National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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

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

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

This is page 195 out of 8,753

Result pages: prev   96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294   next


VAERS ID: 1828610 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0191 / 3 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Influenza like illness, Pain, Pyrexia, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hearing impairment (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Adverse affect after second Pfizer shot. Tinnitus at age 73
Other Medications: armor thyroid, vit c, vit d, anti-oxidant, bio-identical hormone creme.
Current Illness: None.
Preexisting Conditions: Lyme disease
Allergies: Sulfa, gluten
Diagnostic Lab Data: Routine doctor exam.
CDC Split Type:

Write-up: Day of and Day After: Fever, Chills, Aches. Flu like symptoms My biggest concern is: Tinnitus. Tinnitus started after second vaccine. Afraid to get booster but had to travel As I feared booster made Tinnitus worse. Hissing sound constant in my left ear with pusatile tinnitus as well.


VAERS ID: 1828627 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-10-07
Onset:2021-10-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Haematochezia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (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: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe Diarrhea (3days), Bloody stool (1 event in the 3 day period). Resolved after about 3 days.


VAERS ID: 1828661 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Dizziness, Fine motor skill dysfunction, Hypoaesthesia, Pain in extremity, Paraesthesia, Sensory loss, Skin warm
SMQs:, Peripheral neuropathy (narrow), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-vitamin, meta mucil, omeprozol, albuterol (as needed).
Current Illness: None.
Preexisting Conditions: Radiculopathy left and right sides, IBS, back, carpal tunnel.
Allergies: Ketokortozol.
Diagnostic Lab Data: In contact with the clinic - awaiting follow-up for treatment and referral (as applicable) to specialist. The answer to Item 21 will change in the coming days.
CDC Split Type:

Write-up: Upon receipt of vaccine at/around 1740 arm began to feel warm/tingly. After a few minutes I began to get dizzy, arm pain worsened and entire arm and face began to feel numb and tingle. The arm pain and soreness has decreased since the event. The dizziness is sporadic since the event. The left side of my face has continued to worsen since the injection, and is numb, loss of taste, feel, sensation, and dexterity.


VAERS ID: 1828730 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-04
Onset:2021-10-12
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088021A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pain of skin, Pruritus, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I woke up and noticed slight redness on my left arm; the redness and patch continued to spread throughout the day?warm, tender, itchy. I was given a low-dose oral steroid which did stop the reaction. By the following day, the swelling, redness, and other symptoms were gone.


VAERS ID: 1828827 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-29
Onset:2021-10-12
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram cerebral, Chest pain, Dyspnoea exertional, Headache, Hemiparesis, Hypoaesthesia, Magnetic resonance imaging head, Mental impairment, Migraine, Paraesthesia, Venogram
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Sexual dysfunction (broad)

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

Write-up: Chest pain began shortly afterwards with shortness of breath on exertion. Four days afterwards developed left sided numbness and weakness, admitted for stroke rule out and diagnosed with migraine variant. Continuing to have migratory pins and needles sensations, severe headaches, foggy thinking and less intense chest pain.


VAERS ID: 1828861 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-03-05
Onset:2021-10-12
   Days after vaccination:221
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3346 / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Diagnosed and hospitalized with COVID 19 while fully vaccinated.


VAERS ID: 1828884 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-03-22
Onset:2021-10-12
   Days after vaccination:204
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Diagnosed and hospitalized with COVID 19 while fully vaccinated


VAERS ID: 1829087 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Autoimmune disorder, Blood test abnormal, Fatigue, Headache, Muscle spasms, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Blood Work 10/26/2021
CDC Split Type:

Write-up: Pt. states that after receiving the 1st dose of J&J 10/12/2021, started experiencing symptoms that evening of severe leg (both) cramping, fever, headache, fatigue, and muscle aches. Primary visit/telehealth 10/20/2021 recommendation for Blood Work. 10/26/2021 Blood Work came back Abnormal "Auto-Immune" Un-diagnosed. Follow-Up 10/29/2021 recommended self-treating with "Ibuprofen". Still continuing to experience symptoms.


VAERS ID: 1829208 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-10-07
Onset:2021-10-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FS2589 / 3 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray abnormal, Cough, Feeling abnormal, Pneumonia
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I take multi vitamin, Vitamins C and D.
Current Illness:
Preexisting Conditions: I have COPD.
Allergies: None.
Diagnostic Lab Data: I had a chest X-Ray done.
CDC Split Type: vsafe

Write-up: After getting the booster I start feeling bad, I had a very bad cough . I went to the hospital and found out I had ammonia.


VAERS ID: 1829259 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-10-12
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, COVID-19, Condition aggravated, Palpitations, SARS-CoV-2 test positive
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: apixaban (ELIQUIS) 5 MG TABS tablet isosorbide mononitrate (IMDUR) 30 MG SR tablets metoprolol succinate (TOPROL XL) 25 MG SR tablets vitamin D3 (CHOLECALCIFEROL) 5000 UNIT CAPS capsule
Current Illness: None known
Preexisting Conditions: Pure hypercholesterolemia Hyperbilirubinemia New onset atrial fibrillation (HCC) Atrial fibrillation with rapid ventricular response (HCC)
Allergies: None known
Diagnostic Lab Data: COVID-19 test positive on 10/12/2021.
CDC Split Type:

Write-up: Patient presented to emergency department on 10/18/2021 with complaints of palpitations. He was diagnosed with COVID-19 infection on 10/12/2021 with minimal symptoms. He was found to be in atrial fibrillation with rapid ventricular response and was treated accordingly. He did not requirement treatment for his COVID-19 infection during admission.


VAERS ID: 1829267 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-10-08
Onset:2021-10-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 2 UN / IM

Administered by: Military       Purchased by: ?
Symptoms: Echocardiogram, Ejection fraction normal, Electrocardiogram, Fatigue, Full blood count, Headache, Laboratory test, Metabolic function test, Myocarditis, Physical examination
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Aloe, Aspirin
Diagnostic Lab Data: CMP and CBC 10 days post second dose obtained and were overall unremarkable. EKG obtained 28 Oct 2021 clinic visit showed 1st degree AV block, otherwise unremarkable. BP slightly elevated 130s/80s. Physical examination unremarkable. ECHO 29 Oct 2021 showed mildly dilated left ventricle, normal thickness, mild global hypokinesis, EF 40-45%. Grade 1 diastolic dysfunction. Mild mitral regurg. Normal pulmonary artery systolic pressure. Additional labs pending a time of report.
CDC Split Type:

Write-up: Approx 4 days post second COVID-19 vaccination dose patient with increase headaches and excessive fatigue. Pt was seen twice at treatment facility and determined on second visit concern for myocarditis was warranted. Currently member is being evaluated for diagnosis.


VAERS ID: 1829534 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-25
Onset:2021-10-12
   Days after vaccination:48
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cimzia, vitamin D, multivitamin
Current Illness:
Preexisting Conditions: Rheumatoid arthritis
Allergies: Codeine, vicodin, percocet, afrin, chlorhexidine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shingles


VAERS ID: 1829889 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-10-07
Onset:2021-10-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE 3590 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Blood glucose decreased, Condition aggravated, Hyperphagia, Mobility decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Parkinson-like events (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (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: Possibly on the second COVID vaccine after February 2021.
Other Medications: Aspirin; Cetirizine; Fish Oil; B12; Isosorbide Mononitrate; Lactaid tablets Losartan; Metamucil; Simvastatin;Multi vitamin Men 50+; Novolog Insulin under 30 units.
Current Illness: 52 years as a diabetic.
Preexisting Conditions: Diabetic.
Allergies: Shellfish; Milk
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have been a diabetic for 52 years. I got the second shot of the Pfizer COVID vaccine in February 2021 and shortly after that I started noticing the my blood sugar levels would stay low for long periods of time even though my food intake was way over my normal amounts. This went on for 2 or 3 weeks, Then the low blood sugar levels would become sporadic. After I got the 3rd shot ( Booster ) on 10/07/2021, the low blood sugars started up again. For the last three weeks I can''t get my blood sugar levels to stay high enough for me to do any activities, even though I have reduced my insulin intake a lot . This is causing severe anxiety. I have no way to prove this is the cause. Two other notes; I got the flu shot on 09/24/2021 and started experiencing diariah . My doctor gave me a prescription for Ciprofloxacin 500mg to b e taken twice a day for 5 days 0n 10/11/2021. The next day my blood sugar levels went low. Can you look into this? I don''t know if there is any and effect.


VAERS ID: 1831044 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-11
Onset:2021-10-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Dyspnoea, Migraine, Mobility decreased, Musculoskeletal stiffness, Neck pain
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None, Comment: Patient History: No
Allergies:
Diagnostic Lab Data: Test Date: 202110; Test Name: Blood; Result Unstructured Data: Test Result:Unknown results
CDC Split Type: USPFIZER INC202101375028

Write-up: Migraine headache/head is still pounding/intense headache in her life; felt like someone hit her in the back of her neck and head/having pain so bad it''s like someone hit her on the back over and over, it''s not normal pain; can hardly breathe; can''t keep her head straight/can''t move her head and can''t move her neck/ hard to get in and out of bed or get up; can''t move her neck; This is a spontaneous report from a contactable consumer (patient). A 53-year-old female patient received BNT162b2 (COMIRNATY), via an unspecified route of administration, administered in left arm on 11Oct2021 in the afternoon (Batch/Lot Number: FF8839) (at the age of 53-years-old) as dose 1, single for COVID-19 immunisation. Vaccine was not administered at military facility. Medical history and concomitant medications were reported as none. The patient had no prior vaccinations within 4 weeks. The patient took the first Pfizer COVID vaccine on Monday, 11Oct2021. She went to sleep shortly after and woke up on Tuesday, 12Oct2021 with migraine headache. She called Pfizer early this morning who told her to go to the ER. She called last night too. She went to the Emergency Room. They gave her a migraine cocktail including Benadryl, Tramadol, and Remaxan. They also did an IV drip and took blood. Her head is still pounding like a pi?ata. The cocktail didn''t do anything. It feels like someone is hitting her upside her head constantly. She came out with the same headache. The hospital didn''t send her anything home to take for the pain. The migraine headache started on 12Oct2021. It has worsened. It was to the point she can''t keep her head straight. It was hard to get in and out of bed or get up. Patient was healthy. She went to the ER at 5 AM. It was hard to get up, and she was home alone which makes it scarier. She doesn''t get why the hospital didn''t send her with a prescription. Course of events were as follows: Patient said when she went to bed and woke up in the morning, she had the "intense headache in her life" which feels like "someone is hitting Pinata box" that has escalated in 5 days. She described it as "worst for the last 4 days" and was intense all the way down. She said it felt like someone hit her in the back of her neck and head, it was so horrible, she can hardly breathe and hold her head straight. She called the pharmacist, but no one is giving her any answers. Patient said, "everyone kept saying it is normal, but this is not normal, this is not normal pain, so it''s completely so excruciating." She was told to take two Tylenol which she did, but the pain did not cease enough and was asking if the pain was a normal headache. She wanted to know what she needs to do, if she needs to go to the emergency room because this is not normal pain to her and she was home alone and said, "this pain is just my fab is killing me, I can''t hold my headache, I can''t get out of bed, I can''t get out of the chair, It is just excruciated from last three days and it''s not cease enough at all and I am taken the Tylenol and they are not working." Patient was suggested to contact urgent care if she had severe adverse event. Patient stated that she was having pain so bad, can''t breathe, it''s so bad it''s like someone hit her on the back over and over, it''s not normal pain, she can''t call anymore number and she needs to know what to do. She added that this was the first vaccination, and it was horrendous, and she wished she had never taken it because this was not normal pain, and this was just absolutely horrible. Patient stated that she had taken vaccinations and never had the side effects before. This was totally horrible pain; she can''t move her head and can''t move her neck. She went to the ER this morning and took Tylenol, but it was not working. She said she took the two Tylenol and took four already and it''s not ceased enough, and it just can''t work. Relevant test included blood test: unknown results on Oct2021. The outcome of all the events was not recovered, except for can hardly breath which was unknown. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1831056 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / OT

Administered by: Senior Living       Purchased by: ?
Symptoms: Fatigue, Immunisation, Off label use, Pain, Paraesthesia, SARS-CoV-2 test, Skin reaction, Swelling, Vaccination site erythema, Vaccination site pain, Vaccination site pruritus, Vaccination site swelling, Vaccination site warmth
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Bee sting hypersensitivity; GERD; Gluten intolerance
Allergies:
Diagnostic Lab Data: Test Date: 20211014; Test Name: Rapid; Test Result: Negative ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101381831

Write-up: body ache; fatigue; tingling fingers; injection site remains red swollen warm painful; injection site remains red swollen warm painful; injection site remains red swollen warm painful; injection site remains red swollen warm painful; periodic itching at site; swelling in right axillary; large hard area red painful x3 days; off label use; booster; This is a spontaneous report from a contactable nurse (patient). A 54-year-old patient of an unspecified gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number and expiry date not reported), intramuscular, administered in Arm Right on 12Oct2021 (age at vaccination was 54 years) as DOSE 3 (BOOSTER), SINGLE for COVID-19 immunisation. Medical history included asthma, gastrooesophageal reflux disease, gluten sensitivity (gluten intolerance), and allergy to arthropod sting (anaphylaxis bee stings). The patient received any other vaccines within 4 weeks prior to the COVID vaccine. The patient was vaccinated at a nursing home/ senior living facility. The patient was not diagnosed with COVID-19 prior to vaccination. Since post vaccination, the patient has been tested for COVID-19. Concomitant medication included influenza vaccine (FLU VACCINE VII) taken for an unspecified indication from 07Oct2021 to 07Oct2021. Historical vaccine included bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot numbers and expiry dates not reported), on 19Jan2021 as dose 2, single and on 23Dec2020 as dose 1, single; both given via intramuscular route, left leg, at the age of 53 years, for COVID-19 immunization. The patient experienced large hard area red painful x3 days on 12Oct2021 with outcome of recovering, swelling in right axillary on 16Oct2021 with outcome of recovering, body ache on 17Oct2021 with outcome of recovering, fatigue on 17Oct2021 with outcome of recovering, tingling fingers on 17Oct2021 with outcome of recovering, injection site remains red swollen warm painful on 17Oct2021 with outcome of recovering, periodic itching at site on 17Oct2021 with outcome of recovering; off label use and booster on 12Oct2021 with outcome of unknown. The patient underwent lab tests and procedures which included sars-cov-2 test: negative on 14Oct2021 Nasal Swab. Therapeutic measures were taken as a result of vaccination site swelling. No therapeutic measure was taken for the other events. The event large hard area red painful x3 days was reported as serious, medically significant, while the rest of the events were reported as non-serious. Lot number for the vaccine was not provided and will be requested during follow-up.; Sender''s Comments: Based on the description given in the narrative, there is reasonable possibility of causal association between the serious event Skin reaction and the suspect BNT162B2 cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer drug is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.


VAERS ID: 1831613 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-22
Onset:2021-10-12
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH I''M SURE HE COU / 3 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Carpal tunnel syndrome, Condition aggravated, Decreased appetite, Gait inability, Groin pain, Laboratory test, Muscular weakness, Musculoskeletal stiffness, Neck pain, Osteoarthritis, Pain in extremity, Polymyalgia rheumatica, Pyrexia, Splint application
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vasculitis (narrow), Osteonecrosis (broad), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: he started having bilateral groin pain (felt due to hips) 8/8/21.
Preexisting Conditions: paroxysymal AFib on eliquis, hypercholesterolemia on pravastatin.
Allergies:
Diagnostic Lab Data: Had classic labs for PMR.
CDC Split Type:

Write-up: Seemed to acutely develop PMR 10/12. Had been having bilateral groin pain from his hips 8/8, and clearly has significant DJD on plain films, but never had pain before, and the groin pain resolves almost instantly with steroids. Timeline below: 8/5 drove 7 hours to beach in DE, they think he felt fine. 8/8 BL groin pain starts, possibly related to a short jog as he never does. 8/14 drove home. Doesn?t recall much pain. 9/3 you thought maybe R ing. hernia 9/7 had both hips injected. Amazing result, pain free. 9/15 PT visit restarted the BL groin pain 9/22 Pfizer COVID booster. 9/30 saw ortho, said consider hip replacements. 2nd opinion said a bit odd for DJD Sx to start so acutely, but possible. 10/2 started meloxicam 15, helped a little 10/6 started prednisone 30 taper?pain free. 10/11 took last prednisone 5 mg, went to mountains, pain free, good enough to carry suitcases up 3 flights? 10/11 R CTS began, likely from carrying luggage, severe, sees provider Tuesday. Splint helps. Felt feverish that night only. Mild anorexia but no HA/dizziness/URI Sx/CP/SOB/abd pain/N/V/D/GU Sx/back pain/rash. No tick bites. 10/12 in addition to the BL groin pain, started with the neck pain and stiffness, both shoulders stiff and hurt, both hands feel ?weak? and painful PIP joints sparing L thumb (almost certainly R CTS but had L CT release in past), both thighs and knees hurt. No red/warm/swollen joints. Sx so bad he didn?t even go out with friends for dinner and he?s usually the life of the party. 10/13 started Motrin 800 bid, helpful. 10/16 flu shot 10/18 Needed to go to ED as couldn''t walk. Started on steroids. Doing better now on high dose steroids. Seeing optho next week to r/o GCA.


VAERS ID: 1831683 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-05
Onset:2021-10-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Full blood count, Insomnia, Metabolic function test, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair
Current Illness: cold, sinus infection
Preexisting Conditions: asthma
Allergies: Keflex, penicillin, soy protein, all legume protein
Diagnostic Lab Data: CBD with Differential/Platelet Comp. Metabolic Panel (14)
CDC Split Type:

Write-up: I had extreme itching in all my extremities. The itching began in my hands, then quickly spread to my arms, legs, feet. I itched so much that I could not sleep for a week. Benedryl did not help at all. I finally took a week''s course of prednisone, and the itching stopped.


VAERS ID: 1831697 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-10-11
Onset:2021-10-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8027 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram normal, Arrhythmia, Arthritis, Bradycardia, Chest X-ray normal, Computerised tomogram head normal, Electrocardiogram ambulatory, Erythema, Fibrin D dimer normal, Fluid replacement, Heart rate abnormal, Palpitations, Rash macular, Supraventricular tachycardia, Syncope, Tachycardia, Troponin normal
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations: 10/20, flu vaccination, urticaria, age 25.
Other Medications: Fluoxetine-20mg qday Pantoprazole-20mg qday Fexofenadine 180mg qday Multivitamin Probiotic
Current Illness: None.
Preexisting Conditions: Anxiety
Allergies: Amoxicillin, Levaquin, Codeine, Benzoyl Peroxide Animal dander, tree pollens, mold, apples, carrots, celery, tree nuts, cherries, cantaloupe.
Diagnostic Lab Data: D dimer-negative (10/12, 10/21,10/22) Trop-negative (10/12, 10/21, 10/22) Chest X-ray-negative (10/12, 10/22) Ct head and CT angio negative (10/23)
CDC Split Type:

Write-up: SVT- two separate runs. 10/12/21 for approx 30 mins and 10/22/21 for approx 20 mins. Syncopal episode 10/22/21. Heart palpitations- off and on since 10/12/21 Tachycardia/ bradycardia arrhythmias, which include rapid heart rate changes upon changing positions- current since 10/12/21 Joint inflammation Redness/ blotchy was on face Was hospitalized, fluid resuscitated to rule out dehydration, and have received a holter monitor. Will be having an echocardiogram as well as possible other tests and have not ruled out POTS.


VAERS ID: 1831764 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-11
Onset:2021-10-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Arteriogram coronary normal, Arthralgia, Chest pain, Chills, Computerised tomogram abdomen normal, Computerised tomogram thorax abnormal, Dyspnoea, Ear pain, Electrocardiogram T wave inversion, Neck pain, Pain, Pain in extremity, Pain in jaw, Pulmonary embolism, Pyrexia, Troponin normal, Ultrasound Doppler normal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: hyperlipidemia w predominanthypertriglycerides, uncontrolled hypertension, uncontrolled type 2 diabetes
Preexisting Conditions:
Allergies: Fluticasone (mood changes), morphine (nausea/vomiting), grass/pollen (dermatitis), oat (dermatitis)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within 12 hours after receiving dose #3 of the COVID vaccine, the patient reports sharp pain in ear/jaw/neck and knee and toes. The patient also reports body aches and chills/fevers 100.4. The patient took her BP (192/117) and messaged her PCP and rested at home. Patient took her own benazepril 40mg and hydrochlorothiazide 12.5mg. On 10/13, the patient went to Urgent Care per MD instructions and was taken by ambulance from urgent care to Hospital as EKG showed inverted T waves in urgent care and patient reported onset of chest pain. She was given nitroglycerin 0.4mg SL x 1 and aspirin 81mg x 4 by ambulance. She was treated and discharged on 10/15. She rested at home and on 10/16, the chest pain returned and new onset shortness of breath. She drives to a facility. A CT chest showed a tiny nonocclusive pulmonary embolism in a left upper lobe segmental pulmonary artery. CT abd/pelvis showed no DVT. Ultrasound doppler negative for DVTs. CT angiogram is performed and coronary arteries are clear. Troponins are negative. She was treated with Eliquis 10mg BID (10/17-10/23) and then 5mg BID x 3 months. She is discharged on 10/19/21.


VAERS ID: 1831796 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amenorrhoea, Intermenstrual bleeding, Muscle spasms
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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: otc fish oil 1000mg, glucosamine 1500mg with MSN 1500mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe cramping with spoting, missed period.


VAERS ID: 1831928 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-10-09
Onset:2021-10-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301458A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Injection site pain, Neck pain, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? 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: Severe pain on L upper back associated with tingling/sharp shooting pain on L arm/elbow which started 3-4 days post pfizer booster. It started of with pain on L upper arm (injection site) then pain started on neck/upper back and gradually gets worse.


VAERS ID: 1832069 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-21
Onset:2021-10-12
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test normal, Chest pain, Dyspnoea, Electrocardiogram normal, Exercise tolerance decreased, Hypertension, Laboratory test, Loss of personal independence in daily activities
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: ROUTINE BLOOD WORK DONE - RESULTS NORMAL EKG DONE NORMAL BUT REFERRED TO A CARDIOLOGIST AND THOSE TEST STILL AWAITING RESULTS
CDC Split Type:

Write-up: SHOULDER PAIN, CHEST PAIN, VERY HIGH BLOOD PRESSURE (186/110), SHORTNESS OF BREATH, UNABLE TO EXERCISE OR CONDUCT USUAL ROUTINE


VAERS ID: 1832142 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-01
Onset:2021-10-12
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: GBS
Allergies:
Diagnostic Lab Data: MRI 10-13-21
CDC Split Type:

Write-up: 4-5 days post vaccine. Tingling and nerve pains right side of body, hand, arm, foot leg. No weakness.


VAERS ID: 1832424 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-10-05
Onset:2021-10-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Brain natriuretic peptide increased, Cardiomegaly, Catheterisation cardiac, Chest pain, Computerised tomogram thorax abnormal, Deep vein thrombosis, Dyspnoea, Echocardiogram abnormal, Electrocardiogram QT prolonged, Electrocardiogram ST-T segment abnormal, Fatigue, Hyperhidrosis, Pulmonary hypertension, Right atrial enlargement, Troponin increased, Ultrasound Doppler abnormal, Vomiting
SMQs:, Torsade de pointes/QT prolongation (narrow), Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Conduction defects (narrow), Torsade de pointes, shock-associated conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 10/31 Troponin 54.8, BNP 641 Echo: 10/31 Moderately suppressed function of the right ventricle. Moderate to severe pulmonary hypertension. Otherwise normal cardiac anatomy and left ventricular systolic function. EKG 10/31 Right atrial enlargement Possible Left ventricular hypertrophy Prolonged QT , may be secondary to QRS abnormality No previous ECGs available
CDC Split Type:

Write-up: Pt initially with an episode of substernal chest pain in september (after 1 dose of Pfizer Covid vaccine) that resolved spontaneously. Then on 10/12 pt started having recurrent fatigue, shortness of breath and exertional chest pain. Symptoms then worsened 10/28 and had associated emesis, diaphoresis with worsened fatigue, chest pain and shortness of breath. Pt presented to the ED on 10/30. CT PE significant for bilateral subsegmental PE. Pt found to have R popliteal DVT on bilateral doppler ultrasound (10/31). Echocardiogram (10/31) with severe right heart dilation, RV strain and pulmonary hypertension. Pt taken for cardiac catheterization 10/31, bilateral femoral vein catheters placed with EKOS catheter with TPA and ultrasound transmittion to the L and R pulmonary artery.


VAERS ID: 1832875 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-11
Onset:2021-10-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Ear discomfort, Erythema, Headache, Hypertension, Tinnitus
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypertension (narrow), Hearing impairment (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 1. Lisinopril/hctz Tabs 10/12.5 2. Duloxetine Hcl Dr 30 mg 3. Carvedilol 6.25 mg 4. Atorvastatin 20 mg 5. Humira 80 mg
Current Illness: None
Preexisting Conditions: High Blood Pressure
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Raised Blood Pressure to Hypertension Stage 2. Constant Headache all day, Worsened Ringing in Ears to uncomfortable levels. Redness in Face started with whole face, now just right side.


VAERS ID: 1833030 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-10-10
Onset:2021-10-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: not known
Current Illness:
Preexisting Conditions:
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient said approximately 36 hours after shot...arm became hot and itchy and red. APproximately 2x3 inch square. Attended urgent care, received keflex, didn''t need to take. Reaction only lasted 3 days in total


VAERS ID: 1833231 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-01
Onset:2021-10-12
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Cardiac stress test, Chest X-ray, Chest pain, Cough, Dyspnoea, Echocardiogram, Electrocardiogram, Inflammation, Neck pain, Palpitations, Pericarditis, Ultrasound thyroid
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: quetiapine 26mg per day bupropion 150mg per day lamotrigine 150mg per day
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Emergency Room 10/20, chest xray, blood tests- chest pain, cough ,shortness of breath 10/12 primary care- dr 10/12 cardiologist - blood test and ecg treadmill stress test 11/22 echocardiogram 11/18 thyroid ultrasound 10/15 endoconologist- blood test
CDC Split Type:

Write-up: Heart palpitation and neck pain 30 hours after vaccine Oct 2021 Extreme Chest pain, trouble breathing, burning chest, pericarditis, heart palpitations, inflammation in the neck


VAERS ID: 1833561 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-26
Onset:2021-10-12
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Nasopharyngitis, 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: Nervous Acute embolic stroke (CMS/HCC) Respiratory Nodule of left lung Circulatory Hypertension Basilar artery occlusion Stenosis of right vertebral artery Endocrine/Metabolic Hyperlipidemia Hyperlipidemia, unspecified hyperlipi
Current Illness:
Preexisting Conditions: ALPRAZolam (XANAX) 0.25 mg tablet aspirin tablet atorvastatin (LIPITOR) 80 mg tablet benzocaine 20 % gel mucosal gel docusate sodium (COLACE) 100 mg capsule ferrous sulfate 325 mg (65 mg iron) tablet multivitamin capsule OLANZapine (ZYPREXA) 10 mg tablet (Expired) predniSONE (DELTASONE) 20 mg tablet rituximab-pvvr (RUXIENCE) 10 mg/mL solution warfarin (COUMADIN) 2.5 mg tablet warfarin (COUMADIN) 2.5 mg tablet
Allergies: NKA
Diagnostic Lab Data: 10/18/2021 1132 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 10/18/21 1132 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result Detected Critical 10/18/2021 1132 COVID-19 PCR Collected: 10/18/21 1132 | Final result | Specimen: Swab from Nasopharynx
CDC Split Type:

Write-up: Cold symptoms


VAERS ID: 1833612 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Migraine, Pain
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: n/a
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: After vaccination I had started to get a migraine about 1-2 hours later. On top of the migraine I had body aches, chills and fatigue. Everything but the headaches have resolved. It has been 20 days since first injection and I have had a continuing migraine that has not improved. These migraines are the same migraines I have had when I had contracted Covid in November 2020 that took months to resolve.


VAERS ID: 1835497 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-11
Onset:2021-10-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vaccination site pain
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 INC202101362344

Write-up: Very sore arm near injection site; This is a spontaneous report from a contactable consumer, the patient. A 65-year-old non-pregnant female patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FE3590) via an unspecified route of administration in the right arm on 11Oct2021 at 20:30 (at the age of 65-years-old) as a single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID -19. The patient did not receive any other vaccine within four weeks prior to the COVID-19 vaccine. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3183) via an unspecified route of administration in the left arm on 30Aug2021 at 10:30 (at the age of 65-years-old) as a single dose for COVID-19 immunisation. On 12Oct2021 at 08:00, the patient experienced very sore arm near injection site. The event did not result in doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care. Since the vaccination, the patient had not been tested for COVID-19. No therapeutic measures were taken as a result of the event. The clinical outcome of the event very sore arm near injection site was not resolved at the time of this report. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1835498 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Immunisation, Pain in extremity
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ASPIRIN [ACETYLSALICYLIC ACID]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Arthritis; Atrial fibrillation
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101366914

Write-up: Headache; Sore arm; Tired; Joint aches; Administration date 12Oct2021, dose number=3; This is a spontaneous report from a contactable consumer, the patient. A 59-year-old male patient received the third dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: Unknown) via an unspecified route of administration in the left arm on 12Oct2021 at 12:00 (at the age of 59-years-old) as a single dose for COVID-19 immunisation. Medical history included atrial fibrillation and arthritis. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications included acetylsalicylic acid (ASPIRIN); from an unknown date for an unknown indication and unknown if ongoing. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: Unknown) via an unspecified route of administration in the left arm on an unknown date, as a single dose for COVID-19 immunisation and also received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: Unknown) via an unspecified route of administration in the left arm on an unknown date, as a single dose for COVID-19 immunisation. On 12Oct2021 at 12:00, the patient had "administration date 12Oct2021, dose number=3". On 13Oct2021 at 10:00, the patient experienced headache, sore arm, tired and joint aches. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events headache, sore arm, tired and joint aches. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events headache, sore arm, tired and joint aches was not recovered. The clinical outcome of the event "administration date 12Oct2021, dose number=3" was unknown at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1835513 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 INC202101375618

Write-up: Body aches; Fever; Chills; Fatigue; 3rd booster dose; This is a spontaneous report from a contactable consumer, the patient. An 83-year-old non-pregnant female patient received the third booster dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 12Oct2021 at 14:45 (at the age of 83-years-old) as a single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 22Jan2021 at 14:45 (at the age of 82-years-old) and the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 14Feb2021 at 14:45 (at the age of 82-year-old) as a single dose for COVID-19 immunisation. On 13Oct2021, the patient experienced body aches, fever, chills and fatigue. The events did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events body aches, fever, chills and fatigue was resolving at the time of this report. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1835535 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergic reaction to bee sting (Known allergies: Bee venom); Cancer
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101383232

Write-up: Itchy; This is a spontaneous report from a contactable consumer, the patient. A 46-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the right arm on 12Oct2021 at 13:15 (at the age of 46-years-old) as a single dose for COVID-19 immunisation. Medical history included cancer and known allergies to bee venom. Prior to vaccination, the patient was not diagnosed with COVID -19. Concomitant medications were not reported. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. On 12Oct2021 at 13:15, the patient experienced itchy. The event itchy did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the event. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event itchy was unknown at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1835972 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 - / OT

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

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

Write-up: 318 patients received dose from vials beyond 30-day use by date; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (318 patients received dose from vials beyond 30-day use by date) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020F21A) for COVID-19 vaccination. No Medical History information was reported. On 12-Oct-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (318 patients received dose from vials beyond 30-day use by date). On 12-Oct-2021, EXPIRED PRODUCT ADMINISTERED (318 patients received dose from vials beyond 30-day use by date) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant drugs were not reported. Treatment medications were not provided. Date of refrigeration was reported on 10-08-2021. This case was linked to MOD-2021-364559, MOD-2021-363032, MOD-2021-363226 (Patient Link).


VAERS ID: 1836187 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New York  
Vaccinated:2021-10-11
Onset:2021-10-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 1 - / SYR

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

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

Write-up: around 28 hrs after vaccine I began having chest pains, radiating to the left armpit, chills, and shortness of breath making it hard to talk and breath. The shortness of breath only lasted around 10 minutes and the chest pains lasted 5 hrs


VAERS ID: 1836745 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dizziness, Dyspnoea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Chest pain, dizziness, fainting, shortness of breath


VAERS ID: 1836822 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8141 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Nausea, Pain, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (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: Multivitamin, Melatonin, Folic Acid, Vitamin D (50,000mg QW)
Current Illness: None
Preexisting Conditions: Fibrocystic Breast Disease
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Nausea, Vomiting, Virtigo, Fatigue, Body Aches, Chills began roughly four to five hours after the dose. This lasted three days before symptoms resolved


VAERS ID: 1837139 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-10-07
Onset:2021-10-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Gingival bleeding, Platelet count decreased, Swelling face, Thrombocytopenia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Gingival disorders (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations: swelling of jaw with previous 2 doses of Pfizer COVID vaccine
Other Medications: None
Current Illness: Hodgkin''s disease Autoimmune hemolytic anemia Idiopathic thrombocytopenia Non Ischemic cardiomyopathy Steroid induced diabetes
Preexisting Conditions: Hodgkin''s disease Autoimmune hemolytic anemia Idiopathic thrombocytopenia Non Ischemic cardiomyopathy Allergic rhinitis
Allergies: Lisinopril
Diagnostic Lab Data: blood count on 10/31/2021 showed platelet of 7 from a platelet count of 359 on 7/21/2021.
CDC Split Type:

Write-up: Swelling of left jaw and possible exacerbation of his chronic stable Immune thrombocytopenia causing acute thrombocytopenia. He started bleeding from the gun and was evaluated in specialized Care clinic on 10/31/2021 and admitted to hospital which due to acute drop in platelet count to 7 from previous platelet counts of 359, 337, 433 from 7/21/2021, 1/19/2021, 8/21/2020 respectively. He started taking prednisone which helped with the bleeding. Currently hospitalized and platelets are recovering.


VAERS ID: 1837402 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 reports feeling like her face was swelling within an hour or two of vaccination. She stated that she never visualized and swelling. She stated that her face had a numb feeling like it was swollen. The feeling resolved on its own within a few hours without treatment. Since that initial incident she reports that she hasn''t felt swelling again, but that she routinely feels tingling in her face for a few minutes most days since. This tingling resolves on its own after a matter of minutes each time it occurs.


VAERS ID: 1837447 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dysphonia, Dyspnoea, Rash macular
SMQs:, Anaphylactic reaction (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Pt having difficulty breathing, hoarse voice, blotchy skin, 0.3 of Epinephrine given IM, O2 via nonrebreather, 95-100% SPO2 by 1 minute, recovering. Care given by Paramedic on site from Fire Dept.


VAERS ID: 1838073 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-09
Onset:2021-10-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Arthralgia, Chills, Fatigue, Myalgia, Pain, Palpitations, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Anxiety Body aches Heart palpitations Shivers Fever Fatigue Joint pain Muscle pain


VAERS ID: 1838837 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 - / OT

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

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

Write-up: 318 patients received dose from vials beyond 30-day use by date; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (318 patients received dose from vials beyond 30-day use by date) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 020F21A and 002F21A) for COVID-19 vaccination. No Medical History information was reported. On 12-Oct-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (318 patients received dose from vials beyond 30-day use by date). On 12-Oct-2021, EXPIRED PRODUCT ADMINISTERED (318 patients received dose from vials beyond 30-day use by date) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications information were reported No treatment medications were provided Date of refrigeration was 19-Aug-2021 This case was linked to MOD-2021-363729, MOD-2021-363032 (Patient Link).


VAERS ID: 1838969 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 2 - / OT

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

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

Write-up: Received dose from vials beyond 30-day use by date; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Received dose from vials beyond 30-day use by date) in a 31-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020F21A) for COVID-19 vaccination. No Medical History information was reported. On 12-Oct-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Received dose from vials beyond 30-day use by date). On 12-Oct-2021, EXPIRED PRODUCT ADMINISTERED (Received dose from vials beyond 30-day use by date) had resolved. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant product use was provided by the reporter. No treatment medication was provided. Patient received dose from vial refrigerated on 19-AUG-2021. This case was linked to MOD-2021-364760 (Patient Link).


VAERS ID: 1839039 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 2 - / OT

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

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

Write-up: Patient received dose from vials beyond 30-day use by date; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient received dose from vials beyond 30-day use by date) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020F21A) for COVID-19 vaccination. No Medical History information was reported. On 12-Oct-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient received dose from vials beyond 30-day use by date). On 12-Oct-2021, EXPIRED PRODUCT ADMINISTERED (Patient received dose from vials beyond 30-day use by date) had resolved. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Date of refrigeration reported as 19-AUG-2021. Concomitant product use was not provided by the reporter. Treatment information was not provided by the reporter. This case was linked to MOD-2021-365046 (Patient Link).


VAERS ID: 1839978 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-11
Onset:2021-10-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF 8839 / 2 AR / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 5 HTP and L-Theanine
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: I took her to her dr. The dr. screened her for a sinus infection, but found no evidence of any kind of an infection. I also took her to her dentist to rule out any kind of infection in her mouth, and the dentist did a full exam and found no evidence of a tooth infection or gum infection.
CDC Split Type:

Write-up: She woke up the day after her second dose of the vaccine, and her sense of taste and smell were completely altered. It has been just under a month and her sense of taste and smell are still completely altered, Although this side effect may seem minor it has impacted her life in a big way. She says the food smells and tastes like "eggs" (sulphur) and either burnt or rancid. She is only able to eat a handful of foods because everything else she unable to get down because of the taste and smell.


VAERS ID: 1839984 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-01-14
Onset:2021-10-12
   Days after vaccination:271
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: EPINEPHrine (EPIPEN 2-PAK) 0.3 mg/0.3 mL injection syringe levothyroxine (SYNTHROID) 25 mcg tablet multivit with min-folic acid (WOMEN''S MULTIVITAMIN GUMMIES) 200 mcg tablet,chewable
Current Illness:
Preexisting Conditions: Genitourinary Irregular menstrual cycle Musculoskeletal Nevus of left lower leg Endocrine/Metabolic Hypothyroidism
Allergies: Bee Venom Protein (Honey Bee)Anaphylaxis PenicillinsRash
Diagnostic Lab Data: 10/18/2021 1825 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 10/18/21 1825 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result Detected Critical
CDC Split Type:

Write-up: Fever or Chills New loss of taste or smell


VAERS ID: 1840023 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site erythema, Injection site swelling, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin--Novolin R and N. Lisinopril 10mg
Current Illness: n/a
Preexisting Conditions: Type 1 diabetic
Allergies: Codene and lipitor allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore arm, red, raised bump at injection site, body aches. 103.0 fever for 48 hours


VAERS ID: 1840052 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

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

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

Write-up: Severe chest pain everyday since Vaccination


VAERS ID: 1840423 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-10-08
Onset:2021-10-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Chest pain, Glossodynia, Heart rate increased, Lymphoedema, Palpitations, Stomatitis, Stress echocardiogram, Supraventricular tachycardia
SMQs:, Severe cutaneous adverse reactions (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies: Allergy to carrots, apples, nuts, kiwi, shellfish
Diagnostic Lab Data: Stress Echo performed 10/22/2021 and came back normal but evidence of SVT.
CDC Split Type:

Write-up: Unexplained abdominal pain to the left of belly button after both injections that lasted 24 hours. Lymphedema in left arm post second shot that lasted 24 hours. Elevated heart rate and palpitations starting 10/09/2021 and resolved 10/24/2021. Chest pain that started 10/12/2021 and resolved 10/28/2021. Oral sores on tongue and gums started 10/21/2021 and still unresolved.


VAERS ID: 1840434 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-17
Onset:2021-10-12
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Echo Cardigram on November 11, 2021. EKG on 10-12-2021.
CDC Split Type:

Write-up: Rapid Heartrate and Atrial Fibriliation for 2+ hours on several occasions. Prescribed Pradaxa blood thinner and metoprolol to regulate heart beat. Taken off metoprolol five days later because heart rate was too low. Will have an Echo Cardigram next week and appointment with the EP cardiologist for either an ablation or pace maker.


VAERS ID: 1840475 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / N/A RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Wrong 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: Patient received Moderna booster dose (0.25 mL) and was found to have only received one dose in series (Pfizer). Patient was given additional (0.25 mL) Moderna to make full dose.


VAERS ID: 1840637 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood potassium decreased, Computerised tomogram normal, Concussion, Fall, Head injury, Seizure, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Hypokalaemia (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: Over-the-counter multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CAT scan - normal - 10/12/21 Finger blood prick - potassium slightly low - 10/12/21
CDC Split Type:

Write-up: Within 10 minutes of receiving the shot, I had a seizure. I have never had a seizure before in my life. The seizure caused me to fall off of the bed in the room and hit my head on the floor. With the help of EMT, I regained awareness 20-30 minutes after the seizure began. The fall cause me to split my head open near my eyebrow. I was taken to the emergency room and received several stitches at the wound site. The emergency room doctor also told me I had a minor concussion.


VAERS ID: 1840686 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-11
Onset:2021-10-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia, Oral pain, Stomatitis
SMQs:, Severe cutaneous adverse reactions (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Painful mouth sores, metallic taste


VAERS ID: 1842189 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-10-11
Onset:2021-10-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Depressed mood, Dizziness, Fall, Joint swelling, Movement disorder, Skin discolouration, Tooth injury, X-ray
SMQs:, Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma (Verbatim: Asthma)
Allergies:
Diagnostic Lab Data: Test Date: 202110; Test Name: X-ray; Result Unstructured Data: Test Result:Unknown results
CDC Split Type: USPFIZER INC202101419364

Write-up: started getting dizzy; like the world was going round and round and round and round; I fell face down on the concrete; Damaged the three front teeth''s that have to be replaced; very upset; I could not move; knee was all swelled up; my face; it was all black and blue; This is a spontaneous report from a contactable consumer (patient). A 69-year-old female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), via an unspecified route of administration, administered in right arm on 11Oct2021 (at age of 69 years old, Batch/Lot number was not reported) as single dose for covid-19 immunisation. Medical history included asthma. The patient stated she did take other medication. The patient previously took the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), via an unspecified route of administration, on an unknown date (Batch/Lot number was not reported) as single dose for covid-19 immunisation. She had a reaction from the first shot. Patient stated she had a very bad reaction from the second COVID shot. She was on the capsules three ''solid'' weeks. She got up because had to get some doggy food and food for the house and whatever, whatever and she had to go to the bank and started getting dizzy, like the world was going round and round and round and round and do not have any that kind of illness ever. It was going round and round. She fell face down on the concrete and have a 6000 Dollar dental bill right now, okay 6000 dollars. Damaged the three front teeth''s that had to be replaced. She was so very upset. It was not fair. She never heard of this kind of side effect and the, Pharmacy said well that was really severe. This month has been a nightmare for her. Those events occurred on 12Oct2021 (the next day after vaccination), when she woke up, she could not move. She was on the capsule three weeks. Patient stated, she went and got, she went to an urgent care, she fell and they took X-ray to make sure that she did not break anything in her face. Her knee was all swelled up. It was horrible and her face she had it was all black and blue. Just to make sure that she did not break anything. Especially face. That is ''when she went to'' an urgent care. The outcome of the events was recovered on Oct2021. The lot number for the vaccine BNT162B2 was not provided and will be requested during follow up.


VAERS ID: 1842461 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-17
Onset:2021-10-12
   Days after vaccination:237
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, Feeling abnormal, Influenza like illness, Nasal congestion, Nasopharyngitis, Pyrexia, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VITAMIN D NOS; MULTIVITAMINS [VITAMINS NOS]; CENTRUM SILVER [ASCORBIC ACID;CALCIUM;MINERALS NOS;RETINOL;TOCOPHERYL ACETATE;VITAMIN B NOS;VITAMINS.
Current Illness: Hypertension.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211005; Test Name: COVID-19 Virus test; Test Result: Negative; Result Unstructured Data: Negative; Test Date: 20211016; Test Name: COVID-19 Virus test; Test Result: Positive; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Nose is still stuffy; He didn''t have a fever by then; COVID-19; Lack of drug effect; Feeling bad; Cold; Something was coming like a fllu; This spontaneous case was reported by a consumer and describes the occurrence of DRUG INEFFECTIVE (Lack of drug effect), FEELING ABNORMAL (Feeling bad), NASOPHARYNGITIS (Cold), INFLUENZA LIKE ILLNESS (Something was coming like a fllu) and NASAL CONGESTION (Nose is still stuffy) in a 79-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Hypertension. Concomitant products included VITAMIN D NOS, MULTIVITAMINS [VITAMINS NOS] and ASCORBIC ACID, CALCIUM, MINERALS NOS, RETINOL, TOCOPHERYL ACETATE, VITAMIN B NOS, VITAMINS NOS, ZINC (CENTRUM SILVER [ASCORBIC ACID;CALCIUM;MINERALS NOS;RETINOL;TOCOPHERYL ACETATE;VITAMIN B NOS;VITAMINS NOS;ZINC]) for an unknown indication. On 17-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 12-Oct-2021, the patient experienced FEELING ABNORMAL (Feeling bad), NASOPHARYNGITIS (Cold) and INFLUENZA LIKE ILLNESS (Something was coming like a fllu). On 16-Oct-2021, the patient experienced DRUG INEFFECTIVE (Lack of drug effect) and COVID-19 (COVID-19). On an unknown date, the patient experienced NASAL CONGESTION (Nose is still stuffy) and PYREXIA (He didn''t have a fever by then). The patient was treated with FLUTICASONE PROPIONATE (FLONASE [FLUTICASONE PROPIONATE]) for Nose congestion, at an unspecified dose and frequency; AZELASTINE for Adverse event, at an unspecified dose and frequency and Immunotherapy (Monoclonal antibody treatment) for COVID-19. At the time of the report, DRUG INEFFECTIVE (Lack of drug effect) and COVID-19 (COVID-19) outcome was unknown, FEELING ABNORMAL (Feeling bad), NASOPHARYNGITIS (Cold) and INFLUENZA LIKE ILLNESS (Something was coming like a fllu) was resolving, NASAL CONGESTION (Nose is still stuffy) had not resolved and PYREXIA (He didn''t have a fever by then) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 05-Oct-2021, SARS-CoV-2 test: negative (Negative) Negative. On 16-Oct-2021, SARS-CoV-2 test: positive (Positive) Positive. Concomitant product includes: Blood pressure medication. Company comment includes-This case concerns a 79-year-old, female patient with relevant medical history of hypertension, who experienced the non-serious adverse event of special interest of COVID-19, non-serious unexpected events of feeling abnormal, nasopharyngitis, influenza like illness, nasal congestion, non-serious expected event of pyrexia. Drug ineffective was considered as an additional event. The event COVID-19 occurred approximately 8 months after the second dose of Spikevax. The events feeling abnormal, nasopharyngitis, influenza like illness, occurred approximately 7 months and 26 days after the second dose of Spikevax. Nasal congestion and pyrexia occurred on an unknown date after the second dose of Spikevax. The rechallenge was assessed as not applicable since the AEs occurred after the second dose. The medical history of hypertension could be a risk factor for the event COVID-19. The benefit-risk relationship of Spikevax (Moderna COVID-19 vaccine) is not affected by this report. This case was linked to MOD-2021-366741 (Patient Link). Sender''s Comments: This case concerns a 79-year-old, female patient with relevant medical history of hypertension, who experienced the non-serious adverse event of special interest of COVID-19, non-serious unexpected events of feeling abnormal, nasopharyngitis, influenza like illness, nasal congestion, non-serious expected event of pyrexia. Drug ineffective was considered as an additional event. The event COVID-19 occurred approximately 8 months after the second dose of Spikevax. The events feeling abnormal, nasopharyngitis, influenza like illness, occurred approximately 7 months and 26 days after the second dose of Spikevax. Nasal congestion and pyrexia occurred on an unknown date after the second dose of Spikevax. The rechallenge was assessed as not applicable since the AEs occurred after the second dose. The medical history of hypertension could be a risk factor for the event COVID-19. The benefit-risk relationship of Spikevax (Moderna COVID-19 vaccine) is not affected by this report.


VAERS ID: 1842600 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / UNK - / OT

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

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

Write-up: Patient was administered a dose from an expired vial.; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient was administered a dose from an expired vial.) in a 43-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 049E21A) for COVID-19 vaccination. No Medical History information was reported. On 12-Oct-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient was administered a dose from an expired vial.). On 12-Oct-2021, EXPIRED PRODUCT ADMINISTERED (Patient was administered a dose from an expired vial.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications reported. No treatment reported This case was linked to MOD-2021-366918 (Patient Link).


VAERS ID: 1843115 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-16
Onset:2021-10-12
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Cardiac failure, Computerised tomogram, Pulmonary thrombosis, Thrombectomy, Thrombosis
SMQs:, Cardiac failure (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations: flu shot
Other Medications: triamterene
Current Illness: None
Preexisting Conditions: high blood pressure
Allergies: penicillin
Diagnostic Lab Data: CT scans, blood tests, emergency surgery to remove blood clots
CDC Split Type:

Write-up: saddle blood clot in both lungs, blood clots in legs, heart failure


VAERS ID: 1844544 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / UNK - / 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: Vaccine was given 7 days past beyond use date. Per Pfizer Manager of Quality Operations their data stated, "Stability assessment indicates there is no product quality impact and the vaccine was suitable for use."


VAERS ID: 1844545 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / UNK - / 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: Vaccine was given 7 days past beyond use date. Their data stated, "Stability assessment indicates there is no product quality impact and the vaccine was suitable for use."


VAERS ID: 1844549 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / UNK - / 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: Vaccine was given 7 days past beyond use date. Per Pfizer Manager of Quality Operations their data stated, "Stability assessment indicates there is no product quality impact and the vaccine was suitable for use."


VAERS ID: 1844554 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / UNK - / 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? 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: Vaccine was given 7 days past beyond use date. Per Pfizer Manager of Quality Operations their data stated, "Stability assessment indicates there is no product quality impact and the vaccine was suitable for use."


VAERS ID: 1845284 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / UNK - / OT

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

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

Write-up: Patient was administered a dose from an expired vial.; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient was administered a dose from an expired vial.) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 049E21A) for COVID-19 vaccination. No Medical History information was reported. On 12-Oct-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Oct-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient was administered a dose from an expired vial.). On 12-Oct-2021, EXPIRED PRODUCT ADMINISTERED (Patient was administered a dose from an expired vial.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medication was not provided. Treatment information was not provided. This case was linked to MOD-2021-366918, MOD-2021-366925 (Patient Link).


VAERS ID: 1845581 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-19
Onset:2021-10-12
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 3 - / OT

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

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

Write-up: expired vaccine used; This spontaneous case was reported by a health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (expired vaccine used) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 049E21A) for COVID-19 vaccination. No Medical History information was reported. On 19-Oct-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .25 milliliter. On an unknown date, the patient experienced EXPIRED PRODUCT ADMINISTERED (expired vaccine used). At the time of the report, EXPIRED PRODUCT ADMINISTERED (expired vaccine used) had resolved. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.


VAERS ID: 1846336 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-02
Onset:2021-10-12
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Influenza B virus test, Influenza like illness, Influenza virus test negative, SARS-CoV-2 test negative
SMQs:, COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: avapro, atorvastatin, aspirin
Current Illness: none so far as I know
Preexisting Conditions: type ii diabetes
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: I had a long, flu-like reaction a full week after the vaccination. I did see a doctor at an urgent care clinic who tested me for influenza B and COVID. I was negative for both. Though I''m not positive this was a reaction to my booster, it seems likely, given the timing. Doctor said that he had seen that in others.


VAERS ID: 1846347 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 3 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Antiplatelet therapy, Cerebrovascular accident, Condition aggravated, Gait disturbance, Product storage error, Speech disorder
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Medication errors (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: lisinopril, HCTZ, atenolol, glipizide, metformin, lipitor insulin
Current Illness:
Preexisting Conditions: diabetes, heart disease
Allergies:
Diagnostic Lab Data: Non-conclusive. Yes she had a stroke, but not aware it was because she received a Covid vaccine.
CDC Split Type:

Write-up: 10/12/21 at 11:45am received Pfizer shot - 3rd dose * The dose give needs to be given again due to a temperature Excursion. 10/12/21 at 3pm reported greater difficulty walking - patient claims shes has difficulty walking prior to shot also. 10/13/21 7:30am was speaking on phone with some difficulty speaking. 8:pm she called 911 and went to Hospital She was put on plavix for 21 days and told she had a stroke. 10/14/21 She came home in afternoon. 11/5/21 Says shes making good progress.


VAERS ID: 1846420 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-13
Onset:2021-10-12
   Days after vaccination:241
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient was hospitalized on Oct. 12, 2021 for COVID-19 related symptoms. This is classified as a breakthrough case.


VAERS ID: 1846906 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-10
Onset:2021-10-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 2.5mg
Current Illness: No.
Preexisting Conditions: No.
Allergies: Dust.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: A redness along with a rash began on the left arm around the area of which the vaccine was given. The rash in turn also spread to the right arm October 12th, 2021.


VAERS ID: 1846929 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 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? 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: Moderna Vaccine was administered after the beyond use date of 30 days at refrigerated temperature. BUD 10/01/2021


VAERS ID: 1848330 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-02-18
Onset:2021-10-12
   Days after vaccination:236
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Chills, Erythema, Fatigue, Illness, Incorrect dose administered, Limb discomfort, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: COPD
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: degree Fahrenheit
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: arm blew up; it was red; chills; 103.3 degrees F fever; tired; it kept getting redder and bigger; got really sick; 3 full 0.5 mL doses; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (it kept getting redder and bigger), ILLNESS (got really sick), INCORRECT DOSE ADMINISTERED (3 full 0.5 mL doses), LIMB DISCOMFORT (arm blew up) and ERYTHEMA (it was red) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 004F21A, 006M20A and 007B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included COPD. On 18-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 milliliter. On 18-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to .5 milliliter. On 12-Oct-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to .5 milliliter. On 12-Oct-2021, the patient experienced INCORRECT DOSE ADMINISTERED (3 full 0.5 mL doses). On an unknown date, the patient experienced PERIPHERAL SWELLING (it kept getting redder and bigger), ILLNESS (got really sick), LIMB DISCOMFORT (arm blew up), ERYTHEMA (it was red), CHILLS (chills), PYREXIA (103.3 degrees F fever) and FATIGUE (tired). The patient was treated with CHLORPHENAMINE MALEATE, DEXTROMETHORPHAN HYDROBROMIDE, PARACETAMOL, PSEUDOEPHEDRINE HYDROCHLORIDE (TYLENOL [CHLORPHENAMINE MALEATE;DEXTROMETHORPHAN HYDROBROMIDE;PARACETAMOL;PSEUDOEPHEDRINE HYDROCHLORIDE]) for Adverse event, at an unspecified dose and frequency. On 12-Oct-2021, INCORRECT DOSE ADMINISTERED (3 full 0.5 mL doses) had resolved. At the time of the report, PERIPHERAL SWELLING (it kept getting redder and bigger), ILLNESS (got really sick), LIMB DISCOMFORT (arm blew up), ERYTHEMA (it was red), CHILLS (chills), PYREXIA (103.3 degrees F fever) and FATIGUE (tired) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 103.3 (abnormal) degree Fahrenheit. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Patient taking inhaler as a concomitant medication for COPD. Doctor told her to take Tylenol, antihistamine and to put ice on it.


VAERS ID: 1848924 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-10
Onset:2021-10-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram cerebral, Anti-thyroid antibody, Dizziness, Echocardiogram, Gait disturbance, Headache, Hypoaesthesia, Laboratory test, Loss of personal independence in daily activities, Movement disorder, Muscle spasms, Pain, Pain in extremity, Paraesthesia, Pruritus, Scan with contrast, Urine analysis, Vision blurred, Vitamin D
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Vestibular disorders (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pregabalin of 150mg
Current Illness: Fibromyalgia, Vaginal/Urinary tract infection
Preexisting Conditions: Fibromyalgia
Allergies: Do not know
Diagnostic Lab Data: Blood chemistry, General urine test, CT tomography A.C. of skull with contrast, ECO Doppler both legs, Thyroid with antibodies, Vitamin D
CDC Split Type:

Write-up: I started with tingling in lower limbs (legs), in the following days tingling also occurred in the upper limbs (hands) presenting numbness in extremities subsequently I started with spasms (itching) and pain in legs, arms, then tingling sensation and itching in the head, head pain, dizziness, blurred vision. Currently I have complications when walking and moving, pain, numbness and tingling in the body that prevent me from performing my daily activities.


VAERS ID: 1850565 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Folic Acid, Gabapentin, Hydromorphone, MS contin, ondansetron, Senna, Omeprazole, Temazepam
Current Illness: none
Preexisting Conditions: depression, fusion of spine, osteoporosis, Rheumatoid arthritis
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt was given dose #2 of Moderna on 10/12/21. Expiration date 10/10/21. No adverse effects noted


VAERS ID: 1850650 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-07
Onset:2021-10-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Human chorionic gonadotropin negative, Menstruation delayed
SMQs:, Fertility disorders (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: November 4, 2021 Ancillary Visit for HCG SERUM, QUALITATIVE - Quantitative Beta hCG Value <3 resulted on 11/5/21
CDC Split Type:

Write-up: Received my first dose of Pfizer BioNTech on October 7, 2021 and missed my expected period (10/13-10/18) completely. I got my period today 11/8/21 after missing the full month of October. I have on time, consistent, and accurate periods until receiving the vaccine and I believe this is something that needs to be discussed and acknowledged instead of brushing it off to the public like always.


VAERS ID: 1850755 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-23
Onset:2021-10-12
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 3 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Coagulation test, Computerised tomogram head, Echocardiogram, Electrocardiogram ambulatory, Ischaemic stroke, Magnetic resonance imaging head, Scan with contrast
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Miralax 17G daily Cetirizine 10mg daily Multivitamin daily
Current Illness: No illnesses
Preexisting Conditions: TRISOMY 21 CONGENITAL HEART DEFECT (REPAIRED) BILATERAL CONDUCTIVE HEARING LOSS
Allergies: No known medical allergies
Diagnostic Lab Data: CT head w/ IV contrast, MRI head, hypercoag studies, echocardiogram w/ bubble study, and 2 week Holter monitor. Planned sleep study set for this week.
CDC Split Type:

Write-up: Patient experience a left posterior insular ischemic stroke on 10/12/2021 - no known cause at this time, but given recent vaccination, wanted to report on vaers.


VAERS ID: 1850787 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-11
Onset:2021-10-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011F21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: alprazolam 2mg
Current Illness: none of note
Preexisting Conditions: anxiety
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: vaginally bleeding, off and on, allegedly still going on at time of second vaccine.


VAERS ID: 1850805 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 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? 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: Moderna Vaccine wad administered after the beyond use date at refrigerated temperature. BUD 10/01/2021


VAERS ID: 1850954 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-11
Onset:2021-10-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiocardiogram, Angiogram, Arthralgia, Back pain, Blood glucose increased, Blood pressure increased, Chest X-ray, Chest pain, Computerised tomogram abdomen, Computerised tomogram thorax, Ear pain, Echocardiogram, Eczema, Electrocardiogram, Electrocardiogram T wave inversion, Insulin resistance, Lymph node pain, Lymphadenopathy, Neck pain, Pain, Pain in extremity, Pain in jaw, Painful respiration, Palpitations, Pruritus, Rash, Ultrasound Doppler, X-ray limb
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Lipodystrophy (broad), Osteonecrosis (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Benazepril, HCTZ, Lantus and Humalog
Current Illness: No
Preexisting Conditions: HTN, DM II Overweight and uterine fibroids
Allergies: Oats, animal hair and grass
Diagnostic Lab Data: 10/13/2021, 10/16/2021 Chest xrays 10/13/2021, 10/16/2021 ECGs 10/14/2021 2D Echo 10/16/2021 CT Chest Angiogram 10/18/2021 Ultrasound Duplex Bilateral Legs 10/18/2021 CT Coronary Angiogram 10/19/2021 CT Abdomen and Pelvis Angiogram 10/20/2021 Right Knee xray Right knee and calf pain 10/27/2021 2D echo at Cardiology office
CDC Split Type:

Write-up: 10/12/2021 at 1:15 am Sharp Left ear pain, left jaw pain, neck pain chest pain extreme pounding of the left side of heart sharp left wrist pain, extreme itching then noticed new eczema rash left arm and left axilla enlarged painful burning lymph node. Sharp right knee pain and left and right big toes. Chest pain began to pierce through to left side of back when inhaling and exhaling. Blood pressure 190s over 120s and blood sugars in high 200s low 300s blood pressure, and insulin medication not working. Chest pain never went away Tylenol and Ibuprofen did not work and blood pressure continued to be high. 10/12/2021 Notified PCP at 11 am. PCP replied on 10/13/2021 at 8:30 am giving instructions to go to Urgent Care went to Urgent care and ECG had inverted T waves paramedics called. 1st admission 10/13/2021-10/15/2021 2nd Admission 10/17-10/19/2021


VAERS ID: 1851120 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 3 LA / IM
UNK: VACCINE NOT SPECIFIED (OTHER) / UNKNOWN MANUFACTURER - / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Magnetic resonance imaging head normal, Migraine, Pain, Photophobia, Photopsia, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin 150mg
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: 10/13/2021- Urgent Care 10/14/2021-ER, Hospital MRI Optometry Dose 1: 02/27/2021 # EN6201 Dose 2: 03/20/2021 #EN6207
CDC Split Type: vsafe

Write-up: The evening that I got my third dose of the vaccine I got a pounding Migraine. After the first dose I had a mild headache. I do not get headaches or Migraines normally. I went to the Urgent Care on the third day after and they Toradol shot and it did help. I returned to the ER the next day and they gave me a cocktail of painkillers. It did not really help the pain. The Migraine finally subsided on 10/17/2021. When I woke up that morning I had flashing lights in my vision. I now have a variety of vision problems after a month. I have since had a two-hour eye exam and an MRI of my Brain. All tests have been negative except that that they want to test my vision angles which could have been due to inflammation. I see flashes of light and I am very sensitive to light as well as flashing lights at the edge of my vision. It does not seem to be improving.


VAERS ID: 1851309 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Condition aggravated, Dizziness, Seizure, Vomiting
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (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: None
Current Illness: None
Preexisting Conditions: Asthma, Seizures of unknown origin, Ehlers Danlos Syndrome
Allergies: Codiene
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Approximately 1 hour post administration employee became very light headed and began vomiting she then had a series of 3 seizures.


VAERS ID: 1851622 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: not known
Current Illness: none reported
Preexisting Conditions: Essential HTN
Allergies: KNDA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: This was NOT an Adverse Event. The vaccine was in freezer longer than 14 days. The patient was advised to revaccinate per CDC. Patient revaccinated on 11/2/2021 at 2:15pm


VAERS ID: 1851631 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: This was not an adverse event. Vaccine in freezer longer than 14 days. The patient advised to revaccinate.


VAERS ID: 1851786 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 3 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not known
Current Illness: Not known
Preexisting Conditions: Hypothyroid, Bronchitis, Dizziness
Allergies: KNDA
Diagnostic Lab Data: NO
CDC Split Type:

Write-up: This was NOT an Adverse Event. The vaccine was in freezer longer than 14 days. The patient was advised to revaccinate per CDC.


VAERS ID: 1851805 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: None reported
Preexisting Conditions: None reported
Allergies:
Diagnostic Lab Data: No.
CDC Split Type:

Write-up: This was not an adverse event. Vaccine in freezer longer than 14 days. The patient advised to revaccinate.


VAERS ID: 1851815 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, 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: not none
Current Illness: not known
Preexisting Conditions: HTN
Allergies: No Allergies
Diagnostic Lab Data: no
CDC Split Type:

Write-up: This was NOT an Adverse Event. The vaccine was in freezer longer than 14 days. The patient was advised to revaccinate per CDC. Patient re-took 11/2/2021


VAERS ID: 1851822 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 3 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: not none
Current Illness: none / reported not aware
Preexisting Conditions: Not Patient
Allergies: no known allergies
Diagnostic Lab Data: No
CDC Split Type:

Write-up: This was NOT an Adverse Event. The vaccine was in freezer longer than 14 days. The patient was advised to revaccinate per CDC. Patient got Vax 11/3/2021


VAERS ID: 1851830 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 3 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Not reported
Preexisting Conditions: HTN
Allergies: No known allergies
Diagnostic Lab Data: No.
CDC Split Type:

Write-up: This was not an adverse event. Vaccine in freezer longer than 14 days. The patient advised to revaccinate. Re-vax 11/3/2021.


VAERS ID: 1851840 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: No adverse event, 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: Breo Ellipta, Pepcid, TCM Cr, Estradiol Cream,
Current Illness: Not aware
Preexisting Conditions: Asthma, Maglignant Neoplasm,
Allergies: Morphine & Peanut Oil, latec, Codiene
Diagnostic Lab Data: No
CDC Split Type:

Write-up: This was NOT an Adverse Event. The vaccine was in freezer longer than 14 days. The patient was advised to revaccinate per CDC. Patient Re-Vax 11/3/2021


VAERS ID: 1852027 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, Immunisation, 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: Not known
Current Illness: Not reported/ not none
Preexisting Conditions:
Allergies: NO ALLERGIES
Diagnostic Lab Data: no
CDC Split Type:

Write-up: This was NOT an Adverse Event. The vaccine was in freezer longer than 14 days. The patient was advised to revaccinate per CDC. Patient got Re-Vax 11/3/2021


VAERS ID: 1853879 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-11
Onset:2021-10-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091021A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Electrocardiogram, Eye swelling, Heart rate abnormal, Heart rate irregular, Hypertension, Migraine, Muscle swelling, Sensory disturbance, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiac arrhythmia terms, nonspecific (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Allergic to all pain medications, allergic to migraine shot, allergic to birth control pills
Diagnostic Lab Data: EKG, blood work 10/11/2021
CDC Split Type:

Write-up: Woke up at 2am with swollen left eye, migraine, abnormal heart rate, and high blood pressure. Few hours later I could feel the vaccine moving in my body to past injuries, ripped muscle in my back became swollen, that injury was at least 20 years previously. Heart rate was irregular and could feel blood pressure extremely high. This continued for days as migraine and old injuries were affected. Face continued to be swollen and eye, migraine still present. On 10/19 I went to doctor as I was not getting better and at times I was much worse. I went to a doctor, do not have a regular doctor as I am never sick and allergic to any meds in the past. The doctor took blood pressure, very high, did ekg, chest X-ray, blood work, and suggested being referred fir the migraine. After seeing the doctor I made an appointment with eye doctor, eyes were fine. Still am experiencing issues


VAERS ID: 1854126 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076C21A / 1 UN / IM

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

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

Write-up: Patient accidentally received 1st dose of Moderna on 10/12/2021 even though they were under 18. This was discovered today (11/9/2021) as they were coming in for their 2nd dose. Per immunizer, Pt reported feeling fine after their dose of Moderna. Per CDC guidelines, pt can receive Pfizer as their 2nd dose. Pt was given Pfizer as their 2nd dose today and they reported feeling fine after their 15 minute waiting period.


VAERS ID: 1854750 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-10-11
Onset:2021-10-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Esomeprazole Magnesium 40mg cap Alfuzosin 10mg
Current Illness: None
Preexisting Conditions: Acid Reflux Sleep Apnea
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: My 1st Covid shot on 2/28/2021, I was fine. My 2nd Covid shot on 3/21/2021, I experienced dizziness, headaches and generally felt sluggish for about 3-4 days. However after my 3rd Covid shot on 10/11/2021, i have been experiencing low grade headaches EVERY day from 10/12/2021 up to the present day (11/09/2021) Generally speaking, these are low grade headaches that I treat with a single Execedrin, but on occasion the headaches are much stronger and I can''t identify any pattern as to why they are mild one day and more severe the next day. Yesterday, 11/08/2021 was a bad day where I was bedriden for most of the day. My hope was that these headaches would decline in intensity and frequency but that doesn''t appear to be the case.


VAERS ID: 1854793 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-10-08
Onset:2021-10-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Atrial enlargement, Blood folate normal, Blood immunoglobulin A, C-reactive protein normal, Chest X-ray normal, Computerised tomogram thorax normal, Cytomegalovirus test negative, Dizziness, Electrocardiogram, Epstein-Barr virus test negative, Fatigue, Fibrin D dimer, Full blood count normal, Headache, International normalised ratio normal, Metabolic function test normal, Nausea, Palpitations, Paraesthesia, Red blood cell sedimentation rate normal, Sensory disturbance, Serum ferritin normal, Sinus tachycardia, Thyroid function test normal, Tremor, Troponin normal, Vitamin B12 normal, Vitamin D
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Parkinson-like events (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (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: none reported
Current Illness: no known illnesses
Preexisting Conditions: Lyme disease history Anxiety and depression history
Allergies: NKDA
Diagnostic Lab Data: ED visit 10/22/21 after having positive D-dimer at NC state health clinic: normal CXR, normal/neg Chest CT, EKG demonstrating: Sinus tachycardia, Biatrial enlargement. normal CBC, CMP, troponins and PT-INR 11/2/21--negative TFTs, CMV and EBV studies, Sed rate and CRP normal. Vitamin B12, folate, Vitamin D and ferritin normal. IgA normal Scheduled to see cardiology for Echo and consult 11/11/21
CDC Split Type:

Write-up: fatigue, hand and feet tremors, nausea, dizziness, heart pounding sensation, h/a, tingling to hands and feet, heart pounding when lying down, "shock wave" sensation that would occur suddenly and travel up her body.


VAERS ID: 1855311 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-02
Onset:2021-10-12
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Chest discomfort
SMQs:, Anaphylactic reaction (broad), Other ischaemic heart disease (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: doxycyline monohydrate 40 mg SR capsule Soolantra 1 % cream loperamide 2 mg oral tablet Magnesium Citrate
Current Illness:
Preexisting Conditions:
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chest pain/pressure; heart-related (left side of chest). Still ongoing; I feel it a few times a week. It lasts several minutes; usually fades away in 15 minutes.


VAERS ID: 1856764 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-02
Onset:2021-10-12
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 3 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CLOTRIMAZOLE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy to legumes (Known allergies: Lima beans); Ear infection fungal; Migraine aura (migraine (aura only) - every 6 months)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101456725

Write-up: tinnitus - seeming to be right ear - very high pitch (10k-12k Hz); This is a spontaneous report from a contactable consumer (patient) reported for herself. A 50-year-old female patient (not pregnant) received bnt162b2 (Pfizer COVID-19 vaccine), dose 3 via an unspecified route of administration, administered in Arm Left on 02Oct2021 at 50 years old (Batch/Lot Number: FF8839) as dose 3 (booster), single for covid-19 immunisation. Facility where the most recent COVID-19 vaccine was administered was Public Health Clinic/facility. Medical history included migraine (aura only) - every 6 months, known allergies to lima beans, Ear infection fungal. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient had not been tested for COVID-19. Concomitant medications included clotrimazole cream in outer ears for fungus, start and stop date were not reported. The patient didn''t receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient previously took bnt162b2 dose 1 (lot number: EN6200) on 03Mar2021 at 50 years old in Left arm for covid-19 immunisation, bnt162b2 dose 2 (lot number: EP7534) on 25Mar2021 at 50 years old in Left arm for covid-19 immunisation, dicloxacillin and bactrim and experienced drug allergy. The patient experienced tinnitus - seeming to be right ear - very high pitch (10k-12k Hz) on 12Oct2021. No treatment was received for the event. The event resulted in Doctor or other healthcare professional office/clinic visit. No hospitalization was prolonged. The outcome of the event was not recovered. Serious criteria for the event was reported as disabling/Incapacitating.


VAERS ID: 1856783 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-28
Onset:2021-10-12
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bone pain, Decreased appetite, Fatigue, Gait disturbance, Headache, Mental impairment, Myalgia, Nausea, Night sweats, Pain, Pain in extremity, Pain of skin, Polymerase chain reaction, SARS-CoV-2 antibody test, Somnolence, Vaccination site pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (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), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: Test Date: 20211015; Test Name: Pcr; Test Result: Negative ; Comments: Nasal Swab; Test Date: 20211017; Test Name: Pcr; Test Result: Negative ; Comments: Nasal Swab; Test Date: 20211014; Test Name: Otc; Test Result: Negative ; Comments: Nasal Swab; Test Date: 20211016; Test Name: Otc; Test Result: Negative ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101458316

Write-up: muddled thinking; I had severe total body pain; I had severe total body pain. Muscles bones even skin; I had severe total body pain. Muscles bones even skin; I had severe total body pain. Muscles bones even skin; Headache; Nausea; Feet so sore I could barely walk.; Feet so sore I could barely walk.; Night sweats twice; No appetite; Very tired and sleepy; Very tired and sleepy; Did have a lot of site itching right after shot; This is a spontaneous report from a contactable Nurse (Patient). A 71-year-old female patient received third dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: Ff2589) via an unspecified route of administration, administered in Arm Right on 28Sep2021 as single dose booster for COVID-19 immunisation. Medical history included p enicillin allergy. The patient received first dose of Concomitant medications were not reported. The patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: EL9261) on 02Feb2021 on arm right and second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: EN5318) on 23Feb2021 on arm right, both at single dose, for COVID-19 immunisation. The patient experienced muddled thinking (medically significant) on 12Oct2021 with outcome of recovered, I had severe total body pain (non-serious) on 12Oct2021 with outcome of recovered , I had severe total body pain. muscles bones even skin (non-serious) on 12Oct2021 with outcome of recovered ,I had severe total body pain. muscles bones even skin (non-serious) on 12Oct2021 with outcome of recovered , I had severe total body pain. muscles bones even skin (non-serious) on 12Oct2021 with outcome of recovered , headache (non-serious) on 12Oct2021 with outcome of recovered , nausea (non-serious) on 12Oct2021 with outcome of recovered , feet so sore i could barely walk. (non-serious) on 12Oct2021 with outcome of recovered, feet so sore I could barely walk. (non-serious) on 12Oct2021 with outcome of recovered, night sweats twice (night sweats) (non-serious) on 12Oct2021 with outcome of recovered , no appetite (non-serious) on 12Oct2021 with outcome of recovered , very tired and sleepy (non-serious) on 12Oct2021 with outcome of recovered , very tired and sleepy (non-serious) on 12Oct2021 with outcome of recovered , did have a lot of site itching right after shot (non-serious) on 12Oct2021 with outcome of recovered. The patient underwent lab tests and procedures which included Nasal Swab polymerase chain reaction: negative on 15Oct2021 and on 17Oct2021, SARS-CoV-2 antibody test negative on 14Oct2021 and on 16Oct2021. Sender''s Comments: Based on known drug safety profile, there is reasonable possibility of causal association between the event mental impairment and BNT162B2. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1856801 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Exercise induced asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101463712

Write-up: angioedema; raised red bumps on upper right deltoid / diffuse hives across torso, right leg and arm; Booster; This is a spontaneous report from a contactable Nurse (patient). A 37-year-old no pregnant female patient received third dose of bnt162b2 (BNT162B2) (vaccinated at 37-year-old), via an unspecified route of administration, administered in left arm on 12Oct2021 09:30 (Batch/Lot Number: FF2590) as DOSE 3 (BOOSTER), SINGLE for covid-19 immunisation. Patient received first dose of BNT162B2 in left arm with Batch/Lot No: EL1283 on 05Jan2021 10:00 AM, second dose of BNT162B2 in left arm with Batch/Lot No: EL8982 on 27Jan2021 10:00 AM. No other vaccine in four weeks. Medical history included sports induced asthma. No covid prior vaccination. Concomitant medications include Multivitamin. On 12Oct2021 17:30, approximately 8 hours post 3rd dose booster vaccine patient developed raised red bumps on upper right deltoid (vaccine was on left arm). Approximately 12hrs post booster dose, developed diffuse hives across torso, right leg and arm, relieved by Zyrtec. Zyrtec was taken for 4 days following incident. 9 days following (21Oct2021) booster dose vaccination developed angioedema relieved by Zyrtec and Pepcid. 15 days following (27Oct2021) booster dose, hives continued on right arm, torso and right hip. Relieved by loratadine. Event resulted in professional office/clinic visit. The outcome of events was recovering. No covid tested post vaccination.; Sender''s Comments: Based on the information in the case report and a plausible temporal relationship, a possible causal relationship between the reported events and suspect drug BNT162B2 cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1857179 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-10-11
Onset:2021-10-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acne, Arthralgia, COVID-19, Chills, Cough, Ear pain, Headache, Hyperhidrosis, Injection site pain, Nausea, Ocular discomfort, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive, Secretion discharge, Toothache, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Patient tested positive for COVID 19 on 10/16/2021 (five days after vaccination
Preexisting Conditions: Morbid obesity Seasonal allergies Major depressive disorder
Allergies: NKDA
Diagnostic Lab Data: Positive PCR COVID test five tests after COVID vaccine administered. Symptoms likely due to COVID infection.
CDC Split Type:

Write-up: Per patient''s written complaint as he was unable to be evaluated in person due to COVID 19 infection: Day 1: sore throat, sore at injection site Day 2: headache, fever, sore throat, mucus, sweating and chills, coughing, ear aches Day 3: headache, fever, sore throat, mucus, sweating and chills, coughing, eye?s felt feverish. Gonads had fever, joint pain, face broke out in pimples (haven?t done so for years). Ear aches, tooth aches Day 4: fever, coughing, nauseous, vomited bile, joint pain, ear aches and tooth aches Day 5. fever, coughing, nauseous, vomited bile, joint pain, ear aches and tooth aches


VAERS ID: 1857438 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, No adverse event, Vaccination 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 inadvertently received vaccine after published expiration date. Moderna Company analyzed lot 031L20A and advised vaccine maintained activity necessary to protect against covid 19 on date vaccine was administered. Also patient did not call in to complain of adverse event. This is administrative error without adverse event.


VAERS ID: 1857447 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, No adverse event, Product administration 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 inadvertently received vaccine after published expiration date. Moderna company analyzed lot 031L20A and advised vaccine maintained activity necessary to protect against covid 19 on date vaccine was administered. Also patient did not call in to complain of adverse event. This is administrative error without adverse event.


VAERS ID: 1857455 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: No adverse event, Product administration error, 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 inadvertently received vaccine after published expiration date. Moderna analyzed lot 031L20A and advised vaccine maintained activity needed to protect against covid 19 on day vaccine was administered. Also patient did not call in to complain of adverse event. This is administrative error without adverse event.


VAERS ID: 1857468 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-12
Onset:2021-10-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 4 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: No adverse event, Product administration error, 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 inadvertently received vaccine after published expiration date. Moderna analyzed lot 031L20A and advised vaccine maintained activity necessary to protect against covid 19 on date vaccine was administered. Also patient did not call in to complain of adverse event. This is administrative error without adverse event.


Result pages: prev   96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=195&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166