekend of 5/8 - vomiting, likely fever (felt like true vaccine side effects) - no vomiting/fever since Since then, lots of tests/dr visits. Current symptoms: tingliness/numbness - left leg - midshin to foot/toes. Left arm - elbow to hand/fingers. Face started to tingle ~2 weeks post vaccine - left side. Extremely fatigued. Some brain fog/forgetfullness. Lack of motivation. Irritability some days. Headaches - some days really bad, other days none. Chest pains come/go throughout day. Was getting winded walking up 3 stairs but that has been slightly better. Some days - extensive muscle pain. Especially in lower back & left hip area. Some days - whole body aches. Chills - feels like body temp is off. Things come in waves - numbness/tingliness is pretty much all the time though. Also, insomnia. Did start to take 1.25mg of melatonin as needed but still very fatigued. 5/19 - Stared acupuncture (plan is 2x a week) Around 5/21 - developed rash. Face (R&L side), neck/jaw area (L), inner thigh (L). Doesn''t itch all the time but when it does, it really itches. Has continued 5/22 & 5/23 - headaches worsened 5/22 & 5/23 - developed diarrhea 5/23 - more tingliness developed midshin to right foot and more in right arm. 5/25 - joints began to hurt more - especially in elbow area Lung dr. Rx''ed albuterol (?) on Friday, 5/21 just in case something was going on in lungs. Has not helped. The lung dr. noted weakness in right leg during physical exam. Lung dr. and cardiologist discussed possibility of Guillain Barre Syndrome. Another blood test was ordered to check for some receptors. Awaiting results. Neurologist appt scheduled for 5/ 28


VAERS ID: 1349521 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 LA / -

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, Chest pain, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: 20210125; Test Name: COVID TEST; Result Unstructured Data: Test Result:Negative; Comments: Nasal Swab
CDC Split Type: USPFIZER INC2021516048

Write-up: My chest is constantly hurting, as if it''s being pressed down.; having constant shortness of breath every day since the vaccine/I''ve never had any shortness of breath before; This is a spontaneous report from a contactable consumer (patient). A 37-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection) (at 37 years of age), via an unspecified route of administration, administered in arm left on 02May2021 13:00 (Batch/Lot Number: EW0170) as 1ST DOSE, SINGLE for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. She had no known allergies. The patient was not pregnant. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient was not diagnosed with COVID-19 prior to vaccination. She has not been tested for COVID-19 since the vaccination. It was reported that the patient had been in constant shortness of breath every day since the vaccine. Her chest was constantly hurting, as if it was being pressed down. She never had any shortness of breath before getting this vaccine. The events started on 02May2021 04:00 PM with outcome of not recovered. It was unknown if the patient received treatment for the events. She had COVID test (nasal swab) on 25Jan2021 with negative result. Information about lot/batch number was available. Further in formation was expected.


VAERS ID: 1349557 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-12
Onset:2021-05-02
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 RA / -

Administered by: Other       Purchased by: ?
Symptoms: Deafness unilateral
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NALTREXONE; FOLIC ACID; VITAMIN B-12
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Alcoholism; Diverticulosis; Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021523652

Write-up: Sudden idiopathic hearing loss of the left ear; This is a spontaneous report from a contactable consumer.A 59-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration, administered in Arm Right on 12Apr2021 11:15 (Batch/Lot Number: ER8729) as 2ND DOSE, SINGLE for covid-19 immunisation. Medical history included Alcoholism, diverticulosis, allergies Penicillins. Patient previous received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EN6204) in Mar2021 in Right arm for covid-19 immunization. Concomitant medication(s) included naltrexone taken for an unspecified indication, start and stop date were not reported; folic acid taken for an unspecified indication, start and stop date were not reported; cyanocobalamin (VITAMIN B-12) taken for an unspecified indication, start and stop date were not reported. Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient experienced sudden idiopathic hearing loss of the left ear on 02May2021 12:00 with outcome of not recovered.Therapeutic measures were taken as a result of sudden idiopathic hearing loss of the left ear. Case was reported as serious as Disabling/Incapacitating. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1350305 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-16
Onset:2021-05-02
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Asthenia, COVID-19, Diarrhoea, Incomplete course of vaccination, SARS-CoV-2 test positive
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Medication errors (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: abatacept (ORENCIA, WITH MALTOSE,) 250 mg injection amLODIPine (NORVASC) 2.5 mg tablet amoxicillin (AMOXIL) 500 mg capsule apixaban (ELIQUIS) 2.5 mg tablet ascorbic acid, vitamin C, (VITAMIN C) 500 mg tablet aspirin 81 mg tablet atenolol (T
Current Illness:
Preexisting Conditions: Nervous Back pain Cataract Cerebrovascular accident (CVA) (CMS/HCC) Epigastric pain Circulatory Hypertension Pre-syncope Syncope TIA (transient ischemic attack) Essential hypertension PAF (paroxysmal atrial fibrillation) (CMS/HCC) Paroxysmal atrial fibrillation (CMS/HCC) Digestive Congenital anomaly of bile ducts Disorder of intestine Gastroesophageal reflux disease Hereditary hemochromatosis (CMS/HCC) Pneumobilia Gallstones Genitourinary Chronic urinary tract infection Stress incontinence in female Increased frequency of urination Midline cystocele Nocturia Urge incontinence of urine Retention of urine Musculoskeletal Arthritis Dental caries Fracture of bone Closed fracture of multiple ribs of right side Contusion of right knee Osteoporosis Endocrine/Metabolic Disorder of thyroid Hyperthyroidism Dyslipidemia Acquired hypothyroidism Hematologic Anemia Anticoagulated on Coumadin Immune Rheumatoid arthritis (CMS/HCC) Rheumatoid arthritis involving multiple sites (CMS/HCC) Other Dizziness Incontinence Mixed incontinence Personal history of venous thrombosis and embolism Personal history of transient cerebral ischemia Fall Ambulatory dysfunction Localized edema Elevated LFTs
Allergies: AdhesiveOther (document details in comments) Gold SaltsShortness of breath / Dyspnea IbuprofenHives / Urticaria Remicade [Infliximab]Shortness of breath / Dyspnea Avelox [Moxifloxacin]Other (document details in comments) CiprofloxacinOther (document details in comments) Myochrysine [Gold Sodium Thiomalate]Other (document details in comments) Nitrofurantoin Monohyd/m-crystOther (document details in comments) Sulfamethoxazole-trimethoprimOther (document details in comments)
Diagnostic Lab Data: 05/02/21 1615 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 05/02/21 1304 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: COVID 19 test POSITIVE Patient''s husband was notified of positive test results from test completed on 5/2/21. Stated patient was sleeping at this time, but she is already aware of the diagnosis. Signs and symptoms: 1. When did your symptoms start? 5/2/21 2. What symptoms have you experienced? Diarrhea, weakness, upset stomach. Close contact questions: 1. # in household: 2 2. Have you been in close contact with anyone two days before symptoms including going to work while you were sick? Yes


VAERS ID: 1350363 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004021A / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Loss of consciousness, Nausea, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: Lexapro, Spironalactone (acne Medicine), Birth control (oral)
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: The day after my 2nd shot, I woke up very nauseous, ended up fainting, then processed to vomit while being unconscious still.


VAERS ID: 1350473 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-17
Onset:2021-05-02
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Valsartan-hydrochlorothiazide, aspirin 81mg
Current Illness:
Preexisting Conditions: HTN, hyperglycemia controlled with diet
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt developed herpes zoster on the left side of her face and scalp.


VAERS ID: 1350505 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-31
Onset:2021-05-02
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the ED and was subsequently hospitalized within 6 weeks of receiving COVID vaccination.


VAERS ID: 1350585 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-29
Onset:2021-05-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, COVID-19, Chest X-ray normal, Chest pain, Chills, Diarrhoea, Nausea, SARS-CoV-2 test positive, Troponin, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol HFA (VENTOLIN HFA) 90 mcg/actuation inhaler amLODIPine (NORVASC) 5 mg tablet ascorbic acid, vitamin C, (VITAMIN C) 1,000 mg tablet aspirin 81 mg tablet atorvastatin (LIPITOR) 80 mg tablet clopidogreL (PLAVIX) 75 mg tablet desvenla
Current Illness:
Preexisting Conditions: Nervous Epigastric pain Respiratory Chronic obstructive pulmonary disease (HCC) Extrinsic asthma without status asthmaticus Lung nodule Wheezing Circulatory Chronic coronary artery disease Essential hypertension Digestive Gastroesophageal reflux disease Genitourinary Malpositioned intrauterine device (IUD), initial encounter Musculoskeletal Dental caries Primary localized osteoarthritis Edema of both feet Endocrine/Metabolic Hyperlipidemia Other Attention deficit disorder Bipolar affective disorder (HCC) Depression Chronic fatigue Abnormal glucose level Tobacco use disorder H/O heart artery stent Abnormal mammogram of left breast Disorder of tooth History of COPD Mixed incontinence
Allergies: Amoxicillin-pot ClavulanateOther (document details in comments), Nausea Only, Throat Swelling, Swelling Lactose Sulfa (Sulfonamide Antibiotics) AzithromycinOther (document details in comments) Milk Containing ProductsIndigestion / GI upset Niacin Niacin PreparationsOther (document details in comments)
Diagnostic Lab Data: 05/02/21 2145 COVID-19/Flu/RSV PCR - Asymptomatic screening for admission Collected: 05/02/21 2045 | Final result | Specimen: Swab from Nasopharynx Influenza A Not Detected Respiratory Synctial Virus Not Detected Influenza B Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Procedure Component Value Ref Range Date/Time X-ray chest 1 view, Portable Resulted: 05/03/21 0929 Order Status: Completed Updated: 05/03/21 0929 Narrative: XR CHEST 1 VW PORT IMPRESSION: No focal consolidation or pulmonary edema. No evidence of COVID-19 associated lung disease. Chest X-ray is less sensitive than CT Chest and can be normal in the early phase of this disease. CT Chest is not routinely recommended to diagnose COVID-19. END OF IMPRESSION: INDICATION: Pt c/o chest pain that has been going on since Thursday. Epigastric chest pain. TECHNIQUE: Portable AP projection of the chest was obtained. COMPARISON: Chest radiograph dated 4/30/2021. FINDINGS: Medical devices: None. Limitations: None. The trachea is midline. The mediastinum is not widened or shifted. The heart is normal in size. The thoracic aorta is unremarkable. No focal consolidation. No pulmonary edema. No pleural effusion. No pneumothorax. Bones and soft tissues of the chest wall demonstrate no acute or focal destructive abnormality.
CDC Split Type:

Write-up: ED to Hosp-Admission Discharged 5/2/2021 - 5/3/2021 (3 hours) Hospital MD Last attending ? Treatment team Epigastric pain Principal problem Discharge Summary MD (Physician) ? ? Internal Medicine Inpatient Discharge Summary BRIEF OVERVIEW Admitting Provider: MD Discharge Provider: MD Primary Care Physician at Discharge: DO 35 min. Admission Date: 5/2/2021 Discharge Date: 5/10/2021 Discharge Diagnosis 1. Chest pain in a patient with history of coronary artery disease cardiac catheterization and stents. 2. Nausea vomiting diarrhea most likely secondary to COVID-19 3. Positive COVID-19 no respiratory symptoms 4. History of dyslipidemia Hospital Course Patient was admitted with chest pain and GI symptoms most likely from COVID-19 nausea vomiting diarrhea. She decided to sign out AGAINST MEDICAL ADVICE and left the hospital Patient is a 56 y.o. female on hospital day number 0 presented with chest discomfort nausea vomiting diarrhea Medical Problems Hospital Problems POA * (Principal) Epigastric pain Yes Plan 1. Chest pain in a patient with history of coronary artery disease status post cardiac catheterization with multiple stents chest pain is very atypical most likely gastric in origin as she also has history of Barrett''s esophagus. I will change the Protonix to 40 IV twice a day. We will start the patient on chest pain protocol we will trend the troponins 2D echo cardiology consult 2. Possible gastroesophageal reflux 3. Nausea vomiting diarrhea with positive COVID-19 most likely GI symptoms of COVID-19 we will hydrate her with normal saline at 100 mL/h. 4. Positive COVID-19 no respiratory symptoms pulse ox 95% on room air we will keep an eye on her inflammatory markers she has GI symptoms. 5. History of dyslipidemia 6. DVT prophylaxis moderate risk subcutaneous heparin bilateral compression devices. 7. CODE STATUS she is a full code. Patient will be admitted to med surgical floor under hospitalist service. Medical management was discussed with the patient in detail. Chief Complaint Patient presents with ? Chest Pain 1. *Extended Emergency Contact Information 2. Primary Emergency Contact: spouse 8. Relation: Spouse 9. Preferred language: English 10. Interpreter needed? No_ History of Present Illness Patient is an 56 y.o. female with past medical history significant for coronary artery disease dyslipidemia status post cardiac catheterization with multiple stents presented to the ER with chief complaint of abdominal discomfort mainly epigastric region she been having pain off and on for 2 years she was in the ER the day before yesterday and signed out AGAINST MEDICAL ADVICE her troponin at that time was 0.04. Today she started having some abdominal discomfort again nonradiating centrally located in epigastric region, she also has diarrhea she has 6-7 bowel movements loose watery as well as she is nauseated and vomited multiple times mainly yellowish stuff with food in it. She denies any blood with stool or blood with urine. She says that she had some chills and uncomfortable feeling and felt like she is having fever. As her symptoms did not get any better she came to the ER. She denies any shortness of breath cough or phlegm. Her pulse ox is 95% on room air


VAERS ID: 1350908 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Condition aggravated, Fatigue, Feeling abnormal, Hypersomnia, Migraine, Pain, Pyrexia, SARS-CoV-2 test negative, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: probiotic , estradiol 1/2 mlg, vitamin c, vitamin d-3 , multivitamins, taken daily
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: I had covid 5 months earlier, in November. I had little bit fever, body aches, nothing compared to the vaccine. Lost my sense of smell. It was mild and only lasted 24 hours. I was given a covid-19 test- in the ER - which was negative.
CDC Split Type: vsafe

Write-up: about 10 pm, the same day of the vaccine. I had migraine headache, body aches, the whole body ached, chills, 103 fever, shaking so bad could not have called 911 if I wanted to. At 2 am, I did not take any medications bc the instructions said not to take any thing any relief. At 6 am I went to the ER, I felt like I wanted to die I felt so horrible. I was given ibuprofen and benadryl. I was given IV fluids. I was discharged at 1:00 pm. I slept for 3 days straight. and I still had the side effects. I still had low grade fever and fatigue. Migraine headache was the worst, it just continued and the fatigue. Even now I am still tired.


VAERS ID: 1351182 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM

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

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

Write-up: Shortness of breath, itching, facial swelling, throat and chest tightness.


VAERS ID: 1351195 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Hypersensitivity, Nasal congestion, Productive cough, Respiratory tract congestion, Sneezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin Aspirin Ozempic Metropolol Atorvastatin Lisinopril
Current Illness: None
Preexisting Conditions: Obesity, Diabetes (Type 2)
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe allergic reaction: nasal and throat congestion, mild fatigue, productive cough, sneezing Lasted 10-12 days. No fever, no nausea


VAERS ID: 1351387 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-26
Onset:2021-05-02
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Antinuclear antibody, Central nervous system lesion, Demyelination, Faecaloma, Lumbar puncture, Magnetic resonance imaging head abnormal, Magnetic resonance imaging spinal abnormal, Paraesthesia, Sensory loss, Spinal cord disorder, Urinary retention
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Optic nerve disorders (broad), Demyelination (narrow), 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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: hyperlipidemia, anxiety, atopic dermatitis
Allergies: NKDA
Diagnostic Lab Data: MRI of brain and spinal cord LP - results pending ANA 1:320, speckled pattern
CDC Split Type:

Write-up: Progressive ascending sensory loss/paresthesias, urinary and bowel retention. MRI with several demyelinating lesions in thoracic and cervical cord as well as brain. Diagnosis not established by neurology at this time (labs/data still pending); patient hospitalized and treated with high dose IV steroids on 5/21, with improvement but not back to baseline by discharge on 5/26/21.


VAERS ID: 1353473 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Facial paralysis, Magnetic resonance imaging
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: MRI; Result Unstructured Data: Test Result:Good
CDC Split Type: USPFIZER INC2021529455

Write-up: Left side of my lips paralysis, affecting my ability to use American Sign Language accurately and to smile; This is a spontaneous report from a contactable consumer (Patient). A 64-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Left on 30Apr2021 16:00 (Lot Number: ER8729) as 1ST DOSE, SINGLE for covid-19 immunisation. Medical history reported as none. The patient''s concomitant medications were not reported. The patient previously took morphine for drug hypersensitivity. The patient experienced Left side of lips paralysis on 02May2021 06:00, affecting ability to use American Sign Language accurately and to smile. The patient was told by Dr. to go into the ER to rule out, Bell Palsy or a Stroke. The patient had an MRI done with and without contrast in 2021. All looked good. This leaves the COVID vaccine as the cause of my problem. The patient received treatment for the event. The outcome of event was not recovered. No other vaccine in four weeks; Prior to vaccination, the patient was diagnosed with COVID-19.


VAERS ID: 1353551 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Swollen tongue, Tongue discomfort, Tongue erythema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021537327

Write-up: This is a spontaneous report from a contactable consumer (patient). A 67-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm right on 30Apr2021 at 13:00 (Lot Number: EP6955) (at the age of 67-year-old) as single dose for COVID-19 immunisation. The patient medical history and concomitant medications. The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm right on 09Apr2021 at 13:00 (Lot Number: ER8737) (at the age of 67-year-old) as single dose for COVID-19 immunisation. The patient experienced swollen red and burning tongue on 02May2021 with outcome of recovered on 08May2021. The events required emergency room visit (not the emergency room in the hospital, but one of those after care places) and physician office visit, both on 06May2021. Therapeutic measures were taken as a result of the events and included some mouthwash stuff and take a vitamin. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1353561 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-05-02
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Broken leg
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021539913

Write-up: Hives; This is a spontaneous report from a contactable consumer. A 53-years-old male patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration, administered in Arm Left on 08Apr2021 (Batch/Lot number was not reported) as single dose for covid-19 immunisation (age at vaccination 53 years). Medical history included , lower limb fracture on an unknown date. Tetanus vaccine taken because of broken leg. The patient''s concomitant medications were not reported. The patient experienced hives on 02May2021 with outcome of not recovered. The reported event was considered an Important Medical Event. The event was treated with diphenhydramine (BENADRYL) tablet and cream. Course of the event. The patient reported he got the first Covid shot on 08Apr2021 and everything was fine until about a week ago. He started breaking out in hives and going through Benadryl. States nothing in his life has changed, no change in detergent or what he eats, the only thing different was him getting the shot. Is due for the other one and is concerned if he should get the other one with him having the hives. Will this go away or will he get more hives with the second one. Has been taking Benadryl tablets and the hives go away but within 6 hours they come back and he has been using a Benadryl anti-itch cream so that he is not over doing the tablets. Has been through at least 7-8 tubes of cream in the last week or so. The patient also clarified he is actually using a generic Benadryl, its called generic healthcare allergy relief tablets. Has been taking 2 tablets every 8 hours for the last 7-9 days and when the hives come back he uses the Benadryl cream, it has diphenhydramine as active ingredient the same as Benadryl. As soon as the pills wear off he uses the cream. Information on the Lot/Batch has been requested.


VAERS ID: 1354117 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-05-02
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Immunoglobulin therapy, Petechiae, Platelet count decreased, Platelet transfusion
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Warfarin, Keppra, B12, Calcium, Zinc, Amlodopine, Vitamin D3,
Current Illness: None
Preexisting Conditions: ITP and antiphospholipid syndrome
Allergies: None
Diagnostic Lab Data: 5/4/21: platelets 8,000 5/5/21: platelets 16,000 5/6/21: platelets 20,000 5/7/21: platelets 22,000 5/8/21: platelets 21,000 5/9/21: platelets 12
CDC Split Type:

Write-up: 5/2/21: Petechiae on arms, legs and inside mouth. Platelets at 1,000. Hospitalized through 5/27/21. 1st line of treatment was platelet infusion. 2nd line of treatment was IVIG. 3rd line of treatment was rixutan infusions weekly for 3 weeks. 4th line of treatment was Doptelet in increased doses for 10 days. Discharged with platelets at 20,000 and return for blood work on June 1st; follow-up with surgeon in 2 weeks to check spleen.


VAERS ID: 1354574 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / SYR

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

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

Write-up: Fever, chills, body aches, exhaustion for 24 hours


VAERS ID: 1354588 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient developed generalized itching, and flushed face after receiving second dose of COVID-19 vaccine. Patient received a 25 mg dose of diphenhydramine resulting in improved symptoms within 30 minutes. BP,P,RR : 115/68, 72, 20 @ 0732 118/72, 76, 18 @ 0750


VAERS ID: 1354906 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-09
Onset:2021-05-02
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Conjunctival haemorrhage, Eye pain, Ocular hyperaemia
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Glaucoma (broad), Conjunctival 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: Metformin HCL 500mg 1 daily Vitamin D 3 1000units Vitamin B12 500mcg
Current Illness: N/A
Preexisting Conditions: Diabetes Mellitus II
Allergies: Compazine
Diagnostic Lab Data: Seen by PCP and ophthalmologist
CDC Split Type:

Write-up: I am 61, received Pfizer-BioNTech Covid Vaccine on 3-19-21, & 4-9-21. On 5-2-21, after doing some gardening, I felt a sharp pain in my right eye resulting in the sclera part of eye becoming red/bloodshot. I saw PCP, then ophthalmologist on 5-5-21, diagnosing it as right sub conjunctival hemorrhage. I did not lose any vision, but as of today, I still have some residual redness in sclera. My younger sister who had the same above vaccine on same above dates, also experienced right eye redness on 5-11-21, stating no trauma to area.


VAERS ID: 1355059 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-14
Onset:2021-05-02
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abnormal faeces, Balance disorder, Blood magnesium, Blood thyroid stimulating hormone, Cardiac flutter, Chest X-ray, Cognitive disorder, Differential white blood cell count, Echocardiogram, Electrocardiogram, Feeling abnormal, Fibrin D dimer, Full blood count, Heart rate increased, Hypoaesthesia, International normalised ratio, Liver function test, Magnetic resonance imaging head, Metabolic function test, Palpitations, SARS-CoV-2 test, Sinus tachycardia, Ultrasound scan
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Biliary system related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole 40mg per day, 20mg in the morning and 20mg at night / Loratadine 10mg per day / Folic Acid 800mcg per day / Vitamin D 2000IU per day / Vitamin B12 500mcg per day
Current Illness: No
Preexisting Conditions: Eosinophilic Esophagitis (EoE), Beta Thalassemia Minor
Allergies: All Seafood, Environmental and Cat Allergies
Diagnostic Lab Data: 5/2: D-dimer / Troponin T / CBC and Differential / Basic META / Magnesium / PT-INR / Bedside Ultrasound, Echocardiogram / Covid - 19 test / EKG 5/3: Basic META / TSH with reflex / LFTs (hepatic panel) 5/11: MRI Brain 5/20: Troponin T / TSH with reflex / Magnesium / Basic META / CBC and Differential / Covid - 19 test / EKG / XRAY Chest
CDC Split Type:

Write-up: In the morning of May 2nd I was driving and I felt my heart rate increasing lasted about 30 minutes to an hour. I ended up going to the ER and I was diagnosed with sinus tachycardia, I stayed overnight. After that event I developed a cognitive fog and a sensation of numbness on the left side of my head like someone is pulling the skin on my face ever so slightly. I also developed a sense of imbalance like I am in a boat for an extended period of time. These feelings remained constant and I noticed that they were getting better by May 19th. At 6 am on May 19th I walk up to the feeling of my heart pounding and my heart rate increasing, I measured my pulse on my watch and it was around 150 bpm average. This event lasted about 5 minutes and went away. On May 19th around 10 pm I was in the shower and my heart rate increase again and I felt a tickling sensation on the left side of my chest when I was breathing in. I ended up going to the ER gain and stayed overnight. May 26th I felt the sensations of fogginess and just feeling off cognitively. May 27th I woke up rested without fogginess and after a morning walk with my dog I felt my heart increasing. This episode lasted about 10-20 minutes and my heart rate was ranging between 120-150 bpm. My stools from April 20th till May 26th have been lighter in color yellowish and soft, when I consumed vegetables I could see specs of them in my stools like they were not fully processed. May 27th was the first day where my stool color was brown but still soft.


VAERS ID: 1355244 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-29
Onset:2021-05-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain
SMQs:, Retroperitoneal fibrosis (broad), Arthritis (broad)

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

Write-up: Patient reported shoulder and back pains a few days after receiving the vaccine. She took some OTC painkillers, which did not help much. She reported she continues to have pain in the back when she came in for her second shot.


VAERS ID: 1355369 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-28
Onset:2021-05-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Blood thyroid stimulating hormone normal, Brain natriuretic peptide normal, Chest X-ray normal, Chills, Dizziness, Echocardiogram, Electrocardiogram abnormal, Full blood count normal, Headache, Malaise, Metabolic function test normal, Nausea, Troponin normal
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No prescriptions, OTCs, or herbals
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: As above. ECHO pending at discharge
CDC Split Type:

Write-up: Vaccine on Wednesday 4/28/21. Started to have mild headache, nausea, generalized malaise and chills on Thursday 4/29/21. Seemed to then improve but then became lightheaded and dizzy. Came to emergency room 5/2/21 at 1000. BP stable at 136/69, O2 sat 99% on room air. No significant findings on blood work (CMP, CBC, Troponin, BNP, TSH all within normal limits). Chest Xray was normal. EKG showed atrial fibrillation with rapid ventricular rate in the 150s. She was given IV diltiazem and her heart rate was controlled. She was admitted to the hospital for observation and conversion from IV to PO diltiazem. She declined oral anticoagulation. She was discharged home on 5/3/21 and instructed to follow up with her PCP and was to see cardiology.


VAERS ID: 1355557 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram, Chest X-ray, Chest pain, Computerised tomogram, Pneumonia, Ultrasound Doppler
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CT scans, chest xray, and lower extremity dopplers.
CDC Split Type:

Write-up: Patient developed pleuritic chest pain. Presented to ER and had CT angiogram to eval for pulmonary embolism. Unfortunately, study was suboptimal but showed possible subsegmental PE vs mixing defect and consolidation in lingula consistent with pneumonia vs pulmonary infarct from PE. Scan initially read as more likely pneumonia but patient without consistent symptoms and re-read as concerning for pulmonary embolism. Patient otherwise healthy without other risk factors for PE. Repeat CTA 2 weeks later with better quality without e/o PE and improving but not resolved opacity in lingula. LE dopplers 3 wks after onset w/o DVT. Hypercoaguable labs pending.


VAERS ID: 1355832 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-29
Onset:2021-05-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / IM

Administered by: Public       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: Zoloft 50 mg
Current Illness: Bacterial Vaginosis
Preexisting Conditions: N/A
Allergies: Seasonal allergies
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Experiencing hives (welts) on right side of the body 3 days after the second dose of vaccine. No known allergies or other changes to food, clothing, or environment. Welts still persist nearly 1 month after second does of vaccine.


VAERS ID: 1356514 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Ear disorder, 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: Prenatals
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tinnitus, aural fullness


VAERS ID: 1357161 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Hyperventilation, Pruritus, Urticaria, Vaccination site pruritus
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin [MINERALS NOS;VITAMINS NOS]; LACTAID
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cellulitis (Onset Age: 3 or 4 years old Treatment included antibotics); Generalized anxiety disorder (diagnosed with generalized anxiety 10-12 years ago); Vaccination site erythema (the patient received a vaccine and got a localized, big red circle around the injection area.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021524244

Write-up: super anxious; Breathing a little rapid; hives on her legs, arms, and neck that have been extremely itchy; Arm was a little itchy/itching/itchy arm was very mild; itchy arm was due to irritation from the band aid that was applied after her vaccination; This is a spontaneous report from a contactable consumer (parent). A 29-years-old female patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration, administered in Arm Left on 02May2021 at 14:00 (Batch/Lot Number: EW0173) as 1ST DOSE, SINGLE for covid-19 immunization. Facility in which the vaccine was give was a ''mass vaccination site''. No other vaccines were given within 4 weeks. Medical history included cellulitis (at the Age: 3 or 4 years old, Treatment included antibiotics), generalized anxiety disorder from an unknown date and unknown if ongoing (diagnosed with generalized anxiety 10-12 years ago). No family history was provided as patient was adopted. Concomitant medication included multivitamin [MINERALS NOS;VITAMINS NOS] (Reported as Multi-Vitamin and vitamins) from an unspecified date and ongoing for general health and Lactaid (occasionally). The patient previously had a vaccine (unable to recall which vaccine caused the reaction event occurred at 3-4 years old) and experienced localized, big red circle around the injection area. The patient experienced hives on her legs, arms, and neck that have been extremely itchy on 09May2021, arm was a little itchy/itching/itchy arm was very mild on 02May2021, itchy arm was due to irritation from the band aid that was applied after her vaccination on 02May2021 breathing a little rapid on 10May2021 and super anxious on an unspecified date, Treatment was given for the events hives and itching. The clinical course was reported as follows the patients arm began to itch a couple hours after the patient received the first dose the Covid-19 vaccine on 02May2021. The patient thought the itchy arm was due to irritation from the band aid that was applied after her vaccination. She had some itching for a day or two after the vaccine was administered also stated itchy arm occurred on and off for one day. The patients arm was a little itchy, but other than that she did not have anything major on until around midnight on 09May2021. Patient woke up and had hives everywhere. Stated she had Hives on her legs, arms, and neck that have been extremely itchy. The hives come and go and she has taken Benadryl but there has been no improvement. The patient''s primary care physician was contacted on 10May2021. The event resulted in a physician office visit. The physician noted the patients breathing was a little rapid. Patient thought her breathing was a little rapid because she was super anxious. Patient denied having any difficulty breathing. The patient reported she didn''t drink anything new, didn''t eat anything new, didn''t have new hair or shower products, no new laundry detergent was being used. The physician stated that from the size and extent of the hives, the hives were probably from the Covid-19 vaccine. Caller reported her daughters hives have stayed pretty much the same. One hive will disappear and then another will appear on the patients body somewhere else. The hives are on her neck, arms and legs are very itchy and appear as big blotches. The patient took pictures of her hives and would show them to her doctor in the event they improved before the patient could be seen. Caller reported that the patient would be able to share the photos of her hives with Pfizer if requested. The patient is due to have her second dose of the Covid-19 vaccine. Caller stated the patient''s physician leaned toward the patient not getting the second dose. Caller preferred to get more information from Pfizer prior to canceling the patient''s second appointment. The clinical outcome of the event Hives and itching was ongoing, Breathing a little rapid was recovered on 10May2021 and the remaining events were unknown. follow-up attempts are needed. further information is requested.


VAERS ID: 1357172 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Diplegia, Hypoaesthesia, Neck pain, Pain in extremity, Paraesthesia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021535476

Write-up: she was paralyzed, both hands weren''t working; the pain got to her neck; numbness and tingling developed in her fingers, palms, wrists, forearms, and neck and then began in her left leg and toes; numbness and tingling developed in her fingers, palms, wrists, forearms, and neck and then began in her left leg and toes; the pain started to move from her finger to her palm and then a little bit further down the wrist/ pain went all the way to her forearm and to the back of her arm; the pain started to move from her finger to her palm and then a little bit further down the wrist; burning like sensation in her right fingertips/ she was burning; burning like sensation in her right fingertips and they felt swollen but did not appear swollen; The initial safety information received was reporting only non-serious adverse drug reactions. Upon receipt of follow-up information on 12May2021, this now contains serious adverse event. Information processed together. This is a spontaneous report from a contactable consumer (patient). A 35-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EW0170), via an unspecified route of administration in left arm on 30Apr2021 at 12:00 at 1st dose, single for COVID-19 immunization. Medical history and family history relevant to the events were reported as none. The patient''s concomitant medications were not reported. There was no other vaccine administered on the same date as BNT162B2. There were no other prior vaccinations within 4 weeks of BNT162B2. The patient received her first Pfizer COVID vaccine dose on 30Apr2021 at a pharmacy. On 02May2021, she started to feel a little bit of weirdness in her fingertip, index finger right finger. She received the vaccine in a different arm. It was more like when she burns her finger, it was a burning like sensation in her right fingertips and they felt swollen but did not appear swollen. On 03May2021, she was still feeling the same way in her fingers, there was no development of pain anywhere in her hand yet, she went to the doctor, but they didn''t notice what the problem was. On 04May2021, the pain started to move from her finger to her palm and then a little bit further down the wrist. On 05May2021, the pain went all the way to her forearm and to the back of her arm as well. On 06May2021, the patient reported that''s when the rest of the development happened so rapidly. The pain, numbness, and tingling got to her neck which has been transferred on the left side. She started feeling the tingling, pins, needles, numbness, and pain on her left hand, fingers, forearm, and arm itself; she was feeling burning in the upper side of her wrist and it went all the way down to her feet, her legs, a little bit on her toes, not all the toes, but some of them. On 07May2021, she went back to the doctor, clearly, she was paralyzed, both hands weren''t working, both were numb, with pins and needles and tingling. She was burning, her neck was under a lot of pain as well. She''s currently on medication, so it just came back sometimes. Like yesterday (11May2021), she felt like she was on fire, like someone opened the fire inside her. She was burning yesterday, but the day before that she was thinking she was recovering, and today, she''s starting to feel the burning in her neck again, it just comes and goes. All her symptoms haven''t worsened, that she could tell, just because it comes and goes, she was not sure. She wanted to know if these were reported side effect of the vaccine. She also asked if she could take the second dose of the vaccine. Therapeutic measures were taken as a result of the events. The events required physician office visit. She went to a specialist on Friday because her symptoms were way different than when she started to go to the doctor. There were no relevant tests. The outcome of the events was not recovered.


VAERS ID: 1357180 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZEREWO167 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Heart rate, Heart rate increased, Investigation
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: THYROX
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Thyroid crisis
Allergies:
Diagnostic Lab Data: Test Date: 20210502; Test Name: heart rate; Result Unstructured Data: Test Result:110-150; Comments: resting heart rate was 110 reaching up to 150; Test Date: 20210507; Test Name: heart rate; Result Unstructured Data: Test Result:130 - 150; Comments: Heart rate was going 130 - 150; Test Name: test; Result Unstructured Data: Test Result:All the test reports appeared negative
CDC Split Type: USPFIZER INC2021536043

Write-up: Experienced shortness of breath from the next day after my 2nd dose of Pfizer vaccination.; a very high heart rate (resting heart rate was 110 reaching up to 150)/Heart rate was going 130 - 150; This is a spontaneous report from a contactable consumer (patient). A 43-years-old female patient (non-pregnant) received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in left arm on 01May2021 (Batch/Lot Number: PFIZEREWO167) as 2ND DOSE, SINGLE for covid-19 immunisation at Pharmacy or Drug Store. Medical history included thyroid. Concomitant medication (patient received within 2 weeks of vaccination) included levothyroxine sodium (THYROX) taken for an unspecified indication, start and stop date were not reported. The patient previous took first dose of BNT162B2 on 10Apr2021 at 04:45 PM (Lot number: PFIZEREWO161) administered in left arm for covid-19 immunisation. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient experienced shortness of breath from the next day after her 2nd dose of Pfizer vaccination (02May2021). A severe shortness of breath with a very high heart rate (resting heart rate was 110 reaching up to 150) after 2nd dose of Pfizer vaccination started on 02May2021. Symptoms were getting worse, got admitted in Emergency Hospital on 07May2021. As it was worsening day by day and the Heart rate was going 130 - 150, had to admit in Emergency room on 07May2021. All the test reports appeared negative. Patient had thyroid and was within range. Patient didn''t see any reason of such a severe shortness of breath other than reaction of vaccination. The adverse event result in Doctor or other healthcare professional office/clinic visit and Emergency room/department or urgent care. When asking what treatment received for the adverse event, ''Please reach out to (withheld)''. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The outcome of events was recovering. The reporter classified the events as serious with Seriousness criteria - Life threatening and Caused/prolonged hospitalization. Information on the lot/batch number has been requested.


VAERS ID: 1357197 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-22
Onset:2021-05-02
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

Administered by: Work       Purchased by: ?
Symptoms: Body temperature, Genital herpes, Herpes simplex test, Kidney infection, Lymphadenopathy, Lymphocyte count, Lymphocyte count decreased, Nausea, Pain in extremity, Pyrexia, Rash, Urinary tract infection, White blood cell count, White blood cell count decreased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Breast cancer; Hashimoto''s disease
Allergies:
Diagnostic Lab Data: Test Date: 20210505; Test Name: Fever; Result Unstructured Data: Test Result:102.6; Comments: day 3 developed 102.6 fever; Test Date: 20210505; Test Name: HSV1 Genital; Test Result: Positive ; Test Date: 20210505; Test Name: Lymphocytes; Result Unstructured Data: Test Result:Low; Test Date: 20210505; Test Name: WBC counts; Result Unstructured Data: Test Result:Low
CDC Split Type: USPFIZER INC2021537710

Write-up: severe Dysuria tested positive for HSV1 Genital; Low WBC count and low lymphocytes; Low WBC count and low lymphocytes; patient developed 102.6 fever; nausea; Swollen groin lymph nodes; kidney infection; severe UTI; the patient experienced bad leg pain; rash on legs; This is a spontaneous report from a contactable other hcp (patient). A 53-year-old female patient received bnt162b2 (Pfizer-BioNTech COVID-19 vaccine), dose 2 via an unspecified route of administration, administered in Arm Right on 22Apr2021 13:30 (Batch/Lot number was not reported) as 2ND DOSE, SINGLE for covid-19 immunisation. Medical history included breast cancer and Hashimoto disease. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient''s concomitant medications were not reported. The patient previously received first dose of bnt162b2 at the age of 53-years-old on 01Apr2021 12:30 in the arm right for COVID-19 immunization. On 02May2021 22:00, the patient experienced bad leg pain, rash on legs, flowed by severe UTI and kidney infection. On 05May2021, day 3, the patient developed 102.6 fever, nausea, swollen groin lymph nodes, severe dysuria tested positive for HSV1 Genital, with bad lower pelvic pain, low WBC counts and low lymphocytes. The patient had 2 trips to ER in 3 days, missed 8 days of work due to the events. The patient received IV fluids, IV antibiotic, IV pain meds, anti-nausea as treatment for the events. The outcome of the event was recovered with sequel. Information on the Lot/Batch number has been requested.; Sender''s Comments: Based on the information in the case report and a plausible temporal relationship, A possible causal relationship between reported events and suspect drug BNT162B2 Cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Committees, and Investigators, as appropriate.


VAERS ID: 1357215 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-29
Onset:2021-05-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pulmonary thrombosis, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021539781

Write-up: Blood clot in leg and one in each lung. Admitted to hospital on 02May2021; Blood clot in leg and one in each lung. Admitted to hospital on 02May2021; This is a spontaneous report received from a contactable consumer. A 55-year-old female patient (not pregnant) received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), dose 2 via an unspecified route of administration on 29Apr2021 08:30 (at 55 years old, not pregnant) (Batch/Lot number was not reported) as 2ND DOSE, SINGLE for covid-19 immunisation. The patient''s medical history was not reported. No concomitant medications. On 02May2021 08:30 patient experienced Blood clot in leg and one in each lung. Admitted to hospital on 02May2021.No other vaccine in four weeks. No other medications in two weeks. Treatment for event was Blood thinners. No covid prior vaccination. Not covid tested post vaccination. The outcome of the events was not recovered. Events resulted in visit to emergency room and physician office. Device Date: 12May2021. Information on the Lot/Batch number has been requested.


VAERS ID: 1357230 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Hyperhidrosis, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021541544

Write-up: diaphoretic; hypotensive; This is a spontaneous report from a contactable consumer (patient''s mother). A 34-year-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE) intramuscular, administered in Arm Left on 02May2021 15:20 (at the age of 34-years-old) (Batch/Lot Number: EW0171; Expiration Date: 31Aug2021) as single dose for covid-19 immunisation. The patient had not medical history. The patient''s concomitant medications were not reported. 12 minutes after receiving the vaccine, the patient became hypotensive and diaphoretic for about 1 to 1.5 minutes. He was scheduled for his second dose on 23May2021. The outcome of the events was recovered. The events were assessed as serious, medically significant. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1357283 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LIPITOR [ATORVASTATIN]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021547200

Write-up: measle type rash/raised, had pus, plus hives with it; headache; itching; This is a spontaneous report from a contactable nurse (patient).A 66-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 intramuscular, administered in Deltoid Left on 02May2021 10:00 (Batch/Lot number was not reported) as 1ST DOSE 0.3ML, SINGLE for covid-19 immunisation. Medical history included blood pressure. Concomitant medication(s) included atorvastatin (LIPITOR [ATORVASTATIN]) taken for blood pressure, start and stop date were not reported. She knew she could have a rash, but after 30 minutes she had a headache and took Tylenol. She mentioned she had a measel type looking rash. It was really bad. She did not say anything about it at first, just kept fighting through it. It was so bad she had to take 100mg Benadryl to try and control the itch for several days She is afraid to get the second shot on the 23rd. She is debating on going through with it. She is still having itching symptoms, but its not as bad. She is able to control it with steroid cream and lidocaine. Email: Declined to provide Weight: Knocking on on 200 pounds The events started on the same date of the vaccine which she later clarified was 02May2021. Measle type rash: At first it was getting worse and worse, but initially stated now it is about the same. It was raised and runny, but now it is drying a tad bit. It was raised, had pus, plus hives with it. Its still raised and red. It was a thick layer of measles. It was one layer on top of another. She mentioned this to a doctor at the clinic she works with. Started 30 minutes after the vaccine, but within 1 hour time frame it was getting. Her husband noticed she was starting to scratch and he questioned her about. By 11:00 it was full blown.Seriousness Criteria: When probed for seriousness criteria she felt it was really serious, but she hates going to the hospital . She decided she would watch her own symptoms until she could not anymore. If it did not get any better within the week she would go and get checked out. However, she did have a doctor at her clinic look at it and he questioned her about the rash. He asked her if she has having anything else and she said this was just about it. The doctor said it was a pretty good rash. She later stated the rash is looking better now. If the doctor reacted more to it she would have done more, but he just kept saying he hoped it was not more than that. Itching: She had itching a long with the rash, but the itching is getting better. Headache: It started and stopped the same date of the vaccine. The headache/ was more so annoying . If it was more severe she would have gone to hospital. Normally she does not get headaches. She knew it was not from the norm, but she was able to watch it on her own. Within 2-3 hours it was a light headache more so and then after the whole day it was not there. It was a different kind of headache It was a pounding headache. She does not have her vaccination card with her to provide lot/exp/NDC. She is currently at her sons house. Indication: Mentioned she was reluctant to get it at first. She was saying initially she was not going to take it, but she had a stat over at the COVID clinic where she works. She heard stories and people were asking her if she had her vaccine. They are the ones promoting it. She felt crazy saying no she did not and would just say she would get it later. She held true to her word. She is exposed to people and wanted to be safe for them and herself. Concomitant Medication: Lipitor: It was brought on by COVID. She has been monitoring her blood pressure lately due to COVID and the things she is going through. She questioned what was going on. She informed her doctor of this and was informed she should be started on a low does and to see how things are on it. She clarified and confirmed this is what she meant by it was brought on by covid. She clarified it was due to blood pressure issues due to patient workload.The outcome of measle type rash was unknown, of headache was recovered, of itching was recovering. Follow-up attempts are completed; information about lot/batch number cannot be obtained.; Sender''s Comments: The events measeles like rash, headache and pruritis was considered related to suspect drug based on strong temporal association and known safety profile of the drug. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Committees, and Investigators, as appropriate.


VAERS ID: 1357426 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-05-02
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Pre-diabetic
Preexisting Conditions: Medical History/Concurrent Conditions: Back pain; Comments: The patient had no known allergies. The patient had no history of headache for several years.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210548992

Write-up: STROKE; This spontaneous report received from a patient concerned a 49 year old male. The patient''s weight was 250 pounds, and height was 70 inches. The patient''s past medical history included back pain, and concurrent conditions included pre-diabetic. The patient had no known allergies. The patient had no history of headache for several years. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 1808980 expiry: UNKNOWN) dose was not reported, 1 total, administered on 07-APR-2021 to left arm for prophylactic vaccination. No concomitant medications were reported. On 02-MAY-2021, the patient developed a headache. Heath care professional (HCP) told him that he probably had been experiencing stroke symptoms from 02 to 04-MAY-2021. On 04-MAY-2021, the patient went to the hospital and was diagnosed with a stroke. He was hospitalized for 7 days. He experienced cognitive issues, like taking time to get his thoughts together, but no paralysis. He has been out of work. HCP has started him on aspirin (acetylsalicylic acid), but he could not remember what medications he was taking. He stated that until getting the vaccination, had no problems with his health. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from stroke. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0:20210548992-covid-19 vaccine ad26.cov2.s-stroke. 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: 1357729 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Blood ketone body, Blood test abnormal, Migraine, Paranasal sinus discomfort, Pyrexia, Rash, Rash erythematous, SARS-CoV-2 test negative, Skin warm, Systemic lupus erythematosus, Vomiting, White blood cell count decreased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Immune-mediated/autoimmune disorders (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Women''s daily vitamin Hydroxychloroquin Xanax Prozac Pantoprazol
Current Illness:
Preexisting Conditions: Lupus SLE
Allergies: succinylcholine zythomax asthmacort doxycyclin
Diagnostic Lab Data:
CDC Split Type:

Write-up: May 2- vommitting and low grade fever and migraine May 3- migraines joint pain and stomach pain May 4- went to the ER My white blood cell count dropped to 2.7 My ketones were 15 my labs were not good. Moderna sent my entire body into a lupus flare I was treated with 2 bags of fluids, torodol, pepcid and prednisone May 8- I''ve now lost 4 lbs my sinuses are so swollen I can''t smell, but have a negative covid test The next week I feel better May 13- I get a tattoo, didn''t know that falls under the "procedure" umbrella My body starts adversely reacting to my tattoo. The nurse says it''s because of the vaccine.. Painful red rashes spread it''s hot my arm is hot. Also the same arm I got the moderna in. May 18- put on more steroids and antibiotics The "free and safe" vaccine has now cost me over $400 and 2 days of work. Er- copay $300 Urgent care- copay $45 Meds- $30 Work- $110 Tattoo- $100 that will need to be redone


VAERS ID: 1357890 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-25
Onset:2021-05-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (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: Armour Thyroid, Methyl Folate
Current Illness: Hypothyroidism/Hashimotos
Preexisting Conditions: Hypothyroidism/Hashimotos
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: A week after vaccine, I experienced my right arm hurting and having tingles. This has not gone away and I currently feel my right arm still not the same way it was before the vaccine.


VAERS ID: 1358506 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram normal, Hypoaesthesia, Magnetic resonance imaging abdominal, Magnetic resonance imaging normal
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Enlarged liver
Preexisting Conditions: None
Allergies: Allergic to penicillin
Diagnostic Lab Data: Had MRI of my pelvis and spine. Also had CT scan. Both showed fine nothing else that would indicate total numbness in my lower half.
CDC Split Type:

Write-up: Two days after receiving my first Covid-19 shot, I went number from my belly button down. I can wal, just not feel. Looks like censory nerves are impacted but not motor nerves.Had MRIs and CR scans to see if it were something wrong with my spine and nerves. All came back clear. Both my GP and my chiropractor agreed that it is too coincidental to ignore that just two days prior was when I got my shot so it is probably a symptom. Advised me to report it so here I am.


VAERS ID: 1359734 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular 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: Nausea; Lightheadedness; Patient felt SOB after vaccine. No significant medical history, seen by EMS with no intervention needed. Released to self care.


VAERS ID: 1360498 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-20
Onset:2021-05-02
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eczema
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021548429

Write-up: Eczema all over forehead, lips and neck.; This is a spontaneous report from a contactable consumer (patient) reported that a 50-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number was not reported), via an unspecified route of administration, administered in arm left on 20Apr2021 16:00 (at the age of 50-years-old) as 2nd dose, single dose for covid-19 immunisation. The vaccine was administered at the Pharmacy/drug store. The patient was not pregnant at the time of vaccination. The patient''s medical history and concomitant medications were not reported. The patient had no known allergies. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. No any other medications the patient received within 2 weeks of vaccination. The patient previously received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number was not reported), administered in arm left on 30Mar2021 02:00 PM (at the age of 50-years-old) as 1st dose for covid-19 immunization. On 02May2021 at 12:00 PM, the patient experienced eczema all over forehead, lips and neck. Therapeutic measures were taken as a result of eczema all over forehead, lips and neck as the patient received Cortizone. The outcome of the event was not recovered. Since the vaccination, the patient has not been tested for COVID-19. Information on the lot/batch number has been requested.


VAERS ID: 1360710 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Muscle tightness, Pain
SMQs:, Dystonia (broad), Hearing impairment (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: Bell''s Palsy-Medium, Additional Details: The patient called us to report that about 4 hours after she received her first dose, she noticed that her jaw felt heavy/tight, similar to lockjaw but not as severe. It was more difficult for her to talk/chew, although still possible. That evening she felt that it was already subsiding, but she took Benadryl in case. She felt fine by the following morning.


VAERS ID: 1361161 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Nausea, Paraesthesia, Pyrexia, Skin sensitisation, Swelling, Tinnitus
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hearing impairment (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra 180mg 1xday, Spirinolactone 50mg 2xday
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Food: almonds, shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: High Fever (104), Tinnitus, Felt like floating, Skin sensitive (pain) to touch things, Nausea, waited it out, lasted 24 hours after onset. Most intense first 12 hours after onset. 4 hours previous to onset began to sense swelling and tingling internally -- like anaphylaxis


VAERS ID: 1361355 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature increased, Chills, Heavy menstrual bleeding, Hyperhidrosis, Menstruation delayed, Tremor
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Fertility 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? 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: Late period (by 1 week), heavy period, the night after my vaccine I had chills and uncontrollable shaking, cold sweats, and a difficult time regulating my temperature. This subsided with rest within 24 hours


VAERS ID: 1361662 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / UNK LA / IM

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

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

Write-up: patient was under the age of 18. Pharmacy staff at the time of immunization didn''t verify age and or recognize the difference with Pfizer and Moderna


VAERS ID: 1361664 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Impaired work ability, Wrong technique in product usage process
SMQs:, Arthritis (broad), Medication errors (narrow)

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

Write-up: When administering the 2nd dose 5/30/21 - and following up on any complications. Patient mentioned getting the first shot higher than normal and needed to take the next day off as the shoulder area hurt and needed to rest it.


VAERS ID: 1361696 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 1 LA / IM

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

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

Write-up: CHILLS,FEVER, TIREDNESS.


VAERS ID: 1361805 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-23
Onset:2021-05-02
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Culture urine, Full blood count, Haematuria, Metabolic function test, Urine analysis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Tubulointerstitial diseases (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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NKA
Diagnostic Lab Data: UA. pending urine CX, CBC/CMP.
CDC Split Type:

Write-up: Hematuria 10 days post inoculation x2.


VAERS ID: 1361966 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin D
Current Illness: none
Preexisting Conditions: none
Allergies: melons, cucumbers, almonds,
Diagnostic Lab Data: I stayed home and did not seek medical attention
CDC Split Type:

Write-up: initially, it was a splitting headache, piercing pain that came in waves and immobilized me. It lasted two days and was worse when standing or moving. It was less intense on the second day, but hives appeared on my left arm and my arm was more sore on the second day, and stayed sore for 5 days. The body aches started around 10:00 pm on the first day. Then fatigue and joint pain. Really awful.


VAERS ID: 1362342 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-30
Onset:2021-05-02
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019B21A / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Pravastatin, Pepcid, Vitamin D
Current Illness:
Preexisting Conditions: Migraine, Factor XI bleeding deficiency, Hypothyroid, mild high cholesterol, IBS, allergy/mild asthma
Allergies: Penicillin, Sulfa, Flonase
Diagnostic Lab Data: Scheduled, but not yet performed: EMG/Nerve Conduction Study
CDC Split Type:

Write-up: Tingling in hands and feet, spreading to legs and arms. Still present 2 months later.


VAERS ID: 1362375 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-27
Onset:2021-05-02
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Agitation, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), 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: BHRT is only RX, other dietary supplements and herbal remedies
Current Illness: None
Preexisting Conditions: Thyroid nodules
Allergies: NKA
Diagnostic Lab Data: I have only had blood work done since, and I am scheduled to see a doctor June 21st, the earliest I could be seen. I am on a waiting list to be seen earlier if something opens up.
CDC Split Type:

Write-up: On May 2nd, approx 5 days after 1st Pfizer dose, I noticed a change in my mouth - roof of mouth and tongue especially, I have had a different taste ever since, a mineral-ish taste in my mouth since that day that has not gone away. On May 19th, the next evening after my second dose, I had intense radiating arm pain (not just like the sore arm I had the first time), more like what I imagine the radiating arm pain must be like when one suffers a cardiac event, it was very intense and scary and lasted for 15 to 20 minutes. Before and after the radiating arm/possible cardiac-like event, I noticed I was also extremely agitated before and after it happened. I was agitated to a state I am not accustomed to experiencing. It was all very unusual and unnerving for me.


VAERS ID: 1363896 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-05-02
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Oedema, Pain, Swelling, Thrombosis, Ultrasound scan
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anti factor V antibody positive
Allergies:
Diagnostic Lab Data: Test Date: 20210502; Test Name: Diagnostic ultrasound; Result Unstructured Data: Blood Clot in left leg; Test Date: 20210527; Test Name: Diagnostic ultrasound; Result Unstructured Data: Blood clot in right leg
CDC Split Type: USJNJFOC20210556299

Write-up: PAIN; PITTING EDEMA; SWELLING; BLOOD CLOT LEFT AND RIGHT LEG; This spontaneous report received from a patient concerned a 66 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included factor 5 positive.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805022, expiry: UNKNOWN) dose was not reported, administered on 08-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On an unspecified date, the patient experienced pain, pitting edema, and swelling. The patient had an Ultrasound done on 02-MAY-2021 at the emergency room that showed a blood clot in her left leg. On 27-MAY-2021 she went to her doctor and had another ultrasound on her right leg that indicated a blood clot. She was started on Zorelto as a treatment for blood clot on 02-May-2021 15 mg BID Three times daily and is now taking 20mg 1 times daily, but that she may not be able to stay on Zorelto because it was not working. Also stated this vaccine had ruined her life and was very sorry that she ever got the vaccine. She was extremely frustrated and unhappy and had pain and swelling that has not allowed her to play tennis and experience inactivity. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from blood clot left and right leg, and the outcome of pain, pitting edema and swelling was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: 20210556299-covid-19 vaccine ad26.cov2.s-Blood clot left and right leg. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY


VAERS ID: 1364667 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-02-22
Onset:2021-05-02
   Days after vaccination:69
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH KN6198 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blister, Fatigue, Headache, Ophthalmic herpes zoster, Pain, Periorbital swelling, Rash, Swelling face
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Ocular infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (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: Larin Fe, Levothyroxine, Sertraline
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Diagnosed 05/05/2021
CDC Split Type:

Write-up: Herpes Zoster Ophthalmicus (HZO); onset of symptoms 05/02/2021, including painful rash, blisters, fatigue, headache, shooting and buring pain, swollen rash along forehead and over left eye.


VAERS ID: 1365149 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-24
Onset:2021-05-02
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: EIGHT DAYS AFTERE RECEIVING THE FIRST SHOT THE PATIENT COMPLAINED OF ARM PAIN AND A RASH THAT ORIGINALLY GREW TO THE SIZE OF A GOLF BALL BUT EVENTUALLY SPREAD TO ENCOMPASS THE LARGER PART OF HER UPPER ARM. PATIENT HAD PICTURES AND USED A BLACK MARKER TO OUTLINE THE SIZE OF THE RASH. SHE PRESENTED TO THE CLINIC SITE FOR THE SECOND SHOT WHERE SHE SHOWED US PICTURES AND REPORTED THE EVENT.


VAERS ID: 1365207 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-18
Onset:2021-05-02
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster, Neck pain, Pain in extremity, Paraesthesia, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: Began experiencing shingles symptoms on 5/2/2021, fourteen days after first dose. Began with soreness & tingling in neck/arm/hand before developing a rash several days later. Officially diagnosed via tele med by my primary care doctor on 5/12/2021. I was prescribed an anti viral for the shingles, and rash healed after several weeks.


VAERS ID: 1366128 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-13
Onset:2021-05-02
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oligomenorrhoea
SMQs:, Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole, Vyvanse, Prozac, Atarax, Nexplanon
Current Illness:
Preexisting Conditions: Depression, anxiety, silent reflux, allergies.
Allergies: Tree nuts, argan oil, coconut, strong side effects from Prednisone (not actual allergy for Prednisone)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Since two days before the second vaccine, I have had my period, which has now been for more than a month. I have a LARC, which has caused me to not have a period prior to this for probably about the last 6 months.


VAERS ID: 1366145 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Atelectasis, Chest X-ray abnormal, Chest discomfort, Disability, Dizziness, Electrocardiogram abnormal, Injection site pain, Myocardial necrosis marker, Oxygen saturation decreased, Palpitations, Red blood cell count increased
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Vestibular disorders (broad), Respiratory failure (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Jardience, Furosamide
Current Illness: Type 2 Diabedit, No insulin
Preexisting Conditions: Various neuropathies migraine high blood pressure, controlled via medication and diet Other chronic conditions
Allergies: Allergy to metformin
Diagnostic Lab Data: admission to emergency room with diagnosis May 12, 2021 ABNORMAL ECG, lowered pulsox, Atelectisis (Chest Xray) Cardiac enzyme panel Elevated RBC Disability stated in 21 below is from date of injection to the date of this filing.
CDC Split Type:

Write-up: Pain at injection site followed by Angina, Heart palpitation, Tightness in chest, lowered pulsox, dizziness. Followed by admission to emergency room with diagnosis of ABNORMAL ECG, lowered pulsox, Atelectisis (Chest Xray) Followed by referral to Cardiologist Symptoms are persistent Undergoing further treatments and further tests scheduled as of the date of this report.


VAERS ID: 1366889 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-06
Onset:2021-05-02
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 2 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Deafness, Vertigo
SMQs:, Hearing impairment (narrow), 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: MRI
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Had vertigo; Patient can''t hear out of his left ear; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of DEAFNESS (Patient can''t hear out of his left ear) in a 20-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included MRI in May 2021. On 06-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 02-May-2021, the patient experienced DEAFNESS (Patient can''t hear out of his left ear) (seriousness criterion medically significant). On 03-May-2021, the patient experienced VERTIGO (Had vertigo). The patient was treated with CHLORAMPHENICOL (ANTIBIOTIC [CHLORAMPHENICOL]) in May 2021 at a dose of 1 dosage form. At the time of the report, DEAFNESS (Patient can''t hear out of his left ear) and VERTIGO (Had vertigo) had not resolved. The patient was not taking any concomitant medications. Treatment for events included 2 steroids injections in ear. Action taken with mRNA-1273 in response to the events was not Applicable. Company comment: Very limited information regarding the events has been provided at this time. Further information is requested. This case was linked to MOD-2021-155536 (Patient Link).; Sender''s Comments: Very limited information regarding the events has been provided at this time. Further information is requested.


VAERS ID: 1367106 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-02
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021487986

Write-up: Headache; This is a spontaneous report from a contactable consumer (patient). This 36-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; lot number unknown) via an unspecified route of administration on an unknown date as a single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. The patient reported she was scheduled to receive the second dose of BNT162B2 "today" (as of 02May2021). She stated she had a headache in the morning, and she took ibuprofen. She inquired if she should still receive the second dose that day or if she should postpone it. The clinical outcome of headache was unknown. No follow-up attempts are needed; information about lot/batch number cannot be obtained.


VAERS ID: 1367116 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-05-02
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021502624

Write-up: Migraine; This is a spontaneous report from a contactable consumer (patient) via a Pfizer-sponsored program, . This female patient of unspecified age received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; lot number unknown) via an unspecified route of administration on 11Apr2021 as a singe dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. The patient reported she had her first dose on 11Apr2021, and her second dose was scheduled "today" (as of 02May2021). She reported experiencing a migraine and was not sure if it was okay to take the second dose. The clinical outcome of migraine was not recovered. No follow-up attempts are needed; information about lot/batch number cannot be obtained.


VAERS ID: 1367132 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-24
Onset:2021-05-02
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: USPFIZER INC2021549786

Write-up: Fever; Headache; sore arm; very tired; This is a spontaneous report from a contactable consumer (patient). A 28-year-old male patient received the first dose of BNT162B2 (Pfizer-Biontech Covid-19 Vaccine, Lot. EW0150) in the left arm, on 24Apr2021, at 12:15 PM, at single dose, for COVID-19 immunisation. The patient had not received any other vaccines within 4 weeks prior to the BNT162B2 vaccine. Relevant medical history and concomitant medications were unknown. Prior to vaccination, it was unknown if the patient was diagnosed with COVID-19. On 02May2021, at 06:00 AM, the patient experienced fever, headache, sore arm and he was very tired. No treatment was received. Post the vaccination, the patient has not been tested for COVID-19. The patient did not recover from the events at time of this report. The case was assessed as non-serious. Then, on 15May2021, at 09:45 AM, the patient received the second dose of BNT162B2 (COMIRNATY, Lot. EW0179) in the left arm, at single dose, for COVID-19 immunisation. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1367345 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-05-02
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Contusion, Hypoaesthesia, Pain in extremity, Paraesthesia, Pulse absent, SARS-CoV-2 test, Ultrasound Doppler
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ESTRADIOL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy (known_allergies: Penicillin); Sulfonamide allergy (known_allergies: sulfa)
Allergies:
Diagnostic Lab Data: Test Date: 20210506; Test Name: Nasal Swab; Test Result: Negative ; Test Name: venous and arterial ultrasounds; Result Unstructured Data: Test Result:unknown results
CDC Split Type: USPFIZER INC2021593765

Write-up: This is a spontaneous report from a contactable consumer or other non healthcare professional (HCP). The patient reported for self. A 41-years-old (non-pregnant) female patient received BNT162b2 (Formulation: Solution for injection; Lot Number and Expiration date: UNKNOWN) , via intramuscular route of administration on, Solution for injection) (reason for unknown Lot number: Unable to locate or read the details), via an unspecified route of administration on 30Apr2021 (at 41-years-old) as single dose for COVID-19 immunisation. Patient medical history included known allergies to Penicillin, Sulfa from an unknown date and unknown if ongoing. Concomitant medication (other medications the patient received within 2 weeks of vaccination) included estradiol (.025mg patch) taken for an unspecified indication, start and stop date were not reported. No other vaccine within four weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. On 02-May2021 the patient experienced Bruising of legs, calf area. Severe throbbing in both legs, numbness and tingling in both feet and toes. No distal pulse in right foot. Anxiety, due to worry of health after the vaccine. The patient had been tested for COVID-19, underwent lab tests and procedures which included Nasal Swab test (sars-cov-2 test) result was negative on 06May2021. Patient underwent venous and arterial ultrasounds of unknown results. Therapeutic measures were taken for the events occurred. Events were reported as non-serious. The outcome of the events was reported as recovered on an unspecified date. Information on the lot/batch number has been requested.


VAERS ID: 1367721 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-23
Onset:2021-05-02
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Blister, Eye disorder, Headache, Herpes zoster, Inflammation, Neuralgia, Pyrexia, Rash, Swelling
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Corneal disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril w/ HCTZ (10-12.5, 1/ day), Rosuvastatin Calcium (20, 1/day)
Current Illness: None
Preexisting Conditions: High Blood Pressure, High Cholesterol
Allergies: None
Diagnostic Lab Data: Primary Care Provider - 6 May 2021 Ophthalmologist - 7 May 2021 Ophthalmologist - 13 May 2021
CDC Split Type:

Write-up: Shingles outbreak on left side of face/ head beginning ~ 5 weeks after Janssen Covid vaccine (fever, inflammation, blisters, rash, swelling, nerve pain, headache, occular complications)


VAERS ID: 1367849 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (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: Site: Pain at Injection Site-Severe. Additional Details: Pain in arm, unable to lift arm without pain.


VAERS ID: 1368155 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-27
Onset:2021-05-02
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Other       Purchased by: ?
Symptoms: Cardiogenic shock, Lung assist device therapy, Myocarditis, Pericarditis
SMQs:, Cardiac failure (narrow), Systemic lupus erythematosus (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 21 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multi vit, iron, vit c
Current Illness: None
Preexisting Conditions:
Allergies: Carbamazepine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pericarditis; myocarditis, cardiogenic shock. Supported via ECMO and heart pumps for 1.5 weeks


VAERS ID: 1368622 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acoustic stimulation tests, Condition aggravated, Deafness bilateral, Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Visited an Audiologist on 5/25/2021 who ran some tests and confirmed that I now have hearing loss in both ears.
CDC Split Type:

Write-up: Prior to receiving the Moderna vaccine, I had an extremely mild case of tinnitus (minor ringing in my ears that would typically go away after a few minutes). Within a day of getting the vaccine the ringing in my ears is now constant, has increased several decibels and has resulted in some hearing loss.


VAERS ID: 1368896 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure increased, Ear discomfort, Headache, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow), Hearing impairment (narrow)

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

Write-up: Blood pressure spike, took a month to get back to normal with meds. Stuffy ears/constant headache/tinnitus, still on-going.


VAERS ID: 1369545 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-29
Onset:2021-05-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Menstrual disorder, Myalgia, Pain in extremity
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: Lexapro, 10 mg/ once daily Synthroid, 125 mcg / once daily Adderall, 10 mg / 1-2x daily
Current Illness:
Preexisting Conditions: Chronic allergies - going through the allergy shots since 2019
Allergies: Dust, trees, horses, cats (severe - limiting but not life threatening)
Diagnostic Lab Data: I saw a chiropractor for my leg - may be related to hip misalignment when running - not sure if its vaccine related, but timing and no other cause.
CDC Split Type:

Write-up: - Started getting my period every 2 1/2 weeks. Although I am almost 50 I have been very regular, every 29 days, up until injection. I have had 3 periods since April 29, and today is 6/2. - This may or may not be related, but i have awful muscle pain in my right leg that started 3 days after 2nd dose. It is unrelated to activity or clothing. Does not limit my activities - just a weird, dull ache in the muscle of my right quad.


VAERS ID: 1370314 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blindness unilateral, Paraesthesia, Swelling face, Vision blurred
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Lost partial vision in her left eye; Tingling on the injection site; Swelling of the face; Blurred vision; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of BLINDNESS UNILATERAL (Lost partial vision in her left eye) in a 31-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19. Concurrent medical conditions included Allergy. On 02-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-May-2021, the patient experienced PARAESTHESIA (Tingling on the injection site), SWELLING FACE (Swelling of the face) and VISION BLURRED (Blurred vision). On an unknown date, the patient experienced BLINDNESS UNILATERAL (Lost partial vision in her left eye) (seriousness criterion medically significant). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL ALLERGY [DIPHENHYDRAMINE HYDROCHLORIDE]) ongoing since an unknown date for Allergic reaction, at an unspecified dose and frequency. At the time of the report, BLINDNESS UNILATERAL (Lost partial vision in her left eye) had not resolved and PARAESTHESIA (Tingling on the injection site), SWELLING FACE (Swelling of the face) and VISION BLURRED (Blurred vision) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. Patient is immunocompromised. Based on the current available information which shows a strong temporal association between the use of mRNA-1273 and the onset of the reported events, a causal relationship cannot be excluded. Most recent FOLLOW-UP information incorporated above includes: On 31-May-2021: Follow-up received on 31-MAY-2021: New AEs were updated(Blurred vision,partial vision lost); Sender''s Comments: Based on the current available information which shows a strong temporal association between the use of mRNA-1273 and the onset of the reported events, a causal relationship cannot be excluded.


VAERS ID: 1370524 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Chest pain, Coagulation time, Computerised tomogram, Dyspnoea, Myocardial necrosis marker
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Heart attack
Allergies:
Diagnostic Lab Data: Test Name: CT scan; Result Unstructured Data: Test Result:normal; Test Name: COVID-19 test; Result Unstructured Data: Test Result:unknown; Comments: his COVID test results were lost so he never got the test results.; Test Name: cardiac enzymes; Result Unstructured Data: Test Result:normal; Test Name: blood clot test; Result Unstructured Data: Test Result:Good
CDC Split Type: USPFIZER INC2021503792

Write-up: chest pains; shortness of breath, will walk up 3 stairs and gets winded; This is a spontaneous report from a contactable consumer(patient''s wife). A 37-year-old male patient received second dose of bnt162b2(BNT162b2 PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Batch/Lot Number: EW0172), via an unspecified route of administration in right upper arm on 01May2021 at around like 11:00 or so as a single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Batch/Lot Number: UNKNOWN), Reporter stated the lot number for the first dose of the vaccine is either ER8734 or EK8734, she can''t read the person''s handwriting on the vaccine record card) via an unspecified route of administration in right upper arm on 10Apr2021 as a single dose for covid-19 immunisation. Reporter stated after the first dose of COVID 19 vaccine, her husband was pretty much out of it, like completely out of it. She was concerned and was like "are you going to wake up today?". The fatigue was very real and then his neck was super swollen on one side. and said that was the only side effects from the first one, it was nothing horrible. She confirms the fatigue was either 2 or 3 days after her husband received the first dose of the vaccine and it lasted a good 3 to 4 days where he was beyond fatigued. His neck being super swollen started pretty soon after the first dose, either the next day or 2 days later and lasted for a week or so was really sore when he touched it. The reporter stated Family Medical History Relevant to AE includes her husband mother had a heart attack in her 50s and his paternal grandpa died of hardening of arteries when he was 32 years old. On 02May2021 it was reported that patient started having chest pain really bad which it has not improved whatsoever. He was told to go to the urgent care on 03May2021 night and also reported the shortness of breath; will walk up 3 stairs and gets winded or walks across the room and his whole chest is in so much pain. The AE resulted in the visit of emergency room. The reporter reports concern and asks if she was supposed to report this to Pfizer or if any other patients have had really bad, painful chest issues. The patient underwent lab tests and procedures that included: cardiac enzymes and CT scan: normal, blood clot test: looked good and COVID-19: test results were lost on an unspecified dates. Therapeutic methods included: it was told him to just take Tylenol, 1000mg every 6 hours for a day. She clarifies her husband took Acetaminophen 1000mg, every 6 hours. The outcome of the events was not recovered. She confirms her husband''s chest pain is about the same. No further details were provided or obtained. Description of Product Complaint: Caller received his second dose of the COVID-19 Vaccine. He started having chest pain really bad which it has not improved whatsoever. He was told to go to the urgent care Monday night. At the urgent care, they ran all the tests, like typical heart attack type tests, and everything is fine. However, the pain is still the same today. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1370559 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Pain
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? Yes
Hospitalized? Yes, ? 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:
CDC Split Type: USPFIZER INC2021564084

Write-up: swollen eye; pain; This is a spontaneous report from a contactable consumer (patient). A 46-year-old male patient received BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration administered in left arm on 01May2021 12:15 (as reported) (Batch/Lot Number: ER8737) as single dose, and dose 2 via an unspecified route of administration administered in left arm on 01May2021 (as reported) (Batch/Lot Number: Ew8170) as single dose for COVID-19 immunisation. There was no other medical history, no known allergies. The patient had not had COVID prior to the vaccination. COVID was not tested post the vaccination. There was no concomitant drugs, no other vaccine in four weeks. The patient experienced swollen eye and pain on 02May2021 02:00, serious due to hospitalization. The events were treated with antibiotics and eye medication. The events were not resolved.


VAERS ID: 1371014 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster, Injection site pain, Nervous system disorder
SMQs:, Extravasation events (injections, infusions and implants) (broad), Opportunistic infections (broad)

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

Write-up: Site: Pain at Injection Site-Mild, Systemic: shingle disease-Medium, Systemic: Neurological Disorder (diagnosed by MD)-Medium, Additional Details: pt got shingle disease after moderna shot dignosed with her md


VAERS ID: 1371204 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 LA / IM

Administered by: Unknown       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives on her back


VAERS ID: 1372145 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / -

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

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

Write-up: 1205 itchiness and rash light red to arms and back. Reports allergy to shrimp. 2 nd vaccine . No SOB. BP 155/90, resp 18, Sats 98, HR 78. 1208 Educated on the side effects of Benadryl and rational verbalized understanding and to the administration. 50 mg right deltoid administered by Paramedic. 1223 rash and itchiness improved. Educated on S/S to seek immediate care for and to continue taking Benadryl 25 mg every 6 hours for the next 24 hours. Left ambulating accompanied by friend who''s driving. All information translated by portegues speaking staff.


VAERS ID: 1373715 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erectile dysfunction, Loss of libido
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OXYCODONE; TOPIRAMATE; METOCLOPRAMIDE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Chronic pain; Headache; High cholesterol
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021576232

Write-up: developed Erectile Dysfunction; lost all desire for sex; This is a spontaneous report from a contactable consumer (the patient). A 50-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EW0173) via an unspecified route of administration in right arm on 01May2021 14:45 at age of 50-year-old at single dose for COVID-19 immunisation. Medical history included high cholesterol, headaches and chronic pain. Concomitant medications received within 2 weeks of vaccination included oxycodone, topiramate and metoclopramide, all taken for an unspecified indication from an unspecified date. The patient previously took the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EP7533) in right arm on 03Apr2021 02:45 PM at age of 50-year-old for COVID-19 immunisation. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient did not diagnose with COVID-19 prior to vaccination. The patient had not been tested for COVID-19 since the vaccination. After the 2nd dose, the developed erectile dysfunction and lost all desire for sex on 02May2021. He had not been able to have sex and all desire has disappeared. The events resulted in doctor or other healthcare professional office/clinic visit. No treatment received for the events. The outcome of the events was not recovered. The case was non-serious.


VAERS ID: 1373944 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Loss of personal independence in daily activities, Neuralgia, Ultrasound scan, X-ray
SMQs:, Peripheral neuropathy (narrow), Dementia (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 0
Current Illness: 0
Preexisting Conditions: Migraines
Allergies: 0
Diagnostic Lab Data: 05/18/2021-X-ray Date? Ultra sound-on my veins-no blood clot 6/1/2021-ultrasound PT 5/27/2021,06/0102021
CDC Split Type:

Write-up: 05/02/2021..started severe nerve pain from my right shoulder down to my elbow. *My Migraines have also increased !!!!!!!! Was given Gabapentin,Tizanidine, and Prednisone. Sumatriptan Tried heating pad, ice pack, icy hot. The only way I could get comfort from this horrific pain was laying down. For 2 1/2 weeks I did nothing but lay down. By 5/31/2021 my pain has started to let up and I can go for a longer period of time without pain.


VAERS ID: 1374119 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Itch Generalized-Medium, Systemic: Allergic: Rash Generalized-Medium, Additional Details: 45 minutes after patient recieved the vaccine , she came back complaining aboout generalized mild to mederate rash and redness specially in the upper extremeties. advised patient that a call to 911 will be required and possible emergency visit. patient approved , i called 911 and while on the phone briefing the operator i was advised not to give the paient any medications or food or drinks and the emt will be on the way now


VAERS ID: 1374133 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / UNK - / -

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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I will be visiting a specialist by end of June
CDC Split Type:

Write-up: Constant ringing in one ear. It has not gone away nor improved.


VAERS ID: 1297204 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-04-21
Onset:2021-05-02
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EX3510 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Deep vein thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: DEPFIZER INC2021502557

Write-up: developed a thrombosis after the first dose of the vaccine (2-level thrombosis involving the popliteal vein); This is a spontaneous report from a contactable physician based on information received by Pfizer from BioNTech [manufacturer reference number: 49809 and 50355], license party for COMIRNATY. An 18-year-old female patient received BNT162B2 (COMIRNATY) on 21Apr2021, dose 1, as single dose for Covid-19 immunisation at the age of 18-year-old. Lot Number was EX3510. Medical history and concomitant medications were unknown. Patient was not pregnant at the time of report. It was reported that the patient had swellings on left lower leg and pain on left calf on stepping since 02May2021; 2 level thrombosis involving popliteal vein potentially (life threatening); the patient was treated for the event. The outcome of the event was unknown.; Sender''s Comments: Based on the information provided by the reporter, it appears unlikely that subject vaccine contributed to the event of deep vein thrombosis. The reported event likely represent intercurrent medical conditions. There is limited information provided in this report. This case will be reassessed upon receipt of follow-up information. Based on the information provided in the case, this individual report would not seem to modify the risk-benefit profile of the subject product.


VAERS ID: 1277426 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: West Virginia  
Vaccinated:2021-04-01
Onset:2021-05-01
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER EW0150 / 2 LA / UN

Administered by: Other       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Alanine aminotransferase, Angiogram, Aspartate aminotransferase, Blindness unilateral, Blood creatine phosphokinase, Blood glucose abnormal, Blood magnesium, Blood magnesium decreased, Blood phosphorus, Blood thyroid stimulating hormone abnormal, C-reactive protein, Chest X-ray, Computerised tomogram head, Culture urine, Differential white blood cell count, Dizziness, Echocardiogram, Electrocardiogram, Feeling hot, Full blood count abnormal, Fundoscopy, Glycosylated haemoglobin, Hypertension, Influenza A virus test, Influenza B virus test, International normalised ratio, Lipids abnormal, Liver function test, Low density lipoprotein abnormal, Magnetic resonance imaging head, Metabolic function test, Metabolic function test abnormal, Nausea, Prothrombin time, Red blood cell sedimentation rate, Respiratory syncytial virus test, SARS-CoV-2 test, Scan with contrast, Thyroxine free, Troponin I, Urine analysis abnormal, Urine protein/creatinine ratio abnormal, Vomiting
SMQs:, Acute pancreatitis (broad), Dyslipidaemia (narrow), Haematopoietic leukopenia (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Hypertension (narrow), Optic nerve disorders (broad), Retinal disorders (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Vestibular disorders (broad), Chronic kidney disease (broad), Proteinuria (narrow), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine Besylate 10 MG Asprin Chew 81 MG B12 2500 MG Celecoxib 100 MG as needed Centrum Silver DHEA Tablet ? 50 MG Janumet 50-1000 QTY 2 Levalbuterol tartrate HFA Inhalation Aerosol 45 mcg/actation Levothyroxin Sodium 50 MGC Lisonopril 4
Current Illness:
Preexisting Conditions: Asthma, Diabetes, High blood pressure, high cholesterol, Stage 3 kidney failure
Allergies: Penicillin, Amoxycillin, Erythromycin
Diagnostic Lab Data: Test ResultsPrint this page in a printer-friendly format While Medicine providers check results frequently, please understand that in some instances you may see results prior to review by your provider. If you have any concerns regarding test results, please contact your provider. Search this list Search this list Show hospital results Test Ordered By Date The result is abnormalLab PROTEIN/CREATININE RATIO, URINE, RANDOM Apr 22, 2021 The result is abnormalLab BASIC METABOLIC PANEL Apr 22, 2021 Lab TROPONIN-I (FOR ED ONLY) Apr 22, 2021 The result is abnormalLab CBC WITH DIFF Apr 22, 2021 Imaging ECG 12-LEAD Apr 22, 2021 The result is abnormalLab POC GLUCOSE Apr 17, 2021 Lab POC GLUCOSE Apr 17, 2021 The result is abnormalLab POC GLUCOSE Apr 16, 2021 The result is abnormalLab POC GLUCOSE Apr 16, 2021 The result is abnormalLab POC GLUCOSE Apr 16, 2021 The result is abnormalLab POC GLUCOSE Apr 16, 2021 The result is abnormalLab BASIC METABOLIC PANEL Apr 16, 2021 Lab MAGNESIUM Apr 16, 2021 Lab PHOSPHORUS Apr 16, 2021 The result is abnormalLab CBC WITH DIFF Apr 16, 2021 Lab POC GLUCOSE Apr 16, 2021 Lab TROPONIN-I Apr 16, 2021 Lab C-REACTIVE PROTEIN(CRP),INFLAMMATION Apr 16, 2021 Lab COVID-19, FLU A/B, RSV RAPID BY PCR Apr 15, 2021 Imaging XR CHEST AP MOBILE Apr 15, 2021 The result is abnormalLab URINALYSIS, MACROSCOPIC Apr 15, 2021 Lab URINALYSIS, MICROSCOPIC Apr 15, 2021 Lab URINE CULTURE Apr 15, 2021 Imaging ECG 12-LEAD Apr 15, 2021 The result is abnormalLab BASIC METABOLIC PANEL Apr 15, 2021 Lab TROPONIN-I (FOR ED ONLY) Apr 15, 2021 Lab PT/INR Apr 15, 2021 Lab PTT (PARTIAL THROMBOPLASTIN TIME) Apr 15, 2021 Lab CBC WITH DIFF Apr 15, 2021 The result is abnormalLab POC GLUCOSE Apr 14, 2021 The result is abnormalLab POC GLUCOSE Apr 14, 2021 Imaging TRANSESOPHAGEAL ECHOCARDIOGRAM - ADULT Apr 14, 2021 The result is abnormalLab POC GLUCOSE Apr 14, 2021 The result is abnormalLab BASIC METABOLIC PANEL Apr 14, 2021 Lab MAGNESIUM Apr 14, 2021 Lab PHOSPHORUS Apr 14, 2021 The result is abnormalLab CBC WITH DIFF Apr 14, 2021 The result is abnormalLab POC GLUCOSE Apr 13, 2021 The result is abnormalLab POC GLUCOSE Apr 13, 2021 Imaging OPH PHOTOGRAPHY FUNDUS PHOTOS,OPHTHALMOSCOPY W/FUNDUS PHOTOS (AMB) Apr 13, 2021 The result is abnormalLab POC GLUCOSE Apr 13, 2021 Imaging TRANSTHORACIC ECHOCARDIOGRAM - W/SHUNT STUDY - ADULT - Apr 13, 2021 The result is abnormalLab POC GLUCOSE Apr 13, 2021 Imaging MRI ORBITS W/WO CONTRAST Apr 13, 2021 Imaging MRI BRAIN W/WO CONTRAST Apr 13, 2021 The result is abnormalLab LIPID PANEL Apr 13, 2021 Lab COVID-19 WVUH MOLECULAR LAB TESTING Apr 13, 2021 The result is abnormalLab LDL CHOLESTEROL, DIRECT Apr 13, 2021 Imaging CT Angio Carotid-Extracranial (Neck) Apr 13, 2021 The result is abnormalLab BASIC METABOLIC PANEL Apr 13, 2021 Lab SEDIMENTATION RATE Apr 13, 2021 Lab C-REACTIVE PROTEIN(CRP),INFLAMMATION Apr 13, 2021 The result is abnormalLab HGA1C (HEMOGLOBIN A1C WITH EST AVG GLUCOSE) Apr 13, 2021 Lab PT/INR Apr 13, 2021 Lab PTT (PARTIAL THROMBOPLASTIN TIME) Apr 13, 2021 The result is abnormalLab CBC WITH DIFF Apr 13, 2021 Lab AST (SGOT) Apr 13, 2021 Lab ALT (SGPT) Apr 13, 2021 Lab CREATINE KINASE (CK), TOTAL, SERUM Apr 13, 2021 The result is abnormalLab THYROID STIMULATING HORMONE WITH FREE T4 REFLEX Apr 13, 2021 Lab THYROXINE, FREE (FREE T4) Apr 13, 2021 Lab TROPONIN-I Apr 12, 2021 Lab PT/INR Apr 12, 2021 The result is abnormalLab BASIC METABOLIC PANEL Apr 12, 2021 Lab C-REACTIVE PROTEIN(CRP),INFLAMMATION Apr 12, 2021 Lab SEDIMENTATION RATE Apr 12, 2021 The result is abnormalLab CBC WITH DIFF Apr 12, 2021 Imaging CT Brain Apr 12, 2021 Imaging ECG UHC - ADULT Apr 12, 2021 Lab COVID-19 WVUH MOLECULAR LAB TESTING Apr 8, 2021 Imaging CT Angio Intracranial (Brain) Apr 8, 2021 Lab LAVENDER TOP TUBE Apr 8, 2021 The result is abnormalLab BASIC METABOLIC PANEL Apr 8, 2021 Lab PT/INR Apr 8, 2021 Lab PTT (PARTIAL THROMBOPLASTIN TIME) Apr 8, 2021 Lab TROPONIN-I (FOR ED ONLY) Apr 8, 2021 The result is abnormalLab CBC WITH DIFF Apr 8, 2021 Lab MAGNESIUM Apr 8, 2021 Lab PHOSPHORUS Apr 8, 2021 Imaging ECG 12 LEAD Apr 8, 2021 The result is abnormalLab POC GLUCOSE Provider Unknown Apr 6, 2021 Imaging CT Brain Apr 6, 2021 Imaging XR CHEST AP AND LATERAL Apr 6, 2021 The result is abnormalLab BASIC METABOLIC PANEL Apr 6, 2021 Lab HEPATIC FUNCTION PANEL Apr 6, 2021 The result is abnormalLab MAGNESIUM Apr 6, 2021 Lab PT/INR Apr 6, 2021 Lab PTT (PARTIAL THROMBOPLASTIN TIME) Apr 6, 2021 Lab TROPONIN-I (FOR ED ONLY) Apr 6, 2021 The result is abnormalLab CBC WITH DIFF Apr 6, 2021 Imaging ECG 12 LEAD Apr 6, 2021 The result is abnormalLab
CDC Split Type:

Write-up: April 1 - Severe Dizziness. Hot, Nausea. Had several dizzy spells in subsequent days, some with vomiting. April 6 - ER Visit - Dizziness. They cited low magnesium and gave me that via IV. April 8 - ER Visit - High Blood Pressure. April 11 - Lost eyesight, left eye April 12 - Admitted to hospital


VAERS ID: 1277564 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 2 UN / IM

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

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

Write-up: Patient received second dose of Moderna vaccine although underage per guidance of DOH. Accompanied by father.


VAERS ID: 1277655 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood glucose normal, Dizziness, Fall, Hyperhidrosis, Loss of consciousness, Nausea, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pt is prescribed and taking dextroamp-amphet er 20MG for ADHD, PT did not take it this am. Last taken was yesterday before school.
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: PT vitals immediately after as follows; Pulse 90, SP02 78, BP108/68. PT vitals at 10:45 am as follows; Pulse 99, SP02 98, BP 120/86. PT vitals at 10:55 am; Blood Glucose 88.
CDC Split Type:

Write-up: After waiting in the waiting area for about 10 minutes the PT said he felt light headed and passed out falling to the floor. Mom was at his side and stated that he went to ''dead weight'' and then she lowered him to the floor as best as she could. Mom said that she started ''shaking'' and then stopped after about 15 seconds. After PT was stood up he felt like he was going to vomit but he did not. PT was extremely diaphoretic.


VAERS ID: 1277722 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: 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: none
CDC Split Type:

Write-up: Pt was leaving vaccination area when she passed out. She described it like she was listening to music and woke up with her mom over top of her. Patient has a history of fainting when seing needle. Ate water and crackers; color improved - released with mom


VAERS ID: 1277726 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose normal, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE REPORTED
Diagnostic Lab Data: EMT RESPONDED AND DID BS/BP...NORMAL VALUES
CDC Split Type:

Write-up: SYNCOPE WHILE UNDER SUPERVISION


VAERS ID: 1277747 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-29
Onset:2021-05-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Hyperhidrosis, Skin discolouration, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (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: None
Current Illness:
Preexisting Conditions:
Allergies: Allergic to white potato
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fainted 48 hours after shot, sweats, slumped over. Luckily I was there to catch her. Complete loss of color. Came on very suddenly. Could have been catastrophic if she was driving.


VAERS ID: 1277751 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated she felt light headed and dizzy. She put her head down on the table and was sweating. She did not lose consciousness. She was able to respond to questions. She refused the offer of an epi pen or call to 911. She did not want to have someone called to pick her up. I gave her a bottle of water and M&M''s. when the dizziness passed, she ate the M&M''s, had some water. She started to fell better after about 6 minutes. I stayed with her until she able to leave on her own.


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