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

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



Case Details (Reverse Sorted by Onset Date)

This is page 186 out of 6,611

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VAERS ID: 1519975 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-11
Onset:2021-07-28
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Anosmia, Cough, Fatigue, Headache, Oropharyngeal pain, Pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes, Hypertension
Allergies:
Diagnostic Lab Data: Covid 19 viral testing antigen
CDC Split Type:

Write-up: Fever 100.9, body aches, headache, runny nose, sore throat, fatigue, no taste or smell, cough symptom onset 07/28/2021


VAERS ID: 1520027 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-21
Onset:2021-07-28
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Chest discomfort, Cough, Headache, Pyrexia, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

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

Write-up: MOTHER STATED THAT STARTING 7/28/21 SHE HAD A COUGH, HEADACHE AND FEVER OF 101 DEGREES.SHE HAD TIGHTNESS IN THE CHEST. SHE WAS TAKEN TO URGENT CARE AND HAD CHEST XRAYS TAKEN. PA THOUGHT SHE HAD COVID-19 BASED ON HER PRESENTATION. NO RESULTS HAVE BEEN GIVEN FOR COVID TEST AS OF YET


VAERS ID: 1520141 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-22
Onset:2021-07-28
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 103L20A / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Antigen test
CDC Split Type:

Write-up: Covid-19


VAERS ID: 1520181 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-02-16
Onset:2021-07-28
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 2 LA / IM

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

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

Write-up: Patient admitted to hospital on 7/31/2021, with symptom onset beginning on or about 7/28/2021. Hx of chronic hypoxic respiratory failure due to COPD from a long smoking history.


VAERS ID: 1520473 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Observed in ED for about 4 hours. Felt much better. No new issues during ED visit. Discharged home. Impression: Vasovagal episode after vaccination.
CDC Split Type:

Write-up: Within 5 minutes of getting the vaccine patient stated he was starting to feel like he had after the first vaccine. Patient was laid supine. Feet elevated, water provided. Patient was pale and mildly diaphoretic. HR was 40 by O2 monitor. O2 applied at 2 L for comfort. MD notified and evaluated patient. MD recommended ER evaluation/observation. 911 was called and the patient was transferred to the ER by EMS personnel. The patient was monitored continuously prior to transfer.


VAERS ID: 1520734 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthritis, Bone pain, Chills, Condition aggravated, Dizziness, Dysgeusia, Fatigue, Headache, Heart rate increased, Hyperhidrosis, Malaise, Myalgia, Pain, Pallor, Pyrexia, Swelling of eyelid, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Periorbital and eyelid disorders (narrow), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, vitamin D, magnesium, zinc, beet root capsules
Current Illness: No.
Preexisting Conditions: Rheumatoid arthritis
Allergies: Sea food, coconuts, latex, enbrel, methotrexate
Diagnostic Lab Data:
CDC Split Type:

Write-up: Had metallic taste in mouth five minutes after shot that lasted two days. Some dizziness about thirty minutes after shot that started getting better on 7-3172021. Severe fatigue from 7-28 to 7-31 with moderate ongoing. Vomited for about two hours on 7-28-21 from 2000 to 2200. Fever, chills and muscle and bone aches from 7-28-2021 2300 to 7-31-2021 1600. Severe sweating from 7-28 to 8-1-2021. Lid over eight eye was mildly swollen from 7-29 to 8-1. Severe headache 7-28 at 1900 to 8-2-21. Increases heart rate at times. Probably due to being so sick. I took ibuprofen and Tylenol on 7-29-2021 at 1230 am due to the pain. This reaction also flared up my arthritis from 7-29-2021 to now (8-3-2021) still fatigued and a bit pale.


VAERS ID: 1520751 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Private       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: none kown
Current Illness: none kown
Preexisting Conditions: none kown
Allergies: none kown
Diagnostic Lab Data: none indicated
CDC Split Type:

Write-up: Vaccine Administered at 3:27 PM. After 15 minute obersation patient stated she was feeling tingling sensation on Left Arm. FNP assessed patient and per provider observe patient for additional questions. After (15) minute observation took vitals 3:59 PM Spo2: 89 % Pulse : 71 BP: 94/62 mmg. Per patient symptons were relieved after observation, Notified provider and was release home. Advised is symptoms persist she may contact Per PCP or our office. Or she may go to nearestest emergency room if symptons worsen or other symptoms develop. patient verbalized understanding and agreed


VAERS ID: 1520963 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Vaccine Administered on 07/28/2021 at 1:39 PM. At 1:53 PM patient began experimenting nausea and vomitting . Patient was assesed by Dr. Vitals were taken: Pulse: 86 Spo2: 96% BP: 86/64 mmhg. Per Dr. ordered to provide patient with Zofran to alleviate Nausea vaccines, but patient deferred medication. Per Dr. provided hydration and observe patient for additional (15) minutes. After 15 minute observation Vitals taken 2:10 PM: Pulse: 81 Sp2: 97% BP: 90/64mmhg. Per patient symptons were relieved and per Dr. okay to release home. patient notified if symptoms worsen may go to emergency room.


VAERS ID: 1521191 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: No adverse effects reported. Patient''s age does not match indication of vaccine. Mother was made aware.


VAERS ID: 1521907 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-28
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: USJNJFOC20210764333

Write-up: BURNING PAIN IN THE CHEST AREA; HEADACHE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unk) dose was not reported, administered on 28-JUL-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced burning pain in the chest area, and headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the burning pain in the chest area and headache was not reported. This report was non-serious.


VAERS ID: 1521916 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-28
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Diplopia, Dizziness, Headache, Herpes zoster, Pain
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Ocular motility disorders (broad), Hypoglycaemia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Autoimmune disorder (Patient have autoimmune problems)
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210800741

Write-up: SHINGLES ON STOMACH; DIZZY; DOUBLE VISION; VERY WEAK; MILD HEADACHE; PAINFUL SHOT; This spontaneous report received from a patient concerned a 79 year old of unspecified sex. The patient''s height, and weight were not reported. The patient''s concurrent conditions included autoimmune disease. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 28-JUL-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 28-JUL-2021, the subject experienced painful shot. On 29-JUL-2021, the subject experienced shingles on stomach. On 29-JUL-2021, the subject experienced dizzy. On 29-JUL-2021, the subject experienced double vision. On 29-JUL-2021, the subject experienced very weak. On 29-JUL-2021, the subject experienced mild headache. Treatment medications (dates unspecified) included: naproxen sodium. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the shingles on stomach, very weak, dizzy, double vision, mild headache and painful shot was not reported. This report was non-serious.


VAERS ID: 1521920 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: South Carolina  
Vaccinated:0000-00-00
Onset:2021-07-28
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210800946

Write-up: POTENTIALLY EXPIRED VACCINE ADMINISTERED; This spontaneous report received from a physician concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: not reported) dose was not reported, administered on 28-JUL-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 28-JUL-2021, the subject experienced potentially expired vaccine administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of potentially expired vaccine administered was not reported. This report was non-serious.


VAERS ID: 1521931 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-07-28
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Non-smoker
Preexisting Conditions: Comments: The patient had No known allergies no medical history. The patient did not have any history of drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210801358

Write-up: ADMINISTERED VACCINE TO PATIENT BY 9 MINUTES (VIAL PUNCTURED AT 8:33 AM SYRINGE WAS DRAWN UP AND IMMUNIZATION WAS GIVEN 2:42 PM); This spontaneous report received from a health care professional concerned a 35 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non smoker, and other pre-existing medical conditions included the patient had no known allergies no medical history. the patient did not have any history of drug abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1820095, and expiry: 18-AUG-2021) dose was not reported, administered on 28-JUL-2021 14:42 for prophylactic vaccination. No concomitant medications were reported. On 28-JUL-2021, the subject experienced administered vaccine to subject by 9 minutes (vial punctured at 8:33 am syringe was drawn up and immunization was given 2:42 pm). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of administered vaccine to patient by 9 minutes (vial punctured at 8:33 am syringe was drawn up and immunization was given 2:42 pm) was not reported. This report was non-serious.


VAERS ID: 1522033 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-01
Onset:2021-07-28
   Days after vaccination:118
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737OR ER8037 / 1 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: IBUPROFEN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210728; Test Name: COVID-19; Test Result: Positive ; Comments: Rapid test
CDC Split Type: USPFIZER INC202100966628

Write-up: Received both doses Pfizer Covid Vaccine beginning 01Apr2021 and second dose was received three weeks later and just tested positive for Covid; Received both doses Pfizer Covid Vaccine beginning 01Apr2021 and second dose was received three weeks later and just tested positive for Covid; Quite a bit of fever; Headache is mild; This is a spontaneous report from a contactable consumer (patient). A male patient of 64-year-old received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was ER8737or ER8037), first dose on Right shoulder via an unspecified route of administration on 01Apr2021 (Age at vaccination 64-year-old) as dose 1 single for COVID-19 immunization and patient received second dose also for bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was ER8729), on Right shoulder via an unspecified route of administration on 22Apr2021 for COVID-19 immunization. No medical history reported. Concomitant medications include Ibuprofen 200mg (Just prior to Covid vaccine). Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. After Receiving both doses Pfizer Covid Vaccine patient tested positive for Covid on 28Jul2021. Patient also experienced fever and mild headache. Patient underwent lab test and procedures SARS-CoV-2 test was positive on 28Jul2021. QA Review & Rationale:The complaint and its classification have been reviewed. No immediate containment action is required. The complaint, its priority, and its classification have been reviewed and determined to be appropriate. A full investigation will be performed. This is a complaint for lack of effect of lot ER8729 of the PFIZER-BIONTECH COVID-19 VACCINE INJECTABLE. The initial scope of this investigation is limited to the reported finished goods lot ER8729, fill lot EP8681, and the bulk formulated drug product lot EP8568. The investigation will include a review of the returned complaint sample (if received) and reserve samples, if necessary. Summary of Investigation: The initial scope of the investigation was limited to the reported finished goods lot ER8729, fill lot EP8681, and the bulk formulated drug product lot EP8568. Based on the results of the investigation, the scope was not expanded. Manufacturing and packaging batch records were examined for the reported complaint lot.Pfizer withheld QO did not receive photographs or a complaint sample for examination. The complaint was not confirmed. No probable root cause for the complaint related to the manufacturing process of the reported lot was identified. There were no corrective or preventative actions taken as a result of this complaint investigation. No related quality issues were identified during the investigation. There were no planned or unplanned deviations recorded during the manufacture of the complaint lot and associated manufacturing lots that may have caused a complaint of this nature. A review of the manufacturing records confirmed processing steps were performed within pre-established parameters. All raw materials and amounts used in the manufacture of the batch were of the correct weight and identity. The drug product is stored at controlled refrigeration throughout the manufacturing process and a log is maintained documenting the elapsed time out of refrigeration. A review of the logs confirmed that all times were within allowable limits. The product also requires storage in ultra-low temperature freezers following the packaging of the product. A review of the freezer temperature log for the reported batch confirmed that all freezer temperatures were within allowable limits. The results of all analytical tests performed at the time of lot release confirmed that the batch meets potency specifications. There is no impact to the quality of the lot. It is unknown how the product was handled, stored, or administered after it left the origin site.Root Cause Analysis/Identify: Pfizer withheld Quality Operations could not indicate a probable root cause for the complaint to be related to the production process of the involved batch. Review of the manufacturing and packaging batch records and release test results confirmed that the batch meets potency specifications. It is unknown how the product was handled, stored, or administered after it left the Pfizer withheld site. Impact Analysis: Based on the final scope of the investigation, which was limited to the reported finished goods lot and associated fill and formulated drug product lots, and that a root cause related to the production process was not identified, the reported issue is not representative of the lot and does not indicate a negative impact on product quality. No regulatory notification is required. Corrective / Preventive Action: There were no corrective actions as a result of this complaint investigation. The results of all tests, inspections, and in-process controls have been reviewed and all results met the established requirements prior to the release of the reported batch for distribution. Conclusion: The complaint for lack of effect of the PFIZER-BIONTECH COVID-19 VACCINE INJECTABLE lot ER8729 was investigated. The investigation included reviewing manufacturing and packaging batch records, deviation investigations, analytical release test results, and an analysis of complaint history for the reported lot. The final scope was determined to be the reported finished goods lot ER8729, fill lot EP8681, and the formulated drug product lot EP8568. A complaint sample was not returned. No related quality issues were identified during the investigation. There is no impact on product quality. No root cause or CAPA were identified as the complaint was not confirmed. All release testing performed prior to the release of the reported batch was within specifications. The outcome of Events was unknown. The lot number for the vaccine was not provided and will be requested during follow up.


VAERS ID: 1522316 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injected limb mobility decreased, Injection site hypersensitivity, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), 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: Advil before vaccine
Current Illness: None
Preexisting Conditions: Migraines, IBS
Allergies: Lactose intolerance
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pain, sensitivity, and heat where vaccine wad injected. Major pain in the muscle the following days, pain is in the muscle and spreading over my shoulder, the same amount of pain as if I pulled muscles or pinched a nerve, I cannot use my right arm.


VAERS ID: 1522430 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-28
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210728; Test Name: COVID-19 virus test; Result Unstructured Data: positive
CDC Split Type: USJNJFOC20210800788

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID 19 INFECTION; This spontaneous report received from a parent via a company representative concerned a 27year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029, expiry: UNKNOWN) dose was not reported, 1 total, administered on 11-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 26-JUL-2021 (Monday), the patient experienced sore throat, body aches with no fever. It was reported that the patient had over the counter medication, but he still felt ill. On 28-JUL-2021 (Wednesday), the patient tested positive for covid-19 infection (suspected covid-19 infection and suspected clinical vaccination failure). Laboratory data included: COVID-19 virus test (NR: not provided) positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the suspected covid-19 infection and suspected clinical vaccination failure was not reported This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000187932.; Sender''s Comments: V0: 20210800788-Covid-19 vaccine ad26.cov2.s-Suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1522701 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-20
Onset:2021-07-28
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3150 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Hypoaesthesia oral, Lip swelling, Paraesthesia oral, Peripheral swelling, Scan normal, Skin swelling, Swelling face, Swelling of eyelid
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Toprol XL, Apriso, Loratidine
Current Illness: N/A
Preexisting Conditions: Chronic fatigue syndrome, ulcerative colitis, asthma
Allergies: Sulfa, Keflex
Diagnostic Lab Data: Benadryl 50mg relieved symptoms. Admitted to hospital to rule out stroke. All scans negative. Steroids given.
CDC Split Type:

Write-up: 8:00- Left arm became numb up to upper deltoid. 12:00- progressed to left shoulder. 14:00- face numb. . Nose, mouth and lips numb. 15:00- Tongue tingling. 21:00- Eye lids, lips, and left side of face swelled. Fingers puffy.


VAERS ID: 1522708 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-27
Onset:2021-07-28
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 12M20A / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Covid positive, sore throat, headache, cough


VAERS ID: 1522724 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-07-23
Onset:2021-07-28
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, Sulcrate, Nexium, Wellbutrin
Current Illness: none divulged
Preexisting Conditions: GERD, ADHD, Depression
Allergies: Lortab, Robaxin
Diagnostic Lab Data: none performed
CDC Split Type:

Write-up: Pt presented to clinic on 07/30/2021 with c/o left arm redness, swelling, and itchiness after receiving her first Moderna COVID vaccine on 07/23/21 at Pharmacy. She states she noticed some pain the first day after vaccine. She then noticed on 07/28/21 having some redness forming, and this morning woke up and it was larger than the last two days. She wanted me to see it because she is concerned. She has been using ice, and hydrocortisone cream to the area. I informed her this was known on CDC site as "COVID arm" and to treat with hydrocortisone cream, benadryl, and ice affected area. Monitor for worsening symptoms. I talked to her again on 08/02/21 over the phone. She stated the day after seeing me it became more swollen, hot, and red and estimates it was the size of a softball. She stated it has since decreased in size significantly.


VAERS ID: 1522731 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-17
Onset:2021-07-28
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 2 LA / 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine, Anastrozole, Aspirin, Calcium, Vit D, Cinnamon Supplement, Empagliflozin, Glucosamine/Chondroitin, Lantus, Losartan, Omega 3, Tadalafil, Testosterone inj, Turmeric Supplement,
Current Illness:
Preexisting Conditions: DM, HLD, HTN, Low Testosterone, OSA, Arthritis
Allergies: Promethazine
Diagnostic Lab Data: SARS-COV-2 Rapid Results Molecular NAAT Test Positive (A)
CDC Split Type:

Write-up: Patient became COVID (+) on 7/28/21 and required hospitalization on 8/2/21. Patient is requiring oxygen, dexamethasone and remdesivir


VAERS ID: 1522772 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2020-12-19
Onset:2021-07-28
   Days after vaccination:221
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Fatigue, Myalgia, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 RNA increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: NONE
Current Illness:
Preexisting Conditions: Endocrine/Metabolic Pre-diabetes
Allergies: NKA
Diagnostic Lab Data: 07/29/21 1649 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 07/29/21 1041 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: Fever or Chills Cough Fatigue Muscle or body aches Sore throat Congestion or running nose


VAERS ID: 1522819 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-19
Onset:2021-07-28
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Bell's palsy, Facial paralysis
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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: multivitamin, glucosamine, fish oil, and other medications for anxiety, depression,
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: it was concluded that i suffer from BELLS, PALSY.
CDC Split Type:

Write-up: 7 days after receiving the COVID 19 Pfizer shot, I develop Bells Palsy. I didn''t have any issues prior to the shot. Now my left side of my face is paralyze.


VAERS ID: 1522823 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-24
Onset:2021-07-28
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Bladder pain, Condition aggravated, Cystitis interstitial, Fatigue, Headache, Injection site pain, Pain, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (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? No
Previous Vaccinations:
Other Medications: Tramadil, Oxybutin, Ambien, blood pressure medication, estradiol, vitamin d, vitamin b, tynol
Current Illness:
Preexisting Conditions: Interstitial Cystitis, high blood pressure, asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day 1 symptoms major arm pain tiredness Day 2 symptoms major arm pain at injection site, headache, body aches and extreme tiredness Day 5 symptoms flare up of bladder pain and back pain from Interstitial Cystitis I am on Day 11 after first injection and still experiencing bladder issues


VAERS ID: 1522853 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-18
Onset:2021-07-28
   Days after vaccination:132
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Malaise, 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? 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: Coronavirus 2 PCR Detect, V symptomatic POSITIVE
CDC Split Type:

Write-up: reports symptoms starting on 7/28/2021


VAERS ID: 1522861 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-01-15
Onset:2021-07-28
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea paroxysmal nocturnal, Facial pain, Lacrimation increased, Nasal congestion, Non-tobacco user, Paranasal sinus discomfort, Rhinorrhoea, SARS-CoV-2 test positive, Sinus disorder, Sinus pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Pulmonary hypertension (broad), Glaucoma (broad), Lacrimal disorders (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: albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler ALPRAZolam (XANAX) 0.5 mg tablet amoxicillin-pot clavulanate (AUGMENTIN) 875-125 mg per tablet BYSTOLIC 5 mg tablet desvenlafaxine (PRISTIQ) 100 mg 24 hr tablet diphenoxylate-atrop
Current Illness:
Preexisting Conditions: Nervous Right lower quadrant abdominal pain Endocrine/Metabolic Lactic acidosis Hematologic Leukocytosis Other S/P colonoscopic polypectomy Anxiety
Allergies: Contrast [Iodinated Contrast Media]Rash
Diagnostic Lab Data: 07/31/21 1244 POCT COVID-19 PCR Collected: 07/31/21 1243 | Final result | Specimen: Swab from Nares POC COVID-19 PCR DetectedAbnormal Lot # 1000271669 Point of Care COVID-19 PCR Testing Method Cepheid Lot Expiration Date 06/05/2022
CDC Split Type:

Write-up: Chief Complaint Patient presents with ? Cough ? Sinus Problem facial pain, PND, sneezing, watery eyes x 3 days. OTC Tylenol and Benadryl. HPI Patient is a 61 y.o. M presenting today for evaluation of sinus symptoms x 3-4 days. He states that he is having nasal congestion, sinus pain/pressure, rhinorrhea, cough, watery eyes. No fevers, V/D, ear pain, sore throat. He has been taking Tylenol and benadryl. No sick contacts. No hx of COVID-19, but he is fully vaccinated. No hx of asthma or COPD. Nonsmoker.


VAERS ID: 1522889 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-03-19
Onset:2021-07-28
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Coronavirus 2 PCR Detect, V symptomatic POSITIVE
CDC Split Type:

Write-up: 7/28/2021 symptoms started: cough & nasal congestion


VAERS ID: 1522912 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / -

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia oral, Paraesthesia, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: tingling and mild headache after 1st pfizer dose
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had an allergic reaction after receiving the Pfizer COVID-19 vaccine. Reaction included lip and tongue numbness and tingling and feeling that her throat was closing up. Patient was take to the ED for further evaluation


VAERS ID: 1522935 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-25
Onset:2021-07-28
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal distension, Abdominal pain upper, Anxiety, Arthralgia, Asthenia, Diarrhoea, Fatigue, Flushing, Migraine, Myalgia, Nausea, Orthostatic intolerance, Panic attack, Vaccination site pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3, Vit C, Boswellia, THC 2mg:CBD 2mg capsule, homeopathic thuja, homeopathic oscillococcinum, probiotic, multivitamin, andrographis tincture, finished a course of amoxicillin for a sinus infection the day after the vaccine. Finish
Current Illness: Sinus infection (tested COVID negative)
Preexisting Conditions: Ehlers Danlos syndrome, dysautonomia, irritable bowel syndrome, fibromyalgia, suspected mast cell activation syndrome
Allergies: no known
Diagnostic Lab Data: Blood pressure/heart rates were normal after vaccine. No other tests were done
CDC Split Type:

Write-up: Immediately following the vaccine I had a panic attack-like response with a whole-body flush, anxious feelings, weakness and orthostatic intolerance (typical for me). Later that day and the next day I had vaccine-site soreness. 3 days later (Wednesday 7/28) I woke up with severe epigastric pain, nausea, bloating, and intermittent diarrhea that very slowly improved over the course of 5 days, but nausea has been waxing and waning. One 7/29, I had a migraine. On Sat 7/31, I started to feel pain in the muscles around both of my hips, but it progressed to 9/10 muscle pain that night to the point that lying on soft surfaces was extremely painful and I couldn''t sleep. Pain waxed and waned on 8/1-2 but seems to be gone as of today (8/3). Nausea is still waxing and waning. I also had extreme fatigue on 8/1 and 8/2


VAERS ID: 1522974 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-27
Onset:2021-07-28
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Ear pain, Fatigue, Headache, Oropharyngeal pain, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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: amLODIPine (NORVASC) 5 mg tablet amoxicillin (AMOXIL) 875 mg tablet anastrozole (ARIMIDEX) 1 mg chemo tablet aspirin 81 mg tablet blood sugar diagnostic (glucose blood) strip blood-glucose meter kit cholecalciferol, vitamin D3, (VITAMIN D3)
Current Illness:
Preexisting Conditions: Respiratory Incidental lung nodule Circulatory Benign essential hypertension Digestive Lesion of liver Liver cyst Musculoskeletal Degeneration of intervertebral disc Endocrine/Metabolic Uncontrolled type 2 diabetes mellitus with hyperglycemia Pure hypercholesterolemia Other Healthcare maintenance Encounter for screening mammogram for malignant neoplasm of breast Screening for colon cancer Abnormal CT of the abdomen Malignant neoplasm of upper-outer quadrant of left breast in female, estrogen receptor positive
Allergies: NKA
Diagnostic Lab Data: 07/30/21 1629 POCT COVID-19 PCR Collected: 07/30/21 1629 | Final result | Specimen: Swab from Nares POC COVID-19 PCR DetectedAbnormal Lot # 1000271669 Point of Care COVID-19 PCR Testing Method Cepheid Lot Expiration Date 6/5/22
CDC Split Type:

Write-up: Patient presents with ? Sore Throat x 2 days ? Earache right ? Headache ? Fatigue ? Cough


VAERS ID: 1523049 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-20
Onset:2021-07-28
   Days after vaccination:99
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cholecystectomy, Cholelithiasis, Ultrasound biliary tract
SMQs:, Gallbladder related disorders (narrow), Gallstone related 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamictal, Wellbutrin, Lexapro, and birth control
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ultrasound 8/2/2021
CDC Split Type:

Write-up: Gallstones requiring removal of Gallbladder


VAERS ID: 1523060 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-08
Onset:2021-07-28
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adenovirus test, Bordetella test negative, COVID-19, Chest X-ray normal, Chlamydia test negative, Coronavirus test negative, Cough, Enterovirus test negative, Human rhinovirus test, Influenza A virus test negative, Influenza B virus test, Mycoplasma test negative, Pyelonephritis, Pyrexia, Respiratory syncytial virus test negative, Respirovirus test, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler atorvastatin (LIPITOR) 20 mg tablet BD ULTRA-FINE MINI PEN NEEDLE 31 gauge x 3/16" needle blood sugar diagnostic (ONETOUCH ULTRA BLUE TEST STRIP) strip blood-glucose meter (ONETOUC
Current Illness:
Preexisting Conditions: Genitourinary Acute kidney injury (CMS/HCC) Pyelonephritis Infectious/Inflammatory COVID-19 virus infection
Allergies: NKA
Diagnostic Lab Data: 07/28/21 1104 Respiratory virus detection panel Collected: 07/28/21 0934 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Det Hospital Problems POA * (Principal) Pyelonephritis Yes COVID-19 virus infection Unknown X-ray chest 1 view - Portable [3294919030] Resulted: 07/28/21 1747 Order Status: Completed Updated: 07/28/21 1747 Narrative: XR CHEST 1 VW PORT IMPRESSION: No significant findings. END OF IMPRESSION: INDICATION: cough, fever cough, fever.Rule out SARS-CoV-2( related to COVID-19) contact, Droplet isolation. TECHNIQUE: Portable AP view of the chest was obtained.
CDC Split Type:

Write-up: ED to Hosp-Admission Discharged 7/28/2021 - 7/31/2021 (3 days)


VAERS ID: 1523114 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-01-07
Onset:2021-07-28
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 2 - / -

Administered by: Private       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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: tylenol
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: PCR COVID-19 test confirmation
CDC Split Type:

Write-up: Patient contracted COVID despite COVID vaccination.


VAERS ID: 1523124 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Aphasia, Dizziness, Dyspnoea, Fatigue, Feeling abnormal, Movement disorder, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: After the first dose of Pfizer on March 16, 2021 I had hives that started 4 hours after, and I had an anaphylactic attack the ne
Other Medications: Singulair Aimovig Autoinjector Epipen Nucynta Famotidine Protonix Ketotifen Zonisamide Phenergan Hydroxyzine Amitriptyline Cromolyn Oral Gabapentin Benadryl IV Benadryl Tablets D3 Clonidine Corlanor Linzess Xolair Jardiance Benadryl IM Tres
Current Illness:
Preexisting Conditions: Mast Cell Activation Disorder, Hereditary Alpha Tryptasemia, Type 2 Diabetes, Chronic Hives, POTS, Fibromyalgia, Small Fiber Neuropathy
Allergies: Aspirin Codeine Morphine Penicillin Oxycodone Hcl Shellfish Celecoxib Prevnar (Pf) Adhesive Hydrocodone Nickel
Diagnostic Lab Data: No tests were done. The ER doctor thought my mast cell disease was what caused the reaction.
CDC Split Type:

Write-up: I gave myself a 50mg IM shot of Benadryl 30 minutes before getting the vaccine. About 20 minutes after receiving the vaccine I suddenly felt lightheaded and collapsed over my walker. I was unable to talk or move at all. I could still hear, so I was conscious. The nurses got me on the floor, raised my legs, and called EMS. The paramedic gave me another 50mg shot of Benadryl. In the ambulance I started having difficulty breathing. I was given Epinephrine and Solumedrol. After about an hour I was able to talk and move again. I have been feeling very fatigued and out of it ever since.


VAERS ID: 1523142 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-23
Onset:2021-07-28
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO196 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Dizziness, Impaired driving ability, Malaise, Presyncope, Vertigo
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamins, calcium, magnesium
Current Illness: None
Preexisting Conditions: None
Allergies: Iodine
Diagnostic Lab Data: Didn?t go anywhere. Can?t drive.
CDC Split Type:

Write-up: Diarrhea and stomach pain started on day 5 after the shot. Lasted for 5 days. Dizziness and vertigo started in day 9 and is still persisting and getting worse through day 12. Had to call in sick from work; interfering with work in computer; walking, bending, turning head from side to side. The feeling is always near faint. Considering not to get second shot. The dizziness is just too severe.


VAERS ID: 1523155 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-06-21
Onset:2021-07-28
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 2 RA / IM

Administered by: Public       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? 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: tested positive for covid-19


VAERS ID: 1523178 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-07-26
Onset:2021-07-28
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821287 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Magnetic resonance imaging head normal, Muscular weakness, Paraesthesia, Scan with contrast normal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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 known
Diagnostic Lab Data: 8/2 MRI with contract on head. Nothing found 8/2 Panel of blood work, not sure the details on this....all came back as normal
CDC Split Type:

Write-up: 7/28/21 Tingling and minor weakness in right arm 7/29/21 Tingling in right arm, right leg, and right side of face 7/30/21 Tingling in right and left arm, right and left leg, right side of face


VAERS ID: 1523197 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-19
Onset:2021-07-28
   Days after vaccination:100
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cough, Pyrexia, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARSCOVS PCR POSITIVE ON 07/30/2021
CDC Split Type:

Write-up: Fever, Cough, and Vomiting


VAERS ID: 1523290 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-01-20
Onset:2021-07-28
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 12/20/21pfizer,Lot#EK5730 2nd dose: 01/10/21Pfizer,Lot# EL3248 Diagnosed covid positive:07/28/2021 Symptom onset:07/28/2021 Exposure:Home Symptoms:fever,fatigue,muscle aches, sore throat,runny nose


VAERS ID: 1523315 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-26
Onset:2021-07-28
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac telemetry normal, Chest pain, Echocardiogram, Ejection fraction normal, Immunoglobulin therapy, Intensive care, Myocarditis, Pain, Pericarditis, Troponin
SMQs:, Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol PRN taken for body aches and chest pain that developed after vaccine.
Current Illness: none
Preexisting Conditions: none
Allergies: Blue dye - causes vomiting
Diagnostic Lab Data: See faxed/attached documents.
CDC Split Type:

Write-up: The pt received dose 2 of the Pfizer Covid-19 vaccine on 7/26/21. The pt developed diffuse body aches the day after the vaccine which included chest pain. The second day after the vaccine his body aches were improving except for the chest pain which was progressively worsening which prompted presentation to medical care. Hospital course from discharge summary: Patient was admitted for management of myocarditis/pericarditis, presumed to be secondary to Covid immunization. On presentation, his troponin was 21.98 ng/mL with a low normal EF of 52% on formal echo at presentation on 7/29. Troponin peaked at 46.10 ng/mL on the evening of 7/29. Cardiology was consulted who provided recommendations throughout admission. He received 2 g/kg of IVIG, divided over 2 days 7/29?7/30. He was put on scheduled Toradol and received IV methylprednisolone while admitted. Echo normalized on 7/30. He was monitored on telemetry without any significant pain or abnormal rhythm changes in the 1-2 days prior to discharge. He was discharged home on oral steroids and scheduled ibuprofen until follow up with pediatric cardiology on 8/5. Patient and his mother received strict return precautions for return to care and were in agreement with the plan."


VAERS ID: 1523316 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-25
Onset:2021-07-28
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site pain, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro 20mg/day; Welbutrine 300mg/day
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Body aches, fatigue, soreness at injection site July 25-26. Rash occurring on arms, legs, and chest July 27-August 2


VAERS ID: 1523329 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-28
Onset:2021-07-28
   Days after vaccination:61
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 05/7/21 pfizer,Lot#EWO170 2nd dose: 05/28/21Pfizer,Lot# EK8734 Diagnosed covid positive:07/28/21 Symptom onset:07/28/21 Exposure:Travel Symptoms:Asymptomatic


VAERS ID: 1523695 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7584 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hair skin and nail vitamin, Vitamin B-12, Hydrocodone daily (back surgery 3 months ago)
Current Illness: No other illnesses
Preexisting Conditions: No
Allergies: NO
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient called on the way to the hospital on 8/3/21 to inform of hives all over the body after receiving the Pfizer vaccination on 07/28/21. Initially she was uncertain as to the cause of the hives and tried to treat with Calamine Lotion, Benadryl and hydrocortisone. After about a week of treating the hives unsuccessfully she called her physician and explained her situation and that she recently took the Pfizer Vaccination. The Physician informed her to go to the hospital immediately and to call the pharmacy to report the issue.


VAERS ID: 1523892 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN EW0191 / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Extra dose administered, Fear
SMQs:, Medication errors (narrow)

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

Write-up: On 7/30/21 during data entry it was noticed by data entry technician that the patient already had two doses of Pfizer COVID vaccine recorded in the registry, 3/31/21 and 4/21/21, both at the Vaccination Clinic. The patient recorded "NO" to the question on the vaccine administration record 7/28/21 "Have you ever received a dose of COVID-19 vaccine." The patient did not disclose that he had already completed his Pfizer COVID-19 vaccine series and was administered a dose of vaccine on 7/28/21 at his request. Patient admits he did indeed had those two previous doses 3/31/21 and 4/21/21, and states "Variant''s got me scared," so he decided to get a third dose having heard boosters may be recommended. Advised that booster doses are not recommended at this time per CDC, and advised him not to get more doses unless recommended to do so by CDC guidelines.


VAERS ID: 1523919 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discomfort, Feeling hot, Pain, 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: Birth Control - LoLoEstrin
Current Illness: None
Preexisting Conditions: PCOS, Spondylolisthesis
Allergies: Eggplant
Diagnostic Lab Data: None
CDC Split Type: NDC: 59267-1000-02

Write-up: Vaccine: 5:30 pm 7/27/2021 Tuesday 1 am that night: Awoken by intense tingling / pins and needles in back upper both legs, up for 2 hours from the discomfort 7/28 Wednesday (day after): Tingles move down calf, by nighttime into bottoms of my feet. Called my primary care provider with concern and booked in person appt. 7/29 Thursday: 9 am primary care physician in-person appointment. She advised me to rest and booked me an urgent neurologist appt Symptoms worsen, tingles are stronger and have moved into hands and wrists/forearms 7/30 Friday: Pain and discomfort all day, physical activity like walking worsens it Saturday & Sunday 7/31 and 8/1: Numbness in left foot intensifies, symptoms are same Monday 8/2: tingles are hot, heat and isolated in certain spots. Has gone from discomfort to pain. Tuesday 8/3: Continuing to rest and symptoms no worse


VAERS ID: 1524122 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-01
Onset:2021-07-28
   Days after vaccination:118
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0020B21A / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abnormal dreams, 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: No
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Keep getting a sensation of a needle pricking my arm then soreness its quite bizarre to the point it has entered my dream and in my dream i had a syringe floating in my body and its lodged in my right arm inside lol? i guess it means something or its just doing its job


VAERS ID: 1524812 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Nevada  
Vaccinated:0000-00-00
Onset:2021-07-28
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Feeling hot, Injection site pain, Pruritus, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Blood cholesterol abnormal (On Rosetin 300mg)
Preexisting Conditions: Comments: The patient had No known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210802726

Write-up: ITCHING ALL OVER BODY; FELT HEAT ALL OVER BODY; ITCHY RASH; RED RASH WITH DIAMETER AS 1/2 INCH TO 1 INCH ON SHOULDERS LEGS AND ARMS WITH NO SWELLING; ACHE ON LEFT ARM WHERE VACCINE GIVEN; This spontaneous report received from a patient concerned a 63 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included abnormal cholesterol, and other pre-existing medical conditions included the patient had no known drug allergies.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821286, expiry: UNKNOWN) dose was not reported, administered on 28-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 28-JUL-2021, the subject experienced ache on left arm where vaccine given. On 01-AUG-2021, the subject experienced itching all over body. On 01-AUG-2021, the subject experienced felt heat all over body. On 01-AUG-2021, the subject experienced itchy rash. On 01-AUG-2021, the subject experienced red rash with diameter as 1/2 inch to 1 inch on shoulders legs and arms with no swelling. On 02-AUG-2021, treatment medications included: diphenhydramine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from itching all over body, red rash with diameter as 1/2 inch to 1 inch on shoulders legs and arms with no swelling, felt heat all over body, and itchy rash, and the outcome of ache on left arm where vaccine given was not reported. This report was non-serious.


VAERS ID: 1524941 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-01
Onset:2021-07-28
   Days after vaccination:149
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? 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: 20210728; Test Name: Tested positive for COVID today; Test Result: Positive
CDC Split Type: USPFIZER INC202100969162

Write-up: Caller reports she received both doses in Mar2021 and was diagnosed with Covid-19 yesterday.; Caller reports she received both doses in Mar2021 and was diagnosed with Covid-19 yesterday.; This is a spontaneous report from a contactable consumer or other non hcp. A 45-years-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/lot number was not reported) via an unspecified route of administration on Mar2021 as single dose and second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/lot number was not reported) via an unspecified route of administration on Mar2021 as single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient reported that she received both doses in Mar2021 and was diagnosed with COVID-19 yesterday on 28Jul2021. The patient (45 years old, female) inquired about reporting testing positive for COVID-19 after receiving both doses of the Pfizer Covid-19 vaccine. She received both doses in Mar2021 and was diagnosed with COVID-19 yesterday. She received an email last night, she believed it was from something she sent in on the website, with a request to call us directly. She said "my cousin and his wife also got diagnosed a couple days earlier than I did. The patient just wanted to make sure this got reported because I know you are still trying to figure all this out. Especially when the patient found out her cousin and his wife had both doses and tested positive". On 01Apr2021, Pfizer and BioNTech announced an updated topline analysis up to 6 months following second dose of COVID-19 Vaccine. Analysis of 927 confirmed symptomatic cases of COVID-19 demonstrates Pfizer-BioNTech COVID-19 Vaccine (BNT162b2) is effective with 91.3% vaccine efficacy observed against COVID-19, measured seven days through up to 6 months after the second dose. Vaccine was 100% effective in preventing severe disease as defined by the Health Authority and 95.3% effective in preventing severe disease as defined by the Agency Vaccine was 100% effective in preventing COVID-19 cases, where the lineage is prevalento Vaccine safety now evaluated in more than 44,000 participants 16 years of age and older, with more than 12,000 vaccinated participants having at least six months follow-up after their second dose Pfizer and BioNTech plan to share these results with worldwide regulatory agencies soon. The press release is available at: Withheld Please note that the Pfizer-BioNTech COVID-19 Vaccine-Antibody Persistence and Duration of Immunity. Data has been updated to include the Press Release information. Proposed response: Please confirm "Pfizer Covid 19 Vaccine" and speak from attached documents. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 28Jul2021. The clinical outcome of the event was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1525321 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eyelid sensory disorder, Facial paralysis, Hypoaesthesia, Immediate post-injection reaction, Muscular weakness, Ocular discomfort, Peripheral swelling, Photophobia, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: one flu vaccine, unsure of date, brand, etc.
Other Medications: hydrochlorothiazide
Current Illness: none
Preexisting Conditions: high BP, overweight/obese?
Allergies: Sulfa drugs, parsley and cilantro
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Immediately after the shot vision became blurred/distorted. I would not say "double vision" per se, but distorted, blurry, difficult to see. This cleared within about 2-3 minutes of the shot. After the wait time of 15 min, maybe 20-30 min. later, started having numbness on left side of face and across forehead. Then felt pressure/swelling around both eyes and numbness/tingling in them. Checked in mirror-droopy left eye and less wrinkling in left forehead. After 4 hours symptoms were not getting better but stronger, so called doctor. Doctor recommended benadryl. Took benadryl and it helped with the eye issue and numbness. The next day symptoms were back but a bit less severe. Eyes were swollen and crusted over, numbness and feeling like had eye drops from eye doctor to check for glaucoma. Eyes were sensitive to light as well. Friday most symptoms seemed much less. Sunday swelling of hands and eyes/face again, right leg weakness. Drank extra water, symptoms less the following days. The eye issue is persisting at a low level-light sensitivity after day 6 still, some numbness and swelling that comes and goes. Right leg weak day 6. Day 7 woke up symptoms appearing less so far today. Will check with doctor again about the eye issue to see if need to do anything else but it seems to be getting better slowly over time.


VAERS ID: 1525364 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol, Irbesartan and Adderall
Current Illness:
Preexisting Conditions: Marfan Syndrom, Dilated aorta of heart, ADHD
Allergies: N/A
Diagnostic Lab Data: Patient visited Urgent care on 8/1/2021 due to high fever and severe nausea and severe chills. Patient was instructed to follow a Motrin schedule every 6-8 hours of 600mg each time and Tylenol in between if fever. It has been 3 days since on this treatment and symptoms still the same, now with low grade fevers.
CDC Split Type:

Write-up: Vaccine recieved at 11:45am. Symptoms started same day at 3pm. Symptoms include, fever, chills, vomitting, fatigue, headache, nausea. She also started her period 2 days after vaccine, which she had already had that month. Still experiencing all the above Symptoms, after 1 week of vaccine.


VAERS ID: 1525662 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

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

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

Write-up: Patient received 1st dose of Pfizer at our store when she already received 1 dose of J&J earlier this year. Patient did not disclose this information at time of administration. We found out when we billed her insurance.


VAERS ID: 1525680 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-05
Onset:2021-07-28
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Autoimmune haemolytic anaemia, Blood smear test, Chemotherapy, Chronic lymphocytic leukaemia, Dyspnoea, Haemoglobin, Transfusion
SMQs:, Haemolytic disorders (narrow), Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Haematological malignant tumours (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: morphine
Current Illness: chronic back pain
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: peripheral blood smear
CDC Split Type:

Write-up: CLL, autoimmune hemolytic anemia (severe hgb 5.5), shortness of breath, chemotherapy, blood transfusions


VAERS ID: 1525723 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diplopia, Dizziness, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Ocular motility 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: levothyroxine propranolol ativan wellbutrin
Current Illness: none
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: dizzy headache nausea double vision and THIS IS A WEEK LATER


VAERS ID: 1525736 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-05
Onset:2021-07-28
   Days after vaccination:114
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Anticoagulant therapy, Blood thyroid stimulating hormone decreased, Bundle branch block left, COVID-19, Cardiac monitoring, Chest pain, Computerised tomogram thorax, Electrocardiogram abnormal, Fibrin D dimer increased, Hypercoagulation, Infection, Multiple organ dysfunction syndrome, SARS-CoV-2 test positive, Sepsis, Tachycardia, Tachypnoea
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG Oral Tablet Take 2 tablets by mouth every 8 hours as needed for pain. 1/5/21 4/5/21, MD albuterol (PROVENTIL) (2.5 MG/3ML) 0.083% Inhalation Nebulization Solution Take 3 mLs by nebulization every 4 hours as ne
Current Illness:
Preexisting Conditions: No date: Anxiety No date: COPD (chronic obstructive pulmonary disease) (CMS-HCC: 111) No date: Diabetes mellitus No date: Fibromyalgia No date: Gout No date: High cholesterol No date: Hypertension No date: Hypothyroidism
Allergies: ACE inhibitors Allopurinol Gabapentin Metformin
Diagnostic Lab Data: SARS-COV-2, NAA Detected on 07/28/21
CDC Split Type:

Write-up: Patient required hospitalization due to breakthrough infection. She received J&J vaccine on 04/05/21. Hospitalized from 07/28/21-07/31/21. Below is copied from discharge summary: Patient is a 55 y.o. female patient who is being discharged today. Hospital Course: Sepsis with acute organ dysfunction/Acute hypoxic respiratory failure due to COVID-19 - Meeting sepsis criteria based on tacycardia, tachypnea and source of infection - requiring oxygen 2 lpm , oxygen for home ordered - continuous cardiac and SpO2 monitoring - cont dexamethasone daily until 8/6 - Remdesivir 7/28 - 7/30, in View of improvement, ok to stop therapy - therapeutic anticoagulation with Lovenox while inpatient - albuterol PRN Hypercoagulable state/Elevated d dimer -d dimer$g 4K with inconclusive CTA chest -Full dose AC while inpatient Chest pain/LBBB - likely 2/2 COVID and not ACS - LBBB Present on prior EKG - cont daily aspirin, statin and BB COPD -Stable - Breo Elipita - cont montelukast - DuoNebs p.r.n. Hypertension - cont losartan, metoprolol, minoxidil - hold chlorthalidone Hyperlipidemia - cont atorvastatin Type 2 diabetes mellitus -Controlled - cont Jardiance Hypothyroidism - cont levothyroxine - TSH 1.4 Anxiety/Depressive disorder - cont citalopram, amitriptyline RLS - cont Requip Migraines - cont Topiramate Fibromyalgia/ Chronic pain syndrome: -Resume amytriptiline -Oxycodone prn Morbid Obesity, BMI of$g 40: - lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U OPD with PCP Patient is discharged in stable condition with stable vital signs


VAERS ID: 1525777 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 1 AR / IM

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

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

Write-up: Error: Patient Too Young for Vaccine Administered-


VAERS ID: 1525838 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-07
Onset:2021-07-28
   Days after vaccination:82
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Cardiac failure acute, Chronic left ventricular failure, Chronic obstructive pulmonary disease, Condition aggravated, SARS-CoV-2 test positive
SMQs:, Cardiac failure (narrow), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen 1,000 mg Oral Daily PRN Albuterol Sulfate 108 (90 Base) MCG/ACT Aers, 2 puffs Inhalation Every 4 hours PRN 2.5 mg Nebulization Every 4 hours PRN ALPRAZolam 0.25 mg Oral Nightly PRN, DO NOT TAKE UNLESS USING BiPAP THERAPY.
Current Illness: Hemoptysis ? COVID-19 ? Respiratory failure with hypoxia (HCC)
Preexisting Conditions: Atrial fibrillation (HCC) 06/22/2021 Unknown ? Anemia 05/18/2021 Unknown ? Thrombocytopenia (HCC) 05/18/2021 Unknown ? Moderate persistent asthma, uncomplicated 07/30/2021 Unknown ? Shortness of breath 07/10/2021 Unknown ? Controlled substance agreement signed 07/10/2021 Unknown ? Chronic bilateral low back pain with bilateral sciatica 07/09/2021 Unknown ? ACP (advance care planning) 07/09/2021 Unknown ? CAD (coronary artery disease) 05/19/2021 Unknown ? Non-seasonal allergic rhinitis 04/26/2021 Unknown ? Thrombus of left atrial appendage 02/24/2021 Unknown ? Atrial fibrillation with RVR (HCC) 02/16/2021 Unknown ? Chronic respiratory failure with hypoxia and hypercapnia (HCC) 02/16/2021 Unknown ? Anxiety and depression 01/25/2021 Unknown ? Dyslipidemia 01/25/2021 Unknown ? Restless legs syndrome (RLS) 01/25/2021 Unknown ? COPD with asthma (HCC) 01/25/2021 Unknown ? Iron deficiency anemia, unspecified iron deficiency anemia type 01/25/2021 Unknown ? Aortic aneurysm without rupture, unspecified portion of aorta (HCC) 01/25/2021 Unknown ? Cardiac pacemaker in situ 01/25/2021 Unknown ? Bradyarrhythmia 01/25/2021 Unknown ? OSA (obstructive sleep apnea) 01/25/2021 Unknown ? Primary osteoarthritis involving multiple joints 01/25/2021 Unknown ? Physical deconditioning 01/25/2021 Unknown ? History of colon cancer 01/25/2021 Unknown ? Essential hypertension 01/25/2021 Unknown ? Status post hysterectomy 01/25/2021 Unknown ? Urinary incontinence 01/25/2021 Unknown ? Diverticulosis 01/25/2021 Unknown ? Falls frequently 01/12/2021 Unknown ? Diverticulitis 01/12/2021 Unknown ? Chronic diastolic congestive heart failure (HCC) 01/12/2021 Unknown ? Type 2 diabetes mellitus without complication, without long-term current use of insulin (HCC) 01/12/2021 Unknown ? Atrial fibrillation, persistent (HCC)
Allergies: Augmentin, Ciprofloxacin, Demerol
Diagnostic Lab Data: COVID-19 PCR Order: 331514461 Status: Final result Visible to patient: Yes (MyChart) Specimen Information: Nares, Bilateral; Swabbed Collection
CDC Split Type:

Write-up: Patient admitted for COPD exacerbation from COVID with concurrent acute on chronic diastolic heart failure exacerbation


VAERS ID: 1525846 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-08
Onset:2021-07-28
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / 2 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asymptomatic bacteriuria, Decreased appetite, SARS-CoV-2 test false positive, SARS-CoV-2 test negative
SMQs:, 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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen 500 mg Oral Every 8 hours PRN Betamethasone Valerate 0.1 % Topical 2 times daily, Apply to skin. buPROPion HCl 300 mg Oral Daily Calcium Carb-Cholecalciferol 600-800 MG-UNIT 1 tablet Oral 2 times daily Clobetasol Propiona
Current Illness:
Preexisting Conditions: Age-related osteoporosis with current pathological fracture with routine healing ? Vulvar dystrophy ? Uterine prolapse ? Hypophosphatemia ? Weakness ? COVID-19 virus infection ? Pessary maintenance ? Barrett''s esophagus with dysplasia ? Osteopenia ? Major depression, recurrent, chronic ? Gastroesophageal reflux disease without esophagitis ? COPD, mild ? Spinal stenosis of lumbar region - mild to moderate MRI 2015
Allergies: Contrast Dye
Diagnostic Lab Data: COVID-19 PCR, Rapid Order: Collected: 7/28/2021 14:21 Status: Final result Visible to patient: Yes Specimen Information: Nasopharynx; Swabbed Collection
CDC Split Type:

Write-up: 82 year old female who presented from assisted living with c/o decreased appetite. She has asymptomatic bacteriuria for which no antibiotics are prescribed, false positive COVID-19 test (confirmed with two subsequent negative COVID test).


VAERS ID: 1525888 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Arrhythmia, Chest pain, Myocarditis, Pain, Tachycardia, Vaccination complication
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 4 y/o M presents with chest pain starting last night around 2300. No fever, no cough, no vomiting, no diarrhea, no sore throat. Pt denies any trouble breathing or SOB. Pt denies any palpations. Pt reports his current chest pain is 1-2/10 but at its worse it is 8/10. Pt describes the pain as localized and burning. Pt reports that his chest pain is constant and is exacerbated with movement. Pt has not taken any medication for pain. Pt denies any dizziness or syncope. Mom reports pt received 2nd COVID-19 Pfizer vaccine in R arm yesterday at 0930. No sick contacts. No known COVID-19 exposures. No hx of asthma, no past surgery. No hx of asthma or sudden death in family. Mom has a hx of SVT and heart murmur. Differential Diagnosis: Chest pain tachycardia, arrhythmia, myocarditis, post vaccine reaction. Pt feeling much better, is now afebrile, currently has no chest pain, no signs of myocarditis, pt likely with post vaccine reaction. Will d/c home with close f/u with Primary. Return precautions discussed.


VAERS ID: 1525917 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-15
Onset:2021-07-28
   Days after vaccination:74
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute sinusitis, SARS-CoV-2 RNA increased, Suspected COVID-19
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol HFA (VENTOLIN HFA) 90 mcg/actuation inhaler biotin 1,000 mcg tablet,chewable cyanocobalamin 1,000 mcg tablet iron,carbonyl-vitamin C (VITRON-C) 65 mg iron- 125 mg tablet,delayed release (DR/EC) levonorgestreL (MIRENA) 52 mg IUD me
Current Illness:
Preexisting Conditions: Nervous Chronic migraine Hearing loss Respiratory Asthma
Allergies: NKA
Diagnostic Lab Data: 07/29/21 1438 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 07/28/21 1706 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: Suspected COVID-19 virus infection Acute non-recurrent sinusitis, unspecified location


VAERS ID: 1525938 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2020-12-21
Onset:2021-07-28
   Days after vaccination:219
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood lactic acid, Blood pH decreased, COVID-19, COVID-19 pneumonia, Carbon dioxide increased, Cough, Dyspnoea, Hypoxia, Intensive care, Malaise, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Lactic acidosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hospital Morbid Obesity (HCC) COVID-19 Infection Acidosis Lactic Diabetes Mellitus Type 2 Hyperglycemia (HCC) Acute Re Hospital Morbid Obesity (HCC) COVID-19 Infection Acidosis Lactic Diabetes Mellitus Type 2 Hyperglycemia (HCC) Acute Respiratory Distress Syndrome (HCC) Acute Respiratory Failure With Hypoxia (HCC) Non-Hospital Hypertension White Coat Hyperlipidemia Depression Major Primary Osteoarthritis Hip Left Tendinopathy Gluteus Medius Left Impaired Fasting Glucose Aftercare Total Hip Arthroplasty Anticoagulant Therapy [Z79.01] Monitoring For Therapeutic Drug Therapy [Z51.81] Primary Osteoarthritis Hip Right Preoperative Examination Cardiovascular Anxiety
Allergies: NKA
Diagnostic Lab Data: Coronavirus 2 PCR Detect, V symptomatic POSITIVE
CDC Split Type:

Write-up: Client is a 57 year old male who presented to the ED today from outpatient COVID testing and was hypoxic there (50% on RA), they placed a nonrebreather at 15 L and transferred him to the ED. In the ED he was transitioned to HFNC 60 L 100% FiO2 saturating 92-93%. His medical history is significant for obesity, T2DM, and hyperlipidemia. He was vaccinated for COVID-19 with Pfizer in December/January. He reports 2 days shortness of breath, generalized malaise, nonproductive cough. He just returned from a trip. Pertinent labs from the ED include lactate of 9.6, VBG with pH 7.34/CO2 34. He received 1 L IVFs and 6 mg Dexamethasone. He was admitted to the ICU in the setting of COVID pneumonia


VAERS ID: 1526018 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-06
Onset:2021-07-28
   Days after vaccination:144
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Breakthrough symptomatic COVID19 infection


VAERS ID: 1526071 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: Vaccine error; A second dose of Janssen vaccine was received by the patient failure to check prior immunization record: Pt consented having receiving no prior COVID-19 vaccines before.


VAERS ID: 1526133 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-25
Onset:2021-07-28
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Electrocardiogram
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft LoLoestrin24
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Penicillin
Diagnostic Lab Data: EKG
CDC Split Type:

Write-up: Severe chest pain, difficulty breathing


VAERS ID: 1526179 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-29
Onset:2021-07-28
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: hospitalized with cough and shortness of breath after 7 days


VAERS ID: 1526292 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Incorrect dose administered, No adverse event, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad), Medication errors (narrow)

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

Write-up: The RN administered 1mL of the Moderna vaccine as opposed to 0.5mL. Office, contacted the patient to notify and follow up on how the patient was feeling. The patient self-reported no symptoms other than arm soreness. Did not experience any side effects or symptoms on Wednesday (7/28).


VAERS ID: 1526293 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Diarrhoea, Dizziness, Incorrect dose administered, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Medication errors (narrow)

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

Write-up: The RN administered 1mL of the Moderna vaccine as opposed to 0.5mL. Office contacted the patient to notify and follow up on how the patient was feeling. The patient self-reported feeling great today other than arm soreness. Patient reported on Wednesday (7/28) he experienced dizziness & diarrhea. Symptoms have all subsided as of Thursday (7/29). Further instructed patient to call our office if further assistance was needed.


VAERS ID: 1526294 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Incorrect dose administered, No adverse event, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad), Medication errors (narrow)

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

Write-up: The RN administered 1mL of the Moderna vaccine as opposed to 0.5mL. The patient was contacted to notify and follow up on how the patient was feeling. The patient self-reported no symptoms other than arm soreness. Did not experience any side effects or symptoms on Wednesday (7/28).


VAERS ID: 1526302 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-07-25
Onset:2021-07-28
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 0196 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discomfort, Dizziness, Dizziness postural
SMQs:, Anticholinergic syndrome (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: 1. Dizziness (light headed and feeling of about to fall while standing or walking). started on day 4 2. Neck and jaw line pressure on both sided - started on day 2


VAERS ID: 1526323 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Decreased appetite, Diarrhoea, Headache, Pain in extremity, Paraesthesia, Peripheral swelling, Pharyngeal swelling, Swelling face, Urine analysis normal, Vulvovaginal swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi vitamin, Omega, Vitamin D 5000
Current Illness:
Preexisting Conditions:
Allergies: Cortozone
Diagnostic Lab Data: August 3, 2021; blood test ( No result yet), urine test - was ok, blood pressure 130/80
CDC Split Type:

Write-up: Severe headache at night, headache through out the day, swelling sensation of face, swelling around throat area, swelling in the vaginal area, swelling of thighs, feeling of pins and needles in throughout the body, pins and needles feeling in the anal opening, loose bowel, first few days severe pain in the left arm., lack of appetite


VAERS ID: 1526919 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-24
Onset:2021-07-28
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Antibody test, Blindness, Lumbar puncture, Magnetic resonance imaging head abnormal, Optic neuritis
SMQs:, Glaucoma (broad), Optic nerve disorders (narrow), Demyelination (narrow), Retinal disorders (broad), Ocular infections (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: generalized anxiety, hypertension
Allergies: none
Diagnostic Lab Data: MRI brain and orbits LP
CDC Split Type:

Write-up: optic neuritis of left eye. diagnosed by MRI, optho eval. Antibodies pending. Severe vision loss <20/200 over 2 days. Given IV steroids and improved to 20/40 - 20/63


VAERS ID: 1527854 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-03-30
Onset:2021-07-28
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Headache, Oropharyngeal pain, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: tested positive for COVID on 7/30/2021.
CDC Split Type:

Write-up: Patient was immunized with 2 doses of Moderna COVID vaccine, second shot on March 30th. We do not have the lot numbers of her vaccines. Her symptoms of cough, fever, body aches, headache, and sore throat started on 07/28. she tested positive for COVID on 7/30/2021.


VAERS ID: 1527856 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-04-01
Onset:2021-07-28
   Days after vaccination:118
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: He tested positive for COVID on 7/31/2021.
CDC Split Type:

Write-up: Patient states he was immunized with Moderna vaccine, second shot in April, but he temporarily misplaced his COVID vaccination card and we do not have the lot numbers of his immunization on file. he developed symptoms of cough, fatigue, body aches, and sore throat on 07/28. He tested positive for COVID on 7/31/2021.


VAERS ID: 1528164 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-07-28
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210805110

Write-up: ADMINISTERED VACCINE ON 28-JUL-2021 FROM VIAL PUNCTURED ON 27-JUL-2021; This spontaneous report received from a health care professional concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: 21-SEP-2021) dose was not reported, administered on 28-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 28-JUL-2021, the subject experienced administered vaccine on 28-Jul-2021 from vial punctured on 27-Jul-2021. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from administered vaccine on 28-Jul-2021 from vial punctured on 27-Jul-2021. This report was non-serious.


VAERS ID: 1528183 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939893 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)

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

Write-up: patient received the 1st dose of the Moderna vaccine and right after had throat tightening up and had to go to the ER; This spontaneous case was reported by a consumer and describes the occurrence of THROAT TIGHTNESS (patient received the 1st dose of the Moderna vaccine and right after had throat tightening up and had to go to the ER) in a 27-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939893) for COVID-19 vaccination. No Medical History information was reported. On 28-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 28-Jul-2021, the patient experienced THROAT TIGHTNESS (patient received the 1st dose of the Moderna vaccine and right after had throat tightening up and had to go to the ER) (seriousness criteria hospitalization and life threatening). At the time of the report, THROAT TIGHTNESS (patient received the 1st dose of the Moderna vaccine and right after had throat tightening up and had to go to the ER) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication details were reported. No treatment medication details was reported. Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 1528242 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-28
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Drug ineffective, Pyrexia, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210728; Test Name: Covid19; Result Unstructured Data: Test Result:Positive
CDC Split Type: USPFIZER INC202100968719

Write-up: positive for Covid19; positive for Covid19; fever; lost his sense of taste and smell; lost his sense of taste and smell; This is a spontaneous report from a contactable consumer. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: not reported), dose 1 via an unspecified route of administration on an unspecified date as a single dose and dose 2 via an unspecified route of administration on an unspecified date as single dose for covid-19 immunization. The patient medical history was not reported. The patient''s concomitant medications were not reported. On 28Jul2021, the patient tested positive for Covid19, has a low grade fever, lost his sense of taste and smell. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 28Jul2021. The outcome of all the events was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1528370 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-07-28
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 antibody test, Therapy non-responder
SMQs:, Lack of efficacy/effect (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Diabetes (receives medication for her Diabetes); Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies, no drug abuse or illicit drug use and the patient was not pregnant at the time of reporting.
Allergies:
Diagnostic Lab Data: Test Date: 20210728; Test Name: COVID-19 antibody test; Result Unstructured Data: Negative; Comments: Tested at Labcorp.; Test Date: 20210728; Test Name: COVID-19 antibody test; Result Unstructured Data: Negative; Comments: Tested at Clinic
CDC Split Type: USJNJFOC20210804988

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient concerned a 66year old African American, Non-Hispanic or Latino female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included diabetes, no alcohol use, and non-smoker. The patient had no known allergies, no drug abuse or illicit drug use and the patient was not pregnant at the time of reporting. The Patient was Diabetic and was taking medication for Diabetes The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805020, and expiry: UNKNOWN) dose was not reported, 1 total, administered on 12-MAR-2021 to left arm for prophylactic vaccination. No concomitant medications were reported. On 28-JUL-2021, the patient took covid-19 antibody test twice and results were negative both the time. The incubation period of 28 days has been completed (Confirmed immunological vaccine failure). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000188319.; Sender''s Comments: V0: 20210804988- JANSSEN COVID-19 VACCINE Ad26.COV2.S- Confirmed immunological vaccine failure . This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS.


VAERS ID: 1528374 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-07-28
   Days after vaccination:107
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Anticoagulant therapy, C-reactive protein increased, Catheterisation cardiac, Chest pain, Echocardiogram, Fibrin D dimer increased, Glucose tolerance test, Red blood cell sedimentation rate increased, Troponin increased
SMQs:, Haemorrhage laboratory terms (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: elevated d dimer, elevated crp elevated sed rate, elevated troponin
CDC Split Type:

Write-up: chest pain x2 days, treatment was heparin gtt, heart cath, ct angio and echo


VAERS ID: 1528619 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-02-13
Onset:2021-07-28
   Days after vaccination:165
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 - / -

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

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

Write-up: Patient tested positive for COVID on 7/29/2021, symptoms started on 7/28/2021. Admitted to hospital on 7/29/2021 Received Pfizer vaccine on 1/23/2021 & 2/13/2021


VAERS ID: 1528664 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood creatine normal, Dyskinesia, Enzyme level test, Feeling abnormal, Muscle spasms, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dyskinesia (narrow), Dystonia (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine .5 MG
Current Illness: None
Preexisting Conditions: Degenerative disc disease
Allergies: Latex
Diagnostic Lab Data: I went to the ER on 8/4/2021 and I was given saline drip and 1.5 MG of Toradol. I series of labs were done to check my enzymes and creatine levels which were all normal. I was then discharged to follow up with my primary.
CDC Split Type:

Write-up: A day after my 2nd vaccine I experienced muscle cramping/pain in neck/shoulder blade area, forearms, calves and hamstring, muscle spams throughout body, palpitations, brain fog, unbalanced, and hypnic jerks. It has been nine days since my 2nd dose and symptoms seem to be worsening.


VAERS ID: 1528708 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Bottle of Janssen COVID-19 vaccine was punctured on 7.26 at 17:00 and administered to another patient. Bottle was refrigerated, but not discarded 6 hours after puncture, as is the protocol. Patient was administered a vaccine from the punctured, refrigerated bottle 46 hours after puncture, but the recommendation is to use all vaccine or discard after 6 hours. Patient was notified of event when it was discovered on 8/3/21. Patient had not noted symptoms or side effects from the medication administration error and declined revaccination. Janssen was contacted for guidance on revaccination, and was not able to provide comprehensive guidance due to lack of data.


VAERS ID: 1528801 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-01
Onset:2021-07-28
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 03/12/2021 / 2 - / -

Administered by: Public       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? 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: Positive for Covis 19


VAERS ID: 1528919 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-12
Onset:2021-07-28
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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:

Write-up: Bells Palsy


VAERS ID: 1528944 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Diarrhoea, Eye pain, Headache
SMQs:, Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Arthritis (broad), Noninfectious diarrhoea (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: No
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Headache, eye pain, diarrhea and bilateral knee achiness and weakness


VAERS ID: 1528953 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-26
Onset:2021-07-28
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW00190 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: alprazolam
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: latex, erythromycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports white spots (looks like skin is bleached) on arms and legs that appeared ~2 days after vaccination and has not gotten better 1.5 weeks post vaccination.


VAERS ID: 1529013 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-02-18
Onset:2021-07-28
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, COVID-19, Condition aggravated, Constipation, Dyspnoea, Fatigue, Headache, Hypoxia, Nausea, Productive cough, Pyrexia, SARS-CoV-2 test positive, Sinus congestion, Urinary tract infection, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: PMHx of a flutter, carotid artery stenosis, COPD, GI bleed, IBS, obesity, abdominal pain, hypothyroidism, pulmonary hypertension, type 2 diabetes
Allergies: Levaquin (Diarrhea) Oral Pain Relief (Hallucinations) Rocephin (Diarrhea) codeine (Dizzy, Hallucinations, Vomiting) metFORMIN (diarrhea) NSAIDS (Shortness of breath, Nausea and vomiting) Lactose Toradol (Hallucinations) polyethylene glycol 3350
Diagnostic Lab Data:
CDC Split Type:

Write-up: cough, congestion, fever, nausea, vomiting, dyspnea x 1 week History of Present Illness Patient 80 year old female with a PMHx of a flutter, carotid artery stenosis, COPD, GI bleed, IBS, obesity, abdominal pain, hypothyroidism, pulmonary hypertension, type 2 diabetes who presents for 3 weeks of increased cough and dyspnea. Patient reports feeling ill over the past three weeks with sx of fatigue, fevers, cough, chest and sinus congestion, HA, and abdominal pain. She states over the past two days her cough and shortness of breath have become acutely worse. She has not had any recent sick contacts, received Covid vaccine in Jan/Feb 2021, and follows precautions. She additionally has recently finished a 5 day course of Bactrim for recent UTI. She states she has had increased constipation and n/v since starting it. She denies dysuria, frequency, or urinary discomfort. In the ED, she required 3L O2. She is having significant cough with clear sputum. She tested positive for COVID and will be admitted for acute hypoxia 2/2 to COVID.


VAERS ID: 1529073 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-02
Onset:2021-07-28
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Hypoxia, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Vaccine Breakthrough COVID + 7/28/21. Inpatient hospitalization for hypoxia.


VAERS ID: 1529081 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-25
Onset:2021-07-28
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, Intensive care, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Vaccine Breakthrough COVID + 7/31/21. Inpatient hospitalization for acute respiratory failure in ICU


VAERS ID: 1529193 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-08
Onset:2021-07-28
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Acute respiratory failure, Ageusia, Anosmia, Asthenia, COVID-19, Decreased appetite, Hypernatraemia, Influenza, Influenza virus test positive, Malaise, Pancytopenia, Productive cough
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Agranulocytosis (narrow), Haematopoietic cytopenias affecting more than one type of blood cell (narrow), Taste and smell disorders (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Myelodysplastic syndrome (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Home medications unknown, states she was on aspirin and Plavix.
Current Illness:
Preexisting Conditions: CVA without residual deficits, 2019 Hypertension Insulin-dependent diabetes mellitus CKD
Allergies: NKDA
Diagnostic Lab Data: 7/28/2021 by FLU/SARS-COV-2 (Rapid ED-Only) (Collected 07/28/21) - confirmed positive
CDC Split Type:

Write-up: Patient hospitalized due to breakthrough covid-19 infection from 7/28/21 to 8/4/21. Patient completed the Pfizer vaccine series in March. Below information is copied from patient progress note (8/3/21): Patient is a 77 y.o. female with a history of CKD, diabetes mellitus, CVA without residual deficits and hypertension the presented to the emergency department with complaints generalized weakness, productive cough, malaise, decreased appetite, loss of taste and smell. COVID-19 positive. Acute hypoxemic respiratory failure due to COVID-19 -Stable tolerating NC -COVID 19 order set initiated -Cardiac and SpO2 monitoring -Dexamethasone 6 milligram p.o. daily times 10 days -Trend markers -ProBNP 524 -TTE WNL -Awaiting home o2, possible DC if O2 deliver Hypernatremia -Start D5W -Oral intake AKI over CKD -Improving -Continue to monitor -Avoid nephrotoxic agents -Hold spironolactone -Strict I/O -Nephrology consulted Insulin-dependent diabetes mellitus -Improving, steroid induce -Follow accucheks -Endoconsulted -Continue insulni per endo recs -Hold glipizide for now Pancytopenia -likely secondary to acute infection with COVID-19 -Monitor Hypertension - home antihypertensives: Amlodipine 10 mg PO daily, Metoprolol 25 mg PO BID, Spironolcatone 50 mg BID -Continue amlodipine and metoprolol -Hold spironolactone with possible acute on chronic kidney injury


VAERS ID: 1529220 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Contusion, Dyspnoea, Injection site pain, Injection site swelling, Migraine, Mouth ulceration, Myalgia, Nausea, Oral pain, Skin discolouration, Skin sensitisation, Swollen tongue
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allopurinol
Current Illness: None
Preexisting Conditions: Smoking 3-5 cigarettes a day
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 07/27/21 --Sore arm at injection, minor swelling. 07/28/21 -- 7:00 am Previous symptoms clear up, Symptoms that I had when sick with covid19 back in early February 2021 came back. Sore muscles, major migraines, sensitive skin(clothes felt like sandpaper) nausea, around 12pm took 2 liquid gel advil every 4 hours for pain. 07/29/21 -- previous symptoms gone was feeling normal. 07/30/21 --new dark spots that look like small bruises appear on forehead, penis, scrotum. No pain or itching. 07/31/21 -- oral ulcers appear on one lips and tongue, tongue was swollen and hard to breathe, went to ER for treatment. Was prescribed prednisone 50mg for 5 days and Hydrocodone 5/325mg tablets. Could only eat smoothie like food and drinks. 08/5/21 -- symptoms still persist, dark spots disappearing slowly. Still have oral ulcers but not as painful as before.


VAERS ID: 1529228 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-01-19
Onset:2021-07-28
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Exposure to SARS-CoV-2, 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? 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: Moderna
CDC Split Type:

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 12/29/20 PfizerLot#EL0142 2nd dose: 01/19/21,Pfizer,Lot# EL3247 Diagnosed covid positive:07/28/21 Symptom onset: Exposure:Travel Symptoms:


VAERS ID: 1529292 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Deafness unilateral, 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: Atorvastation 10mg; Gabapentin 600mg; Trazadone 50mg
Current Illness:
Preexisting Conditions: NASH;
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: I temporarily lost hearing in my left ear and experienced subsequent "ringing" in both of my ears but predominantly in my left ear. It took several days for the condition to improve but I am still experiencing some low level ringing in my ears.


VAERS ID: 1529366 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ozempic, Indapamide, Imitrex, Zinc, Cinnamon, Fish Oil, Allegra, Tumeric, Low Dose Aspirin, Benadryl and Milk Thistle.
Current Illness: Diabetic
Preexisting Conditions: Sleep apnea
Allergies: No known allergies
Diagnostic Lab Data: Echocardiogram on 8/05/2021 at Hospital.
CDC Split Type:

Write-up: Chest pain shortly after the shot. Continuing chest discomfort.


VAERS ID: 1529395 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-01-11
Onset:2021-07-28
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9231 / 2 LA / IM

Administered by: Private       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? 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: Tested positive for COVID after being fully vaccinated.


VAERS ID: 1529430 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Rash, Rash erythematous, Skin warm
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nortrel birth control Zyrtec allergy medicine
Current Illness: N/A
Preexisting Conditions: Asthma PCOS
Allergies: N/A
Diagnostic Lab Data: Going to the doctor asap.
CDC Split Type:

Write-up: Massive red patch appeared hours after injection and has gotten larger and larger since. It is painful to the touch and red hot. It had been a week since I had the shot so I called the clinic today to ask about it and the on call pharmacist told me to report it and schedule a doctor''s appointment for tomorrow.


VAERS ID: 1529581 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-28
Onset:2021-07-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C and D
Current Illness: No
Preexisting Conditions: No
Allergies: Almonds
Diagnostic Lab Data: Blood Work
CDC Split Type: vsafe

Write-up: I broke out in a rash on my arms and leg


VAERS ID: 1530463 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Louisiana  
Vaccinated:0000-00-00
Onset:2021-07-28
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain, SARS-CoV-2 test positive, Sinus disorder, Suspected COVID-19, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Retroperitoneal fibrosis (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Asthma; Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies, drug abuse or illicit drug usage. The patient was not pregnant at the time of reporting.
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test positive; Result Unstructured Data: POSITIVE
CDC Split Type: USJNJFOC20210803371

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; BACK PAIN; SUSPECTED COVID-19 INFECTION; SINUS; This spontaneous report received from a patient concerned a 61 year old female. Initial information was processed along with additional information received on 03-AUG-2021. The patient''s height, and weight were not reported. The patient''s concurrent conditions included asthma, non-alcohol user, and non-smoker, and other pre-existing medical conditions included the patient had no known allergies, drug abuse or illicit drug usage. The patient was not pregnant at the time of reporting. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805018, and expiry: UNKNOWN) dose was not reported, 1 total administered to left arm on 20-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 28-JUL-2021, the patient started feeling or having sinus, sore throat, chills and fever. The patient also had a headache that was really bad and was having body aches. The patient stated that the symptoms are like waves they come and go and also back hurts really bad. The patient had Tylenol and Advil for symptoms. The patient had contacted the physician and planned to receive infusion as patient was asthmatic. The patient was tested positive for covid-19 and test type was nasal instant test. The patient believed that it was the delta one. Treatment medications (dates unspecified) included: paracetamol, and ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the sinus, suspected covid-19 infection, suspected clinical vaccination failure and back pain was not reported. This report was serious (Other Medically Important Condition). This report was associated with a product quality complaint 90000188105.; Sender''s Comments: V0:20210803371-covid-19 vaccine ad26.cov2.s-Suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1530470 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-28
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821287 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Hypoaesthesia, Magnetic resonance imaging, Muscular weakness, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210802; Test Name: Blood test; Result Unstructured Data: Normal; Test Date: 20210802; Test Name: MRI; Result Unstructured Data: Normal
CDC Split Type: USJNJFOC20210805146

Write-up: MUSCLES IN THIGHS AND ARMS ACHE AT TIMES; TINGLING AND MINOR WEAKNESS SPREAD TO MY RIGHT LEG; NUMBNESS IN RIGHT ARM (ALSO HAVE PERIODS OF NUMBNESS ON THE RIGHT SIDE OF MY FACE); TINGLING RIGHT ARM HAD SPREAD TO LEFT ARM AND LEFT LEG ALSO; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821287, expiry: UNKNOWN) dose was not reported, administered on 26-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 28-JUL-2021, the subject experienced tingling right arm had spread to left arm and left leg also. On 28-JUL-2021, the subject experienced numbness in right arm (also have periods of numbness on the right side of my face). On 29-JUL-2021, the subject experienced tingling and minor weakness spread to my right leg. On 30-JUL-2021, the subject experienced muscles in thighs and arms ache at times. On 02-AUG-2021, Laboratory data included: Blood test (NR: not provided) Normal, and MRI (NR: not provided) Normal. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from tingling right arm had spread to left arm and left leg also, muscles in thighs and arms ache at times, tingling and minor weakness spread to my right leg, and numbness in right arm (also have periods of numbness on the right side of my face). This report was non-serious.


VAERS ID: 1530491 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-28
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Feeling abnormal, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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: USJNJFOC20210807991

Write-up: FEELING OFF; UP ALL NIGHT WITH FEVER/LOW GRADE FEVER; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported) dose was not reported, administered on 28-JUL-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 28-JUL-2021, the subject experienced up all night with fever/low grade fever. On 03-AUG-2021, the subject experienced feeling off. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from up all night with fever/low grade fever, and feeling off. This report was non-serious.


VAERS ID: 1530590 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-27
Onset:2021-07-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LISINOPRIL; CARVEDILOL; TELMISARTAN; ELAVIL [ALLOPURINOL]; LORAZEPAM; PRILOSEC [OMEPRAZOLE MAGNESIUM]; FOLIC ACID; VITAMIN B2 + B6; BENTYL; TYLENOL; ZOFRAN MELT
Current Illness: Blood pressure high (this for quite a few years/Mother had high blood pressure along with her sisters)
Preexisting Conditions: Medical History/Concurrent Conditions: Cancer (dad had cancer); Heart murmur; Macular degeneration (Diagnosed a couple of years ago)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100962963

Write-up: whole arm is swollen; The whole arm is not sore, only the upper part where she received the vaccination; This is a spontaneous report from a contactable consumer (patient). A 79-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: ER8731), via an unspecified route of administration, administered in arm on 27Jul2021 19:00 (at the age of 79-years-old) as dose 1, single for covid-19 immunisation. Medical history included ongoing blood pressure high (this for quite a few years/mother had high blood pressure along with her sisters), macular degeneration (diagnosed a couple of years ago), heart murmur and cancer (dad had cancer). The caller has a ton of allergies so she was hesitant about getting the vaccine. Prior to vaccinations, no medication received within 4 weeks. Investigation Assessment was no. When the caller takes the flu vaccine she gets the regular one, not the one that the elderly people get because of all of her allergies. Concomitant medications included allopurinol (ELAVIL); lorazepam (MANUFACTURER UNKNOWN); omeprazole magnesium (PRILOSEC); folic acid (MANUFACTURER UNKNOWN); pyridoxine hydrochloride/riboflavin (VITAMIN B2 + B6); all for an unspecified indication, from an unspecified date and unknown if ongoing, lisinopril (MANUFACTURER UNKNOWN) for blood pressure high, start and stop date were not reported; carvedilol (MANUFACTURER UNKNOWN) for blood pressure, start and stop date were not reported; telmisartan (MANUFACTURER UNKNOWN) for blood pressure high, start and stop date were not reported; dicycloverine hydrochloride (BENTYL) for stomach, start and stop date were not reported; paracetamol (TYLENOL) for aches and pain, start and stop date were not reported; ondansetron (ZOFRAN MELT) for nausea, start and stop date were not reported. The patient received her first dose of the Pfizer COVID-19 Vaccine yesterday, 27Jul2021 19:00. This morning her arm was sore and swollen all the way down the arm. The whole arm was not sore, only the upper part where she received the vaccination but the whole arm was swollen. Caller would like to know if this was normal. Caller states that she would see her Nurse Practitioner tomorrow, she comes there twice a week. Patient has taken her blood pressure medication and states she could take Tylenol and anything else she can do. The caller was calling about the Pfizer covid vaccine. The caller had the vaccine around 7:00 last night. The caller knows the arm being sore was normal but her whole arm was swollen. This event happened after the first dose. These events started this morning. When the caller lifted her sleeve she noticed her whole arm was swollen. This was the same arm that she received the vaccine in. The event does not require a visit to emergency room and physician office. The outcome of events was not resolved.


VAERS ID: 1530606 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-01
Onset:2021-07-28
   Days after vaccination:88
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210728; Test Name: nasal swab; Test Result: Positive
CDC Split Type: USPFIZER INC202100975250

Write-up: She thought maybe she has a sinus infection; She has been feeling sick; Has Covid and she received both the Pfizer vaccines; Has Covid and she received both the Pfizer vaccines; This is a spontaneous report from a non-contactable consumer (patients parent) via Pfizer Sales Representative. A 23-year-old female patient received bnt162b2 (Pfizer-BioNTech COVID-19 Vaccine, Solution for injection), dose 2 via an unspecified route of administration on 01May2021 (at the age of 23-years-old) (Batch/Lot Number: EW0153; Expiration Date: Jul2021) as DOSE 2, SINGLE for prevention for Covid 19. The patient medical history was not reported. There were no concomitant medications. The patient previously took bnt162b2 (Pfizer-BioNTech COVID-19 Vaccine, Solution for injection), dose 1 via an unspecified route of administration on 10Apr2021 (Batch/Lot Number: ER8730) as DOSE 1, SINGLE for covid-19 immunisation. The patient parent (Pfizer Sales Representative) stated his daughter received her vaccine on 10Apr2021 and 01May2021 but through Pfizer. Today, she just texted that she has Covid. Reporter was not a health care professional he was just sales representative. Reporter further stated, do you need the final result to the report, she just sent me her report that says she is positive? The patient was taking, the doctor just put her on an antibiotic be-cause she thought maybe she had a sinus infection on an unspecified date. She al-so had been feeling sick on an unspecified date. So, she was taking an antibiotic that was Amoxicillin (Intent: Treatment). The patient underwent lab test, which was nasal swab, it was collected on 27Jul2021 at 11:09:57. Collected 27Jul2021, received 28Jul2021 and Released 28Jul2021 at 11:43 pm, they are not ''Time'' (not clear). Her report that says she was positive on 28Jul2021. The patient had no prior vaccination within 4 weeks. The outcome of all events was unknown. Follow-Up (03Aug2021): This follow-up is being submitted to notify that the lot/batch number is not available despite the follow-up attempts made. Follow-up attempts have been completed and no further information is expected.


VAERS ID: 1531533 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-24
Onset:2021-07-28
   Days after vaccination:95
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ortho Tri Cyclen Lo
Current Illness: none
Preexisting Conditions: migraines, kidney stones
Allergies: Latex, shellfish, sulfa, codeine, percocet
Diagnostic Lab Data: CT angiogram 7/29/2021
CDC Split Type:

Write-up: Patient developed extensive pulmonary embolism 3 months after vaccination


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