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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 195 out of 4,799

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VAERS ID: 1388404 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Calcium, Vitamin D3, Omega 3
Current Illness: Sprained Wrist
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: There were no medical tests done at either Emergency Room.
CDC Split Type:

Write-up: Extreme Hive Break Out for three days. Extreme Lip Swelling. I have plenty of pictures if you want them. We went to Emergency room on Friday and they gave her an IV with Antihistamine and Steroids and Pepcid. She got better and we went home. She broke out again all over her body on Saturday and this time we went to Emergnecy room. They observed her and basically told us when they discharged us to keep her on Benadryl every four hours for the next 48 hours. I think it''s important to note that she did test positive for COVID 19 on December 11, 2020 and had a fairly mild case of the virus. ALso, that she has never had this reaction to anything ever before.


VAERS ID: 1388420 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
SMQs:, Medication errors (narrow)

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

Write-up: Patient was given second dose of Moderna vaccine at a 21 day interval not 28


VAERS ID: 1388470 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Headache, Mobility decreased, Nausea, Pain, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair 100 Diskus, Iron and multi-vitamin
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Bacitracin Allergy
Diagnostic Lab Data: None - just reported to her physician
CDC Split Type:

Write-up: Woke up exactly 12 hours after vaccine with the following symptoms: Fever 99.5-100, red cheeks, shaking, body aches, nausea, headache, couldn''t lift her arms much. Symptoms lasted 24hours and as fast as they came on, they went away the same. A severe headache remained the second day.


VAERS ID: 1388814 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Muscle contractions involuntary
SMQs:, Dystonia (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: Influenza vaccines-she experienced similar muscle tetany
Other Medications: Claritin 10mg, Flonase nasal spray, Depo-Provera IM injection
Current Illness: Amplified pain syndrome
Preexisting Conditions: Amplified pain syndrome, IBS, migraines, exercise induced asthma, obesity
Allergies: Compazine, sulfa, influenza vaccines (developed muscle tetany)
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Within 30 minutes of the injection she developed forceful, involuntary muscle contractions to her abdomen and B. hands. Had less severe muscle contractions to jaw. She has had similar reactions to compazine and to influenza vaccines.


VAERS ID: 1388849 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016CZIA / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036CZIA / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Eye swelling, Headache, Injection site pain, Lymphadenopathy, Pain, SARS-CoV-2 test negative, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: The NP tested my breathing with a stethoscope, checked my eyes for reactivity, and had me read from the letter chart to ensure my vision was fine. He gave me a rapid COVID-19 test that came back negative. I told him I had been taking one Zyrtec every morning since 06/04/2021 and Benadryl before bed just in case the reaction rapidly worsened while I slept. On 06/06/2021, I began using Alaway allergy eye drops as well. The NP told me that I was doing everything that he would recommend and that my symptoms were likely due to the COVID Vaccine I received on 06/03/2021. He told me that he would normally prescribe/give prednisone to treat the reaction but that studies have found the steroid to reduce the efficacy of the vaccine so he would not recommend it. My visit was on 06/09/2021 at 8:30 am CT, 6 days after my vaccine , and 5 days after my reaction began.
CDC Split Type:

Write-up: Starting the day after the vaccine, 06/04/2021, I had severe body aches, severe headache, pain on my arm where the shot was given, and severely swollen eyes but no vision problems. The body aches, headache, and arm pain lasted until 06/06/2021. The swollen eyes are still swollen today, 06/10/21, 7 days after the vaccine. On 06/09/2021 my lymph nodes in my right arm pit and on my left pectoral muscle swelled up, became red, and had an aching pain without touch and a moderate pain when touched. As of today, 06/10/2021, my lymph nodes are still swollen but with very minor pain with touch.


VAERS ID: 1388865 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-23
Onset:2021-06-04
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Covid Swab 6/4/2021 positive
CDC Split Type:

Write-up: Employee reported to Health Services that she tested Positive for Covid on 6/4/2021, after having 2 doses of Covid Vaccine. 12/23/2020 & 1/13/2021


VAERS ID: 1388875 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-06-04
   Days after vaccination:58
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Patient tested Positive For Covid -19


VAERS ID: 1388887 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-04-22
Onset:2021-06-04
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site nerve damage, Neuralgia, Phantom limb syndrome
SMQs:, Peripheral neuropathy (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: Flomax, Zyrtec
Current Illness: Spinal stenosis
Preexisting Conditions: Spinal stenosis, service injuries to spine
Allergies: None
Diagnostic Lab Data: None to date
CDC Split Type:

Write-up: Nerve damage Pain at time of injection by nurse. Currently experiencing pain and phantom shot replication.


VAERS ID: 1389064 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthma, Blood pressure increased, Chills, Coagulation factor, Cough, Decreased appetite, Epistaxis, Full blood count, Heart rate increased, Hyperhidrosis, Lethargy, Pulmonary function test, Pyrexia, X-ray
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol, concerts, methylphenidate, advair
Current Illness:
Preexisting Conditions: Asthma
Allergies: Augmentin, Zithromax
Diagnostic Lab Data: X-rays, CBC, clotting factor tests, pulmonary function test,
CDC Split Type:

Write-up: Coughing, fever, chills, sweating, lethargy, decreased appetite, SEVERE nose bleeds lasting 20+ minutes, increased blood pressure and heart rate. Induced an asthmatic flare which required increased breathing treatments, steroids, and antibiotics. **Maternal grandmother had severe reaction. VAERS NUMBER 1182545


VAERS ID: 1389088 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-29
Onset:2021-06-04
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Chest pain, Injection site mass, Injection site pain
SMQs:, Peripheral neuropathy (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Patient was experiencing arm pain around injection site with a lump where moderna was given. She mentioned that she has burning of the chest/sternum area radiating down to left arm with little to no effect when using ibuprofen for relief. It has been continuous since when she has reported having symptoms


VAERS ID: 1389100 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-16
Onset:2021-06-04
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Trismus
SMQs:, Dystonia (narrow), Hearing impairment (broad)

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

Write-up: 6/3/21: started having left eye watering with the inability to close the eyelid 6/6/21: received 2nd covid vaccine 6/8/21: Developed inability to close his mouth and to smile which has persisted 6/10/21: Seen in clinic and diagnosed with left Bells Palsy and prescribed prednisone


VAERS ID: 1389156 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Chills, Diarrhoea, Erythema, Fatigue, Headache, Nausea, Pain, Palpitations, Peripheral swelling, Pyrexia, Rash, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (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: Straterra, Spironolactone.
Current Illness: No
Preexisting Conditions: Hashimoto?s Thyroiditis
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine administered at 11am. By 11:30am, I was severely nauseous. Abdominal cramping. Nausea until 2:30pm. By 3:30pm, head ache, body aches, chills, joint paint, fatigue, fever of 100.8 By 6:00pm, my hands and feet became red, swollen, and hot. Rash on my legs. Racing heart rate of 115bpm. Continued body aches and joint pain. No more fever. By 9:30pm, 25mg Benadryl taken. By 10:30pm, redness and swelling reduced, heart rate decreases to 85bpm. 06/05/2021: diarrhea and continued fatigue and body aches, residual swelling of extremities. Currently, it?s 6/10/2021, and fatigue and body aches/joint pain are continuing.


VAERS ID: 1389203 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient received 2nd dose of pfizer covid vaccine on 06/03/2021, next day noted supraclavicular lymph node.


VAERS ID: 1389227 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-28
Onset:2021-06-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Diarrhoea, Rash, Rash maculo-papular, Urticaria
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (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: Sertraline 50mg, gemmily (OCP), B12 lozenge, probiotics
Current Illness: None
Preexisting Conditions: Neurocardiogenic syncope
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately 6 days after, I developed a rash on my thighs, hands, forearms, elbows, upper arms, low back, and some on my lower interior stomach. The rash ranged from welt/hive-like to macule/papule type. The ones on my hands felt more like blisters. I had no anaphylaxis... Mild loose stool. Breathing fine. I still have the rash on my hands, elbows, and upper thighs, but it has started to go down as of today.


VAERS ID: 1389303 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Flank pain, Headache, Nausea, Pain, Pyrexia, SARS-CoV-2 test, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Migraines, depression
Allergies: None
Diagnostic Lab Data: PCR COVID pending, collected on 6/10/2021
CDC Split Type:

Write-up: severe headache, body aches, fever (highest 102.3), and flank pain (right) for 7d. As well as, milder nausea/vomiting. Mild cough after 6d of vaccination (#2).


VAERS ID: 1389334 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-05-11
Onset:2021-06-04
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster, Ophthalmological examination
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Lactose intolerance
Diagnostic Lab Data: Visual diagnosis
CDC Split Type:

Write-up: Shingles (herpes zoster) first signs occured on 6/4/21 and diagnosed on 6/9/21. Prescribed Valacyclovir HCL 1 gram tablet twice a day for 7 days, and Prednisone 50mg tablet once per day for 5 days.


VAERS ID: 1389523 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-26
Onset:2021-06-04
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Fatigue, Hypertension, Pain in extremity
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow), 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: High blood pressure
Allergies: Allergies to grass pet dander , dust
Diagnostic Lab Data:
CDC Split Type:

Write-up: Feel pain in back of calves legs still fatigue still blood pressure raised higher


VAERS ID: 1389531 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pain, Paraesthesia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin ,Jardiance
Current Illness: Nothing
Preexisting Conditions: Diabetic
Allergies: Pencyllin,Sulphur
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling pain Redness and sensation


VAERS ID: 1389532 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site urticaria, Rash, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: birth control
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: large rash on neck area initially; rash spread to back and legs; hives on arm of injection in the middle of the night Took Benadryl which seemed to clear it up but rash came back in morning. Threw up in morning. Went to urgent care. No respiratory issues and rashes cleared up. Instructed to monitor and continue Benadryl as needed. If hives come back and Benadryl does not clear it up then go to urgent care or ER. Benadryl did seem to work but rashes continued for several days.


VAERS ID: 1389563 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-06-01
Onset:2021-06-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 064C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Inflammation, Injection site erythema, Injection site inflammation, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: PATIENT REPORTED PAIN AND INFLAMMATION IN HER ARM 10 DAYS AFTER 1ST SHOT OF MODERNA. SITE ON LEFT ARM WAS RED AND INFLAMMED. PATIENT REPORTED HER ARM WAS STILL VERY SORE (SCORE 4 ON 1-10 SCALE) BUT REPORTED SHE FELT HIGHER PAIN 2-3 DAYS AFTER INJECTION WAS GIVEN. PATIENT ALSO REPORTED THAT SHE HAS BEEN TAKING TYLENOL FOR THE PAIN. SHE HAS ALSO BEEN HAVING HEADACHES THAT STARTED AFTER RECEIVING THE VACCINE. SHE REPORTED THIS IS ABNORMAL FOR HER AND USUALLY DOES NOT HAVE HEADACHES. SHE HAS BEEN DRINKING LOTS OF WATER SO THE HEADACHES ARE UNRELATED TO DEHYDRATION.


VAERS ID: 1389572 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (broad)

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

Write-up: This is just to report that Nurse gave the patient a Pfizer vaccination instead of his second Moderna. Patient is aware and experienced no side effects


VAERS ID: 1389758 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Laboratory test, Pyrexia, X-ray
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: He had the 2nd Pfizer covid vaccine on Thursday late afternoon. By Friday evening, he was complaining of chest pain and shortness of breath. He was also running a fever. Called the advice line for his dr and were told to monitor him. Saturday early morning, took him to urgent care due to no improvement. They did an x-ray and other tests to rule out myocarditis. His symptoms eventually resolved on Monday.


VAERS ID: 1390057 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO185 / 2 LA / SYR

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

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

Write-up: Hives started on my abdomen on day 3 and are spreading to upper arms and legs. Tried Benedryll first then Zyrtec. Went to see doctor on day 6 and was given a Solu-Medrol injection and prescription for a Medrol dose pack. On day two of dose pack currently.


VAERS ID: 1390349 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Blood pressure increased, Chest pain, Constipation, Decreased appetite, Diarrhoea, Dry mouth, Eye pain, Headache, Injection site pain, Lymphadenopathy, Muscle spasms, Nasal dryness, Nausea, Neck pain, Otorrhoea, Pain, Thirst
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Hypertension (narrow), Cardiomyopathy (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Sore arm where shot was given
Other Medications: None were taken.
Current Illness: Hypothyroidism & Hypertension
Preexisting Conditions: N/A
Allergies: Allergies to: Penicillin, Ampicillin, Betadine, and Sulfur.
Diagnostic Lab Data: None at this time
CDC Split Type:

Write-up: Chest pains, sore left arm where shot was given, painful swollen lymph nodes under left arm pit, bad head pain, eye pain from the head pain, elevated blood pressure (even after medication), body pain everywhere, diarrhea, nausea, lost of appetite, neck pain from the head pain, constipation, left/right side stomach pain, left/right muscle spasms in both calves, dry mouth, thirsty, dry nostrils, and ear drainage from right ear.


VAERS ID: 1390688 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-06-04
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A 21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Face oedema, Hypersensitivity, Hypotension, Hypoxia, Nausea, Oxygen saturation decreased, Pharyngeal oedema, Tongue oedema, Vomiting, Wheezing
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: THC DROPS STENOCARE
Current Illness: Alcoholic (rarely about two (2) drinks per month.); Allergy to antibiotic (Allergic to cipro, doxycycline, flagyl and cephalosporins); Antihemophilic factor; Arthritis; Asthma; Endometriosis; Non-smoker; Penicillin allergy (Allergy to penicillin, amoxicillin.); Post-traumatic stress disorder; Slipping rib syndrome; Vesicoureteral reflux with reflux nephropathy, bilateral
Preexisting Conditions: Medical History/Concurrent Conditions: Food allergy (Allergic to tree nuts, almonds, peanuts and legumes.); Comments: No illicit drug use or drug abuse.
Allergies:
Diagnostic Lab Data: Test Date: 20210604; Test Name: Oxygen saturation low; Result Unstructured Data: 92%, 92%; Test Date: 20210604; Test Name: Blood pressure; Result Unstructured Data: 62/80, 62/80
CDC Split Type: USJNJFOC20210611762

Write-up: OXYGEN WAS AT 92%; BLOOD PRESSURE 62/80; EDEMA OF FACE; EDEMA OF THROAT; EDEMA OF TONGUE; EMESIS; WHEEZING; ALLERGIC REACTION; NAUSEA; This spontaneous report received from a patient concerned a 23-year-old white, Not-Hispanic/ Latino female. The patient''s weight was 230 pounds, and height was 64 inches. The patient''s concurrent conditions included non-smoker, alcoholic, penicillin allergy, anti-biotic allergy, food allergy, factor VIII (a), endometriosis, bilateral urinary reflex, arthritis, slipping rib syndrome, asthma, and PTSD (Post-traumatic Stress Disorder), and other pre-existing medical conditions included no illicit drug use or drug abuse. The patient was previously treated with Leuprorelin acetate for 10 years which was ended on FEB-2020 and 2 rounds of Intravenous chemotherapy for 6 months apart ending 22-NOV-2019, for drug used for unknown indication; and experienced drug allergy when treated with acetylsalicylic acid, gabapentin, ethinylestradiol/ferrous fumarate/norethisterone acetate, meloxicam, ibuprofen, paroxetine hydrochloride, topiramate, ketorolac tromethamine, venlafaxine, and sertraline hydrochloride for drug used for unknown indication. The patient mentioned that she had also taken 2 oral chemotherapy drugs of which names she did not remembered. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 202A 21A and expiry: 23-JUN-2021) dose was not reported, frequency of 1 total, administered on 04-JUN-2021 18:10 for prophylactic vaccination on right deltoid. Concomitant medications included cannabis sativa flower for arthritis. The patient reported that after vaccination on 04-JUN-2021 at 18:15 she began experiencing allergic reactions with symptoms of nausea, vomiting, wheezing, and swelling of face, throat and tongue. She also mentioned that her oxygen was at 92% and blood pressure was 62/80. Laboratory data included: Blood pressure (NR: not provided) 62/80 62/80, and Oxygen saturation low (NR: not provided) 92% 92%. On 04-JUN-2021 18:20, treatment medications included: epinephrine. On 04-JUN-2021 18:20, treatment medications included: Epinephrine, 2 doses had been administered. The patient had visited the emergency department for monitoring. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from oxygen was at 92%, blood pressure 62/80, emesis, and nausea on 04-JUN-2021, was recovering from wheezing, edema of face, edema of throat, and edema of tongue, and the outcome of allergic reaction was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: 20210611762-COVID-19 VACCINE AD26.COV2.S-OXYGEN WAS 92%,BLOOD PRESSURE 62/80,EDEMA OF FACE,EDEMA OF THROAT,EDEMA OF TONGUE,EMESIS,WHEEZING. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).20210611762-COVID-19 VACCINE AD26.COV2.S-ALLERGIC REACTION,NAUSEA. This event(s) is labeled per RSI and is therefore considered potentially related.


VAERS ID: 1390701 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-06-04
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210614695

Write-up: VACCINE ADMINISTERED AFTER THE 6 HOUR MARK AFTER FIRST PUNCTURE IN REFRIGERATED CONDITIONS; INCORRECT STORAGE OF DRUG; This spontaneous report received from a pharmacist concerned a 20 year old of unspecified sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, intramuscular, batch number: 205A21A, and expiry: 23/JUN/2021) dose was not reported, administered on 04-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 04-JUN-2021, the subject experienced vaccine administered after the 6 hour mark after first puncture in refrigerated conditions. On 04-JUN-2021, the subject experienced incorrect storage of drug. The action taken with covid-19 vaccine was not applicable. The outcome of the vaccine administered after the 6 hour mark after first puncture in refrigerated conditions and incorrect storage of drug was not reported. This report was non-serious.


VAERS ID: 1391029 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-21
Onset:2021-06-04
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Cough, Headache, Insomnia, Malaise, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 INC2021655185

Write-up: headache/Headache, excruciating, which caused trouble sleeping; Feeling weak, after second vaccine; not feeling well; Vomiting/ sensation of vomiting; coughing; headache/Headache, excruciating, which caused trouble sleeping; This is a spontaneous report received from a contactable consumer (patient). A 25-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number EW0186), via an unspecified route of administration in left arm on 21May2021 at 14:50 (age at vaccination 25 year) as second dose, single dose for COVID-19 immunisation. The patient had received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number EW0167), via an unspecified route of administration into left arm on 30Apr2021 at 14:50 (Age at vaccination: 25 year) as a single dose for COVID-19 immunisation. Patient did not had any Medical History. No Family Medical History Relevant to AE. No additional vaccines were administered on same date of the Pfizer vaccine. Patient previously took tylenol. No prior Vaccinations within four weeks to the first administration date of the suspect vaccine. Concomitant medication was not reported. Patient Stated she had some vomiting after second vaccine. Vomiting, occurred on two separate occasions, after second vaccine. She stated that she reacted strongly, for about 24 hours, and had vomiting, and a headache and she had trouble sleeping. She stated she got through that and felt fine, in the days that followed. She stated that last night, about two weeks after her second vaccine, she had similar events of headache and vomiting, that mimicked those initial symptoms. Patient was concerned that maybe she had food poisoning. She stated vomiting returned yesterday (03Jun2021) along with a headache. Described also as sensation of vomiting, coughing on 04Jun2021. On 04Jun2021 01:00 am, she experienced headache, excruciating, which caused trouble sleeping, she woke up and felt weak after second vaccine. Caller states that she had the sensation of vomiting, similar to coughing, and this was identical to the first experience, but milder. She then thought that it was not food poisoning. Caller stated she was healthy, and that is why these reactions were concerning to her. She reported that compared to other people, she felt her effects a little stronger. She later reclarified, from earlier in report, that after the second vaccine, she initially did not have a headache until later. She stated she had vomiting initially after the second vaccine that was stronger last time. She stated the vomiting lasted the first time for about 23 hours. She stated the vomiting that occurred, again, the second time at 3 am on an unspecified date in 2021, was milder. She stated she still felt a little weak, which could be from the vomiting, and she was still not feeling well, and taking it easy and not working today. She stated she did not take anything and a couple of hours went by and she took some Tylenol for headache. Caller stated the Tylenol, did not help her headache. She stated she had taken Tylenol before and it had been effective. Regarding feeling weak, patient stated when she woke up this morning at 7:18 am, she felt better now than earlier today. The outcome of the event "headache/Headache, excruciating, which caused trouble sleeping" with PT ''Insomnia'' was recovered on 04Jun2021; Feeling weak, after second vaccine was recovering; Event Vomiting/ sensation of vomiting, "headache/Headache, excruciating, which caused trouble sleeping" with PT ''Headache'' was not recovered; coughing and not feeling well was unknown.


VAERS ID: 1391042 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Work       Purchased by: ?
Symptoms: SARS-CoV-2 antibody test, Vaccination site pain, Vaccination site rash, Vaccination site swelling
SMQs:, Hypersensitivity (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Appendectomy (Appendectomy in Feb2019, otherwise healthy boy)
Allergies:
Diagnostic Lab Data: Test Date: 20201005; Test Name: Nasal Swab; Result Unstructured Data: Test Result:Negative; Test Date: 20210307; Test Name: Nasal Swab; Result Unstructured Data: Test Result:Negative
CDC Split Type: USPFIZER INC2021656745

Write-up: left arm deltoid injection site with red circular rash with well defined border; There was general swelling (puffy/boggy) of upper arm centered around the injection site that extended under the rash 4 inches in diameter with diffuse/tapered border.; The injection site was very tender to palpation w/ pain raising or using arm.; This is a spontaneous report from contactable consumer (patient). A 13-year-old male patient received BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number- UNKNOWN) via an unspecified route of administration in left arm on 03Jun2021 at 10:30 as 2nd dose, single dose for COVID-19 immunization. Medical history included appendectomy in Feb2019, otherwise healthy boy. Patient previously took Amoxicillin and experienced full body rash. Concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient did not receive any other medications the patient received within 2 weeks of vaccination. On 05Oct2020, patient had been tested for COVID-19 via Nasal Swab and resulted negative. Prior to vaccination, patient was not diagnosed with COVID-19. Historical vaccine included BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number- unknown) via an unspecified route of administration in left arm on 13May2021 at 09:15 AM as 1st dose, single dose for COVID-19 immunization. It was reported that, patient experienced on left arm deltoid injection site with red circular rash with well defined border that was not raised and about 2 inches in diameter. Does not itch. There was general swelling (puffy/boggy) of upper arm centered around the injection site that extended under the rash 4 inches in diameter with diffuse/tapered border. The injection site was very tender to palpation w/ pain raising or using arm. This was only a day following the 2nd injection (On 04Jun2021 at 14:00). No treatment was received for the adverse events. Since the vaccination, the patient had been tested for COVID-19 via Nasal Swab. On 07Mar2021, patient tested COVID-19 and resulted negative. The device date was 05Jun2021. The outcome of the events was recovering. Information about batch/ lot number has been requested.


VAERS ID: 1391046 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Ear pain, Feeling abnormal, Malaise, Pain, Pain in extremity, Pyrexia, Vertigo
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Temperature; Result Unstructured Data: Test Result:101
CDC Split Type: USPFIZER INC2021658025

Write-up: Head spinning; Body ache/Intense body ache; Aching or having such an intense ache that even her thumbs and ears on the inside hurt and she did not want to touch her thumbs; Felt horrible; Aching or having such an intense ache that even her thumbs and ears on the inside hurt and she did not want to touch her thumbs; Temperature of 101/Had a temperature of 101; She just feels like the remnants of how you feel after you have a headache ; did not want to move; This is a spontaneous report from a contactable consumer or other non-Health Care Professional. A 56-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: EW0172 and Expiry date: Unknown), dose 2 via an unspecified route of administration, administered in Arm Right on 03Jun2021 as 2ND DOSE, SINGLE DOSE for covid-19 immunization. The patient medical history was not reported. The patient''s concomitant medications were not reported. On 04Jun2021 the patient experienced head spinning , body ache/intense body ache, aching or having such an intense ache that even her thumbs and ears on the inside hurt and she did not want to touch her thumbs, felt horrible, thumbs and ears on the inside were aching, aching or having such an intense ache that even her thumbs and ears on the inside hurt and she did not want to touch her thumbs, Temperature of 101/Had a temperature of 101. Also, At 5:00 am this morning, she took 325 mg Aspirin (treatment) and is feeling so much better now. She just feels like the remnants of how you feel after you have a headache ; did not want to move. The patient underwent lab tests and procedures which included body temperature: 101 on an unspecified date. The outcome of event was recovering. Follow up attempts are needed. Further information has been requested.


VAERS ID: 1391057 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dysgeusia, Eating disorder, Headache, Nasopharyngitis, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021658761

Write-up: Headache; shakes; shivers/Chills; throwing up/vomiting; quit eating things; Bad taste in his mouth; Cold; This is a spontaneous report from a contactable consumer or other non health professional (Parent) reported for a patient(son). A male patient of an unspecified age received second dose of bnt162b2 (BNT162B2, Formulation: Solution for injection, Lot number: Unknown) via an unspecified route of administration on 03Jun2021 as 2ND DOSE, SINGLE DOSE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. On 04Jun2021, the patient experienced headache, shakes and shivers/chills; throwing up/vomiting; quit eating things; bad taste in his mouth and cold. Reporter stated that he had headache at school the next day, he had the shot yesterday. Today real bad headache and stuff at school today. He came home and started having shakes and shivers. Then he started vomiting, throwing up, quit eating things. Had bad taste in his mouth. (distorted voice and unclear) but then he had problems like cold, chills, shakes in it. Reporter wants to know why patient was having chills, shakes and he was throwing up. The outcome of all events was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1391062 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Off label use, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021658898

Write-up: 14 yr old received the 2nd dose of the Pfizer Covid vaccination; Sore arm; This is a spontaneous report from a non-contactable consumer. A 14-year-old patient of an unspecified gender received second dose of BNT162B2 (Pfizer Covid vaccine, Solution for injection) via an unspecified route of administration on 03Jun2021 (Lot number was not reported) as single dose for Covid-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient previously took first dose of BNT162B2 (at age of 14-year-old) as single dose for Covid-19 immunization. It was reported that, 14-year-old received the second dose of the Pfizer Covid vaccination on 03Jun2021 and had a slight sore arm the following morning. Event took place after use of product. Reporter did not wish to be contacted for follow-up. Outcome of the events was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1391065 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021658999

Write-up: slight sore arm; This is a spontaneous report from a non-contactable consumer reported for a 12-year-old male patient who received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection), via an unspecified route of administration on 03Jun2021 (Batch/Lot number was not reported) as second dose single for covid-19 immunization. The patient medical history and concomitant medications were not reported. The patient received the second dose of the Pfizer Covid vaccination on 03Jun2021 and experienced a slight sore arm the following morning (i.e., on 04Jun2021). The event took place after use of the product. The outcome of the event was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1391071 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021659160

Write-up: She experienced migraine; This is a spontaneous report from a contactable consumer (patient) via a Pfizer sponsored program. A female patient of an unspecified age received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: solution for injection), via an unspecified route of administration on 04Jun2021 as single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. It was reported that she received the 1st dose of Pfizer COVID- 19 vaccine yesterday and she experienced migraine that was yesterday on 04Jun2021 and this morning and she drank acetaminophen (NDC number, UPC number and Expiry Date of acetaminophen were unknown) as treatment and now she was asking if she can drink Butalbital 335 mg? It was reported that she was still experiencing Migraine. The outcome of the event was not recovered. Information on Lot/Batch number has been requested.


VAERS ID: 1391076 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Fatigue
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021659384

Write-up: Fatigue; Dizziness; This is a spontaneous report from a Non-contactable pharmacist. This pharmacist reported that a 12-year-old male patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/Lot Number: unknown), via an unspecified route of administration on 03Jun2021, as single dose for Covid-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/Lot Number: unknown), via an unspecified route of administration on an unspecified date, as single dose for Covid-19 immunization. On 04Jun2021, the patient complained of fatigue and dizziness. The outcome of the events was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1391102 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dyspnoea, Fatigue, Headache, Malaise, Nausea, Pain in extremity, Vaccination site erythema, Vaccination site pain, Vaccination site pruritus, Vaccination site swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVOTHYROXIN; PROBIOTICS NOS
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021662911

Write-up: I have side effects:Injections pain, swelling, redness, itching.; I have side effects:Injections pain, swelling, redness, itching.; I have side effects:Injections pain, swelling, redness, itching.; I have side effects:Injections pain, swelling, redness, itching.; Tiredness; Headache; Nausea; Feeling unwell; Arm pain; Weakness; Short of breath; This is a spontaneous report from a contactable consumer (patient). A 55-year-old non-pregnant female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: EW0178), via an unspecified route of administration, administered in Left arm on 03Jun2021 at 17:00 (at the age of 55-years-old) as 2ND DOSE, SINGLE DOSE for covid-19 immunisation. The patient medical history was not reported. and the patient had no known allergies. Concomitant medications included levothyroxine sodium (LEVOTHYROXIN) taken for an unspecified indication, probiotic supplement (PROBIOTICS NOS) taken for an unspecified indication, on an unspecified date received in two weeks of vaccination. The patient previously took first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: EW0185, Expiration date: unknown), via an unspecified route of administration, administered in Left arm on 13May2021 17:00 at the age of 55-years-old for covid-19 immunisation. The patient did not receive other vaccine in four weeks of vaccination. The patient was not diagnosed with COVID-19 prior vaccination. The patient has not been tested for COVID-19 post vaccination. On 04Jun2021 at 11:00, the patient experienced side effect Injections pain, swelling, redness, itching, Tiredness, Headache, Nausea, feeling unwell, Arm pain, Weakness and Short of breath. patient did not received any treatment for adverse events. The outcome of the events was unknown. .


VAERS ID: 1391119 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-06-04
   Days after vaccination:56
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021664738

Write-up: He said he had just started having muscle pain in his leg; This is a spontaneous report from a contactable consumer (patient). A 36-years-old male patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE Solution for injection, Batch/Lot Number: ER8729; Expiration Date: 31Jul2021), via an unspecified route of administration, administered in Arm Left on 09Apr2021 (at the age of 36-years-old) 09:30 as 2ND DOSE, SINGLE for covid-19 immunisation. The patient had no medical history and concomitant medications were not reported. The patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE Solution for injection, Batch/Lot Number: EN6206; Expiration Date: 30Jun2021), via an unspecified route of administration, administered in Arm Left on 19Mar2021 as 1ST DOSE, SINGLE DOSE for covid-19 immunisation. History of all previous immunization with the Pfizer vaccine considered as suspect was none. Patient had no prior vaccinations (within 4 weeks). No additional administered Vaccines. On 04Jun2021, the patient experienced muscle pain in leg. Patient stated that he wanted to know if this was still associated with the vaccine and heard of people who had side effects 1 week or just 24 hours after receiving the Pfizer-BioNTech Covid-19 Vaccine. He wanted to know if there had been reports of people having side effects almost 2 months after receiving the vaccine and had tried to find out if the side effect he was having from the Pfizer vaccine. He has a primary care doctor but declined to provide HCP information and he just put ice on it. Patient had not visited emergency room and physician office. The patient had no relevant tests. The outcome of event was not resolved.


VAERS ID: 1391138 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-04
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dysarthria, Epistaxis, Pain, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021665196

Write-up: difficult to speak; nose bleed; fever; body aches; This is a spontaneous report from a contactable consumer (patient). A 30-years-old female patient received bnt162b2 (PFIZER- BIONTECH COVID- 19 VACCINE, Solution for injection), dose 2 via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as 2nd dose, single dose for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The 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 1st dose, single dose for covid-19 immunisation. On 04Jun2021, the patient experienced fever and body aches. On 07Jun2021, she experienced nosebleed and on an unspecified date she experienced difficult to speak. The patient stated she received her second Pfizer covid vaccine on Friday. Over the weekend she had fever and body aches. On 07Jun2021, morning she developed a nose bleed. She wanted to know how to what to do about her nose bleed specifically. She was calling for treatment advice and agent referred her to her doctor. Agent asked if patient would like to complete a safety report based on the adverse events she has been experiencing. Patient stated if it is quickly, she could not speak more, and she would like to rest. Patient stated the fever has gone and she still has body aches. Patient stated did not had history and investigations, she was all good. Therapeutic measures were taken as a result of fever. The outcome of the event fever was recovered on 06Jun2021. The outcome of the event body aches was not recovered and unknown for nosebleed and difficult to speak.


VAERS ID: 1391382 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-20
Onset:2021-06-04
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 OT / -

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram, Magnetic resonance imaging, Ultrasound Doppler
SMQs:, Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Simvastatin, Atenolol, Esomeprazole MA DR, L-Thyroxine, Androgel, Finesteride, Monoxidil, Aspirin (81 mg), Folic Acid, Vitamin D3, Naproxin Sodium, Align, daily multiple vitamin.
Current Illness: None
Preexisting Conditions: High blood pressure High Chloresterol Aorotic Stenosis
Allergies: None
Diagnostic Lab Data: CAT scan, MRI, and Coratid Ultrasound
CDC Split Type:

Write-up: Belle''s Palsy, Left side of face. Treatment Anti-Viral and Prednisone. Has not normalized to date.


VAERS ID: 1391467 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Confusional state, Dizziness, Flushing, Grunting, Headache, Loss of consciousness, Nausea, Syncope, Tremor, Unresponsive to stimuli, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (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: Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Headache-Mild, Systemic: Nausea-Mild, Systemic: Shakiness-Mild, Systemic: Visual Changes/Disturbances-Mild, Systemic: Weakness-Mild, Additional Details: made grunting sounds before passing out


VAERS ID: 1391468 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Fear of injection, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: During monitoring period post Pfizer COVID-19 vaccine, pt experienced lightheadedness, feeling faint, sweating. 2 minutes post vaccine, BP was 108/70, P-64, O2 100% RA. Patient was easily aroused, stated he hadn''t eaten or had hydration for $g 12 hours and "needles make him nervous." Crackers and orange juice provided. After extended observation patient stated he felt better and symptoms were relieved.


VAERS ID: 1391475 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Discomfort, Dizziness, Dyspnoea, Eye swelling, Fatigue, Hyperhidrosis, Lip swelling, Oropharyngeal pain, Pruritus, Rash, Tachycardia, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: During monitoring period post initial Pfizer COVID-19 vaccine, pt experienced lip swelling, "ball in throat," itching, lightheaded, sweaty, then chills, dizziness, fatigue, tachycardia, heaviness all over. Medications Given: Epi-Pen injection 0.3ml SC in left thigh, Benadryl 25mg IM for itching given before and after Epi-Pen due to severe itching/rash. Patient has had severe anaphylactic reactions to other vaccines previously that was not disclosed during intake. Patient remained in extended Observation for over 2 hours. VS: 140/82, P-79, Resp 17, O2 97% on RA. Refused to transfer to ER after observation. Later presented to ER with swollen eyes and SOB, rashes, sore throat and took fexofenadine at home. Given additional diphenhydramine 25mg IV and methylprednisolone 125mg IV. Discharged from ED with medrol dosepak.


VAERS ID: 1391485 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

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

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

Write-up: Patient became lightheaded and fainted in her chair in the observation room post injection. BP 103/71, HR 66, R 16, O2 sat 100%. Patient was given water and graham crackers. Continued to monitor patient; at 1003, BP 106/70, HR 73, R 16, O2 sat 100%. Patient stated that she was feeling better and was ready to leave. Patient was discharged to mother to go home.


VAERS ID: 1391767 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-22
Onset:2021-06-04
   Days after vaccination:74
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 2 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Laboratory test abnormal
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Congestive heart failure, asthma HX of stroke
Allergies: Unknown
Diagnostic Lab Data: Antigen testing on 06/06/2021, came back positive PCR testing on 06/06/2021, came back positive
CDC Split Type:

Write-up: Patient became symptomatic with shortness of breath on 06/04/2021. She was admitted into the hospital on 06/06/2021. She was discharged on 06/08/2021.


VAERS ID: 1391791 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
SMQs:, Medication errors (narrow)

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

Write-up: Patient administered 2nd dose in series on day 15 instead of 21.


VAERS ID: 1391928 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-06-01
Onset:2021-06-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 - / IM

Administered by: Work       Purchased by: ?
Symptoms: Blood test abnormal, Chest pain, Computerised tomogram, Echocardiogram, Electrocardiogram, Infection, Myocardial infarction, Troponin
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Have taken creatine for workout supplement.
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: Echocardiogram 6/5/21 CT Scan 6/4/21 Blood work (2) 6/4/21 and 6/10/21 EKG (2) 6/4/21 and 6/10/21
CDC Split Type:

Write-up: On Friday patient woke up with severe chest pain. He had to be taken to the emergency room. His troponin levels were above 1300 which indicated a heart attack so they admitted him to the hospital overnight. However, the blood work indicated an infection and Ibuprofen was the only medicine that helped with the pain. While at the hospital a series of tests were done to find out what was going on. Once the patient was stable enough he left the hospital and he is now undergoing more tests and getting his medical records transferred to the doctors here. We are still in the process of finding out the exact issue and will hopefully get some answers soon.


VAERS ID: 1391971 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

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

Write-up: PATIENT HAS EXPERIENCED MUSCLE PAIN FROM THE SHOULDER TO THE TOE OF THE LEFT SIDE OF HIS BODY FROM 06/04/2021 UNTIL NOW . THE PAIN HAS PERSISTED AND NOT GOTTEN ANY BETTER. HE WENT TO MASSAGE PARLOR ON JUNE 7,2021 FOR MASSAGE , THE PAIN WAS GETTING WORSE AFTER MASSAGE.


VAERS ID: 1392087 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-27
Onset:2021-06-04
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Contusion, Deep vein thrombosis, Erythema, Influenza like illness, Pain in extremity, Peripheral swelling, Skin discolouration
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (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: Estradiol 0.5MG Tablets 1 a day
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: After vaccine the following day Friday 5/28 I had COVID flu like symptoms and right arm very sore for 24 plus hours until Wednesday 6/2 stopped. Than woke up Friday 6/4 early AM with swollen right arm, purple and reddish in color.. Continued on through Sunday morning 6/6 went to ER at 9 am. treated for deep vein thrombosis, blood clot found in right arm and given an injection of Eliquis to the stomach to last 24 hours until Eliquis tablets starter pack. My arm is still swollen and bruised now at vaccine spot, today Friday 6/11 scheduled to see a Hematologist Dr. MD 6/14 I am very concerned and don''t understand.


VAERS ID: 1392096 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-01
Onset:2021-06-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Echocardiogram normal, Electrocardiogram ST segment abnormal, Electrocardiogram abnormal, Heart rate irregular, Immunoglobulin therapy, Inflammatory marker increased, Intensive care, Nausea, Palpitations, Troponin increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Procysbi, Aleve, Cystadrops Eyedrops omeperazole Lexapro
Current Illness: None
Preexisting Conditions: Cystinosis, Anxiety depression
Allergies: NKA
Diagnostic Lab Data: 6/5/2021 ER EKG ST segment abnormalities, irregular heart rate, elevated troponin 12.5, inflammatory markers elevated. Given NS 1L. ECHO normal Transferred to PCICU by ambulance, troponin 30 given morphine IV, Toradol IV, IVIG, solumedrol Discharged home 6/8
CDC Split Type:

Write-up: 2 days after 2nd Pfizer dose sudden severe chest pain with SOB, nausea, palpations. Unrelieved by OTC IB or rest.


VAERS ID: 1392125 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-01
Onset:2021-06-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstruation delayed, Muscle spasms, Scar
SMQs:, Dystonia (broad), 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: Multiple
Current Illness: High blood pressure, diabetes,overactive bladder,arthritis, carpal tunnel, back issues.
Preexisting Conditions: Obesity, back issues
Allergies: Lactose intolerance
Diagnostic Lab Data:
CDC Split Type:

Write-up: Scars on left arm, cramps, late period.


VAERS ID: 1392128 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: Type 2 diabetes Hypertriglyceridemia
Preexisting Conditions: n/a
Allergies: No Known Allergies
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Pt received 2nd dose of COVID vaccine at 21 days after 1st dose instead of 28 days.


VAERS ID: 1392409 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Wrong technique in product usage process
SMQs:, Medication errors (narrow)

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

Write-up: Patient presented to clinic to receive 2nd dose of Pfizer COVID vaccine. NP SD cleaned arm with alcohol swab, grabbed a syringe and inserted needle in arm, attempted to push but no vaccine in clean, sterile syringe/needle. Less than 0.1mL air bolus administered. Provider then had to administer a second needle this time with the vaccine.


VAERS ID: 1392482 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Epistaxis, Tinnitus
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Took Tylenol 5 hours after second shot of Pfizer COVID vaccine
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Allergy to dust, Panadol and majority of shampoo & conditioner
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 1st shot on 05/13/2021: in the next 24 hours, taste changed. It eventually went away 2nd shot on 06/03/2021: in the next 48 hours, ear whooshing sound and nosebleed. It eventually went away


VAERS ID: 1392487 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 59676-0580-15 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Headache, Palpitations, Sleep disorder
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamins: d, B. C, Zinc, Magnesium, CoQ10
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Resting heart rate increased from 58 to 77 over the course of 7 days. racing heart rate, not correlated with activity, tired, fatigued, unable to sleep, loss of appetite, headache


VAERS ID: 1392514 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-05-25
Onset:2021-06-04
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Constipation, Dysuria, Gait inability, Magnetic resonance imaging spinal abnormal, Myelitis transverse, Paraesthesia, Spinal cord infarction
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Recent spider bite to left ribcage; patient did not seek treatment per report Substance Abuse
Preexisting Conditions: Remote history of cardiac disease
Allergies: No known Allergies
Diagnostic Lab Data: Thoracic MRI: Signs of transverse myelitis vs. spinal cord infarction
CDC Split Type:

Write-up: Presents to our facility today with complaints of progressive weakness, inability to ambulate, abdominal pain, left thoracic wall paresthesias, inability to move bowels, and urinary difficulties. Reports he was also bitten by a spider on his left side recently and did not seek treatment, but decided to seek treatment when he developed same symptoms in his right side. Reports he has been experiencing symptoms for 1 week or more.


VAERS ID: 1392539 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / UNK - / 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none known
Current Illness: none known
Preexisting Conditions: none known
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was 11 years and 9 months years old at time of vaccination. Must be 12+ for Pfizer


VAERS ID: 1392755 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-11
Onset:2021-06-04
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Nasal congestion, Oropharyngeal pain, Paranasal sinus discomfort, Respiratory tract congestion, SARS-CoV-2 test positive, Upper-airway cough syndrome
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diffuse large B cell lymphoma- in remission
Allergies: NKA
Diagnostic Lab Data: SARS-COV-2 Rapid: SARS-COV-2 detected (6/4/2021)
CDC Split Type:

Write-up: 62 YO female presents to the ED on 6/4 with complaints of non productive cough, chest congestion, post-nasal drip, nasal congestion, chills, SOB, sinus pressure, and sore throat. Denies fever. COVID rapid test results back negative the same day. Vitals were stable and pt was discharged with COVID-19 diagnosis. She is s/p J&J vaccination on 5/11.


VAERS ID: 1392758 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-15
Onset:2021-06-04
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1508015 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Cough, Decreased appetite, Dyspnoea, Headache
SMQs:, Anaphylactic reaction (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: symptom onset 05/25- cough , SOB, headache, poor appetite, abdominal discomfort.


VAERS ID: 1392849 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Injected limb mobility decreased, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (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: moderate pain at injection site for 2 days with no immobility issues.
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none known
Diagnostic Lab Data: none. no doctor
CDC Split Type:

Write-up: Severe pain at injection site, muscles of outer upper right arm. Immobility of right arm. By 06/07/2021 , little change. Range of possible motion only 30% of normal. Severe pain and (arm "not working") outside of 30% range of motion.


VAERS ID: 1392878 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-05-01
Onset:2021-06-04
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Catheterisation cardiac, Chest pain, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: lisinopril effexor
Current Illness: none
Preexisting Conditions: hypertension depression tinnitus sensoneural hearing loss
Allergies: none
Diagnostic Lab Data: troponin 6/08 cardiac catheterization
CDC Split Type:

Write-up: myocarditis. chest pain, elevated troponin


VAERS ID: 1392882 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: body fatigue everyday. nausea, headache even after a week


VAERS ID: 1392914 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: ADMINISTERED VACCINE THAT HAD BEEN OXPOSED TO A TEMPERATURE BREACH. REQUIRED RE-VACCINATION


VAERS ID: 1392924 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: PATIENT RECIEVED INCORRECTLY STORED VACCINE; REQUIRES RE-ADMINISTRATION


VAERS ID: 1392977 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia, Immediate post-injection reaction, Nausea, Taste disorder
SMQs:, Acute pancreatitis (broad), Taste and smell disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)

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

Write-up: STRONG Metallic taste in mouth within seconds of injection lasting 48 hours initially, then off & on throughout the day for 48 additional hours. Nausea and adverse taste made it hard to eat food, affected taste buds.


VAERS ID: 1392992 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-12
Onset:2021-06-04
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Amniorrhoea, Blood test, Epidural injection, Exposure during pregnancy, Induced labour, Laboratory test abnormal, Premature delivery, Premature labour
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: I was taking prenatal vitamins, clindamycin and a topical betamethasone.
Current Illness: I did not have any other illnesses.
Preexisting Conditions: I do not have any chronic or long-standing health conditions.
Allergies: I do not have any allergies.
Diagnostic Lab Data: I had blood work drawn and my amniotic fluid checked. I had an epidural and everything else that comes along with giving birth.
CDC Split Type: vsafe

Write-up: On 06/04 I woke up and I had a lot of water leakage and I let it go throughout the day a little longer. I called the OBGYN and I went in and had it checked around 4:00PM. There were several tests that were run. I was leaking amniotic fluid. I had to go into labor that day. The pregnancy was considered pre-term because I wasn''t due until 07/15. On 06/05, my baby was born at 5lb, 5oz. After I was told I had to go into labor, I was induced. I received a cervix softener and than I was given Pitocin. I was induced at 10PM on 06/04 and I delivered at 12PM on 06/05. I was in labor for 14 hours. Right now my baby is in the NICU and she will hopefully be coming home 06/13. If she does come home on 06/13, she will have been in the NICU for 8 days. I was given penicillin and betamethasone, which is supposed to help with the development of the babies lungs. All of her tests have come back normal. The only issue was with her bilirubin levels.


VAERS ID: 1393000 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ecchymosis, Induration
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (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:
CDC Split Type:

Write-up: Crescent shaped ecchymoses and induration oinferior to external lower lip, abuts vermillion border. No other ski changes or rash, no oral/airway angioedema.


VAERS ID: 1393226 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspepsia, Flatulence
SMQs:, Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Daily at bedtime: Rosuvastatin Tabs 20 mg Lisinopril Tabs 5 mg
Current Illness: none
Preexisting Conditions: high blood pressure high cholesterol
Allergies: penicillin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: constant gas, acid indigestion, and heartburn


VAERS ID: 1393246 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 0R8736 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 0R8736 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Headache, Malaise, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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: Tamoxifen Protonix Vitamin D Magnesium Melatonin Glucosamine chondroitin Biotin
Current Illness: None
Preexisting Conditions: Acid reflux
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: At 4 o?clock the day of my shot I became extremely exhausted. I have been through chemo and it was that type of exhaustion. Then the headache and nausea started. I woke up Saturday morning running a low-grade fever, by lunch it was 102.7. Around that time diarrhea started. Friday night until 915 Sunday morning, I would be awake for an hour and a half or two hours, then sleep for the same around the clock. I had every symptom on the nonemergency list except for injection site problems and vomiting. The fever broke Sunday afternoon, but I still felt terrible. I barely made it through work on Monday. I started feeling a little better throughout the week. But a week later I still have nausea and diarrhea no matter what I eat. Also still more tired than usual. I had Covid back in November, and I heard that the vaccine side effects could be worse, but I sure wasn?t expecting all of this!


VAERS ID: 1394032 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-06-04
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cerebrovascular accident, Migraine, Thrombosis
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: XARELTO
Current Illness: Antiphospholipid syndrome; Migraine
Preexisting Conditions: Medical History/Concurrent Conditions: Vertigo (She has a history of vertigo and went to the hospital about 18 months ago.); Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210617520

Write-up: THROMBOSIS OF THE CLOT; INCREASED FREQUENCY OF MIGRAINES/VERTIGO; STROKE; This spontaneous report received from a consumer concerned a female of unspecified age. The patient''s height, and weight were not reported. The patient''s past medical history included vertigo, and concurrent conditions included lupus antiphospholipid syndrome, and migraine. The patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on APR-2021, 1 total dose for prophylactic vaccination. Concomitant medications included Xarelto (rivaroxaban) for lupus antiphospholipid syndrome. On APR-2021, the patient developed thrombosis of the clot and increased frequency of migraines/vertigo (over the past month or two). On 04-JUN-2021 (3 night ago), she was diagnosed with stroke. Later, she underwent procedure for thrombosis of the clot and she was stable. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from stroke, and thrombosis of the clot, and the outcome of increased frequency of migraines/vertigo was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0:20210617520-covid-19 vaccine ad26.cov2.s-Stroke, Thrombosis Of The Clot. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1394072 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 1 LA / OT

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

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

Write-up: Seizure immediately after the dose was given; This spontaneous case was reported by a consumer and describes the occurrence of SEIZURE (Seizure immediately after the dose was given) in a 24-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025C21A) for COVID-19 vaccination. No Medical History information was reported. On 04-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Jun-2021, the patient experienced SEIZURE (Seizure immediately after the dose was given) (seriousness criterion medically significant). On 04-Jun-2021, SEIZURE (Seizure immediately after the dose was given) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Concomitant medications were reported. No treatment information was reported.; Sender''s Comments: Very limited information regarding this event/s has been provided at this time. Further information has been requested.


VAERS ID: 1394142 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Atrial fibrillation, Atrial flutter, Cardiac failure congestive, Chest pain, Condition aggravated, Diarrhoea, Dyspnoea, Fatigue, Fear of death, Headache, Heart rate increased, Nausea, Pruritus, Rash
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: COUMADIN
Current Illness: Atrial fibrillation; Chest pain; Congestive heart failure; Flutter atrial; Heartbeats increased; Shortness of breath
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021665319

Write-up: congestive heart failure exacerbated; Atrial Fibrillation; however these symptoms were exacerbated after having the 1st dose; The patient stated that she know that if she got a covid vaccine she may die because of her heart and lungs.; flutter; shortness of breath exacerbated; chest pain/ chest pain exacerbated; racing heartbeat at times exacerbated; abdominal pain/ cramping in abdomen/ belly pain; diarrhea; tired; headache; stomach was queasy; rash; itching; This is a spontaneous report received from a contactable consumer via medical information team. A 73-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot Number: Unknown), via unspecified route of administration in the right arm, on 04Jun2021 (at the age of 72-year-old), as a single dose for COVID-19 immunisation. Medical history included ongoing congestive heart failure, ongoing atrial fibrillation, ongoing flutter and does experience shortness of breath (ongoing), ongoing chest pain, and racing heartbeat at times (ongoing). Concomitant medications included Warfarin sodium (COUMADIN). On 04Jun2021 after vaccination, when the patient by reaching to home experienced itching and rash that initially was on her left arm and knuckles and moved to her right arm where she got the vaccine. Those symptoms have since resolved with no further concerns. A couple hours after the administration of the vaccine, the patient experienced severe pain in her chest. It was reported that the pain was an 11 on a scale of 1 to 10, and her heart was really racing. The patient had shortness of breath, which she had with her problems, but it was a little more. The patient stated that she has a history of congestive heart failure, with Atrial Fibrillation and flutter and does experience shortness of breath, chest pain, and racing heartbeat at times however these symptoms were exacerbated after having the 1st dose administered. The patient stated her symptoms almost put her in the Emergency Room but she held off on going and chose to wait her symptoms out. It calmed down so the patient did not go to the emergency room. Later, on the patient had a chest pain but not as severe. It was reported that in the morning and over the weekend it was minor. The patient started cramping in her abdomen and had diarrhea at night and had it again on Saturday and she had some yesterday (06Jun2021). This morning (07Jun2021) the patient had it and then around 2:00 she started having belly pain/abdominal pain and diarrhea. The patient wanted to know if there were any contraindications with receiving the Pfizer COVID19 vaccine in conjunction with Coumadin use. Response was provided for the same as: When vaccinating Persons with Increased Bleeding Risk, providers often avoid giving intramuscular injections (not just this vaccine) or choose alternative routes because of the risk for hematoma formation after injections. The Pfizer-BioNTech COVID-19 Vaccine should only be administered as an intramuscular injection. Also reported that there was no contraindication listed upon the package insert for patients receiving blood thinners and getting the COVID19 vaccine as well as provided information regarding use with blood thinners. It was reported that one provider advised her to not get the vaccine, however her cardiologist recommended her to get the vaccine due to risks vs benefits. However, the patient was waiting call back from her Cardiologist regarding her chest pain and racing heart symptoms at that time. The patient wants to make sure the physician doesn''t want to see her. The patient was overall not felt well and was fatigued as well and she wanted to know if those symptoms are commonly seen or have they been reported. She also stated that she gets tired easily due to heart congestion but she was feeling more tired than usual. Patient does not usually get headaches and also got a headache on Friday after getting her COVID19 vaccine. The patient wanted to know how long her side effects may last because already she was scheduled dental procedure tomorrow (08Jun2021) wants to make sure everything was okay, and also she wanted to know more information regarding the reported cases of Myocarditis. The patient was more concerned and worried about getting the second dose because with the first dose she experienced events and she stated that her second dose was scheduled on the 25Jun2021. It was reported that when the patient''s husband visited for vaccination, they asked whether he was on blood thinner. But the patient was mentioning that she (his wife) was on blood thinner coumadin, however they did not ask her regarding the blood thinners. Even the patient had not informed about the blood thinners to them. The patient queried about whether they give a different type of vaccine for blood thinners or its okay to take normal vaccine. The patient stated that she know that if she got a covid vaccine she may die because of her heart and lungs. It was reported that her stomach was queasy. The events congestive heart failure exacerbated, Atrial Fibrillation, however these symptoms were exacerbated after having the 1st dose were assessed as medically significant. The outcome of the events was unknown. Follow-up attempts are needed; Information on the lot/batch number has been requested.


VAERS ID: 1394226 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest pain, Dyskinesia, Feeling cold, Headache, Hyperhidrosis, Hypersomnia, Influenza like illness, Mobility decreased, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Duloxetine 60MG Daily Humira 40mg/0.4ml bi-weekly Avastin eye injection every 10 weeks Eylea eye injection every 10 weeks
Current Illness: None
Preexisting Conditions: Fibromyalgia Retinal issues
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: My injection was Friday June 4th around 930am. After returning home Friday after my 2nd Moderna Covid-19 vaccination I went to sleep. I woke up a little while later EXTREMELY cold and shaking very bad. My head was pounding and hurting so bad and I felt like I had the worst flu ever. I could not hardly move my left arm and it hurt really bad. The rest of my body felt shaky and weak. I covered up with multiple blankets and turned my A/C off using an app on my phone. I needed to pee but i felt so bad I couldn''t bring myself to get up and walk to the bathroom. I wanted to go to the hospital but I was home by myself. I fell back asleep and woke up later still feeling the same only now I was sweating so much I no longer needed to pee. I fell back asleep and didn''t wake up until around 6 am when my husband got home from work. I was so tired I just wanted to sleep. He gave me some ibuprofen and I went back to sleep. I woke up around noon feeling a bit better. I laid in bed watching TV and napping. Eventually I felt better that Saturday afternoon/evening. I had a bad headache every day after that until around Wednesday that I got rid of using ibprophen. On that Monday night following my injection I was driving and I got a sudden extremely sharp pain in my heart and my left leg and arm jerked hard and my left side of my face contorted. I felt fine immediately after no lingering pain. Then yesterday I had an aching pain in my left chest but then it went away


VAERS ID: 1394245 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-21
Onset:2021-06-04
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER EW0173 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain lower, Appendicitis, Computerised tomogram abdomen abnormal, Monocyte count increased, Neutrophil count increased, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Allegra
Current Illness: none
Preexisting Conditions: none
Allergies: sulfa, penicillin
Diagnostic Lab Data: 6/4/2021: abdominal pain right lower quadrant in stomach 6/5/2021: went to urgent care for pain. CT scan showed acute appendicitis Labwork: monocytes "High" 1.04x10(9)/L ANC Auto: "high" 12.92x10(9)/L WBC: "high" 16.05x10(9)/L
CDC Split Type:

Write-up: Acute Appendicitis


VAERS ID: 1394281 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / UNK RA / IM

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

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

Write-up: Cellulitis


VAERS ID: 1394296 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
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: Booster Given Too Early


VAERS ID: 1394329 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Headache, Mental impairment, Pain, Pyrexia, Speech disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mobic & 5 mg melatonin (at night)
Current Illness: None
Preexisting Conditions: Chronic back pain from 2 herniated/bulging discs
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within 6 hours, I developed a fever, all over body aches (from neck to toes), headache, inability to think clearly, difficulty speaking. This lasted for approximately 48 hours until the fever broke. Fogginess and headache lasted for another 48 hours.


VAERS ID: 1394332 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-06-02
Onset:2021-06-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Nausea, Nodule, Pain, Pain in extremity, Palpitations, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown, nothing listed at pharmacy
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: NKDA
Diagnostic Lab Data: None, recommended the patient follow-up with her provider or acute provider if needed however, reports improvement in symptoms.
CDC Split Type:

Write-up: reports 2 days following her 1st Covid 19 vaccine she had left leg ache and small nodule/lump on her left leg, reports she "massaged it out", denies redness or swelling but states leg feels sore. Also reports palpitations beginning on 6/4, full body pain, fever, nausea. She presented to the pharmacy today and appeared in no acute distress and arrived with her husband to report the event.


VAERS ID: 1394371 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-05-20
Onset:2021-06-04
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gait inability, Headache, Hypoaesthesia, Muscle spasms, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad)

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

Write-up: Headache, body numbness ,muscle cramp,tingling all over the body, extreme pain, not able to walk As of today, june 12 2021, he still in pediatrics department, since June 7 2021.


VAERS ID: 1394429 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

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

Write-up: It was discovered the pfizer vaccine was not removed from the freezer to the refrigerator after 14 days in the freezer. After contacting Pfizer, the vaccine was not viable after 17 days. The vaccine was administered to the patient after the 17 day timeframe.


VAERS ID: 1394431 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: It was discovered the pfizer vaccine was not removed from the freezer to the refrigerator after 14 days in the freezer. After contacting Pfizer, the vaccine was not viable after 17 days. The vaccine was administered to the patient after the 17 day timeframe.


VAERS ID: 1394436 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: It was discovered the pfizer vaccine was not removed from the freezer to the refrigerator after 14 days in the freezer. After contacting Pfizer, the vaccine was not viable after 17 days. The vaccine was administered to the patient after the 17 day timeframe.


VAERS ID: 1394439 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

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

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

Write-up: It was discovered the pfizer vaccine was not removed from the freezer to the refrigerator after 14 days in the freezer. After contacting Pfizer, the vaccine was not viable after 17 days. The vaccine was administered to the patient after the 17 day timeframe.


VAERS ID: 1394442 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

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

Write-up: It was discovered the pfizer vaccine was not removed from the freezer to the refrigerator after 14 days in the freezer. After contacting Pfizer, the vaccine was not viable after 17 days. The vaccine was administered to the patient after the 17 day timeframe.


VAERS ID: 1394446 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 1 RA / IM

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

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

Write-up: vaccine was outdated no adverse effects known


VAERS ID: 1394447 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect product formulation administered, Product storage error, Product use issue
SMQs:, Medication errors (narrow)

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

Write-up: It was discovered the pfizer vaccine was not removed from the freezer to the refrigerator after 14 days in the freezer. After contacting Pfizer, the vaccine was not viable after 17 days. The vaccine was administered to the patient after the 17 day timeframe.


VAERS ID: 1394453 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

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

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

Write-up: It was discovered the pfizer vaccine was not removed from the freezer to the refrigerator after 14 days in the freezer. After contacting Pfizer, the vaccine was not viable after 17 days. The vaccine was administered to the patient after the 17 day timeframe.


VAERS ID: 1394456 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

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

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

Write-up: It was discovered the pfizer vaccine was not removed from the freezer to the refrigerator after 14 days in the freezer. After contacting Pfizer, the vaccine was not viable after 17 days. The vaccine was administered to the patient after the 17 day timeframe.


VAERS ID: 1394459 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 2 RA / IM

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

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

Write-up: vaccine was outdated unknown adverse effects


VAERS ID: 1394465 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 1 RA / IM

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

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

Write-up: vaccine was expired no adverse effects known


VAERS ID: 1394470 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 1 LA / IM

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

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

Write-up: vaccine was out of date no adverse effects known


VAERS ID: 1394473 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 1 RA / IM

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

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

Write-up: vaccine was outdated no known adverse effected


VAERS ID: 1394474 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 1 LA / IM

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

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

Write-up: vaccine was outdated no adverse effects known


VAERS ID: 1394481 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 1 LA / IM

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

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

Write-up: vaccine was out of date no adverse effects known


VAERS ID: 1394489 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 2 LA / IM

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

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

Write-up: vaccine was outdated unknown adverse effects


VAERS ID: 1394490 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 2 RA / IM

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

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

Write-up: vaccine was out of date no adverse effects known


VAERS ID: 1394495 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 2 LA / IM

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

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

Write-up: vaccine was outdated no adverse effects known


VAERS ID: 1394500 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 1 LA / IM

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

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

Write-up: vaccine was outdated no adverse effects known


VAERS ID: 1394709 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-24
Onset:2021-06-04
   Days after vaccination:72
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic reaction, Arthropod sting, Bronchospasm, Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)

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

Write-up: I had an acute anaphylactic reaction to a yellow jacket sting. Within 20 minutes of the sting, my whole body was swollen and airways began to constrict. I received epinephrine, type 1 and 2 antihistamines, and steroids, and the symptoms resolved. I am reporting this because I was stung by a yellow jacket in the same location a year earlier (pre-vaccine) and had no reaction. I had never had an anaphylactic reaction. Clearly, other factors could have caused the new response to what appears to be the same stimulus, but receiving an MRNA vaccine designed to stimulate immune response seems like a suspect worth investigating.


VAERS ID: 1394833 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

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

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

Write-up: PHARMACYLEFT PFIZER VIALS IN THE FREEZER FOR LONGER THAN 2 WEEKS AT THE TEMPERATURE (-25 AND -15 DEGREES C). WE GAVE OUT DOSES FROM THESES VIALS RENDERINGTHEM POSSIBLY LESS EFFECTIVE


VAERS ID: 1394848 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

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

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

Write-up: PHARMACY LEFT PFIZER VIALS IN THE FREEZER FOR LONGER THAN 2 WEEKS AT THE TEMPERATURE (-25 AND -15 DEGREES C). WE GAVE DONES OUT OF THESE VIALS, RENDERING THEM POSSIBLY LESS EFFECTIVE


VAERS ID: 1394877 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeding disorder, Incorrect dose administered, Incorrect product formulation 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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: PHARMACY LEFT PFIZER VALS IN THE FREEZER FOR LONGER THAN 2 WEEKS AT THE TEMPERATURE (-25 AND -15 DEGREES C). WE GAVE OUT DOSES FROM THE VIALS, RENDERING THEM POSSIBLY LESS EFFECTIVE.


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