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

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

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

This is page 186 out of 8,753

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VAERS ID: 1821673 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-10-13
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008B212A / UNK - / -

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? 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: COVID 19.


VAERS ID: 1821819 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic reaction, Aphasia, Chest discomfort, Electroencephalogram, Intensive care, Laboratory test, Malaise, Myocardial necrosis marker, Pain in jaw, Protein total, Pruritus, Rhinorrhoea, Seizure, Stridor, Swollen tongue, Unresponsive to stimuli, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Dementia (broad), Convulsions (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: Yes
Diagnostic Lab Data: EEG/ protein/ cardio enzymes and a whole punch of other test
CDC Split Type:

Write-up: Itchy,,tongue swelling, running nose pain in right jar, tighten in my chest, strider breathing, wheezing, anaphylactic, unresponsive and seizure, could not speak they gave me 1 tablet of Benadryl and administer Epinephrine this is when I911 was called at the hospital that?s where I had the seizure the strider breathing there they administer again epinephrine gave me Albuterol and prednisone to opn me so I could breathe, the Allergyiest snook in with another doctor from her office who I never meet and as to listen to my lungs both of them then walked out and never to see her or him again I was in the trauma part of the hospital went to icu and was admitted there from the 13-15 I was discharged and after coming home was very sick went to my PCP who them put me on antibiotics for 7days and I?m still feeling sick. Prior to getting the vaccine I went in for skin testing and had a reaction that?s on 9-22/2021 at the same location


VAERS ID: 1822585 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-12
Onset:2021-10-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

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

Write-up: The day after my second shot I started spotting like a period and have been spotting since. I haven?t had a period in 10 years and now am spotting since the vaccine.


VAERS ID: 1823571 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-12
Onset:2021-10-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ESTRADIOL CIPIONATE; PROGESTIN
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101367182

Write-up: After both 2nd & 3rd dose my period came the next day after several months of not getting a period; This is a spontaneous report from a contactable consumer. A 53-year-old female patient (not pregnant) received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in the right arm on 12Oct2021 11:00 (at the age of 53 years) (Batch/Lot number was not reported) as DOSE 3 (BOOSTER), SINGLE for covid-19 immunisation. The patient had no medical history. Concomitant medication included estradiol cipionate; progesterone (PROGESTIN). The patient previously took BNT162B2 DOSE 1 on 17Feb2021 16:30 (lot: EN6201) and DOSE 2 on 10Mar2021 16:30 (lot number: EN6206); at the age of 52 years both in the right arm for COVID-19 immunization; Flu vaccine on 23Sep2021 (at the age of 53 years) for immunization. It was reported that the patient''s period came the next day after several months of not getting a period (postmenopausal haemorrhage) on 13Oct2021 04:00. The event was assessed as serious (medically significant). The patient did not received treatment for the event. The outcome of the event was recovered on an unspecified date.


VAERS ID: 1823596 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-10-13
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Dermatitis contact
Allergies:
Diagnostic Lab Data: Test Date: 20211006; Test Name: Nasal Swab; Test Result: Negative ; Test Date: 20211008; Test Name: Nasal Swab; Test Result: Negative ; Test Date: 20211013; Test Name: Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202101369159

Write-up: Tested positive for COVID-19; Tested positive for COVID-19; This is a spontaneous report from a contactable consumer or other non-health care professional. A 19 year old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection; lot number: EP6955 and expiration date: not reported), via intramuscular, in Left Arm, on 19Mar2021 (at the age of 18-year-old) as DOSE 1, SINGLE and BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection; lot number: EP6955 and expiration date: not reported), via intramuscular, in Left Arm, on 09Apr2021 (at the age of 18-year-old) as DOSE 2, SINGLE both for covid-19 immunization. Medical history included allergy to Some adhesives. There were no concomitant medications. The patient was not pregnant at time of vaccination. The patient didn''t receive any other vaccines within 4 weeks prior to the COVID -19 vaccine. The Patient had not been diagnosed with COVID-19 prior to vaccination and had been tested since the vaccination. The patient tested positive for covid-19 on 13Oct2021 at 10:30. The events resulted in Doctor or other healthcare professional office/clinic visit. The patient underwent lab tests and procedures which included sars-cov-2 test: negative on 06Oct2021, sars-cov-2 test: negative on 08Oct2021, sars-cov-2 test: positive on 13Oct2021.No treatment was received for the events. The outcome of the events was recovering at time of report. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1824731 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-12
Onset:2021-10-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / UNK - / OT
FLUR4: INFLUENZA (SEASONAL) (FLUBLOK QUADRIVALENT) / PROTEIN SCIENCES CORPORATION - / 1 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: USSA2021SA345050

Write-up: swelling in her left armpit, Swollen lymph nodes; The injection site was slightly achey; Initial information regarding an unsolicited valid non-serious case was received from a consumer/non-health care professional (Reference number- 00812694) and transmitted on 14-Oct-2021. This case involves a 65-year-old female patient who had swelling in her left armpit, swollen lymph nodes (lymphadenopathy) and the injection site was slightly achey (vaccination site pain) after receiving INFLUENZA QUADRIVALENT RECOMBINANT VACCINE [FLUBLOK QIV] and coronavirus disease of 2019 (COVID-19) VACCINE. The patient''s medical history, medical treatment(s), vaccination(s) and family history were not provided. The patient had no other vaccines. On 12-Oct-2021, the patient received a 0.5 mL first dose of suspect INFLUENZA QUADRIVALENT RECOMBINANT VACCINE (batch number and expiry not reported, formulation: solution for injection) via intramuscular route in the left arm for prophylactic vaccination. On an unknown date, the patient received a dose of suspect COVID-19 VACCINE (batch number and expiry not reported) via unknown route in unknown administration site for prophylactic vaccination. On 13-Oct-2021 the patient developed non-serious swelling in her left armpit, swollen lymph nodes (lymphadenopathy) and injection site was slightly achey (vaccination site pain) 1 day following the administration of INFLUENZA QUADRIVALENT RECOMBINANT VACCINE and (unknown latency) COVID-19 VACCINE. It was reported "Caller has questions about possible side effects of FLUBLOK QUADRIVALENT. Caller states that she received the FLUBLOK QUADRIVALENT vaccine. The injection site is fine; slightly achey, but there is a swelling in her left armpit. She noticed the swelling about 30 hours after getting the vaccine; she believes that it is a swollen lymph node. She states that she feels fine, she is having no other side effects. She has spoken with multiple pharmacists and her doctor, who have given her different answers about whether the swollen lymph node could be related to receiving the vaccine. Caller states that her arm was really bad after receiving the Covid vaccine." No laboratory data was reported. The patient was treated with NAPROXEN SODIUM (ALEVE) for Lymphadenopathy and vaccination site pain. At time of reporting, the outcome of the event was unknown. The reporter did not report the causality of events with FLUBLOK QIV. There will be no information available on the batch number for this case.


VAERS ID: 1824870 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse 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: No adverse reaction reported. Vaccine given outside of EUA.


VAERS ID: 1824872 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Malaise, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Weakness, vomitting, general ill feeling that was unexpected. This happened at home after leaving the pharmacy some hours after the shot. This was the booster and it hurt quite a bit. With the first two doses the shots were painless.


VAERS ID: 1825337 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-10-10
Onset:2021-10-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Contusion
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Entresto 49/51 2 X Daily Sotalol 80 2 X Daily Xarelto 20 1PD
Current Illness: None
Preexisting Conditions: Unspecified Cardiomyopathy; compromised Ejection Fraction; ICD implant; Ankylosing Spondylitis; Bladder Cancer; Asthma
Allergies: Gatifloxacin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Right shoulder sore post 2 weeks vaccine date About 3-4 days post vaccine, an area on lower left leg right above the ankle developed what appeared to be areas of blood vessel bursts under the skin - 5 circular areas developed, the largest was 1/2 inch across. Spots did not blemish when pressed, meaning, there was no change in color when pressed upon. 2 Physicians inspected area and collaborated and stated they didn''t know what it was. I was given a topical steroid cream and told to return in two weeks if it became worse. I did not use cream and areas cleared but left a blemish under the skin at 2 weeks post vaccine.


VAERS ID: 1825432 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-02-01
Onset:2021-10-13
   Days after vaccination:254
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

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

Write-up: Breakthrough COVID-19 + case after completion of full primary vaccination series. Required ICU care.


VAERS ID: 1825618 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-30
Onset:2021-10-13
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Blood creatinine increased, Blood urea increased, Brain natriuretic peptide increased, C-reactive protein increased, Echocardiogram abnormal, Electrocardiogram abnormal, Fibrin D dimer increased, Multisystem inflammatory syndrome in children, Red blood cell sedimentation rate increased, Serum ferritin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Haemorrhage laboratory terms (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Toxic-septic shock conditions (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), 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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: NKA
Diagnostic Lab Data: BUN, Creatinine, BNP, ALT, Ferritin, DDimer, CRP, and ESR all elevated. EKG and ECHO abnormal.
CDC Split Type:

Write-up: Developed MIS-C


VAERS ID: 1825692 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-12
Onset:2021-10-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Dizziness, Hyperhidrosis, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Feeling as if she was going to pass out x 2 days. Had to actually lie down to avoid passing out. This is the most worrisome, had minor reaction of muscle aches, and sweating.


VAERS ID: 1825716 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-10-11
Onset:2021-10-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF589 / 1 LA / -
FLUA4: INFLUENZA (SEASONAL) (FLUAD QUADRIVALENT) / SEQIRUS, INC. - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (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: Amlodipine, Losartan, Cetirizine
Current Illness: Had Covid infection 7/2021
Preexisting Conditions: Hypertension, Obstructive sleep apnea, Vitamin D deficiency, Prediabetes, Hyperlipidemia
Allergies: Lemon/Pepper seasoning
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: left arm pain and numbness of left thumb two days after receving both Covid Pfizer vaccine and Flu vaccine at the pharmacy.


VAERS ID: 1825752 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-17
Onset:2021-10-13
   Days after vaccination:210
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046A21 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Anticoagulant therapy, Bladder catheterisation, Bladder scan, Blood glucose increased, Blood lactate dehydrogenase, Brain natriuretic peptide increased, C-reactive protein, COVID-19 pneumonia, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Deep vein thrombosis, Fibrin D dimer, Fungal test, Glycosylated haemoglobin, Inflammatory marker increased, Intensive care, Leukocytosis, Liver function test normal, Lung consolidation, Lung opacity, Pneumonia, SARS-CoV-2 test positive, Scan with contrast abnormal, Serum ferritin, Ultrasound Doppler abnormal, Urinary retention, White blood cell count increased
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvastatin
Current Illness: None
Preexisting Conditions: hyperlipidemia, GERD, sleep apnea (not on CPAP machine)
Allergies: nkda
Diagnostic Lab Data: CT CHEST WITH CONTRAST ** HISTORY **: 75 years old, HYPOXEMIA, COVID pneumonia ** TECHNIQUE **: CT images of the chest acquired with 75 mL Omnipaque 300 intravenous contrast. CTDI: 5.52 mGy DLP: 223.03 mGy-cm COMPARISON: None available. ** FINDINGS **: HEART AND GREAT VESSELS: Heart size normal. LYMPH NODES: No suspicious lymph nodes. OTHER MEDIASTINUM: No significant abnormality. LUNGS: Diffuse bilateral groundglass and dense consolidations involving the upper and lower lobes. No suspicious pulmonary nodule. PLEURAL SPACE: Normal. UPPER ABDOMEN: No significant abnormality. SOFT TISSUES: No significant abnormality. BONES: No significant abnormality
CDC Split Type:

Write-up: 75 Y male with history of HLD, GERD, sleep apena not on CPAP admitted for ACUTE HYPOXEMIC RESPIRATORY FAILURE 2/2 COVID pneumonia. Received two doses of Moderna vaccine in March but not COVID positive after recent travel abroad. Patient returned on 10/2, developed symptoms on 10/6, and presented to the ED on 10/13. Note pt still in hospital on 10/28/21 AHRF // COVID PNA Hypoxemic respiratory failure due to COVID PNA. Interval CXR with improvement, CT chest b/l GGO, possible nodularity. Negative fungal culture, no sputum cultures. On admission, afebrile, WBC 15, no lactic acidosis, confirmed COVID swab, vaccinated (moderna), most c/w COVID pneumonia. S/p 1 x decadron, transitioned to solumedrol. S/p toci x 2. LFTs stable. BNP elevated initially, but downtrended. Leukocytosis still uptrending, most likely steroid-induced. Now s/p empiric CAP doxycycline and cefepime. Still with high oxygen requirements, but now off iNO. Inflammatory markers elevated, but stable. Continue to wean O2 as tolerated. Currently satting at 92% on 40L 40% FiO2. - Bactrim ppx, d/c when prednisone at 10mg daily - Continue to monitor inflammatory labs - CRP, d-dimer, ferritin, LDH every other day - Prednisone 20mg x 2 days starting 10/28, then 10mg x 2 days. - Wean O2 as tolerated, maintain O2$g 92% - Prone as tolerated at night - Lasix prn - Out of bed into chair. - Bedside commode - Tessalon pearls - Codeine/guaifenesin PREDIABETES Hx of pre-DM, glucose still elevated, likely due to steroids. A1c 6.6. Still with significant insulin requirements. CTM while weaning steroids. With prednisone taper, will adjust insulin regimen - Hypoglycemic protocol - NPH 10U BID - Regular ISS URINARY RETENTION Patient with $g999mL in PM bladder scan. Foley replaced. Patient with urinary retention in ICU and had foley placed. - Cont Tamulosin 0.4mg qd HLD - Continue home atorvastatin 20mg daily GERD - GI PPx: protonix PO - Bowel regimen: senna/miralax DVT Right popliteal DVT on lower extremity US (10/14/2021). Continue therapeutic dosing for lovenox. - ASA 81mg qd - VTE: Lovenox 40mg q12h per pharmacy recs


VAERS ID: 1825794 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-05
Onset:2021-10-13
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER 8729 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH 8736 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Appendicectomy, Appendicitis, Computerised tomogram abdomen abnormal
SMQs:, Retroperitoneal fibrosis (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Abilify and Adderall
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT scan to identify appendicitis and appendectomy
CDC Split Type:

Write-up: Appendicitis developed 6 months later


VAERS ID: 1825802 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: no adverse event/outcome. At the time of the vaccination, moderna had not had authorization for a booster dose yet.


VAERS ID: 1825809 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-10-10
Onset:2021-10-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017F21A / 2 LA / IM

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

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

Write-up: Patient received vaccine # 2 in her Moderna series on 10/10 and left the bandage on until it fell of on the morning of 10/13. She developed a red lined rash going up and down her arm and was advised to go to her provider. she was seen and diagnosed with infection


VAERS ID: 1825838 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-08
Onset:2021-10-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Blood test, Chest discomfort, Computerised tomogram abnormal, Computerised tomogram thorax, Dizziness, Dyspnoea, Electrocardiogram, Electrocardiogram ST segment abnormal, Extra dose administered, Hypersensitivity, Inappropriate schedule of product administration, Lethargy, Mobility decreased, Pain
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin; Oxybutynin
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa drugs
Diagnostic Lab Data: Bloodwork - 16th; Monday, the 18th ER = ruled out pulmonary embolism - EKG - they told my EKG was normal and sent me home. Found out later when I got the written report that the EKG was not normal. Result was: Non specific ST abnormality and also Mild dependent Collapse-result of a Chest CT scan.
CDC Split Type: vsafe

Write-up: I saw a doctor on four different occasions. On Wednesday, the 13th, I had a telehealth for extreme lethargy. I couldn''t get out of bed. I had the classic symptoms right after the vaccine - that started late Friday night and through Sunday - and then Monday the achy went away but I still couldn''t get out of bed and I was kind of light headed and Tuesday was the same and Wednesday was the same. The doctor said to give it another couple of days. I made an appt on the Saturday after that (16th) and was seen by a doctor that day. She thought I was have an extreme allergic reaction the vaccine. On the following Monday, I still wasn''t feeling great and I had a weird feeling in my chest and some shortness of breath. I went to an Urgent Care and they did and EKG and it was abnormal and they sent me to ER Hospital. They sent me home after telling things were normal. But they weren''t normal. They did not send me home with any treatment. They told me it was important that I follow up with my primary care physician. I followed up with the doctor (in person) on the 23rd. She is making referrals to cardiology and pulmonology. Plus she has ordered a repeat Chest CT. No treatment yet. I still have shortness of breath and I have an odd feeling in my chest. I have gotten some energy back. Got the flu vaccine 9/29/2021 through my work - before this 3rd dose of my COVID vaccine.


VAERS ID: 1826046 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-08-25
Onset:2021-10-13
   Days after vaccination:49
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW.178 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: Stress Test scheduled for 11NOV21, and a CT Calcium Score I''ll have in the next few days.
CDC Split Type:

Write-up: Pain in left chest. Started as throbbing off and on, lasted for a few days. Changed to a sharp knife-like pain that lasted for a few days. It wasn''t continual, but lasted for more than five days.


VAERS ID: 1826061 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-10-02
Onset:2021-10-13
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Joint swelling, Peripheral swelling, Tenderness, Ultrasound scan
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Norvasc 5 mg od edarbi 80 mg od Lipitor 40 mg B-12 D-3 flax seed oil
Current Illness: no
Preexisting Conditions: asthma
Allergies: sulfa
Diagnostic Lab Data: 10/13/2021-ultra sound - negative blood work done - normal
CDC Split Type: vsafe

Write-up: On 10/13/2021, my right ankle and foot was swollen, no pain. Every day I would ice it, elevate it. At night it would be really big and in the morning it was fine. I knew I had not injured it. It started to feel tight. I went to see my doctor because I was concerned it might be a blood clot. A week later, 10/13/2021, I went to see Dr. He ordered an ultra sound to see if it was a blood clot. Now, 10/28/2021- the foot is not as swollen as it was, but my ankle is still swollen. I have a little pain now if I put my sock on because it hit right where it''s swollen. There is really no pain in that ankle unless I touch it. I don''t know what is going on in that ankle. It is really weird to me.


VAERS ID: 1826266 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-10-12
Onset:2021-10-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Diarrhoea, Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Injection site warmth, No reaction on previous exposure to drug, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol-ipratropium, chlorhexidine mucous membrane liquid, cholecalciferol, cyanocobalamin, fluoride topical paste, glucagon, levothyroxine, metoprolol, midodrine, renal caps multivitamin, mupirocin topical, ondansetron, oxycodone, pantop
Current Illness: None
Preexisting Conditions: End stage renal disease on dialysis, hypothyroidism, osteoarthritis
Allergies: Adhesive bandage, amlodipine, aspirin, bee stings, codeine, companzine spansule, demerol hcl, droperidol, erythromycin, fish, gabapentin, green pepper, inapsine, nsaids, palivizumab, robaxin, shellfish, synalgos-dc, tetracycline, tizanidine, tolectin 600
Diagnostic Lab Data: None
CDC Split Type:

Write-up: No issues with first 2 vaccines. 10/12 received booster. 10/13 started having symptoms. Severe chills and shaking, had to stop dialysis early. Diarrhea x2 days. Redness, hardness, swelling, heat, pain at injection site, wrapped around to backside of arm. Continued worsening until 4th day after injection. Still sensitive to the touch, but no longer red and hot for another couple of days.


VAERS ID: 1826675 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-18
Onset:2021-10-13
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA ER8731 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Condition aggravated, Cough, Decreased appetite, Fatigue, Headache, Lacrimation increased, Nasal congestion, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test positive, Seasonal allergy, Vertigo
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (narrow), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Hypersensitivity (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: benzonatate (TESSALON) 100 mg capsule doxycycline (MONODOX) 100 mg capsule fexofenadine (ALLEGRA) 180 mg tablet fluticasone propionate (FLONASE) 50 mcg/actuation nasal spray meclizine (ANTIVERT) 12.5 mg tablet
Current Illness:
Preexisting Conditions: Nervous Pain of left lower extremity due to injury Respiratory Allergic rhinitis Obstructive sleep apnea Circulatory Presence of cardiac pacemaker Sinoatrial node dysfunction (CMS/HCC) Cardiac pacemaker Musculoskeletal Osteoarthritis, localized, knee Other Male erectile disorder of organic origin Psychic factors associated with disease Tremor Vertigo
Allergies: AspirinSwelling PantoprazoleHives / Urticaria SertralineHives / Urticaria, Rash ClarithromycinRash PenicillinsRash
Diagnostic Lab Data: 10/18/2021 0950 POCT COVID-19 PCR Collected: 10/18/21 0950 | Final result | Specimen: Swab from Nares POC COVID-19 PCR Detected Abnormal Lot # 100291745 Point of Care COVID-19 PCR Testing Method Cepheid Lot Expiration Date 9/11/22 RN Registered Nurse Progress Notes Signed Encounter Date: 10/21/2021 Signed Hide copied text Patient is here for MAB Infusion O2 sats $g or = 90% Signs of potential reaction reviewed with patient. Tolerated IV start and MAB infusion without complication. Pt has access to pulse oximeter and thermometer for home monitoring
CDC Split Type:

Write-up: Office Visit 10/18/2021 Urgent Care - CRNP Family Medicine COVID-19 +2 more Dx Cough ? Sore Throat ? Runny nose ? watery eyes ? Fatigue ? Poor Appetite ? Headache Reason for Visit History Chief Complaint Patient presents with ? Cough eating cough drops like candy ? Sore Throat sx started wed. ? Runny nose ? watery eyes ? Fatigue ? Poor Appetite ? Headache for weeks seeing neuro appts keep being canceled HPI Patient is a 75 y.o. male presents to UC without family accompanied with complaint of cough sore throat congestion fatigue and decreased appetite. Symptoms started on Wednesday. He is a farmer and has been dealing with corn dust, relates that this is his typical allergies this time of year. Typically he gets steroids and an antibiotic. No shortness of breath. No fever. He is vaccinated. Relates that he has also been dealing with some headaches and intermittent vertigo for months. Has been seen by ENT previously and has a pending appointment with neurology. Chief Complaint Patient presents with ? Cough eating cough drops like candy ? Sore Throat sx started wed. ? Runny nose ? watery eyes ? Fatigue ? Poor Appetite ? Headache for weeks seeing neuro appts keep being canceled


VAERS ID: 1827468 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-29
Onset:2021-10-13
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 3 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TADALAFIL; LATANOPROST
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: C5 palsy; Cervical spinal stenosis; Erysipelas; Sepsis (due to LLE erysipelas); Spinal decompression
Allergies:
Diagnostic Lab Data: Test Date: 20211013; Test Name: ECG; Result Unstructured Data: Test Result:atrial fibrillation w/ rapid ventricular response; Comments: confirmed
CDC Split Type: USPFIZER INC202101373751

Write-up: Atrial Fibrillation with Rapid Ventricular Response; This is a spontaneous report from a contactable physician (patient himself). A 66-year-old male patient received third dose (booster) of BNT162B2 (Pfizer-BioNTech COVID-19 mRNA vaccine, Lot number: 301308A), via an unspecified route of administration, administered in the right arm, on 29Sep2021 20:30 (at the age of 66 years) at a single dose for COVID-19 immunization. The patient received his vaccine at a pharmacy or drug store. Medical history included sepsis from Feb2019 due to LLE erysipelas on unspecified date, C-spine stenosis with decompression from Jun2015, and complicated by RUE C5 palsy on unspecified date. The patient has no known allergies. The patient has no Covid prior vaccination. The patient was not tested for Covid post vaccination. Concomitant medications included tadalafil and latanoprost eye drops. The patient previously received first dose of BNT162B2 (Pfizer-BioNTech COVID-19 mRNA vaccine, Lot number: EJ1685) administered in the left arm on 17Dec2020 at 06:00PM (at the age of 65 years) for COVID-19 immunisation, second dose of BNT162B2 (Pfizer-BioNTech COVID-19 mRNA vaccine, Lot number: EL0142) administered in the left arm on 06Jan2021 at 11:00PM (at the age of 66 years) for COVID-19 immunisation, and Influenza Fluzone High Dose Quad Strength administered in the left arm on 22Sep2021 (at the age of 66 years) for immunisation. The patient experienced atrial fibrillation with rapid ventricular response, first episode, duration of 25 min on 13Oct2021 22:45 with outcome of recovered on 13Oct2021 23:10. The event was ECG confirmed on 13Oct2021. No treatment was received for the event. The event resulted in emergency room/department or urgent care.; Sender''s Comments: Based on the available information in the case, the causal association between the event atrial fibrillation and the suspect drug BNT162B2 cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1827479 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-10-12
Onset:2021-10-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, SARS-CoV-2 test
SMQs:, Hearing impairment (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cancer
Allergies:
Diagnostic Lab Data: Test Name: COVID; Result Unstructured Data: Test Result:Unknown results; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101375004

Write-up: Bell''s Palsy; This is a spontaneous report from a contactable consumer (patient). A 71-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: FF8841), via an unspecified route of administration, administered in left arm on 12Oct2021 11:45 (at the of 71 years old) as dose 3 (booster), single for COVID-19 immunisation. Medical history included cancer. The patient has not had COVID prior to vaccination. The patient''s concomitant medications were not reported. No other vaccine was given in four weeks. The patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in left arm on 05Mar2021 10:30 (Batch/Lot Number: En6203, at the of 70 years old) for COVID-19 immunization and the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in right arm on 26Mar2021 09:30 (Batch/Lot Number: Er8733, at the of 70 years old) for COVID-19 immunization. The patient experienced bell''s palsy on 13Oct2021. No treatment was given in response to the event. The event resulted in Doctor or other healthcare professional office/clinic visit. The patient was tested for COVID post vaccination via nasal swab on an unspecified date with unknown results. The outcome of the event was not recovered.


VAERS ID: 1828793 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-12
Onset:2021-10-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Neuritis, Paraesthesia, Sensory loss
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Immune-mediated/autoimmune 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: No
Current Illness: No
Preexisting Conditions: migranes
Allergies: No
Diagnostic Lab Data: I saw neurologist on Oct 27. He mentioned mild sensory loss and developed mild immune neuritis .
CDC Split Type:

Write-up: Numbness and tingles on fingers and feet. At first more pronounced on left arm and feet. Now about the same on both sides.


VAERS ID: 1828850 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-10-09
Onset:2021-10-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE.
Current Illness: NONE.
Preexisting Conditions: NONE.
Allergies: NONE.
Diagnostic Lab Data: URGENT CARE - 10/16/2021 (PRESCRIBED DEBROX FOR EAR WAX AND NAC VITAMIN SUPPLEMENT) PRIMARY CARE DOCTOR - 10/21/2021 (FLUSHED RIGHT EAR AND PRESCRIBED AMOXICILIAN ANTIBIOTIC) ENT DOCTOR - 10/27/2021 (UNDERWENT HEARING TEST WHICH WAS NORMAL, PRESCRIBED METHYLPREDNISONE)
CDC Split Type:

Write-up: I AM EXPERIENCING A RINGING IN MY EARS SINCE MY 2ND DOSE OF THE PFIZER VACCINE.


VAERS ID: 1828859 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Cough, Discomfort, Immunodeficiency, Myalgia, Productive cough
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: First Pfizer COVID shot 3/22/2021
Other Medications: Many
Current Illness: None
Preexisting Conditions: Long history of childhood asthma. Very susceptible to upper respiratory infections.
Allergies: Sulfa antibiotics
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extremely uncomfortable above the waist. Muscle and joint pain virtually everywhere. Went away on Sunday. More importantly, some time shortly after booster, developed intermittent hacking cough, resulting in phlegm in throat. This continues to this day. I am out of town, and won?t be able to discuss with MD until Monday. Breakthrough case??? Or simply a mild URI?


VAERS ID: 1828936 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Herpes zoster, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Opportunistic infections (broad)

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

Write-up: 1 hr later I felt tired, muscle aches and joint pain. This Sat - 23Oct2021, really tired and there rash right side - mild case of shingles not so much pain. the doctor didnt say its linked to vaccine. Saw dermatologist on 26Oct2021. Still being treated .it not getting worse.


VAERS ID: 1828991 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-04-22
Onset:2021-10-13
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Lethargy, Malaise, Respiratory distress, Seizure like phenomena, Tachypnoea
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Convulsions (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient hospitalized with Covid symptoms after receiving Covid vaccination. Patient experienced respiratory distress, tachypnea, lethargy, and seizure like activity.


VAERS ID: 1829010 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Dizziness, Fatigue, Headache, Pain in extremity, Peripheral swelling, Swelling face, Ultrasound scan, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: White matter abnormalities Fibromyalgia Predispositions or genetic marks for cancer
Allergies: MRI contrast dye Some medications like Trazadone Epidural Outdoor allergies Walnuts Shellfish Eggs
Diagnostic Lab Data: Blood work Ultrasound of left leg
CDC Split Type: vsafe

Write-up: Extreme fatigue Dizziness Leg swelling Pain in the leg Hives Facial swelling Headache


VAERS ID: 1829019 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-25
Onset:2021-10-13
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Mental status changes, Oxygen saturation decreased, SARS-CoV-2 test positive
SMQs:, Dementia (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (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, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine 10 mg oral tablet, 10 mg= 1 TAB, PO, Daily aspirin, 81 mg, PO, Daily atorvastatin 80 mg oral tablet, 80 mg= 1 TAB, PO, Daily carvedilol 3.125 mg oral tablet, 3.125 mg= 1 TAB, PO, BID (2 times a day) MiraLax oral powder for recons
Current Illness:
Preexisting Conditions: ANEMIA, BACK INJURY, BACK PAIN, FOOT DROP, HYPERTENSION, OSTEOARTHRITIS
Allergies: ONIONS, PEPPERS
Diagnostic Lab Data: COVID POSITIVE 10/13/2021
CDC Split Type:

Write-up: CHANGE IN MENTAL STATUS, DECREASE IN O2 SATS


VAERS ID: 1829029 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-10
Onset:2021-10-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 1 RA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Hypoaesthesia, Laboratory test, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Penicillin, Sulfa
Diagnostic Lab Data: I had labs drawn 10/28/2021 and still waiting for results.
CDC Split Type:

Write-up: Three days after the first dose of the Moderna COVID 19 Vaccination I experienced chest pain with tingling/numbness in fingers and arms. Still currently experiencing symptoms.


VAERS ID: 1829345 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-10-12
Onset:2021-10-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Fall, Fatigue, Feeling hot, Pain in extremity
SMQs:, Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Patient reports on 10/13/2021 at approximately 11:30 pm patient was laying in bed. He reports he started to feel hot and went out to his chair in the living room. Patient was sitting in chair when his left arm had extreme pain and then severe chest pain began. Patient reports he fell to his knees and was unable to call out to his spouse for approximately two minutes after chest pain started. Patient reports "I thought my heart was going to explode". Patient reports the pain subsided after a couple of minutes. He denies no further symptoms of chest pain but does report continued left arm pain and fatigue since this time.


VAERS ID: 1829359 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-10-12
Onset:2021-10-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac discomfort, Chest pain, Fatigue, Feeling hot, Limb discomfort, Pain in extremity
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Patient reports on the night of Oct 13th at 1130 pm he was in bed and started to feel very hot. Patient reports he went out to the living room and was sitting in his chair. He reports sudden onset of severe left arm pain and the severe chest pain. Patient reports he fell to his knees with the chest pain and reports he was unable to call for his wife due to the pain, for approximately 2 minutes. Patient reports "I thought my heart was going to explode". Patient reports after that time, the chest pain subsided but he continues to have left arm discomfort and has fatigue since this time.


VAERS ID: 1829371 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-15
Onset:2021-10-13
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Acute respiratory failure, C-reactive protein increased, Chest X-ray abnormal, Fibrin D dimer increased, Lung opacity
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: DM, HTN, Hyperlipidemia, Obesity, CKD, COPD, Osteoarthritis
Allergies: ACE Inhibitors
Diagnostic Lab Data: CRP 3.4, D-dimer 0.51; CXR fine alveolar opacities suspected occupying the right and left mid to lower lung zone
CDC Split Type:

Write-up: Hospitalized 3 days with acute respiratory failure with hypoxia. Resolved. Treated with incentive inspirometer, albuterol inhaler, remdesivir, oxygen, decadron


VAERS ID: 1829875 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-17
Onset:2021-10-13
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anaphylactic reaction, Dysphonia, Fatigue, Pruritus, Spirometry, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fluvirin and Boostrix
Other Medications: Advair 500-50 Diskus blister with device Montelukast SOD 10 mg tablet Sertraline HCL 25mg tablet Sertraline HCL 50 mg tablet Claritin 24 FE liqui-gels (10mg loratidine) Acyclovir 400 mg tablet Albuterol HFA (Ventolin INH)
Current Illness: n/a
Preexisting Conditions: asthma
Allergies: Tree nuts Penicillin Molds, dust, dander
Diagnostic Lab Data: Spirometry
CDC Split Type:

Write-up: Very mild anphylaxis occurred after vaccine administration on 9/17/21. Resolved without antihistamine, and patient avoided taking loratidine that evening as to not interfere with the vaccine. On 10/11 patient''s montelukast prescription manufacturer changed, and the new brand contained PEG while her old brand did not. This was the only change in medications. On or around 10/13 patient starting having allergic reaction symptoms including itchy throat and body, hoarse voice, and exhaustion. Benadryl was taken and helped with itch symptoms but not exhaustion or hoarse voice. Symptoms resumed until manufacturer was changed back to the generic montelukast. The total time of the allergic reaction was around 10 days, and patient has never had an allergic reaction last longer than 1-2 days, other than getting the flu vaccine and having asthma symptoms afterward. Dr. advised to avoid PEG and increase loratidine to 20mg/day for 2 weeks until resolved, with methylpredinose boost added for labored breathing. Patient did not change any PEG levels other than the vaccine, the generic asthma med, and some cosmetics items.


VAERS ID: 1829882 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE QUADRIVALENT) / SANOFI PASTEUR UJ732AA / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Joint swelling, Thrombosis, Ultrasound scan
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NOT KNOWN
Current Illness: NOT KNOWN
Preexisting Conditions: NOT KNOWN
Allergies: NOT KNOWN
Diagnostic Lab Data: PATIENT STATES THAT ULTRASOUND WAS DONE AND BLOOD CLOT WAS CONFIRMED.
CDC Split Type:

Write-up: PATIENT STATES THAT AFTER ABOUT 2-3 HOURS OF VACCINATION STARTED TO HAVING SOME SWELLING IN HER LEFT ANKLE . SHE STATES THAT THE SWELLING WAS VERY BAD.


VAERS ID: 1831050 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dizziness, Erythema, Flushing, Inappropriate schedule of product administration, Oropharyngeal discomfort, Skin burning sensation, Swelling face, Throat clearing, Tongue discomfort
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Medication errors (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: OLMESARTAN
Current Illness: Headache (thought she had pink eye)
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure abnormal (Blood pressure); Chills; COVID-19; Diarrhea; Loss of smell; Loss of taste
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101381300

Write-up: so dizzy that she cannot get out of bed; her tongue well either now; face was flushed red on the left side and swollen, cheek was swollen and red; face was flushed red on the left side and swollen, cheek was swollen and red; face was flushed red on the left side and swollen, cheek was swollen and red; cheek felt like it was sunburned a little; fist dose of the Pfizer Covid-19 Vaccine on 15Jan2021/ second dose of the Pfizer Covid-19 Vaccine on13Oct2021; coughing; had the feeling of needing to clear her throat; felt like something was in her throat; This is a spontaneous report from a contactable consumer (patient) via Medical Information Team. A female patient of an unspecified age received BNT162B2 (COMIRNATY; lot number and expiration date were not reported), via an unspecified route of administration on 13Oct2021, dose 2, single for COVID-19 immunisation. Medical history included Blood pressure abnormal (blood pressure), COVID-19, chills, ongoing headache (thought she had pink eye), diarrhea, loss of smell and taste. Concomitant medication included olmesartan. Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number and expiration date were not reported) administered via an unspecified route of administration on 15Jan2021, dose 1, single for COVID-19 immunisation and experienced allergic reaction, tongue got swollen, she was told she may have had covid or been exposed to someone that had covid, yesterday and still today it felt like I burnt the tip of my tongue/burn your tongue with hot liquid, her tongue was red, poking my tongue with needles, very painful/poking her tongue with needles, it very was painful, tongue was numb for 2-3 hours/tongue got numb, arm hurt, diarrhea, now feeling cold and thinks she might have a fever/37 degrees C, she feels warm, she looked at her tongue later on, like 3 days later, and it had holes in it, not feeling well, is now feeling cold and thinks she might have a fever, patient stressed out. The patient''s doctor''s office said to get the second dose. The patient went to a clinic and her own doctor gave her the second dose and she had a nurse watch her for an hour. About 45 minutes after the shot, the patient started coughing and it would not stop. The patient had the feeling of needing to clear her throat and she could not stop. The patient had a really bad, it felt like something was in her throat. The doctor came and looked at the caller and said her throat was fine but because of the coughing and stuff she got an antihistamine shot. The patient''s doctor said he was going to prescribe prednisone, but he did not give it to her, and they did not call it in. The patient was fine all day on 14Oct2021 and then around 14:00, which was like 24 hours after she got her second dose, she looked at her face and it was flushed red on the left side and swollen, the cheek was swollen and red, it felt like it was sunburned a little. An hour and a half later the patient got it on the other cheek. Up until 23:00, when the patient went to bed, both of her cheeks were red but the last cheek was redder than the other. The patient called her allergist and they said to take Benadryl. On 15Oct2021, the patient was so dizzy and she was afraid to get out of bed. It was stated that the patient looked it up and could not find anything about dizziness and the Pfizer COVID-19 Vaccine. The patient asked whether this from the Benadryl or the COVID-19 vaccine. It was stated the patient could not control her tongue well either now. The patient spoke with medical information in the reporting week to figure out if she needed to get the second dose or restart the series. The patient''s doctor said to get the first shot again, but her allergist said the second one was okay. The patient spoke to medical information and referred a document that states it was the second dose that she does not repeat the first dose, but the patient''s doctor did not agree with this. The patient stated that she was reading that people who had the reaction only had it with the first dose and not the second dose, but the patient had a reaction with both. The outcome of the events was Information on the lot/batch number has been requested.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-2021040025 Same patient/product, different dose/event


VAERS ID: 1831054 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Reading disorder, Sinus headache, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (if covid prior vaccination: Yes)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101381661

Write-up: vision became blurry/I couldn''t focus on objects; I could not read at all; severe sinus headache; This is a spontaneous report from a contactable Other HCP (patient). A 55-years-old female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration, administered in left arm on 13Oct2021 10:30 (Lot Number: 301308A) (at the age of 55-year-old) as dose 2, single for COVID-19 immunisation. The patient was not pregnant at the time of vaccination. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 22Sep2021 11:00 AM (lot number=FC3183) (at the age of 55-year-old) in left arm for COVID-19 immunisation, and the patient experienced COVID-19. Medical history included COVID-19 prior vaccination. No COVID tested post vaccination, there was no known allergies. There were no concomitant medications. On 13Oct2021, the patient''s vision became blurry. She couldn''t focus on objects. She could not read at all. It lasted about 15-20 minutes. Also, on 13Oct2021, a severe sinus headache came on shortly after her vision recovered, lasting approximately 24 hours. No treatment received. The patient was recovered from vision became blurry and could not read at all on 13Oct2021, recovered from severe sinus headache on 14Oct2021.


VAERS ID: 1831409 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-01
Onset:2021-10-13
   Days after vaccination:165
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / OT
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Influenza virus test, Malaise, Pyrexia, SARS-CoV-2 test, Unevaluable event
SMQs:, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: DUPIXENT
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: flu test; Test Result: Negative ; Comments: had a blood culture drawn; Test Name: COVID-19 virus test; Result Unstructured Data: result not received; Comments: had a blood culture drawn
CDC Split Type: USSA2021SA347708

Write-up: bad reaction; not doing very well; high fever; Initial information received on 15-Oct-2021 regarding an unsolicited valid non-serious case received from a physician and consumer/non-healthcare professional. This case involves a 65 years old female patient who experienced high fever (pyrexia), not doing very well (malaise) and bad reaction (unevaluable event) while treated with DUPILUMAB [DUPIXENT], while receiving PNEUMOCOCCAL VACCINE, INFLUENZA VACCINE and MODERNA COVID-19 VACCINE. The patient''s past medical treatment(s), vaccination(s) and family history were not provided. It was unknown if the patient had any medical history, concomitant disease or risk factor. In May 2021, the patient started taking DUPIXENT (DUPILUMAB) solution for injection 300 mg every other week subcutaneous (with an unknown batch number) for dermatitis atopic. On 13-Oct-2021, the patient received a dose of suspect INFLUENZA VACCINE and PNEUMOCOCCAL VACCINE (batch number and expiry date not reported) produced by unknown manufacturer lot number not reported via an unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, the patient received a dose of suspect MODERNA COVID-19 VACCINE not produced by Sanofi Pasteur lot number not reported via an unknown route at an unknown administration site for prophylactic vaccination. On 13-OCT-2021 the patient developed a non-serious high fever (pyrexia), not doing very well (malaise) and bad reaction (unevaluable event) same day following the administration of INFLUENZA VACCINE and PNEUMOCOCCAL VACCINE, (unknown latency) following the dose intake of DUPILUMAB and administration of MODERNA COVID-19 VACCINE. Patient stated she was tested for flu and COVID and had a blood culture drawn her flu test was negative and COVID test was not received yet. It was unknown if there were other lab data/results available. It was unknown if the patient experienced any additional symptoms/events. DUPILUMAB (DUPIXENT) was continued. It was not reported if the patient received a corrective treatment for the events (high fever, not doing very well, bad reaction). On an unknown date, the patient recovered from high fever (temperature is now back to normal). The event outcome was unknown for not doing very well, bad reaction. There will be no information available on the batch number for this case.


VAERS ID: 1831755 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-25
Onset:2021-10-13
   Days after vaccination:230
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007M20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013A21A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Blood culture negative, COVID-19, Computerised tomogram head normal, Fall, Mobility decreased, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), 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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 75-year-old male was admitted to the hospital with weakness. He had high fever and fell at home unable to get up. Pt was diagnosed with COVID-19. No respiratory symptoms. Has been on room air with no cough or shortness of breath. We kept the patient on observation for 24 hours as he is taking Coumadin. CT of the head came back normal. Negative blood cultures. Patient was discharged and instructed to return if he had and SOB or cough.


VAERS ID: 1831770 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: School       Purchased by: ?
Symptoms: Amnesia, Anxiety, Back pain, Depression, Fatigue, Feeling abnormal, Injection site swelling, Insomnia, Irritability, Migraine, Nausea, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (narrow), Hypoglycaemia (broad)

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

Write-up: Extreme brain fog, migraines, memory loss, fatigue, nausea, depression, anxiety, large softball size injection site. Tingling down forearm and into fingers . Sharp stabbing pain in back left side, just off of spine. Irritability, wanting sleep but having trouble sleeping.


VAERS ID: 1832112 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-10-12
Onset:2021-10-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arteriogram coronary normal, Arthralgia, Back pain, Blood pressure increased, Chest discomfort, Electrocardiogram normal, Hypoaesthesia, Laboratory test, Myocardial necrosis marker, Pain, Pain in extremity, Painful respiration, Panic attack, Pericarditis, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Chronic kidney disease (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cetirizine 10mg, famitodine 20mg, vitamin D3 5000IU, levothyroxine 88 mcg, clonazepam 1mg, quetiapine 25mg.
Current Illness: None
Preexisting Conditions: CKD Stage 3, asthma, hypothyroidism, anxiety, depression, PTSD
Allergies: Sulfa, morphine, egg, environmental
Diagnostic Lab Data: Multiple labs, ekg, angiogram
CDC Split Type:

Write-up: Got 1st shot on 10/12/21 in left arm. On 10/13 right arm started having numbness and pain from shoulder to wrist. It was continual and daily. On 10/24/21 in evening I experienced heavy chest pressure, sharp pain in back between shoulder blades, more numbness and pain in right arm. Worse pain with deep breathing. Worse when lying down. Called 911. Medics ran ekg several times. It was normal. BP elevated. Brushed off as panic attack. No trip to ER. ON FRIDAY 10/29/21 I woke at 4:45 am to the exact same symptoms as stated on 10/24. 911 called and this time my husband had them transport me to Medical Center ER. labs drawn showed enzymes at 117. Dr. diagnosed pericarditis and was prepared to send me home. 2nd labs came back as he was preparing to send me home. Heart enzymes shot up to 282. Had to have angiogram done, which was all clear. I was able to come home later that evening. Angiogram was done by Dr. I have a follow up appointment with their partnering ANRP on 11/5/21


VAERS ID: 1832113 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-10-11
Onset:2021-10-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 1 RA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE QUADRIVALENT) / SANOFI PASTEUR - / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Joint swelling, Peripheral swelling, Rash, Ultrasound Doppler normal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lisinopril,
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: blood test 10/20/2021 ultrasound no evidence of DVT 10/27/2021
CDC Split Type:

Write-up: rotating rash legs/buttocks, rotating feet/ankle/hand/calf swelling


VAERS ID: 1832576 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-10-12
Onset:2021-10-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Dizziness, Dyspnoea, Eye pruritus, Faeces soft, Heart rate increased, Hypoaesthesia, Joint range of motion decreased, Nausea, Neuralgia, Oropharyngeal pain, Pain in extremity, Paraesthesia, Pharyngeal swelling, Pruritus, Urticaria, Vision blurred, Visual impairment
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, omeprazole,vitamin C
Current Illness: Gerd
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None no health insurance
CDC Split Type:

Write-up: 15 minutes; dizziness,nausee urgent onset of soft stool, ,itchy ears ,,blurry vision, 30 min; swollen throat , itchy eye''s, itchy shin, upper body hives..45 min to 1 hour ; right side numbness and tingling ,, left side bone joint pain ,sore throat,, about 2 hours after shortness of breath, chest tightening,,,,, rapid heart rate,,,..2.5 weeks after still severe left arm. nerve pain, limited range of motion, pain mostly worse while body at rest,,vision changes.


VAERS ID: 1832853 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-29
Onset:2021-10-13
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 3 LA / SYR

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

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

Write-up: seems to be chronic spontaenous urticaria (based on online research), itchy hives and splotches all over trunk, scalp, neck, arms, legs randomly throughout day. Goes away with antihistamine but returns every day. This was after his booster shot, which he received since he is immunocompromised as he is lacking a spleen. He will see a doctor if it does not resolve itself soon.


VAERS ID: 1832863 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 3 LA / IM

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

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

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


VAERS ID: 1833315 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Influenza like illness
SMQs:, Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: alendronate, fluconazole, vitamins, calcium, probiotics
Current Illness:
Preexisting Conditions: ibs, fibromyalgia
Allergies: penicillin, sulfur, bees, wheat, whet
Diagnostic Lab Data:
CDC Split Type:

Write-up: flu like symptoms, joint pain


VAERS ID: 1833428 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 EXP: / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Cough, Disturbance in attention, Fatigue, Immunodeficiency, Injection site reaction, Pain in extremity, Pyrexia, Rash macular
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Second COVID shot March 2, 2021
Other Medications: Levothyroxin 100mcg As needed: Flonase Losartan 50 mg Advair Simvastatin 40 mg
Current Illness: None
Preexisting Conditions: Chronic Lymphocytic Leukemia Thyroid problem High blood pressure
Allergies: Sulpha Drugs Tuna Fleet Phospho Soda Biaxin (Clarithromycin) Transdermal scop patch
Diagnostic Lab Data: None - dealt with at home
CDC Split Type:

Write-up: Reaction to COVID booster shot (Phizer): Low grade fever (Wednesday, Thursday, and Friday), Cough on Wed. Thurs. Fri. Sat., Weakness on W, Th, F, Sa, S and Mon, Tired (just wanted to sleep), Left arm pain (aching and throbbing starting mid chest, left arm, to left shoulder blade (Wed. evening thru Thursday), Trouble focusing (Th, F, and Sa), Blotchiness on arm around injection sight - developed on Sunday - lasted til Monday No treatment by doctor given


VAERS ID: 1833596 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (broad)

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

Write-up: Patient verbally and in writing states his first covid vaccine was a Pfizer. PHN was in the trailer by herself without a computer at the time. PHN chose to give a Pfizer based off of his word and in fact his first one was a Moderna. PHN called patient to apologize and patient apologized to PHN even more. PHN explained that he does not need to repeat dose.


VAERS ID: 1833599 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-21
Onset:2021-10-13
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Nausea, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 mg tablet atorvastatin (LIPITOR) 10 mg tablet chlorthalidone (HYGROTON) 25 mg tablet clobetasoL (TEMOVATE) 0.05 % ointment irbesartan (AVAPRO) 300 mg tablet sildenafiL (VIAGRA) 50 mg tablet
Current Illness:
Preexisting Conditions: Nervous Decreased hearing of right ear Circulatory TIA (transient ischemic attack) Essential hypertension Dilatation of aorta Digestive Adenomatous polyp of colon Barrett''s esophagus without dysplasia Gastroesophageal reflux disease Fatty liver Musculoskeletal Tendinitis of right forearm Rash of hand Endocrine/Metabolic Pure hypercholesterolemia Glucose intolerance (impaired glucose tolerance) Other Obesity, Class II, BMI 35-39.9 History of transitional cell carcinoma of kidney Vasculogenic erectile dysfunction Neuro-endocrine carcinoma Encounter for preventative adult health care examination
Allergies: NKA
Diagnostic Lab Data: 10/19/2021 1002 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 10/19/21 1002 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result Detected Critical 10/19/2021 1002 COVID-19 PCR Collected: 10/19/21 1002 | Final result | Specimen: Swab from Nasopharynx
CDC Split Type:

Write-up: COUGH, Fatigue, Congestion or runny nose, and Nausea or vomiting


VAERS ID: 1833603 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Gait disturbance, Mobility decreased, Muscular weakness, Walking aid user
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyndamax, Losartan, eliquis, allopurinol, metoprolol, gabapentin, atorvastin, furosemide, tamsulosin, CoQ10, D-3, vit B complex
Current Illness: None
Preexisting Conditions: Stage 3 kidney disease, Wild Amyloidosis
Allergies: Celebrex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme chills with intense shivering. Followed the next morning with extreme weakness so couldn''t walk without help using walker. Unable to get out of chair. Weakness lasted all day after shot day till mid day of second day after shot.


VAERS ID: 1833644 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-25
Onset:2021-10-13
   Days after vaccination:230
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, COVID-19, COVID-19 pneumonia, Cardiac telemetry, Cardiomegaly, Chest X-ray abnormal, Chronic kidney disease, Cognitive disorder, Computerised tomogram, Condition aggravated, Cough, Decreased appetite, Dyspnoea, Exposure to SARS-CoV-2, Fatigue, Fibrin D dimer increased, Hyperglycaemia, Hypoxia, Insulin-requiring type 2 diabetes mellitus, Interstitial lung disease, Lung infiltration, Lung opacity, Malaise, Osteoarthritis, Pneumonia, Procalcitonin, SARS-CoV-2 test positive, Scan with contrast abnormal, Spinal osteoarthritis, Ultrasound Doppler normal
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Hypersensitivity (broad), Arthritis (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ACCU-CHEK AVIVA strip amLODIPine (NORVASC) 10 mg tablet aspirin 81 mg tablet carvediloL (COREG) 6.25 mg tablet cholecalciferol, vitamin D3, 25 mcg (1,000 unit) capsule codeine-guaiFENesin (ROBITUSSIN-AC) 10-100 mg/5 mL liquid dutaster
Current Illness:
Preexisting Conditions: Nervous Polyneuropathy, diabetic (CMS/HCC) Lower back pain Early stage nonexudative age-related macular degeneration of both eyes Pseudophakia of both eyes Benign neoplasm of skin of right lower eyelid Respiratory Acute respiratory failure with hypoxia (CMS/HCC) Cough Bronchitis Circulatory Hypertension Digestive Rectal polyp Vitamin D deficiency Obesity, morbid (more than 100 lbs over ideal weight or BMI $g 40) (CMS/HCC) Obesity (BMI 30-39.9) Obesity (BMI 30-39.9) Genitourinary Benign enlargement of prostate Stage III chronic kidney disease (CMS/HCC) Musculoskeletal Actinic keratosis Furuncle Skin lesion of back Skin lesion of left upper extremity Cellulitis of both lower extremities Skin lesion of right leg Intertriginous candidiasis Endocrine/Metabolic Dyslipidemia Hyperkalemia Hypoglycemia Type 2 diabetes mellitus (CMS/HCC) Hematologic Anemia Leukopenia Infectious/Inflammatory COVID-19 Immune Allergic drug reaction Other Elevated prostate specific antigen (PSA) Gynecomastia, male Mild cognitive impairment Overweight(278.02) Dietary noncompliance Localized edema Memory loss H/O colonoscopy
Allergies: DoxycyclineHives / Urticaria AtorvastatinOther (document details in comments) CephalexinRash EzetimibeOther (document details in comments)
Diagnostic Lab Data: 10/19/2021 1114 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 10/19/21 1114 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result Detected Critical 10/19/2021 Narrative & Impression XR CHEST 2 VW IMPRESSION: Patchy bibasilar infiltrates suspicious for multifocal pneumonia. END OF IMPRESSION: INDICATION: Contact with and (suspected) exposure to covid-19 Cough, unspecified. TECHNIQUE: PA and lateral projections of the chest are acquired. COMPARISON: 1/31/2018 FINDINGS: There are patchy bibasilar infiltrates. Heart is mildly enlarged. No pneumothorax or pleural effusion. Degenerative changes are noted in the spine and shoulders. X-ray chest 2 views Result Date: 10/19/2021 XR CHEST 2 VW IMPRESSION: Patchy bibasilar infiltrates suspicious for multifocal pneumonia. END OF IMPRESSION: INDICATION: Contact with and (suspected) exposure to covid-19 Cough, unspecified. TECHNIQUE: PA and lateral projections of the chest are acquired. COMPARISON: 1/31/2018 FINDINGS: There are patchy bibasilar infiltrates. Heart is mildly enlarged. No pneumothorax or pleural effusion. Degenerative changes are noted in the spine and shoulders. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view, Portable Result Date: 10/27/2021 XR CHEST 1 VW PORT IMPRESSION: Interval increase of bilateral patchy airspace opacities within the periphery of the lungs. END OF IMPRESSION: INDICATION: Worsening hypoxia with activity. TECHNIQUE: AP portable projection of the chest is acquired. COMPARISON: Portable chest dated 10/22/2021. FINDINGS: There has been a slight interval increase of the bilateral patchy airspace opacities within the periphery of the lungs when compared with 10/22/2021. No pleural effusions or pneumothorax are identified. The cardiomediastinal silhouette is stable. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view Result Date: 10/23/2021 XR CHEST 1 VW IMPRESSION: 1. Some patchy lung infiltrates suspicious of infectious process and COVID-19 pneumonia changes. 2. Stable some cardiomegaly. END OF IMPRESSION: INDICATION: Shortness of breath. TECHNIQUE: Single AP projection of the chest is acquired. COMPARISON: Chest radiograph dated October 19, 2021. FINDINGS: Some cardiomegaly changes are stable. Some interstitial vascular lung marking prominence is stable. Some patchy lung infiltrates are reidentified. No pneumothorax or effusion changes are noted. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. Ultrasound lower extremity venous bilateral Result Date: 10/25/2021 US LOWER EXTREMITY VENOUS BILATERAL IMPRESSION: 1. Suboptimal visualization of the left peroneal vein. 2. Otherwise no evidence of DVT of the bilateral lower extremities. END OF IMPRESSION: INDICATION: Elevated D-Dimer, rule out DVT. TECHNIQUE: Multiple longitudinal and transverse 2D real-time ultrasound images were performed from the groin to knee, and at the calf and ankle. Color flow and spectral duplex Doppler imaging was also performed. Permanently-recorded images were obtained and stored. COMPARISON: Venous Doppler evaluation of the bilateral lower extremities dated January 30, 2018. FINDINGS: No evidence of deep venous thrombosis. On each side, there is normal flow, compressibility, and augmentation in the common femoral, greater saphenous, superficial and deep femoral veins, and popliteal veins. There is also normal flow, compressibility, and augmentation in the posterior tibial veins, right peroneal, and small saphenous veins in the calves. There is suboptimal visualization of the left peroneal vein. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. CT angiogram chest pulmonary embolism with and without contrast Result Date: 10/24/2021 CTA CHEST PULMONARY EMBOLISM W WO CONTRAST IMPRESSION: Suboptimal opacification of the main pulmonary artery. No large central embolus identified. Evaluation is suboptimal for smaller segmental and subsegmental emboli. Multifocal patchy asymmetric groundglass air-space disease bilaterally, consistent with changes of multifocal COVID-19 pneumonia. END OF IMPRESSION: INDICATION: COVID-19 pneumonia with elevated D-dimer. Assess for pulmonary artery embolism. TECHNIQUE: Enhanced helical CTA scan of the chest was performed from the lung apices to below the diaphragm, including the pulmonary artery. 2 mm axial reconstructions with MPR coronal, oblique and sagittal images were created. 3D post processing imaging was obtained and stored. CONTRAST: 100 mL of IODIXANOL 320 MG IODINE/ML INTRAVENOUS SOLUTION administered INTRAVENOUS. Quality of contrast opacification was suboptimal. COMPARISON: Chest radiograph October 22, 2021. FINDINGS: There is poor opacification of the main pulmonary artery. No large central embolus identified. Evaluation is suboptimal for smaller segmental and subsegmental emboli. No evidence of thoracic aortic aneurysm or dissection. No adenopathy noted. No pleural or pericardial effusions are seen. Regional soft tissues are grossly intact. Limited evaluation of the upper abdomen is unremarkable. On lung windows, there are multifocal patchy asymmetric groundglass infiltrates noted, consistent with changes of multifocal COVID-19 pneumonia. Central airways are patent, without evidence for endobronchial lesions. Osseous structures are grossly intact with scattered degenerative changes. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient
CDC Split Type:

Write-up: 10/19/2021 COUGH,SOB ED to Hosp-Admission Discharged 10/22/2021 - 10/30/2021 (8 days) MD Last attending ? Treatment team Acute respiratory failure with hypoxia (CMS/HCC) Principal problem Chief Complaint Patient presents with ? Shortness of Breath 1. COVID 19 2. Hypoxemia 3. Type 2 diabetes mellitus with hyperglycemia with insulin use 4. CKD Stage 3 5. Mild cognitive impairment Plan: Patient is fully vaccinated but still ill. Will require admission under telemetry and pulse oximetry. Start decadron 6mg IV daily x 10 days -$g obviously will make sugars worse but can work on that as we go forward. Remdesivir full 5 day IV course. Procalcitonin level to determine need for antibiotics. Insulin sliding scale high algorithm for now - monitor sugars closely. Start insulin stat dose now. Spoke to ED physician personally. Patient is an 83 y.o. male. "Patient is a 83 y.o. yo male presenting to the ED with complaints of increasing shortness of breath over the past few weeks. Patient states recently tested positive for Covid however is fully vaccine against Covid as well. Patient states increasing shortness of breath as well as fatigue and loss of appetite however not claiming significant fevers, chills, body aches, nausea, vomiting, abdominal pain, dominant changes urination changes. Patient is also known diabetic and takes insulin. Patient also has history of hypertension, hyperlipidemia however no previous history of pulmonary disease or any cardiac disease. Patient not complain of any lower extremity swelling.


VAERS ID: 1833709 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: No e
Diagnostic Lab Data: Daily blood pressure monitoring three times a day and two dr visits from geriatrician dr
CDC Split Type:

Write-up: High blood pressure 184/98 180/90 This persisted for three weeks Beta blocker had to be given 1-2 times daily Benecar 20-30 mg


VAERS ID: 1833770 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-10-07
Onset:2021-10-13
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, C-reactive protein normal, Full blood count normal, Gait disturbance, Groin pain, Loss of personal independence in daily activities, Metabolic function test normal, Mobility decreased, Musculoskeletal discomfort, Osteoarthritis, Pain in extremity, Red blood cell sedimentation rate normal, Spinal X-ray abnormal, Spinal osteoarthritis, X-ray of pelvis and hip abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Osteonecrosis (broad), Arthritis (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: Quinapril, pravastatin, finasteride, aspirin,tadalafil, vit D, ducosate
Current Illness: None
Preexisting Conditions: HTN, DJD
Allergies: NKDA
Diagnostic Lab Data: CBC, ESR, CRP, metabolic panel all wnl 10/20. Right hip x-ray 10/20 mild djd. LS spine 10/29 minor djd little changed from 2011
CDC Split Type:

Write-up: Starting 10/13 developed right groin pain which resolved, then achy pain right anterolateral thigh then right hip flexor weakness then partial right hip extensor weakness causing difficulty climbing and descending stairs and dressing. Need to lift leg with hand to get into car or to lift foot 12 inches


VAERS ID: 1833909 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-10-08
Onset:2021-10-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Chest pain
SMQs:, Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow)

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

Write-up: 5-7 days after receiving my 2nd dose of the vaccine, I began experiencing some very unusual and concerning chest pain on only the left side of my chest and what felt like a few instances of a "fluttering" heartbeat that lasted for a little over 72 hours. I have NEVER had any symptoms like this before, even after my first vaccine dose, but my mother and two of my siblings did have fairly severe reactions to their first dose so that may be useful background info. I started taking some aspirin at regular intervals for a few days just to play it safe in case what I was feeling was indeed myocarditis/pericarditis, but after about 4 days (around 18 October) I was feeling back to normal and no longer having any symptoms.


VAERS ID: 1834207 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-01
Onset:2021-10-13
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 3 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Body temperature increased, Delirium
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, fentanyl, Norco, liothyronine, diltiazem, carvedilol, cymbalta, trazadone, triamterine, zeros, repatha
Current Illness: None
Preexisting Conditions: Chronic pain, sjogrens, major arthritis, fibromyalgia, sleep disorder
Allergies: Plaquinell, tapes
Diagnostic Lab Data:
CDC Split Type:

Write-up: 103.1 degree temp Delirious


VAERS ID: 1835514 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-10-12
Onset:2021-10-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Prior to vaccination, was the patient diagnosed with COVID-19?:Yes); Hypothyroidism (Hypothyroid)
Allergies:
Diagnostic Lab Data: Test Date: 20211013; Test Name: Body temperature; Result Unstructured Data: Test Result:105; Comments: Fever of 105
CDC Split Type: USPFIZER INC202101375742

Write-up: Fever of 105; This is a spontaneous report from a non-contactable consumer, the patient. A 41-year-old male patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 12Oct2021 at 17:00 (at the age of 41-years-old) as a single dose for COVID-19 immunisation. Medical history included hypothyroid and COVID-19. The patient had no known allergies. Prior to the vaccination, the patient was diagnosed with COVID-19. The patient did not receive any concomitant medications. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the right arm on 21Sep2021 at 17:00 (at the age of 41-years-old) as a single dose for COVID-19 immunisation. On 13Oct2021 at 13:00, the patient experienced fever of 105. On the same day, the patient underwent body temperature test and the result was 105 (units unspecified). The event did not result in doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care. Therapeutic measures were taken as a result of fever and included treatment with paracetamol (TYLENOL) 1000 mg and ibuprofen (MANUFACTURER UNKNOWN) 800 mg. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event fever of 105 was resolved on an unknown date in Oct2021. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected. .


VAERS ID: 1835518 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Immunisation, Neck pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ESTRACE; PROGESTERONE
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None, Comment: Other medical history: no; known allergies: no
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101375923

Write-up: Pain in neck on same side as vaccine; Very swollen armpit on same side; Very swollen armpit on same side. Painful as well; Administration date 13Oct2021 at 09:30, dose number=3; This is a spontaneous report from a contactable other healthcare professional, the patient. A 52-year-old non-pregnant female patient received the third dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: Unknown) via an unspecified route of administration in the left arm on 13Oct2021 at 09:30 (at the age of 52-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history and no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included the first dose of influenza vaccine (MANUFACTURER UNKNOWN) in the left arm on 04Oct2021, estradiol (ESTRACE) and progesterone (MANUFACTURER UNKNOWN); all from an unknown date for unknown indication and unknown if ongoing. The patient previously received the the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EL1284) via an unspecified route of administration in the left arm on 06Jan2021 at 13:00 (at the age of 51-years-old) and the patient also received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EL3246) via an unspecified route of administration in the left arm on 27Jan2021 at 13:00 (at the age of 51-years-old) as a single dose for COVID-19 immunisation. On 13Oct2021 at 09:30, the patient had "administration date 13Oct2021 at 09:30, dose number=3". On 13Oct2021 at 20:30, the patient had pain in neck on same side as vaccine and very swollen armpit on same side, painful as well. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events pain in neck on same side as vaccine, very swollen armpit on same side and painful as well was not resolved at the time of this report. The clinical outcome of the event "administration date 13Oct2021 at 09:30, dose number=3" was unknown at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1835522 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101380055

Write-up: Intractable migraine; The patient administered with third booster dose; This is a spontaneous report from a contactable consumer, the patient. A 47-year-old non-pregnant female patient received the third booster dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the right arm on 13Oct2021 at 11:15(at the age of 47-year-old) as a single dose for COVID-19 immunisation. Medical history was not reported. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient did not receive any medication within two weeks of vaccination. The patient previously received the first dose of (BNT162B2) PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EN6207) via an unspecified route of administration in the right arm on 25Mar2021 (at the age of 46-years-old) and also received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNWON) via an unspecified route of administration in the right arm on 29Apr2021 (at the age of 46-years-old) as a single dose for COVID-19 immunisation. On 13Oct2021 at 13:15, the patient experienced intractable migraine. The event resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measures were taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event intractable migraine was not recovered at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1835537 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: School       Purchased by: ?
Symptoms: Immunisation, Lymphadenopathy, Off label use
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ELMIRON
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101383339

Write-up: Swollen neck on the left side, maybe a lymph node; Third dose/ Booster dose; Off-label use; This is a spontaneous report from a contactable consumer, the patient. A 45-year-old non-pregnant female patient received the third dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 13Oct2021 at 14:30 (at the age of 45-years-old) as a single dose for COVID-19 immunisation. The patient did not have any medical history and known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID-19 vaccine. Concomitant medications included pentosan polysulfate sodium (ELMIRON) and an unspecified vitamin; both for unknown indications from unknown dates and unknown if ongoing. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 06Feb2021 (at the age of 44-years-old) and received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on 27Feb2021 (at the age of 44-years-old); both as a single dose for COVID-19 immunisation. On 15Oct2021 at 13:00, the patient experienced swollen neck on the left side, might be a lymph node. The event did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the event. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event swollen neck on the left side, maybe a lymph node was not resolved at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1835552 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Hypoaesthesia, Immunisation, Off label use
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: GLIPIZIDE/METFORMIN; CARVEDILOL; AMLODIPINE; OLMESAN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood cholesterol abnormal (Cholestrol); Blood pressure high (Controlled high blood pressure); Diabetes
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101385755

Write-up: Complete numbness of right leg (below knee) and foot.; I also had some pain in back of right knee; Off label use; A third (booster) dose of BNT162b2 was administered; This is a spontaneous report from a contactable consumer, the patient. A 67-year-old non-pregnant female patient received the third dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FF2590) via an unspecified route of administration in the right arm on 13Oct2021 at 16:15 (at the age of 67-years-old) as a single dose for COVID-19 immunisation. Medical history included diabetes, controlled high blood pressure and cholesterol. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included glipizide/metformin hydrochloride (GLIPIZIDE/METFORMIN), carvedilol (MANUFACTURER UNKNOWN), amlodipine besilate (AMLODIPINE) and olmesartan medoxomil (OLMESAN); all from unknown dates for unknown indications and unknown if ongoing. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EL9263) via an unspecified route of administration in the right arm on 03Feb2021 at 12:00 (at the age of 66-years-old) as a single dose for COVID-19 immunisation and received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EN6203) via an unspecified route of administration in the right arm on 24Feb2021 at 13:00 (at the age of 66-years-old) as a single dose for COVID-19 immunisation. The patient received other unspecified vaccines within four weeks prior to the COVID-19 vaccine. On 15Oct2021 at 10:15, the patient experienced complete numbness of right leg (below knee) and foot and also had some pain in back of right knee. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events complete numbness of right leg (below knee) and foot and also had some pain in back of right knee was resolved on an unknown date in Oct2021.


VAERS ID: 1835553 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immunisation, Vaccination site erythema, Vaccination site pain, Vaccination site pruritus
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: Medical History/Concurrent Conditions: Allergy NOS (known_allergies: Yes); Osteoarthritis (Other_medical_history: Osteoarthritis)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101385886

Write-up: Usual soreness at injection site; Then a few days of itchy, red area on left arm; Then a few days of itchy, red area on left arm; Administered date 13Oct2021 at 11:00, dose number=3; This is a spontaneous report from a contactable consumer, the patient. An elder female patient of unspecified age received the third dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FF2589) via an unspecified route of administration in the left arm on 13Oct2021 at 11:00 as a single dose for COVID-19 immunisation. Medical history included osteoarthritis. The patient had unspecified allergy. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included first dose of the influenza vaccine inact sag 4v (FLUAD QUAD) in left arm on 15Sep2021 for unknown indication. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EN6206) via an unspecified route of administration in the left arm on 09Mar2021 as a single dose for COVID-19 immunisation and the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: ER8733) via an unspecified route of administration in the left arm on 30Mar2021 as a single dose for COVID-19 immunisation. On 13Oct2021 at 11:00, the patient had "administration date 13Oct2021 at 11:00, dose number=3". On 14Oct2021, the patient experienced usual soreness at injection site, then a few days of itchy, red area on left arm. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events usual soreness at injection site, then a few days of itchy, red area on left arm. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events usual soreness at injection site, then a few days of itchy, red area on left arm was recovering at the time of this report. The clinical outcome of the event "administration date 13Oct2021 at 11:00, dose number=3" was unknown at the time of this report.


VAERS ID: 1835572 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: California  
Vaccinated:2021-06-04
Onset:2021-10-13
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211013; Test Name: nasal swab; Test Result: Positive ; Comments: Covid 19 positive test
CDC Split Type: USPFIZER INC202101393808

Write-up: tested positive for COVID-19 infection with mild symptoms; tested positive for COVID-19 infection with mild symptoms; This is spontaneous report from an agency. The consumer reported same events for two patients. This is the report for her husband. A 43-year-old male patient received bnt162b2 (COMIRNATY, both Lot Number: EW0177) via an unspecified route of administration, on 04Jun2021 as DOSE 2, SINGLE and on 14May2021 as DOSE 1, SINGLE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The consumer stated that her husband and herself received their second dose of the Pfizer COVID-19 vaccine last Jun2021. She states they both have tested positive for COVID-19 infection with mild symptoms on 13Oct2021. Caller is surprised that they have been infected so soon. She states that they have been very cautious and taking all the precautions and they don''t understand how they caught it. The patient was diagnosed with Covid 19 virus on Wednesday (13Oct2021), he displayed symptoms first and within 48 hours she had symptoms. He was confirmed positive on 13Oct2021 (nasal swab), and he is also Pending PCR Test results. Follow-up attempts are completed. No further information is expected. ; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101393306 same reporter/drug/event, different patients


VAERS ID: 1836944 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-22
Onset:2021-10-13
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness unilateral, Dizziness, Headache, Hypoaesthesia, Paraesthesia, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: Dizziness, loss of range of vision in left eye - couldn?t focus vision, numbness/tingling in left leg and arm. Sudden headache onset. I thought I was having a stroke but decided to rest for a couple hours. Vision improved after waking. Numbness lessened but did not completely clear for a week.


VAERS ID: 1837244 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-15
Onset:2021-10-13
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: drospirenone-ethinyl estradiol (YAZ) 3-0.02 mg tablet Sig - Route: Take 1 tablet by mouth 1 time per day - Oral
Current Illness: none
Preexisting Conditions: none
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: First injection was given at mom''s request on 9/15/2021. Second dose given 10/13/2021.


VAERS ID: 1837886 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-02
Onset:2021-10-13
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / 3 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Computerised tomogram, 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? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole 20mg Prilosec Caps
Current Illness:
Preexisting Conditions:
Allergies: Sulfa
Diagnostic Lab Data: Bloodwork CT scan Neurologist visit Urgent care twice
CDC Split Type:

Write-up: Bell?s Palsy Facial paralysis


VAERS ID: 1838824 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019F21A / 2 - / OT

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

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

Write-up: This spontaneous case was reported by a physician and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (4 to 5 patients received shot past 30-day use by date) in a 33-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 019F21A) for COVID-19 vaccination. No Medical History information was reported. On 13-Oct-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (4 to 5 patients received shot past 30-day use by date). On 13-Oct-2021, EXPIRED PRODUCT ADMINISTERED (4 to 5 patients received shot past 30-day use by date) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medications were not provided. Treatment information was not provided. Reporter stated that patient had no side effects. This case was linked to MOD-2021-351064, MOD-2021-363707, MOD-2021-363709, MOD-2021-363708, MOD-2021-355809 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 26-Oct-2021: Contains no new information.


VAERS ID: 1838825 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019F21A / 1 - / OT

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

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

Write-up: 4 to 5 patients received shot past 30-day use by date; This spontaneous case was reported by a physician and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (4 to 5 patients received shot past 30-day use by date) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 019F21A) for COVID-19 vaccination. No Medical History information was reported. On 13-Oct-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (4 to 5 patients received shot past 30-day use by date). On 13-Oct-2021, EXPIRED PRODUCT ADMINISTERED (4 to 5 patients received shot past 30-day use by date) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No treatment medication reported. No concomitant medication reported. Reporter stated that patient had no side effects. This case was linked to MOD-2021-351064, MOD-2021-363703, MOD-2021-363708, MOD-2021-363709, MOD-2021-355809, MOD-2021-351064 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 26-Oct-2021: Contains no new information.


VAERS ID: 1838826 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019F21A / 1 - / OT

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

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

Write-up: 4 to 5 patients received shot past 30-day use by date; This spontaneous case was reported by a physician and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (4 to 5 patients received shot past 30-day use by date) in a 51-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 019F21A) for COVID-19 vaccination. No Medical History information was reported. On 13-Oct-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (4 to 5 patients received shot past 30-day use by date). On 13-Oct-2021, EXPIRED PRODUCT ADMINISTERED (4 to 5 patients received shot past 30-day use by date) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was reported . No treatment medication was reported . Date the vial was initially stored in the refrigerator: 08Sep2021 Reporter stated that patient had no side effects. This case was linked to MOD-2021-351064, MOD-2021-363707, MOD-2021-363709, MOD-2021-363709, MOD-2021-355809, MOD-2021-363703, MOD-2021-351064 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 26-Oct-2021: Contains no new information.


VAERS ID: 1839015 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 - / OT

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

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

Write-up: 318 patients received dose from vials beyond 30-day use by date; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (318 patients received dose from vials beyond 30-day use by date) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020F21A) for COVID-19 vaccination. No Medical History information was reported. On 13-Oct-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (318 patients received dose from vials beyond 30-day use by date). On 13-Oct-2021, EXPIRED PRODUCT ADMINISTERED (318 patients received dose from vials beyond 30-day use by date) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Date of refrigeration: 19-Aug-2021 Concomitant drugs were not reported. Treatment medications were not provided. This case was linked to MOD-2021-363245, MOD-2021-363032, MOD-2021-363226 (Patient Link).


VAERS ID: 1839059 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 2 - / OT

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

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

Write-up: 318 patients received dose from vials beyond 30-day use by date; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (318 patients received dose from vials beyond 30-day use by date) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020F21A) for COVID-19 vaccination. No Medical History information was reported. On 13-Oct-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (318 patients received dose from vials beyond 30-day use by date). On 13-Oct-2021, EXPIRED PRODUCT ADMINISTERED (318 patients received dose from vials beyond 30-day use by date) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Date of refrigeration was on 19-aug-2021. Concomitant medication use was unknown Treatment information was unknown


VAERS ID: 1839142 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135B2 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Diarrhoea, Dyspnoea, Fatigue, Musculoskeletal stiffness, Myalgia, Nasal congestion, Nausea, Oropharyngeal pain, Paraesthesia oral, Pharyngeal paraesthesia, Pruritus, Rash, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Dystonia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy (Known allergies: Yes many)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101395400

Write-up: Upset stomach; Neck muscles stiff; Sore throat; Tingly lips and throat; Stuffy nose; Tingly lips and throat; Muscle pain more than 5 days; Shortness of breath; Nausea; Diarrhea; Fatigue; Rash; Hives; Itching skin; This is a spontaneous report from a contactable consumer, the patient. A 34-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: 30135B2) via an unspecified route of administration on 13Oct2021 at 15:15 (at the age of 34-years-old) as a single dose for COVID-19 immunisation. Medical history included complicated health profile and many unspecified allergy. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient did not receive any concomitant medications. On 13Oct2021, the patient experienced upset stomach, nausea, diarrhoea, sore throat, stuffy nose, fatigue, neck muscles stiff, muscle pain more than 5 days, rash, hives, tingly lips and throat, itching skin and shortness of breath. The events resulted in doctor or other healthcare professional office/clinic visit. It was unknown whether any therapeutic measures were taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events upset stomach, nausea, diarrhea, sore throat, stuffy nose, fatigue, neck muscles stiff, muscle pain more than 5 days, rash, hives, tingly lips and throat, itching skin and shortness of breath was recovering at the time of this report. Amendment: This follow-up report is being submitted to amend previously reported information: added the pregnance information and updated concomitant therapy field.


VAERS ID: 1839184 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-26
Onset:2021-10-13
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy; Sulfonamide allergy
Allergies:
Diagnostic Lab Data: Test Date: 20211014; Test Name: Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202101421180

Write-up: tested positive for Covid-19/runny nose and sore throat began; tested positive for Covid-19/runny nose and sore throat began; This is a spontaneous report from a contactable pharmacist (patient). A non-pregnant 40-year-old female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE), first dose, intramuscularly, administered in arm left on 05Mar2021 10:00 (Lot Number: EN6205) at the age of 40 years old, as dose 1, single dose, and second dose, intramuscularly, administered in arm left on 26Mar2021 10:00 (Lot Number: ER8727) at the age of 40 years old, as dose 2, single dose for covid-19 immunisation. Medical history included known allergies: Penicillin, Sulfa drugs. Prior to vaccination, the patient was not diagnosed with COVID-19. There was no other vaccine in four weeks. Other medications in two weeks includes multivitamin. On 13Oct2021, runny nose and sore throat began. On 14Oct2021, tested positive for Covid-19 (Nasal Swab). Events resulted in Doctor or other healthcare professional office/clinic visit. No treatment was received. The outcome of the events was not recovered. Follow-up attempts are completed. No further information is expected.; Sender''s Comments: Based on the information provided, known drug safety profile and plausible temporal association, the causality between BNT162B2 and Vaccination failure and COVID-19 cannot be completely excluded.


VAERS ID: 1839650 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-10-11
Onset:2021-10-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Buproprion XL 300 Spironolactone 50 Bisoprolol 10
Current Illness:
Preexisting Conditions: High blood pressure, migraines
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe Pain and swelling in left armpit starting two days after injection. 3 weeks later still having shoulder and armpit pain


VAERS ID: 1839991 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2020-12-21
Onset:2021-10-13
   Days after vaccination:296
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Fatigue, Headache, Nausea, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies: NKA
Diagnostic Lab Data: 10/18/2021 0940 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 10/18/21 0940 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result Detected Critical
CDC Split Type:

Write-up: Fever or Chills Fatigue Headache Sore throat Congestion or running nose Cough Nausea or vomiting


VAERS ID: 1840241 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-10-13
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dizziness, Headache, Hypotension, Pyrexia
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Developed a slight cough, and subjective fevers on Wednesday. She noted she also had some intermittent sensation of lightheadedness, not described as vertigo. Has a mild frontal headache that is not described as sudden in onset or maximal at onset. She has noted low blood pressures at home as well. She denied nausea/vomiting/diarrhea, dysuria/hematuria, chest pain, slurred speech/facial droop/focal weakness or other complaints.


VAERS ID: 1840340 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-30
Onset:2021-10-13
   Days after vaccination:256
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer COVID vaccines 1/30/21 and 2/20/21. Hospitalization 10/13/21


VAERS ID: 1840814 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-10-12
Onset:2021-10-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Condition aggravated, Rheumatoid arthritis, Sciatica
SMQs:, Arthritis (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I was taking Synthroid1/12; D3 50mcgs once a day; E 180mgs; Magnesium Citrate 250mgs; Claritin10mgs ; once a day Probiotic; Pantoprazole NA40mgs ; Ezetimibe10mgs once a day ; BREO once a day; Albuterol sulfate inhalation with nebulizer as
Current Illness: None
Preexisting Conditions: I have COPD; SOD; and Thyroid disease. I was recently diagnose with RA. And syodica condition that appeared after the second vaccine.
Allergies: I am allergic to Biaxin; trimethoprim; sulfamethoxazole
Diagnostic Lab Data: I''m getting an mri tonight, and blood work on the first of December.
CDC Split Type: vsafe

Write-up: I had an RA flare a sciatica flare, and the pain got intense on my left shoulder. I''m getting an mri for it tonight. The perezone and araba have been prescribe to help me with this issue.


VAERS ID: 1842182 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-06-25
Onset:2021-10-13
   Days after vaccination:110
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 RA / OT

Administered by: Other       Purchased by: ?
Symptoms: Confusional state, Formication, Hallucination, auditory, Hallucination, visual, Nightmare, Soliloquy, Tinnitus
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Autism (Verbatim: Autism); Cardiac aneurysm; Cognitive disorder; Diabetes; Kawasaki''s disease (at 4 years old); Obesity; Seasonal allergy.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101410670

Write-up: he was talking to her as a different person. He said he was another person; Talking to himself; it went to things talking to him; hearing voices 3-4 days ago; Nightmares; Seeing things at home like shadows; Felt things crawling on him and pulling at him; Hearing voices; This is a spontaneous report from a contactable consumer (patient''s mother). A 19-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE) intramuscular (IM), administered in right deltoid on 25Jun2021 (Batch/Lot Number: EW0196; Expiration Date: 01Sep2021), at the age of 19 years old, as dose 2, single for covid-19 immunisation in a clinic. Medical history was reported as follows. He has heart aneurysms and was diagnosed with Kawasaki at 4 years old. They found out 7-10 days later after he had the heart aneurysms. When he was diagnosed with that, there were so many questions back then about how they develop it. He has diagnosed allergies, compromised immune status, respiratory illness, genetic/chromosomal abnormalities, endocrine abnormalities (including diabetes) and obesity. He is a little overweight at the time of report, but not as a child. He started gaining weight when the COVID thing started and was at home for school versus walking around at school. This was prior to vaccination. He had to have tissues with him all the time for seasonal allergies started as a kid. He was previously diagnosed with autism and cognitive dysfunction and was high functioning and worked 3 hours a day and was also in college. Family medical history relevant to AEs include diabetes, and high blood pressure. Concomitant medications were not reported. No prior vaccinations within 4 weeks. The patient previously received dose 1 of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE) on 04Jun2021 (lot EW0172, expiration 01Aug2021) IM administered in right deltoid for COVID-19 immunisation. The reporter stated things started happening after the vaccine. A week or two later, on unspecified dated in 2021, he started having nightmares. He never had them before. It went week after week from nightmares to seeing things in the dark to hearing voices like 4-5 weeks later. He was seeing things at home like shadows. From that, it went to things talking to him or things touching his skin. He felt things crawling on him and pulling at him. Started at night and lasted all night and day. He was fanning himself and pulling at himself. He felt things crawling on him and hearing voices 3-4 days ago. He was hearing voice at night at first and then it was all the time. She does not know anything about psychotic episodes. When she came home, he was talking to himself. She thinks the vaccine played a part. She is concerned about parents with children with autism and knows that people with schizophrenia shows that it occurs between 18-25 years old, but it was different after the vaccine. She told the doctor 2 weeks after he had the nightmares. She was doing natural things at home to see if it would help. She said no eating after 7pm and no playing video games. No scary movies, and then he confessed to her about 3 weeks after they did not go away, that he was seeing them in the house. He was admitted to a mental hospital 4 days ago. He has been talking to himself. He still says he sees these things. She honestly believes he could read and everything opposite of what they said he could do. He wanted to learn to drive. Four days ago, the nightmares lead up to seeing things and talking to himself. When she got off work on 13Oct2021 at 6:00 am, she came home and was talking to him and he turned around and he was talking to her as a different person. He said he was another person. She took him to the Emergency Room after that. He stayed in the ER for 18 hours and was not admitted to the mental hospital until 14Oct2021. When she told the doctor about the nightmares, she prescribed something for them, clonazepam. They were in a pharmacy vial with no lot or expiration. He was taking 0.5mg once nightly. He also started taking melatonin, over the counter gummies. He was not being honest about the nightmares. He told her that he was still having them and went from having normal conversations to now that he is not himself. She still is going to see him every night. They were in the emergency room for 18 hours, and because he could not sign consent by local health facilities by himself, they would not take him. They received medication from ER doctor that night because they could not get into medical facility. She called administrator at mental health facility and they apologized and got him in that night at 6:30 pm. He was admitted on 14Oct2021. Because they would not take him into the mental health facility, she did not have guardianship at the time. She took him to the physician on 14Oct2021, and the physician helped with paperwork for guardianship. She said it was a longer process though. He was prescribed 5Htp and they ended up not needing it and ended up getting him on psychotic medications. She questions about any vaccines at all. She does not know if he is one of those people that reacts and gets autism. People start talking and she hears things. This one was a little more obvious because he was not having these issues before. The patient has not recovered from the events.


VAERS ID: 1842566 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018B21A / UNK - / OT

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

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

Write-up: Administered expired doses to patients past the published expiration date; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Administered expired doses to patients past the published expiration date) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 018B21A) for COVID-19 vaccination. No Medical History information was reported. On 13-Oct-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Administered expired doses to patients past the published expiration date). On 13-Oct-2021, EXPIRED PRODUCT ADMINISTERED (Administered expired doses to patients past the published expiration date) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No relevant concomitant medications were reported. No treatment information was provided. Number of doses/vials 1 vial, 1 dose involved. The Lot 018B21A vial was initially stored in the refrigerator on 13Oct2021. The vial did not undergone any temperature excursions. This case was linked to MOD-2021-365264 (Patient Link).


VAERS ID: 1842618 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 2 - / OT

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

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

Write-up: Patient was administered a dose from an expired vial.; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient was administered a dose from an expired vial.) in a 38-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 049E21A) for COVID-19 vaccination. No Medical History information was reported. On 13-Oct-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient was administered a dose from an expired vial.). On 13-Oct-2021, EXPIRED PRODUCT ADMINISTERED (Patient was administered a dose from an expired vial.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were reported No treatment medications were reported. This case was linked to MOD-2021-366918, MOD-2021-366925 (Patient Link).


VAERS ID: 1843197 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-03
Onset:2021-10-13
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive, 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? 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: Covid infection


VAERS ID: 1843397 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 3 RA / IM

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

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

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


VAERS ID: 1843499 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 3 LA / IM

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

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

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


VAERS ID: 1843806 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dizziness, Eye pruritus, Eye swelling, Headache, Hypoaesthesia, Ocular hyperaemia, Paraesthesia, Paraesthesia oral, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pt has no routine medications prior to vaccination.
Current Illness:
Preexisting Conditions: Pt has no significant PMH prior to vaccination.
Allergies: NKA prior to vaccination.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt reported that on 10/13, pt had dizziness post vaccination but it improved quickly. Several hours later, pt developed itchy eyes. 10/15 pt had an UC Tele visit where pt reported bilateral, red more itchy eyes swollen w/forehead HA with "numbness". Pt was advised at that time that it was unlikely allergy to moderna since no widespread hives/sob/wheeze/dysphagia/stridor. Rx: zaditor/zyrtec/benadryl for all conj and f/u pcp if fti On 11/2 and 11/3 pt was seen for persistent body rash w/ itchiness that developed ~24hrs after Moderna COVID Vaccine, including bumps under the patient''s neck. Pt also reports 2 days of tingling on left side of face and tongue. No Fever but + for chills. Denies any itchiness or swelling in her throat or difficulty swallowing, or shortness of breath. Pt prescribed prednisone taper in addition to the ketotifen, cetirizine, and diphenhydramine initially prescribed.


VAERS ID: 1845751 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-10-12
Onset:2021-10-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alopecia, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Systemic: hair loss. palpitations-Medium


VAERS ID: 1845763 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-10-13
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Diarrhoea, Fatigue, Headache, Pain, Stool analysis, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: 20211029; Test Name: Stool analysis; Result Unstructured Data: negative, very watery; Test Date: 20211029; Test Name: Blood test; Result Unstructured Data: clean
CDC Split Type: USJNJFOC20211110517

Write-up: WEIGHT LOSS; DIARRHEA; FATIGUED; HEADACHE; BODY ACHES; This spontaneous report received from a patient concerned a 63 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient experienced drug sensitivity when treated with amoxicillin/clavulanic acid. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1822809, and expiry: UNKNOWN) dose was not reported, administered on 13-OCT-2021 10:00 for prophylactic vaccination. No concomitant medications were reported. On 13-OCT-2021, the patient experienced body aches. On 13-OCT-2021, the patient experienced diarrhea. On 13-OCT-2021, the patient experienced fatigued. On 13-OCT-2021, the patient experienced headache. On 20-OCT-2021, the patient experienced weight loss. On 29-OCT-2021, Laboratory data included: Blood test (NR: not provided) clean, and Stool analysis (NR: not provided) negative, very watery. Treatment medications (dates unspecified) included: loperamide hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body aches, and headache on 15-OCT-2021, had not recovered from diarrhea, and the outcome of fatigued and weight loss was not reported. This report was non-serious.


VAERS ID: 1845968 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: New York  
Vaccinated:2021-10-05
Onset:2021-10-13
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Itchy, red,hot spot near the injection site


VAERS ID: 1846191 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-05-05
Onset:2021-10-13
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bronchitis, Chest X-ray normal, Cough, Fatigue, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No.
Current Illness: No.
Preexisting Conditions: No.
Allergies: No.
Diagnostic Lab Data: Chest X-ray, don''t have pneumonia.
CDC Split Type: vsafe

Write-up: I felt tired, my nose started to run and I had a cough in Oct2021. Saw the doctor 31Oct2021, doctor not to bother getting a COVID test. Diagnosed with bronchitis.


VAERS ID: 1846344 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-20
Onset:2021-10-13
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone normal, Hypothyroidism
SMQs:, Hypothyroidism (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: omegas, probiotics, multi
Current Illness: no
Preexisting Conditions: hashimotos
Allergies: no
Diagnostic Lab Data: 10/21/21 TSH was 3.9 It had been below 2 consistently for 10 years
CDC Split Type:

Write-up: I have Hashimotos, and my TSH has been stable for 10 years. After receiving the vaccine, my TSH shot up significantly and I started experiencing hypothyroid symptoms for the first time in 10 years.


VAERS ID: 1846557 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-12
Onset:2021-10-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0180 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arrhythmia supraventricular, Electrocardiogram ambulatory, Extra dose administered, Muscle twitching, Palpitations, Supraventricular tachycardia, Tremor, Ventricular arrhythmia
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Ventricular tachyarrhythmias (narrow), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Medication errors (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothroxin 88 mcg 1/day Pravastatin 40 mg 1/day Mulitivitamin 1 /day Cranberry pill 3 IU. 1/day, SuperBComplex 1/day Bayer Aspirin 81 mg 1/day Vitamin C 500 mg 1/day D3 2000Iu 1/day Lorazepam
Current Illness: No other illnesses. I had no reaction except for a sore arm from the first and second dose of the Pfizer vaccine.
Preexisting Conditions: I have taken thyroid pills for hypothyroidism and pravistatin for high cholesterol. Both are under control. High testosterone level was just discovered after the vaccine (10/19) and am now taking 320 mg of saw palmetto. I was not taking this drug until 2 weeks after I received the vaccine
Allergies: latex causes rashes any narcotic (i.e. morphine or hydocordone) causes vomiting erythomycin auses rash
Diagnostic Lab Data: I wore a Holter monitor beginning 10/19 for 3 days. The Report stated "PSVT rare premature atrial and ventricular arrhythmias. A call from the MD simplified it to "runs of extra heart beats in the upper and lower chambers of the heart." I am NOT sure if the vaccine caused any of my issues or if it was just a coincident. I am just wondering if anything like this has happened to anyone else.
CDC Split Type:

Write-up: Heart palpitations. I had some prior to the boostershot. They were minor before and would go away when changing position. I don''t know if the minor ones started after the first and second shot or not. Waking up in the middle night with the heart palpitations and severe shaking with nerves jumping in my arms, legs, stomach, back. The nerve jumping felt like twitches. It takes about 3 minutes for the twitching to stop, but the palpitations last longer. Mainly happening at night with a few happening during the day.


VAERS ID: 1846921 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3013SBA / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Following in arm injection of Pfizer COVID vaccine on 03/04/21 had low grade fever for 24 hours and felt tired and worn out. A
Other Medications: None
Current Illness: None
Preexisting Conditions: asthma
Allergies: slight allergy to mold and latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Went for a short run 8 hours post vaccination and immediately (within 10 seconds of stopping running) felt the blood flow into my hands. My hands turned bright red and became incredibly itchy; shortly thereafter my feet began to feel incredibly itchy. I went to take a shower and upon entering the bathroom immediately noticed that my face was red around the nose and mouth and I was breaking out in hives on my face, neck and back ( I have never had hives in my life). Within less than a minute of that occurring my underarms began to itch severely and when I lifted them up there was a rash under each arm and soon thereafter rash broke out all over my body (on my stomach, inner legs, back, groin,, etc. I took 2 over-the-counter Benadryl tablets and within 2 hours the itense itching had subsided. By the next morning my rash was gone and I was back to normal.


VAERS ID: 1847146 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-12
Onset:2021-10-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Postural Orthostatic Tachycardia Syndrome developed after vaccination for sub-Saharan meningitis in 1995. Age 38
Other Medications: Latanoprost eye drops Estradiol vaginal cream Alive multivitamin
Current Illness: None
Preexisting Conditions: Glaucoma
Allergies: Cipro
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore and swollen lymph node in left armpit. Took 10 days to return to normal.


VAERS ID: 1847183 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-05
Onset:2021-10-13
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA MODERNA-017C21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Fatigue, Head discomfort, Headache, Nasal congestion, Oropharyngeal pain, Pain, Pyrexia, Sinusitis
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)

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: Adverse effects, chills, fever, achy, nausous. Age 63, 3/25/2021, Covid, Moderna
Other Medications: Atorvastatin, baby aspirin, multi-vitamin, fish oil, probiotic.
Current Illness:
Preexisting Conditions:
Allergies: Codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: On approximately October 13 I started exhibiting Covid like symptoms, chills, low grade fever, achy and tired. Those symptoms subsided but I continued with a sore throat, headache and nasal and head congestion and cough. These symptoms gradually got worse and I made a appointment for a Rapid Covid test at pharmacy on October 26. The test results were negative. The following day on October 27 I saw a Dr. for the symptoms. I was told I had Sinusitis and was prescribed Augmentin, Benzonatate for the cough, and Sudafed for congestion. The Dr. told me she has been seeing a lot of Sinusitis and positive Covid cases lately. The antibiotic is s 10 day prescription and I am feeling back to normal now with no symptoms.


VAERS ID: 1848569 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-10-12
Onset:2021-10-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 2 LA / -

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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Prior to vaccination, was the patient diagnosed with COVID-19?: Yes); Shellfish allergy (Known allergies: shellfish)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101495295

Write-up: Skin rash on abdomen and both legs and feet; This is a spontaneous report from a contactable consumer, the patient. A 60-year-old male patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: 30145BA) via an unspecified route of administration in the left arm on 12Oct2021 at 13:15 (at the age of 60-years-old) as a single dose for COVID-19 immunisation. Medical history included COVID-19. The patient had known allergies to shellfish. Prior to vaccination, the patient was diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient did not receive any concomitant medications. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: 30145BA) via an unspecified route of administration in the left arm on 20Sep2021 at 11:15 (at the age of 60-years-old) as a single dose for COVID-19 immunisation. On 13Oct2021, the patient had skin rash on abdomen and both legs and feet. Therapeutic measures were not taken as a result of the event. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event skin rash on abdomen and both legs and feet was not resolved at the time of this report.


VAERS ID: 1848698 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Fatigue, Gallbladder disorder, Lymph node pain, Lymphadenopathy
SMQs:, Gallbladder related disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Gall Bladder attack starting at about 8pm. Normally attacks are gradual and start over a course of days, increasing in intensity. No symptoms of attack in morning, had vaccine, attack starting around 8pm. Attack was about a 7 out of 10, so not the worst. Also, lymph nodes started to swell under armpit day after, very painful. Stayed swollen for about 7 days. She is also very very tired, even weeks after.


VAERS ID: 1848785 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-10-02
Onset:2021-10-13
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Bell's palsy, Facial paralysis, Facial paresis, Lagophthalmos, Trismus
SMQs:, Dystonia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Periorbital and eyelid disorders (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Slight hypertension. 130/85 is average. Within healthy range when sticking to water regiment. Not taking any medication for it.
Allergies: N/A
Diagnostic Lab Data: Blood pressure check and general in-check to Emergency Room procedures. No lab tests. Was straightforward diagnosis by visualization of lack of muscle operation on left side of face.
CDC Split Type:

Write-up: Bell''s Palsy Started having jaw muscle cramps about 10-11 days after vaccine. Full Bell''s Palsy diagnosis within 13 days after shot. Facial weakness/paralysis. could not operate left side muscles. Slight sagging, no wrinkles in forehead left side, could not fully close eye, left side of mouth does not move while talking or smiling. Was prescribed Prednisone and Valacyclover for 1 week w/ zero refills. Took medicine the full course. Symptoms have been lessening slowly since November 1st. improving symptoms for Bell''s Palsy.


VAERS ID: 1849334 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-10-13
Onset:2021-10-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE QUADRIVALENT) / SANOFI PASTEUR - / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial flutter, Blood pressure increased, Cardioversion, Heart rate irregular, Muscle strain
SMQs:, Neuroleptic malignant syndrome (broad), Supraventricular tachyarrhythmias (narrow), Accidents and injuries (narrow), Hypertension (narrow), Cardiac arrhythmia terms, nonspecific (narrow), Tendinopathies and ligament 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: Carvedilol; Lisinopril; Atorvastatin; Tamsulosin HCL
Current Illness: N/A
Preexisting Conditions: Benign Prostatic Hypertrophy; Unusual Heart Rate; Kidney Cysts
Allergies: N/A
Diagnostic Lab Data: Cardiology: Hospitalization.
CDC Split Type: vsafe

Write-up: One week after the third dose of the vaccine I had to have Cardioversion. I take some medication to lower my blood pressure to take the strain off my heart. My Cardiologist was adjusting my medication and I was monitoring my blood pressure. I took my blood pressure and my Heart Rate was a little elevated a couple of days before my vaccine. I got a Flu shot at the same time as the COVID-19 vaccine. The evening after I got my shot my Heart Rate was fluctuating and my Blood Pressure readings were unusual. I went to the ER and I was diagnosed with Atrial Flutter. I was given a Cardioversion on 10/20/2021 which was a week after the vaccine.


VAERS ID: 1849515 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-12
Onset:2021-10-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FT2593 / 1 LA / SYR
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Myalgia, Pain, Pain in extremity, Pyrexia, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flu vaccine was given at the same time.
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: For approximately 5 days after I received the first shot of the Pfizer vaccine I had muscle pain up and down both arms and both legs. It hurt to sit, stand, and walk. Certain areas on my arms and legs were sensitive to touch. I also had a low-grade fever during that entire period. I had to see a doctor about the symptoms and I was diagnosed with myalgia.


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