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From the 7/16/2021 release of VAERS data:

Found 479,813 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 188 out of 4,799

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VAERS ID: 1410032 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-24
Onset:2021-06-05
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 2 AR / -

Administered by: Other       Purchased by: ?
Symptoms: Menstrual disorder
SMQs:

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

Write-up: I missed my period this month and so have many of my friends that got the vaccine


VAERS ID: 1410035 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site rash, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)

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

Write-up: patient called today stating she developed nausea and fatigue that has lasted over a week from the first shot. she also has a rash on her shoulder from the injection site. Moderna covid vaccine


VAERS ID: 1410094 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 RA / IM

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

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

Write-up: PATIENT WAS GIVEN A VACCINE THAT WAS OUTSIDE OF THE ALLOWABLE TIMEFRAME OF A RECONSTIUTED VACCINES. WHICH MAY HAVE AFFECTED THE EFFICACY. PATIETN WAS INFORMED , INCEDNT REPORTS WERE SUBMITTED. PATIENT VOICED UNDERSTANDING. WOULD LIKE TO HOLD OFF A BIT ON REDOING VACCINE DUE TO SCHEDULE CONFLICT, WILL INFORM OFFICE WHEN ABLE TO SCHEDULE.


VAERS ID: 1410723 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Oral mucosal erythema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: perioral redness within 3 hours after 2nd dose. the next couple of days with diffuse hives.


VAERS ID: 1410819 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-27
Onset:2021-06-05
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster, Rash, Scab, Varicella virus test negative
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Remicade (Infliximab) infusions
Current Illness:
Preexisting Conditions: Hidradenitis Suppurativa Crohns Disease
Allergies: Eggs, Sulfa Drugs
Diagnostic Lab Data: I was given a VZV PCR test. It came back negative but the doctor said that the test is not alway actuate.
CDC Split Type:

Write-up: On June 5 I broke out in painful rashes on my back shoulder (left). It then spread to the front of my shoulder (left) The doctor diagnosed me with Shingles. I prescribed Valacyclovir for 7 days and pain medication. As of today the rash is almost gone. I still have some areas that is scabbing over.


VAERS ID: 1410932 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Headache, Muscle spasms, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, severe muscle aches and cramping, difficulty breathing. Effects lasted 6 days before subsiding.


VAERS ID: 1411752 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-05-05
Onset:2021-06-05
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Heavy menstrual bleeding, Hypertonic bladder, Menstrual disorder, Menstruation irregular, Pollakiuria, Polymenorrhoea
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: no
Preexisting Conditions: no
Allergies: penicillin
Diagnostic Lab Data: June 18, 2021 Excessively long bleeding during menstrual cycle.
CDC Split Type:

Write-up: I experienced overactive bladder and excessive urination starting a couple weeks after the 2nd dose of Moderna vaccine for Covid-19. I then experienced fatigue and headache along with an early and excessive menstrual cycle lasting longer than normal by 10 days so far. The bleeding is on and off heavy and I am very concerned that my menstrual cycle is interrupted and still going on for 15 days.


VAERS ID: 1412445 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature, Chills, Headache, Malaise, Nausea, Pain, Pyrexia, Vaccination site pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data: Test Date: 20210605; Test Name: High Fever; Result Unstructured Data: Test Result:102.7 to 103.2; Comments: 02:45
CDC Split Type: USPFIZER INC2021656454

Write-up: High fever 102.7 to 103,2; general full body malaise; Chills; extreme soreness at injection site; Nausea; Headache; body aches; This is a spontaneous report received from a contactable consumer (patient). A 15-year-old female patient (not pregnant) received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EW0217 and expiration date not provided), via an unspecified route of administration, in arm left, on 04Jun2021 15:45 (at the age of 15-year-old, not pregnant), at single dose, for COVID-19 immunization. Medical history and concomitant medications were reported as "none". Patient had no known allergies. No other medical history. Prior to vaccination, patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient did not receive any other medications within 2 weeks of vaccination. The patient previously took first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL9264 and expiration date not provided), via an unspecified route of administration, in right arm, on 14May2021 15:45 (at the age of 15-year-old), at single dose, for COVID-19 immunization. On 05Jun2021 02:45, the patient experienced high fever 102.7 to 103.2, general full body malaise, chills, extreme soreness at injection site, nausea, headache, and body aches. The patient underwent lab tests and procedures which included body temperature: 102.7 to 103.2 on 05Jun2021 02:45. Since the vaccination, patient had not been tested for COVID-19. No treatment received for events. The outcome of evens was unknown.


VAERS ID: 1412454 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202106; Test Name: Testing; Result Unstructured Data: Test Result:unknown results
CDC Split Type: USPFIZER INC2021656560

Write-up: My daughter lost consciousness either from passing out or seizure; My daughter lost consciousness either from passing out or seizure; This is a spontaneous report from a non-contactable consumer (patient''s mother). A 14-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), dose 2 via an unspecified route of administration, administered in Arm Right at the age of 14-year-old on 04Jun2021 12:00 (Batch/Lot number was not reported) as single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient was not pregnant. The patient previously took first dose bnt162b2 for COVID-19 Immunization. The reporter stated that ''my daughter lost consciousness either from passing out or seizure''. Event start on 05Jun2021 08:00. AE resulted in: Emergency room/department or urgent care. Since the vaccination, the patient has not been tested for COVID-19. The patient underwent lab tests and procedures which included investigation: unknown results in Jun2021. Therapeutic measures were taken as a result of events (Testing and pain meds /IV fluids). The outcome of event was recovering. Information on lot/batch number has been requested.


VAERS ID: 1412954 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-19
Onset:2021-06-05
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

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

Write-up: Pt suffered a heart attack


VAERS ID: 1413138 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angina pectoris, Angiogram, Angioplasty, Computerised tomogram, Echocardiogram, Electroencephalogram
SMQs:, Embolic and thrombotic events, arterial (narrow), Other ischaemic heart disease (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: levaquin
Diagnostic Lab Data: eeg, echocardiogram, ct scan, angiogram
CDC Split Type:

Write-up: acute cardiac angina, angioplast


VAERS ID: 1413445 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-25
Onset:2021-06-05
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Pain in jaw, Pruritus, Swelling face, Throat irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Osteonecrosis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin c
Current Illness: No
Preexisting Conditions: No
Allergies: None that I am aware of
Diagnostic Lab Data: Was prescribed prednisone but it took a long time to work
CDC Split Type:

Write-up: Facial swelling on Saturday evening with itching on face and inside throat. Slight pain on right jaw


VAERS ID: 1413449 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-25
Onset:2021-06-05
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Ear infection, Heart rate increased, Pain in jaw, Pruritus, Swelling face, Throat irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Osteonecrosis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Forgot to mention this in previous submission. Facial swelling, primarily on right side of face. Pain in lower right jaw with itching and itching in throat. Rapid heart rate.. It took 4 days for swelling to dissipate. Developed ear infection with rapid heart rate.


VAERS ID: 1413488 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Mobility decreased, Pain in extremity
SMQs:, Parkinson-like events (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Patient states that arm/shoulder is still significantly painful following injection over 2 weeks ago. Patient states she cannot comfortably lift her arm


VAERS ID: 1413535 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-05-28
Onset:2021-06-05
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Antiphospholipid antibodies, Blood homocysteine normal, Coagulation test normal, Dysphagia, Echocardiogram, Ejection fraction, Facial paralysis, Factor II mutation, Gastrostomy, Glycosylated haemoglobin, Hemiparesis, Ischaemic stroke, Low density lipoprotein increased, Mental disorder, Protein C, Protein S normal, Respiratory failure, Tracheostomy, Weaning failure
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dyslipidaemia (narrow), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (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), Congenital, familial and genetic disorders (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (broad), Hypersensitivity (broad), Respiratory failure (narrow), Hypokalaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No prescription medications Multivitamin Vitamin D3 Vitamin C
Current Illness: none
Preexisting Conditions: Prostate cancer s/p prostatectomy Ankylosing spondylitis (not on immunosuppression) Recurrent UTIs - 4years ago
Allergies: ertapenem, TMP-SMX, clinda: reported nausea and vomiting.
Diagnostic Lab Data: A1C <6.5, LDL 180, TTE (6/11) normal LVEF, no valvular disease,TEE (6/11) without endocarditis or valvular disease. hypercoagulable work up: antiphospholipid <1.6 (WNL), protein C 102 (WNL), homocysteine 8.5 (WNL); prothrombin gene (normal), factor V leiden screen (negative), antithrombin (142^), & protein S (93, normal)
CDC Split Type:

Write-up: Acute Ischemic Multifocal Posterior Circulation strokes resulting in L sided weakness, L facial droop and dysphagia. Hospital course complicated by respiratory failure. Patient had placement of tracheostomy en g-tube given failure to wean off the ventilator and prolonged dysphagia with poor mental status to aid in swallowing


VAERS ID: 1413920 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling hot, Injection site pain, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu vaccine pain, swelling, hotness for at least three days and then the symptoms all gone; happens every time
Other Medications: Metformin; Diabetes pills; Vitamin C; Vitamin D; Elderberry
Current Illness: NO
Preexisting Conditions: Diabetes type 2
Allergies: NO
Diagnostic Lab Data: No
CDC Split Type: vsafe

Write-up: So after I get the vaccine, the day after I feel hotness and feverish but when I took temperature it was only 99. I feel tiredness and pain where the vaccine was. The next day was less symptoms, just tired and exhausted. The arm where I got the vaccine was pain and swelling for about a week. I took some Tylenol on the first day and that is about it.


VAERS ID: 1414334 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: Patient reports feeling nauseated and lightheaded. Patient vs 106/87, 79, blood sugar 120, 97 oxygen. Water provides to patient. She states she feels better. Pt discharge home.


VAERS ID: 1414382 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-22
Onset:2021-06-05
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Dysgeusia, Parosmia
SMQs:, Taste and smell disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole, Lisinopril
Current Illness: denies
Preexisting Conditions: High blood pressure, GERD
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient describes having a metal taste and smell two weeks following her vaccination on 05/22/2021.


VAERS ID: 1414631 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-01
Onset:2021-06-05
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 RA / SC

Administered by: Other       Purchased by: ?
Symptoms: Vaccine positive rechallenge, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (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: vimpat 200 mg daily multi vitamins keppra 1000 mg daily
Current Illness: none
Preexisting Conditions: seizures
Allergies: nka
Diagnostic Lab Data: na
CDC Split Type:

Write-up: Patient started to loose weight after the first dose It became more pronounced after the second dose


VAERS ID: 1414980 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033CZA / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes simplex
SMQs:, Opportunistic infections (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: Fluocinonide
Current Illness:
Preexisting Conditions: Eczema, seasonal allergies
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Herpes Simplex 1 outbreak on corner of lip and center of upper lip, spread to tip of nose and inside of left and right nostrils. Lasted 7 days.


VAERS ID: 1414989 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Erythema, Lymphadenitis, Lymphadenopathy, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Severely swollen left armpit (lymphadenitis), system wide muscular and joint pain lasting approximately 4-5 days. Red skin on lower legs persisting now in third week past second injection.


VAERS ID: 1414998 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1415054 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac imaging procedure abnormal, Chest discomfort, Electrocardiogram ST segment elevation, Myocarditis, Pain, Troponin T increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dexmethylphenidate (Focalin XR) 30mg 24hr capsule daily, dexmethylphenidate 10mg (Focalin) every evening, minocycline capsule once daily.
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: NKDA
Diagnostic Lab Data: Troponin T 1449 on admit, EKG with diffuse ST elevations. Cardiac MR showed inflammation of inferolateral wall consistent with myocarditis.
CDC Split Type:

Write-up: Myocarditis: presenting with body ache, left sided chest discomfort. Moderna vaccine #2 6/4/21.


VAERS ID: 1415094 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-02
Onset:2021-06-05
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Pruritus, Rash, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: She got her shot on June 2nd. Started itching on the 5th. Had a rash on her neck. The rash kept increasing so she called the ER on the 9th. The rash made her face swell and she had shortness of breath. She had to call an ambulance and was taken to the hospital. They prescribed her a steroid for 5 days. Gave her an injection of famotidine. Was at the hospital for about 4 hours. She is still having some itching on top of her head.


VAERS ID: 1415193 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-06-03
Onset:2021-06-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: C-reactive protein increased, Chest pain, Cough, Echocardiogram normal, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Pyrexia, Red blood cell sedimentation rate increased, Respiratory viral panel, SARS-CoV-2 test negative, Troponin increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Obesity (BMI 32)
Allergies: None
Diagnostic Lab Data: -ECG on presentation with ST segment elevation, this normalized by hospital day 3 -Troponin level on admission was 10.6 and peaked to 12.9 (hospital day 2) and decreased to 6.5 on day of discharge (6/8) - echocardiogram normal - CRP 4; ESR 18 - Coxsackie virus B PCR 1:8 (repeat labs pending) - Other respiratory viral panel, other viral studies normal; COVID-19 PCR negative
CDC Split Type:

Write-up: 2 days after vaccine, reported to have fever (unsure what temp). 3 days post vaccine, chest pain worse when lying down and dry cough. On that day, seen in ER with abnormal ECG (ST segment elevation) and elevated troponin level. Transferred and admitted to my hospital. Given ibuprofen for chest pain which improved quickly. Reassuring cardiac findings and improved troponin and ECG and discharged to home on hospital day 3. See below for labs


VAERS ID: 1415520 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-18
Onset:2021-06-05
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Crying, Fatigue, Fear, Feeling abnormal, Hallucination, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (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: Generic zoloft, Iron for anemia and digestive enzymes to maintain my autoimmune disorder - Celiac disease
Current Illness: Anemia, celiac disease
Preexisting Conditions: Celiac disease
Allergies: Codine and anything with any form of wheat gluten
Diagnostic Lab Data: None so far. Seeing family doctor for checkup on this Friday
CDC Split Type:

Write-up: I received my 2nd dose around 9 am...I went home and rested on the couch on and off and took it easy most of the day. No weird symptoms just really tired. Later that night I went to bed and in the middle of the night I shot straight of bed and screamed out my husbands name. I was feeling so fearful and the next thing I knew before I could get myself out of bed I started violently throwing up all over my bedroom and into the bathroom. Once in the bathroom I threw up until my stomach was empty. I could hear people crying and I saw real life pigs flying up to the sky. I also kept seeing flashes. When I was able to calm myself down, I took a shower and went back to bed. 2 hours later the exact thing happened. I have never retched so hard or so long in my life. I was praying to God to either take my soul or relieve me of the trauma. While I was cleaning up my mess the second time I was crying uncontrollably and I felt enormous pain and I could once again hear people crying and I was hallucinating or maybe it was real, I have no idea but I could see and feel all of the extreme agonizing pain and souls of those that had been infected. It sounds totally nuts I know but I am telling the truth. My husband was in the room the entire time and my kids were home. They could hear me throwing up all the way from the back of the house. My husband also got the same shot that day. His didn''t react like that.


VAERS ID: 1416015 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 - / IM

Administered by: Other       Purchased by: ?
Symptoms: C-reactive protein increased, Chest pain, Dyspnoea, Headache, Myalgia, Pain, Troponin
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Mirtazapine 30mg oral tablet, 1 Tablet by mouth every evening
Current Illness: NONE
Preexisting Conditions: Asthma-Childhood, has not required treatment for years.
Allergies: NONE
Diagnostic Lab Data: CRP inflammatory 14 on 6/6/21, Troponin level on 6/6/21 was 7.187 , normal range 0.000-0.030
CDC Split Type:

Write-up: 2 days after second dosage the patient began to experience chest pain and shortness of breath at rest and worse with minimal activity-body aches--myalgias--headache


VAERS ID: 1416173 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Adrenocortical insufficiency acute, Condition aggravated, Laboratory test, Nausea, Vomiting, X-ray
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fludrocortisone, Prednisone
Current Illness: None
Preexisting Conditions: Adrenal insufficiency/Addison''s disease, iron deficiency anemia
Allergies: Citrus, dust, pollen, ragweed
Diagnostic Lab Data: Basic labs, x-rays
CDC Split Type:

Write-up: Nausea, vomiting, abdominal pain consistent with Addisonian crisis


VAERS ID: 1416515 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Disease recurrence, Dizziness, Dyskinesia, Fatigue, Loss of consciousness, Muscle spasms, Paraesthesia, Seizure, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Dyskinesia (narrow), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Fibromyalgia (Hx of tremors and fibromyalgia); Tremor (Hx of tremors and fibromyalgia)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021658065

Write-up: Look faint; lose consciousness; Uncontrollable jerking movements and convulsions; lightheadedness; Tingling in her arms and fingertips; Weakness; Muscle spasms; Uncontrollable jerking movements and convulsions; Tired; Shaking; Shaking; This is a spontaneous report from a contactable pharmacist. A 31-years-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), dose 1 intramuscular, administered in the left arm on 05Jun2021 at 15:30 (Batch/Lot Number: EW0180) as 1ST DOSE, SINGLE (at the age of 31-years-old) for COVID-19 immunisation. Medical history included tremors, fibromyalgia, and asthma. The patient had no known drug allergy (NKDA). Reaction to TDAP vaccine (nausea). The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient''s concomitant medications were not reported. It was unknown if the patient was diagnosed with COVID-19 prior to vaccination and if the patient has been tested for COVID-19 since the vaccination. The patient received the first Pfizer dose at 3:20pm. On a consent form, reaction to TDAP vaccine (nausea) and history (hx) of tremors and fibromyalgia were reported. The patient sat for her observation period. After a few minutes, the patient began to look faint. The patient stated lightheadedness, and she was given some water, juice, and some saltine crackers. The patient stated tingling in her arms and fingertips, and weakness-unable to raise the juice box to drink. The patient started to have muscle spasms and uncontrollable jerking movements and convulsions, still coherent, and breathing was not affected. The patient was lowered to the ground, with continued convulsions, worsening spasms, but reported no pain. The patient did not want her albuterol as breathing was okay and was provided 1/4 tablet of Benadryl to no avail. The patient began to state she was tired and began to lose consciousness, closing her eyes. The patient was still shaking when the paramedics came. Treatment for the events included Valium given at the hospital. The events resolved with sequel. The events required Emergency Room Visit and Physician Office Visit.; Sender''s Comments: Based on the close temporal relationship, the association between the events syncope and loss of consciousness with BNT162b2 can not be completely 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: 1416516 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Body temperature, Pyrexia, SARS-CoV-2 test
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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: VYVANSE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: ADHD; Asthma
Allergies:
Diagnostic Lab Data: Test Date: 20210605; Test Name: Fever; Result Unstructured Data: Test Result:103 to 104; Test Date: 20210605; Test Name: COVID-19 nasal swab (post-vaccination); Test Result: Negative
CDC Split Type: USPFIZER INC2021658069

Write-up: Ran 103 to 104 fever; This is a spontaneous report from a contactable consumer (patient). An 18-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0171; Expiration date was not reported) on the right arm on 04Jun2021 (13:30) as a 2nd dose, single, with route of administration unspecified, for COVID-19 immunization at the public health clinic. Medical history included attention deficit hyperactivity disorder (ADHD) and asthma. Concomitant medication included lisdexamfetamine mesilate (VYVANSE). The patient had previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number: EW0171; Expiration date was not reported) on 14May2021 (13:30) (when the patient was 18 years old) for COVID-19 immunization. On 05Jun2021 (12:00 AM), the patient had run a 103 to 104 fever. The event had resulted into an emergency room/department or urgent care visit. High dose of Motrin and intravenous (IV) fluids were administered to the patient as treatment for the event. The outcome of the event was recovering. The patient was not diagnosed with COVID-19 prior to vaccination; and had been tested for COVID-19 since the vaccination. The patient had a negative COVID-19 nasal swab (post-vaccination) on 05Jun2021.


VAERS ID: 1416526 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-03
Onset:2021-06-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac discomfort, Eructation, Ophthalmic migraine, Panic attack, Photopsia, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ESCITALOPRAM; VITAMIN C [ASCORBIC ACID]; ZICAM [CLONAZEPAM]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Melanoma; Situational anxiety
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021664644

Write-up: heart feeling like a fist when tighten it for a blood draw/heart squeeze; burpy; ocular migraine; seeing the black and white flashy snake thing that makes it hard to focus; seeing the black and white flashy snake thing that makes it hard to focus; almost like a panic attack/Panic; This is a spontaneous report from a contactable consumer (patient) reported that a 41-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EW0167), via an unspecified route of administration, administered in arm right on 03Jun2021 18:30 (at the age of 41-years-old) as 1st dose, single for covid-19 immunization. The vaccine was administered at the Pharmacy/drugstore. The patient was not pregnant at the time of vaccination. The patient medical history included situational anxiety and melanoma. Concomitant medications included escitalopram; vitamin c [ascorbic acid] (VITAMIN C [ASCORBIC ACID]); and clonazepam (ZICAM [CLONAZEPAM]); all were taken for an unspecified indication, start and stop date were not reported. It was reported that 2 mornings after (05Jun2021), she woke up at 5:45 am (after a really good sleep) with her heart feeling like a fist when tighten it for a blood draw. She also was burpy. She did meditative breathing and sat up. It helped, but kept coming back that day (almost like a panic attack -- but the patient never experienced that feeling). A few hours later she got an ocular migraine (no pain, just seeing the black and white flashy snake thing that makes it hard to focus). The visual went away within 30 minutes or so with no lights/eyes covered and in reclining position. Panic/heart squeeze continued on and off --- but underlying feeling -- all day. The next day, (today) heart is feeling a tad tight but no where like yesterday. Plan on talking to doctor tomorrow. She spoke to a medical friend and didn''t feel it was life threatening, so didn''t seek medical care over the weekend. It was unknown if the patient received any treatment for the events. The outcome of the events was recovered with sequel. Information on lot/batch number was available. Additional information has been requested.


VAERS ID: 1416528 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / OT

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Haematochezia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021664962

Write-up: Bloody stool; patient was very tired/ he got extremely exhausted; This is a spontaneous report from a contactable consumer (patient''s wife). A 53-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection; Batch/Lot number was not reported), intramuscular on the right arm on 04Jun2021 13:00 (at the age of 53-years-old) as 1st dose, single for COVID-19 immunisation. The patient''s medical history was reported as none. The patient''s concomitant medications were not reported. The patient had no prior vaccinations within 4 weeks. The reporter didn''t know the lot number. The reporter called because last night (on 05Jun2021), at 09:00 PM, the patient was very tired and also had a bloody stool. The patient now hadn''t gone to the bathroom again. Since that time, he hadn''t had the bloody stool, but he got extremely exhausted after having the bloody stool. The reporter stated that the patient was a healthy person, so they needed to look out for any possible side effects once he got the vaccine. The reporter then added that''s everything and they were just following up because the instructions that he was given was to reach out to the company if they had side effects and reiterated that the patient had exhausted and blood stool at 9 pm last night. The outcome of the events was unknown. Information about lot/batch number has been requested.


VAERS ID: 1416532 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Fatigue, Heart rate irregular, Myalgia, Pyrexia, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210528; Test Name: Nasal swab; Result Unstructured Data: Test Result:Not known; Comments: Nasal Swab; Test Date: 20210605; Test Name: Nasal swab; Result Unstructured Data: Test Result:Not known; Comments: Nasal Swab
CDC Split Type: USPFIZER INC2021665347

Write-up: A little fever, muscle pain, tiredness. (All of the above expected); A little fever, muscle pain, tiredness. (All of the above expected); A little fever, muscle pain, tiredness. (All of the above expected); Chest pain and sudden changes in heart rate (totally unexpected); Chest pain and sudden changes in heart rate (totally unexpected); This is a spontaneous report from a contactable consumer (patient). A 13-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), dose 2 via an unspecified route of administration, in Arm Left on 04Jun2021 12:30 (Batch/Lot Number: EW0191) as single dose for covid-19 immunisation. There was no relevant medical history reported. The patient''s concomitant medications were not reported. On 05Jun2021 13:00, patient experienced a little fever, muscle pain, tiredness. (all of the above expected), chest pain and sudden changes in heart rate (totally unexpected). The patient reported that events resulted in visit to a doctor''s office, Emergency or urgent care department/room, Hospitalization, Disability or permanent impairment. Outcome of the events was recovering. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient underwent nasal swab on 28May2021 and on 05Jun2021 pending result. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1416764 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1416881 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-26
Onset:2021-06-05
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 2 AR / IM

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

Write-up: swollen and painful lymph nodes since the beginning of June, she''s wondering if this a late reaction to the vaccine


VAERS ID: 1417041 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / IM

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

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

Write-up: Welts and hives all over the body


VAERS ID: 1417091 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Loss of consciousness, Pain in extremity, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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: Adderall Methadone Gabapentin Fenofibrate Albuterol Nebulizer Descovey Tivicay Xyzal Valtrex Terbenifine Losartan Alive Multi Vitamin Probiotic Energy Supplement Turmeric Melatonin EpiPen
Current Illness: HIV Depression Carp atonal Lung Cancer
Preexisting Conditions: HIV Depression Carp atonal Lung Cancer
Allergies: Tegretol Abacavir Bee Stings
Diagnostic Lab Data: Vitals were checked by the EMT
CDC Split Type: vsafe

Write-up: I Experienced a sore arm on day 1 and I experienced vomiting on day 2 and 3 after the 2nd dose. On day 3 Around 9pm I got extremely hot around 10 pm I went to get something to eat and around 12am I was found outside of the store by the police. An EMT was called they checked my vitals and I declined to go to the hospital because I was feeling fine.


VAERS ID: 1417157 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-05-18
Onset:2021-06-05
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Herpes zoster, Pain in extremity, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ramipril 10mg/once daily Simvastatin 10mg/once daily
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 18 days after receiving the first dose of the Pfizer COVID vaccine I began having pain in my left hip and thigh. The following day I began developing a painful rash on my left leg from my lower back, hip and thigh all the way to my toes which was diagnosed by two separate doctors as Shingles. I was prescribed 2 courses of Valacyclovir, 3 weeks of Prednisone and Gabapentin for pain. The Shingles infection is currently still ongoing (17 days now).


VAERS ID: 1417366 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-13
Onset:2021-06-05
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042B21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Fatigue, Hyperventilation, Limb discomfort, Oedema peripheral, Pain in extremity, Peripheral swelling, Tachycardia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Allergic to flower pollen
Diagnostic Lab Data: Have not yet been to a Dr.
CDC Split Type:

Write-up: Hyperventilation , tachychardia, and abnormal fatigue during and after mundane activities. Occassional light headedness. Swelling and edema in lower extremities. Aches/discomfort in both arms at times.


VAERS ID: 1417594 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anal incontinence, Chills, Confusional state, Headache, Insomnia, Nausea, Pain in extremity, Swelling, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (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: Lotatadine 10mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: I have been seeing my chiropractor. They told me to report this to you as they think it?s possibly a side affect from my Covid shot.
CDC Split Type:

Write-up: Headache, nausea, vomiting, chills, confusion. Lasted 6 hours. Headache lasted two weeks. Swelling around spine, neck, shoulders, is still on-going but getting better. I had loss of bowl control for a day. Headaches severe. Trouble sleeping still. Arm still sore.


VAERS ID: 1417636 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1417657 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1417826 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-03
Onset:2021-06-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Pruritus, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NOne
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Ha ve broken out in hives starting with ears, back of neck, face, arms . torso. legs are the only part of my body not affected. Have received steroid shot at doctors office, and followed by a week steroid pack, however i am still itching BAD$g


VAERS ID: 1418061 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1418182 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1418352 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1418370 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1418800 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Asthenia, Chest discomfort, Diarrhoea, Feeling abnormal, Headache, Muscle twitching, Nausea, Night sweats, Paraesthesia, Pyrexia, Somnolence
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Dyskinesia (broad), Dystonia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen, Quercetin, Tumeric
Current Illness: Covid
Preexisting Conditions: Long term hauler issues from Covid
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, Night sweats so bad have to change several times in the night. Some chest tightness and uncomfortable feeling Nauseous and burning feeling upper stomach Diarrhea Headaches Weakness and tingling in body Hands and feet falling asleep Face twitch - just a little


VAERS ID: 1419802 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-01-06
Onset:2021-06-05
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arrhythmia, Ventricular extrasystoles
SMQs:, Ventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LOVASTATIN
Current Illness: Hypercholesterolemia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: This spontaneous case was reported by a nurse and describes the occurrence of ARRHYTHMIA (Arrhythmia (PVC) after completing moderna vaccine) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 027L20A and 013M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Hypercholesterolemia. Concomitant products included LOVASTATIN for Cholesterol. On 06-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 05-Jun-2021, the patient experienced ARRHYTHMIA (Arrhythmia (PVC) after completing moderna vaccine) (seriousness criterion medically significant). On an unknown date, the patient experienced VENTRICULAR EXTRASYSTOLES (PVC (Premature ventricular contractions)). At the time of the report, ARRHYTHMIA (Arrhythmia (PVC) after completing moderna vaccine) and VENTRICULAR EXTRASYSTOLES (PVC (Premature ventricular contractions)) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Treatment information was not provided. This case concerns a 57-year-old female with a serious unexpected event of arrhythmia, and non serious ventricular extrasystoles. Event latency 4 months after second dose mRNA-1273. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Sender''s Comments: This case concerns a 57-year-old female with a serious unexpected event of arrhythmia, and non serious ventricular extrasystoles. Event latency 4 months after second dose mRNA-1273. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 1420165 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1420186 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1420205 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1420372 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 27C21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (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: Tylenol and ibuprofen
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Reported that patient had lots of pain the right arm after 2nd does...second does was give on 06/04 and the following day there was pain ..Patient went to the ER and was prescribe 3 medicines but the medication is unknown


VAERS ID: 1420717 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-06
Onset:2021-06-05
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Nasopharyngitis, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: COVID test - negative result - Sunday, the 6th of June.
CDC Split Type: vsafe

Write-up: I got a cold, a sore throat, runny nose and cough. I had these symptoms for about a week.


VAERS ID: 1421028 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1421068 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1421149 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1421199 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, C-reactive protein increased, Myalgia, White blood cell count decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic leukopenia (narrow), Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WBCs 18, CRP elevated
CDC Split Type:

Write-up: Lower extremity myalgias and perceived weakness, currently hospitalized


VAERS ID: 1421219 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1421254 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1421409 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1421414 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1422303 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1422351 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-03
Onset:2021-06-05
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Shingles


VAERS ID: 1422528 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1422534 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine 20 mg
Current Illness: none
Preexisting Conditions: none
Allergies: Amoxicillin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient received her first COVID Vaccine on 6/4/2021 and on 6/5/2021, 6/6/2021, 6/7/2021, and 6/8/2021, she experienced chest pain and shortness of breath. She experienced shortness of breath even when ascending the staircase in our home. She felt chest pain and tightness in her chest for 4 days after receiving her vaccine.


VAERS ID: 1423106 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Hypoaesthesia, Paraesthesia, Pyrexia, Thrombosis
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ELIQUIS
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021672629

Write-up: blood clot; he woke up with a numb hip up to his calf and his foot has been tingling; he woke up with a numb hip up to his calf and his foot has been tingling; chills and fever; chills and fever; This is a spontaneous report from a Pfizer-sponsored program from a contactable consumer (patient''s wife). A male patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) dose 2 via an unspecified route of administration on 04Jun2021 (batch/lot number was not reported) as single dose for COVID-19 immunisation. Medical history not reported. Concomitant medications included ongoing apixaban (ELIQUIS) as blood thinner. Historical vaccine included first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 14May2021 for COVID-19 immunisation. The caller (name withheld) said that she and her husband received the Pfizer Covid-19 Vaccine 1st dose on 14May2021 and 2nd dose on 04Jun2021. Last Saturday (on 05Jun2021), her husband (name withheld) started to experience side effects like chills and fever. Yesterday (on 07Jun2021), he woke up with a numb hip up to his calf and his foot had been tingling. She also mentioned that her husband was taking a blood thinner called apixaban and they thought he had a blood clot. They were asking if they should go to the hospital. The outcome of all events was unknown. Information about batch/lot number has been requested.


VAERS ID: 1423214 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Goli gummies, b complex , levaquin, bupropion, Zyrtec, singulair, elderberry,
Current Illness:
Preexisting Conditions: Fibromyalgia, intracranial hypertension, allergies,
Allergies: Penicillin, tuna, salmon, ,
Diagnostic Lab Data:
CDC Split Type:

Write-up: After high fevers, continued and increasing body pain and extreme fatigue


VAERS ID: 1423217 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-06-01
Onset:2021-06-05
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042B21-2A / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Discomfort, Fatigue, Herpes zoster, Malaise, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: On June 1, 2021, I received my first dose of Moderna COVID-19 shot [LOT # 042B21-2A]. Within 24 hours, I experienced malaise and tiredness and slept for an unusually amount of time. No other issues were noted at the time. The following three days, I was working on building a stone patio in the backyard, an area known to have poison oak. During this time, I noted a small rash on my abdominal area and a developing pain on my left abdominal side. At the time I thought it was due to lawn work and otherwise ignored the discomfort and did not believe it was an adverse event from the vaccination. SEE CONTINUATION PAGE......


VAERS ID: 1423253 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1423466 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-28
Onset:2021-06-05
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / SYR

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

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

Write-up: NO MENSTRUAL CYCLE.


VAERS ID: 1423523 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Fatigue, Heart rate increased, Pain in extremity, Pyrexia, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: COVID test taken 06/06/2021 - it came back as negative the next day.
CDC Split Type:

Write-up: Patient had the vaccine Friday morning (6/4/21). He had typical side effects that afternoon (tired, achy arm). He woke up the next morning, 6/5/21, complaining that his chest hurt (with a stinging. constant pain), his heart was beating rapidly, 102.5 degree fever, and he said it was hard to breathe. I gave him 200mg Ibuprofen and he rested. Symptoms resolved in about 2-3 hours and did not return. I contacted the advice line at, and they set up a video appointment for mid afternoon on that same day, Saturday 6/5. By the time of the visit, symptoms were completely gone. PA recommended he have a Covid test as it was possible those symptoms were from having Covid ( coincidentally and simultaneously). The test was negative.


VAERS ID: 1423586 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Reported per EUA as individual was too young to receive vaccine-First dose was given 3 wks earlier. Series completed with this dose.


VAERS ID: 1423597 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chills, Dyspnoea, Electrocardiogram abnormal, Fatigue, Laboratory test, Nausea, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Trileptal , Adzenys, and Gai Adrenal Health
Current Illness: Chronic Fatigue Syndrome and Fibromyalgia.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Abnormal EKG, Basic lab results were performed at my local urgent care. I also was admitted to hospital where a series of cardiology and lab test were performed.
CDC Split Type: vsafe

Write-up: I had severe hip pain and lower right back pain. I also experienced chills , fever, exhaustion , shortness of breath and pain in upper rt thigh with nausea.


VAERS ID: 1423820 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Hypoaesthesia, Vertigo
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (narrow)

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

Write-up: After an hour of vaccination numb face and brain while driving. Lasted a few seconds. Almost passed out while driving. Thereafter, vertigo. Which began after 2 weeks of vaccination.


VAERS ID: 1424024 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-02
Onset:2021-06-05
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec prn
Current Illness: None
Preexisting Conditions: Obesity Mild intermittent asthma Anxiety Allergic rhinitis
Allergies: No
Diagnostic Lab Data: Patient was diagnosed with positive COVID-19 infection by PCR test on 11/27/2020.
CDC Split Type:

Write-up: Patient reports she developed severe headache, chest pain and shortness of breath 3 days after receiving the vaccination. Her symptoms lasted for 2 days. She did not need to seek medical care.


VAERS ID: 1424209 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

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

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

Write-up: Pt is not of age indicated to receive Pfizer Covid vaccination


VAERS ID: 1424257 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-26
Onset:2021-06-05
   Days after vaccination:99
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 RA / SYR

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

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

Write-up: I started a low grade fever around 7th of June, I contacted my doctor because I believe I had a prostate problem. He prescribed a antibiotic which was Ciprofloxacin 500mg 2xday for 10 days to take. I am not sure if it is related to the vaccine.


VAERS ID: 1424267 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-03-19
Onset:2021-06-05
   Days after vaccination:78
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 RA / SYR

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

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

Write-up: I started to have a low grade fever on June 5th and I saw my doctor due to maybe having prostate issues. He prescribed my a antibiotic to take. I am unsure if this is related to the vaccine or not.


VAERS ID: 1424309 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-30
Onset:2021-06-05
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Ageusia, Bell's palsy, Dysarthria, Dysphemia, Ear pain, Facial paresis, Lagophthalmos, Pain in jaw, Paraesthesia oral
SMQs:, Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), Periorbital and eyelid disorders (narrow), Osteonecrosis (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin
Current Illness: None
Preexisting Conditions: Breast Cancer
Allergies: None
Diagnostic Lab Data: Emergency Room doctor made visual diagnosis, upon observation of my symptoms.
CDC Split Type:

Write-up: Bells Palsy left side of face. Symptoms started on Saturday June 5, 2021 in the morning. Symptoms included but not limited. Tingling of tongue and then loss of taste, pain in left jaw, pain in left ear, muscle weakness left side of face (unable to fully close left eye, unable to raise left eyebrow, left nostril unable to flare, slurring of speech, unable to fully smile, stuttering while speaking) worsening of vision in left eye.


VAERS ID: 1424321 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-01
Onset:2021-06-05
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Thrombosis, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Dulera, albuterol,citraloplam,singular,cetrizine
Current Illness:
Preexisting Conditions: Copd, asthma
Allergies: Penicillin
Diagnostic Lab Data: 6/8/2021 er visit ultrasound on right knee
CDC Split Type:

Write-up: Blood clot superficial thrombosis right knee 72 hours after vaccine


VAERS ID: 1424597 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Feeling of body temperature change, Malaise, Musculoskeletal stiffness, Nausea, Pyrexia, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Shaking teeth chattering I felt tightened up and felt like I was going to throw up but I was soo tightened up and shaking and fevering that I couldn?t throw up and then stomach sick feeling and shaking and fever and teeth chattering episodes all night and cold and hot and freezing and shaking I felt like I was going to have CCD a siezure if it got any worse it was bad


VAERS ID: 1427209 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-21
Onset:2021-06-05
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Hypothyroidism (Take natural thyroid medication)
Preexisting Conditions: Medical History/Concurrent Conditions: Hashimoto''s disease; Rheumatoid arthritis; Undifferentiated connective tissue disease (but was stable and doing well)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021725701

Write-up: Diagnosed with shingles two weeks after second vaccine; This is a spontaneous report from a non-contactable consumer (patient). A 43-years-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation solution for injection, batch/lot number was not reported), via an unspecified route of administration on 21May2021 at 12:00 pm at the age of 43-years-old) as single dose for covid-19 immunization. Medical history included autoimmune disease-RA (rheumatoid arthritis), hashimoto''s and UCTD (undifferentiated connective tissue disease) but was stable and doing well and ongoing hypothyroidism. Concomitant medications included Acela natural thyroid for hypothyroid (received within two weeks vaccination). Patient had no known allergies. Prior to vaccination, the patient was not diagnosed with COVID-19. Patient had not tested for COVID-19 since the vaccination. The patient did not receive any other vaccines within 4 weeks prior to the COVID-19 vaccination. The patient received first dose bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation solution for injection, batch/lot number was not reported) via an unspecified route of administration on an unspecified date, as single dose for COVID-19 immunization and had no reaction. On 05Jun2021, 2 weeks after second vaccine, patient was diagnosed with shingles. Patient received Valetex, and Gabapentin as a treatment for the event. Event was resulted in Doctor or other healthcare professional office/clinic visit. The outcome of the event was not recovered. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1428248 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-10
Onset:2021-06-05
   Days after vaccination:87
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH BN6202 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Oropharyngeal pain, Sinusitis
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Trintellix; Busbar; Xanax; Esomeprazole; Losartan; Simvastatin
Current Illness: None
Preexisting Conditions: HBP; Anxiety
Allergies: None
Diagnostic Lab Data: None.
CDC Split Type: vsafe

Write-up: Sore Throat 10 days long from 06/05/2021, sinus infection; determined Antibiotic.


VAERS ID: 1428445 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Influenza like illness, Mobility decreased, Pain, Pain in extremity
SMQs:, Parkinson-like events (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: Ditropan XL - for sweating Aderall Levothyroxine
Current Illness:
Preexisting Conditions: Over-reactive nervous system Hypothyroidism Fibromylgia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient came in today and reported that she had flu like symptoms the day after she received the vaccine but felt better about three days latter. She reported the fatigue never went away since the day after she received the vaccine. She reported that today when she woke up, her left arm which she received the vaccine on was very painful and she cant move it. She reported that the arm is progressively getting worse. She was advised to massage the arm, warm compress, Tylenol or go to the urgent care if she doesn''t get better.


VAERS ID: 1428792 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Dizziness, Fall, Headache
SMQs:, Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Per mother, pt has history with prior vaccines & pt did not eat or drink prior to vaccinations that morni
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately at 10:36 a.m., pt reported light-headedness after COVID-19 vaccine. Pt was sitting in observation area accompanied by mother. Pt slumped off chair, mother caught pt and laid him on floor. Pt quickly recovered and was A&O x 4. Pt did not hit head, though he reported a slight headache that resolved before he left premises at 11:05 a.m. Pt left walking with normal gait. Per mother, pt has history with prior vaccines & pt did not eat or drink prior to vaccinations that morning. Mother was advised to call MD provider with any further concerns.


VAERS ID: 1429339 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-06-05
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: SARS-CoV-2 test positive
Allergies:
Diagnostic Lab Data: Test Date: 20210605; Test Name: Tested positive for the Covid virus; Test Result: Positive
CDC Split Type: USPFIZER INC2021681703

Write-up: Patient tested positive for Covid virus after first Covid vaccine; Patient tested positive for Covid virus after first Covid vaccine; This is a spontaneous report from a contactable pharmacist via a Pfizer Sponsored Program. A 41-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), dose 1 via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as DOSE 1, SINGLE for COVID-19 immunisation. The patient''s medical history included originally tested positive for the Covid virus on 18Apr2021. The patient''s concomitant medications were not reported. It was reported that on 05Jun2021 the patient tested positive for Covid virus after first Covid vaccine. The reporting pharmacist reported for the patient who came into the pharmacy for her second dose of the Pfizer vaccine, and reported that she tested positive on Saturday for the Covid virus. It was mentioned that the patient was originally tested positive for the Covid virus on 18Apr2021 and then tested positive again, for the Covid virus, this past Saturday. The pharmacist would like to know what the recommendations are for a patient who had tested positive for Covid in getting the second Covid vaccine. The outcome of the events was unknown. Information about lot/batch number has been requested.


VAERS ID: 1429402 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-11
Onset:2021-06-05
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Diplopia, SARS-CoV-2 test
SMQs:, Ocular motility disorders (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Food allergy (Allergy); Soy allergy; Type 2 diabetes mellitus
Allergies:
Diagnostic Lab Data: Test Date: 20210505; Test Name: SARS-Cov-2; Result Unstructured Data: Test Result:Negative; Comments: Nasal Swab
CDC Split Type: USPFIZER INC2021691705

Write-up: double vision; This is a spontaneous report from a contactable consumer (patient). A 62-year-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number: EP7533), via an unspecified route of administration, in arm left on 11Apr2021 at 13:00 (at the age of 62-years-old) as 2nd dose single and first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number: EN6207), via an unspecified route of administration in arm left on 20Mar2021 at 13:00 (at the age of 62-years-old) as 1st dose single both for COVID-19 immunisation (not pregnant at time of vaccination). The medical history of the patient included type 2 diabetes mellitus. The patient had wheat, corn and soy allergy. Patient did not receive concomitant medications within 2 weeks of vaccination. The patient previously took morphine, codeine and demerol for allergy. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with covid-19. On 05Jun2021 at 15:30, the patient experienced double vision. Since the vaccination, the patient was tested for covid-19. The patient underwent lab tests and procedures which included sars-cov-2 test (Nasal Swab): negative on 05May2021. The outcome of the event was reported as not resolved. Follow up attempts are possible. further information is expected.


VAERS ID: 1429433 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Headache, Pyrexia, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021695194

Write-up: Tightness of chest; Severe headaches; Rashes on skin; Feverish ness; This is a spontaneous report from contactable consumer (patient). A 13-years-old male patient received BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EW0176), via an unspecified route on 04Jun2021 (at the age of 13-years) as dose number unknown, single in the left arm for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient had known allergic to Aspirin and Ibuprofen. The patient did not receive any other vaccines within four weeks prior to the vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. On 05Jun2021 at 13:15, the patient experienced tightness of chest for about 15 minutes. Happened again on 06Jun2021 for 5mins and on 07Jun2021 for about 3 minutes. Also experienced severe headaches, rashes on skin and feverish ness. The patient did not received treatment for events. The events was assessed as serious Life threatening illness. The outcome of the events was recovering. Information on the lot/batch was available, further information has been requested.


VAERS ID: 1429478 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Herpangina, Pyrexia, Sinusitis, Stomatitis, Tongue discomfort
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Advil, Unithroid 25 mcg, and Zoloft 25 mg
Current Illness: I began having sinus cold (no fevers just cold symptoms) several weeks after first May 2nd Pfizer vaccine, around May 21st. And after second Pfizer vaccine on June 4th, I noticed visual changes on my tongue and sores in my mouth and throat. I had delayed low grade fever on Sunday night. On Monday or Tuesday of that week, June 7th, I went to a walk in clinic. She diagnosed me with herpangina. She gave me antibiotics for unresolved sinus infection. Several weeks later, and I still have sores on my tongue, throat, and inner cheeks that are not resolving.
Preexisting Conditions: Primary Reynauds, Hashimoto''s Thyroiditis, Rosacea, and have total joint TMJ prostheses.
Allergies: Penicillin
Diagnostic Lab Data: Only a visual test conducted at walk in clinic.
CDC Split Type:

Write-up: As noted earlier, I had cold symptoms develop on May 21st several weeks after my first vaccine. I had no symptoms before. I had a sunus cold that was stubborn and unresolved when I had my second vaccine on Friday June 4th. On Saturday June 5th, I noticed visual changes on my tongue and mouth sores or ulcers and soreness when eating dinner. I went to the walk in clinic on Monday or Tuesday morning. The NP there diagnosed me with sinusitis for the sinus infection, and herpangina for the mouth, tongue, and throat sores and rash. She gave me a prescription for antibiotics for the sinus infection, and a lidocaine oral rinse to numb the mouth sores for one day. It''s over two weeks later, and I still have sores on my tongue, throat, and inner cheeks. I have a pitted tongue too which looks unsightly.


VAERS ID: 1429479 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Confusional state, Injection site erythema, Injection site pruritus, Injection site swelling, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (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), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Site: Itching at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Abdominal Pain-Severe, Systemic: Confusion-Medium, Systemic: Fever-Medium


VAERS ID: 1429650 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH TLC06109 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Anxiety, Blood pressure increased, Body temperature increased, Cardiovascular symptom, Chest pain, Dizziness, Fatigue, Headache, Myalgia, Neck pain, Pain in jaw, Palpitations
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Biaxin/bee stings
Diagnostic Lab Data: None. Didn''t go to doctor.
CDC Split Type:

Write-up: Day after 2nd dose. Temperature over 100 all day. Tylenol did not help. Bad muscle aches. Headache. Fatigue. 2nd day after totally fine. 3rd day after. Fatigue. Headache. Heart palpitations. High blood pressure. Racing heart. Day 4 after. Heart attack symptoms. Severe anxiety. Dizzy. Neck and jaw pain. Severe Chest pain. Upset stomach. High blood pressure. Racing heart.


VAERS ID: 1429855 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-16
Onset:2021-06-05
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Angiogram, Catheterisation cardiac, Chest X-ray, Chest discomfort, Dyspnoea, Echocardiogram, Electrocardiogram, Fatigue, Pain in jaw, Pyrexia, Troponin increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Osteonecrosis (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: June 14 - EKG, chest x-ray June 15 - cardiac catheterization, echocardiogram June 18 - CTA scan of lungs
CDC Split Type:

Write-up: On June 5th while running a race I experienced extreme fatigue, overheating, jaw pain, and shortness of breath. I thought I was suffering from heat exhaustion, but after several days, I was still short of breath and experiencing tightness in my chest. It continued to worsen, making it difficult to breath while walking, and eventually just sitting. I was told by my doctor report to the ER on June 14th. I was admitted that day due to elevated troponin levels. I had an EKG, chest x-ray, and ultrasound of the heart. On June 15th I had a cardiac catheterization. No blockages were found. I was sent home, but continued to experience shortness of breath and tightness in my chest. I went back to the doctor who was concerned about a pulmonary embolism. I had at CTA scan which showed no clots. The symptoms continued. On June 21st I went back to the doctor, who scheduled a pulmonary function test. I had that test on June 24th. It indicated that my lungs had some "blockage" (sorry, I don''t know the exact terminology). I was given a prescription for Symbicort. I also had a follow-up visit with a cardiologist on the 24th. They have concerns about myocarditis and have scheduled me for a cardiac MRI.


VAERS ID: 1430171 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Amnesia, Blood test, Computerised tomogram, Electrocardiogram, Electroencephalogram, Gait inability, Magnetic resonance imaging, Mobility decreased, Speech disorder, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Xarelto, hydrocortisone, multi vitamin, folate all daily. Keytruda and Altima every 3 weeks
Current Illness: One going treatment for stage 4 lung and brain cancer.
Preexisting Conditions: Stage 4 lung and brain cancer - currently in remission Addisons - adrenal I sufficiency Blood thinner for blood clotting genetic disorder
Allergies: Latex
Diagnostic Lab Data: 36 different blood labs, egg, ekg, 4 CT scans, MRI all June 6th and 7th.
CDC Split Type:

Write-up: Lost memory for remainder of day. The night of the 5th and through approximately 9pm on the 6th I was incapacitated. Couldn''t walk, talk, move. Semi unresponsive. No recollection of those hours.


VAERS ID: 1430325 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-05-28
Onset:2021-06-05
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A2114 / 1 LA / OT

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

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

Write-up: After a week from shot, developed itchy rash and red pimples on legs. Spread to torso, shoulders and back. Unable to sleep at night. Lasted for over 2 weeks; thank God is finally subsiding. Not a happy person!


VAERS ID: 1430853 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-05-24
Onset:2021-06-05
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Laryngitis, Vocal cord paralysis
SMQs:, Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec for allergies
Current Illness: None
Preexisting Conditions: None
Allergies: Parafon Forte
Diagnostic Lab Data: 6/24/2101 - Appt with ENT. He diagnosed Paralysis of my left vocal cord. Recommeneded two CAT scans, a videostroboscopy and speech therapy
CDC Split Type:

Write-up: On June 5th, I developed what I thought I was laryngitis for the first time in my life. I went to an ENT doctor and he diagnosed it as a paralyzed vocal cord. I have seen an article where this has happened to other people as well. This is unacceptable and is going to cost me a fortune to fix.


VAERS ID: 1430871 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Escitalopram 20mg
Current Illness: NO
Preexisting Conditions: NO
Allergies: Sulfur, Amoxicillin, Steroid, Latex , Dogs , Cats, Mountain Cedar, Pollen, Dust
Diagnostic Lab Data: No
CDC Split Type:

Write-up: Nothing at first, sat for 30 minutes per instructed, then once I left within the hour developed extreme fatigue, sweats, started itching and rash all over. Assumed side effects, had to drive to pharmacy and purchase Nivea Cream and shea butter for itching. Also took Benadryl.


VAERS ID: 1431332 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-25
Onset:2021-06-05
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthritis, Immediate post-injection reaction, Lymphadenopathy
SMQs:, Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bupropion 150mg Zyrtec 10mg Singular 10mg CBD 25mg Vitamin D
Current Illness: PTSD
Preexisting Conditions: Anxiety
Allergies: Celexa Gabipentin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen lymph nodes under left arm immediately after shot Inflammation of the coastal joint of 3rd and 4th rib


VAERS ID: 1431520 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Lip swelling
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trazodone Sertraline
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt with lip swelling since day after vaccine, currently getting worse. Given oral steroids and epi-pen


VAERS ID: 1431769 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-05
Onset:2021-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone, Brain natriuretic peptide, Chest X-ray, Chest pain, Dyspnoea, Electrocardiogram, Fatigue, Full blood count, Glycosylated haemoglobin, Heart rate irregular, Laboratory test, Lipids, Metabolic function test, Palpitations, Red blood cell sedimentation rate
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (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: Had COVID19 approximately 1 month prior to vaccination
Preexisting Conditions: H/o positive PPD in 08/2018 - normal CXR per verbal report. quant gold negative Aug 2019. Coat''s disease of right eye - followed by ophthalmology anxiety allergic rhinitis
Allergies: NKDA
Diagnostic Lab Data: EKG 6/19/21 Labs drawn 6/22/21 - ESR, TSH, CBC, CMP, HbA1c, Lipid panel Labs drawn 6/26/21 - BNP pending results Chest xray and cardiology referral ordered (pending approval)
CDC Split Type:

Write-up: Reported that he experienced chest pain, irregular heart beat, difficulty breathing and fatigue staring the night he got the 1st dose of the vaccine 6/5/21. Chest pain lasted approx. 7 days (more at night). Palpitations lasted for about 2 weeks (intermittent). Difficulty breathing was only at night when he tried to lay down (lasted about 10 days). When last seen in clinic 6/29/21 reports all symptoms resolved.


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