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

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



Case Details (Reverse Sorted by Onset Date)

This is page 205 out of 4,799

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VAERS ID: 1391257 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-03
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal, Hunger, Hypoaesthesia, Injection site bruising, Injection site pain, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210612797

Write-up: STARVING IN MORNING; HEAD OR BRAIN FUZZY, FEEL DRUGGED, FEEL WEIRD; DIZZINESS; A PALE YELLOW BRUISE WHERE THE INJECTION WENT IN; DIDN''T FEEL A THING IN THE ARM; MINIMAL ARM SORENESS; SHOT DID HURT A LITTLE WHEN IT WENT IN; This spontaneous report received from a patient concerned an adult of unspecified sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported and batch number: 205A21A and expiry: UNKNOWN) dose was not reported, administered on 03-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-JUN-2021, the subject experienced shot did hurt a little when it went in. On 04-JUN-2021, the subject experienced starving in morning. On 04-JUN-2021, the subject experienced head or brain fuzzy, feel drugged, feel weird. On 04-JUN-2021, the subject experienced dizziness. On 04-JUN-2021, the subject experienced a pale yellow bruise where the injection went in. On 04-JUN-2021, the subject experienced didn''t feel a thing in the arm. On 04-JUN-2021, the subject experienced minimal arm soreness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from shot did hurt a little when it went in on 03-JUN-2021, and the outcome of starving in morning, dizziness, head or brain fuzzy, feel drugged, feel weird, minimal arm soreness, a pale yellow bruise where the injection went in and didn''t feel a thing in the arm was not reported. This report was non-serious.; Sender''s Comments: V0:Medical assessment comment not required as per standard procedure as case assessed as Non-serious.


VAERS ID: 1391259 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Louisiana  
Vaccinated:0000-00-00
Onset:2021-06-03
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Injection site pain, Off label use, Product administered to patient of inappropriate age, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210614070

Write-up: FEVER; INJECTION SITE PAIN IN LEFT ARM; PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE; OFF LABEL USE; This spontaneous report received from a pharmacist concerned an adolescent female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included unknown. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 03-JUN-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 03-JUN-2021, the subject experienced product administered to subject of inappropriate age. On 03-JUN-2021, the subject experienced off label use. On 05-JUN-2021, the subject experienced fever. On 05-JUN-2021, the subject experienced injection site pain in left arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fever, injection site pain in left arm, product administered to patient of inappropriate age and off label use was not reported. This report was non-serious.


VAERS ID: 1391306 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

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

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

Write-up: Systemic: swelling in both feet and ankles-Medium, Additional Details: Patient reported swelling of the feet and ankles at around 9pm the night of vaccination. Patient has since recovered since then and reported the event the following day.


VAERS ID: 1391376 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Inappropriate schedule of product administration, SARS-CoV-2 test positive
SMQs:, Medication errors (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Patient received first dose on 2/21/2021 (Lot EL9266) and then received 2nd dose on 6/3/21. She reported getting COVID and receiving antibody therapy after the 1st dose, so she waited the 90 day period after receiving antibody therapy to get the 2nd dose.


VAERS ID: 1391522 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-01
Onset:2021-06-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test normal, Cardiac discomfort, Electrocardiogram normal, Musculoskeletal discomfort, Sleep disorder, Ultrasound scan normal
SMQs:, Rhabdomyolysis/myopathy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lthyroix T4, Thybon T3, progesterone, estrogen, progenolone
Current Illness: none
Preexisting Conditions: No Thyroid, menopause :)
Allergies: penecillin
Diagnostic Lab Data: See above
CDC Split Type:

Write-up: Woke with heart attack like symptoms out of a deep sleep. Throbbing, pressure and pain on my left side by shoulder blades, shoulder. Would not go away for 10 min. then got up to use the bathroom and felt better, googled and said could be this, so leaned forward and was ok. Slept. the next night had same wake up, but had taken advil. was not as intense, leaned forward and was fine again. Saw a cardiologist on Monday and had ultrasound, EKG and bloodwork and was fine. After 3 days of advil, I guess it was temporary.


VAERS ID: 1391596 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / UNK LA / IM

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

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

Write-up: Vaccine administered after 30 days of refrigeration


VAERS ID: 1391603 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / UNK RA / IM

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

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

Write-up: Vaccine administered after 30 days of refrigeration


VAERS ID: 1391604 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / UNK LA / IM

Administered by: Public       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: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine administered after 30 days of refrigeration


VAERS ID: 1391628 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-01
Onset:2021-06-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER EWO191 / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Hypoaesthesia oral
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)

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

Write-up: Whole left side of face is numb. No feeling in lips, ears, jaw line, cheek area on left side.


VAERS ID: 1391647 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / UNK LA / IM

Administered by: Public       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: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine administered after 30 days of refrigeration


VAERS ID: 1391656 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / UNK LA / IM

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

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

Write-up: Vaccine administered after 30 days of refrigeration


VAERS ID: 1391677 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / UNK LA / IM

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

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

Write-up: Vaccine administered after 30 days of refrigeration


VAERS ID: 1391680 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / UNK LA / IM

Administered by: Public       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: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine administered after 30 days of refrigeration


VAERS ID: 1391688 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / UNK LA / IM

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

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

Write-up: Vaccine administered after 30 days of refrigeration


VAERS ID: 1391708 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-01
Onset:2021-06-03
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW1073 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad)

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

Write-up: one month after second dose, left ear had ear ringing or as tinnitus and dizziness, those symptoms do not go away. Just started seeing doctor.


VAERS ID: 1391808 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure increased, Headache, Pain in extremity, Pertussis
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Arm pain, H/A, Whoozy Vital Signs: BP 155/90 HR 68 Resp 18 Skin Signs: Warm and dry Circulation: Cap Refill <2sec Respiratory: Breath sound clear bilaterally Initial Treatment: Sat in triage, drinking water 2:20 PM Vital Signs: BP 140/83 HR 61 Resp 12 O2Sat 99 Skin Signs: Warm and dry Circulation: Cap refill <2sec Respiratory: Breath sound clear bilaterally Follow up Treatment: Observation 2:25 PM Vital Signs: BP 130/78 HR 60 Resp 10 O2Sat 96 Skin Signs: Warm and dry Circulation: Cap refill <2sec Respiratory: Breath sound clear bilaterally Notes: Sent home with father. Feeling better. Still arm pain. Will f/u if not continuing to improve.


VAERS ID: 1391822 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK AR / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Cough, Dyspnoea, Heart rate increased, Malaise, Pneumonia, Respiratory rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amoxicillin for tooth
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Shellfish
Diagnostic Lab Data: Unknown - Care provided at Hospital, - Length of hospital stay unknown. Form requires number of days hospitalized. Indicated 1 in order to be able to submit the report.
CDC Split Type:

Write-up: Patient did not feel well after receiving vaccination. Indicated that she developed a cough, shortness of breath and increased respirations and pulse. She admitted to the hospital on 6/8/21 and was diagnosed with pneumonia.


VAERS ID: 1391841 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: Numbness in the face, still present one week from 2nd dose of Pfizer vaccine.


VAERS ID: 1391999 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

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

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

Write-up: The vaccine was prepared with a multi-dose vial of diluent. The diluent vial was punctured twice to mix two different vials of vaccine. The dose of medication may have been given IM with a 5/8 inch needle.


VAERS ID: 1392085 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-02-09
Onset:2021-06-03
   Days after vaccination:114
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deep vein thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: azelastine, Effexor, ergocalciferol, ibuprofen, lisinopril, metoprolol, Montelukast, Mucinex, singulair, Tamsulosin, trazodone, vitamin c
Current Illness: none
Preexisting Conditions: glaucoma, hypercholesterolemia, hypertension, prostate cancer, vitamin d deficiency
Allergies: mold, dust
Diagnostic Lab Data:
CDC Split Type:

Write-up: DVT-hospitalized on 6/3/2021


VAERS ID: 1392094 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Nervousness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concerta
Current Illness: None reported by client.
Preexisting Conditions: ADHD
Allergies: none reported by client
Diagnostic Lab Data: None completed at site.
CDC Split Type:

Write-up: Patient received the Pfizer COVID vaccine dose 1 (lot EW0187, expiration 06/28/2021) at 1413. Patient reported to RN at 1423 that he was experiencing dizziness about 5 minutes after vaccination that lasted 2 minutes. Client denied experiencing dizziness at the time that RN responded. Vital signs taken at 1423 by EMT and were as follows: O2 99%, pulse 92, blood pressure 112/78, respirations 14. Client denied associated weakness, shortness of breath, itchiness, swelling in throat or tongue, chest pain or any other symptoms. Medical conditions include: ADHD. Per Mother, medication include: concerta daily. No reported allergies. Client reports he had eaten lunch about 2 hours prior to vaccination. Per Grandmother, client get nervous when he is goes to his medical appointments. RN advised Grandmother to inform the client''s Mother that the client''s provider should be notified. Furthermore, RN advised Grandmother of signs of when to contact 911 or go to the Emergency Room. Grandmother verbalized understanding. RN informed client and grandmother that they would be monitored 30 minutes from start of symptom reporting. At 1436, vital signs: O2 99% RA, pulse 90, respirations 14, blood pressure 116/80. At 1455 vital signs: O2 99%, pulse 89, respirations 14, blood pressure 114/80. Patient left walking with steady gait. EMT assisted client and grandmother to the car.


VAERS ID: 1392118 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-15
Onset:2021-06-03
   Days after vaccination:49
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cardiac failure congestive, Chest pain, Dyspnoea, Echocardiogram abnormal, Myocardial necrosis marker increased, Pericardial effusion, Pleural effusion, Pleurisy, Pulmonary oedema, Respiratory viral panel, Right ventricular failure, SARS-CoV-2 test positive, Troponin
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Systemic lupus erythematosus (narrow), Myocardial infarction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 6/3/21: Initial rapid PCR test for COVID-19 (Abbott ID Now) was negative, subsequent PCR Respiratory Panel detected SARS-CoV-2.
CDC Split Type:

Write-up: After fully vaccinated, patient vacationed and had a negative test prior to return home (end of May). Early June, patient experienced burning chest pain & difficulty breathing. Found to be COVID positive, with elevated cardiac enzymes (troponin 0.45ng/mL). Echocardiogram showed pleural effusion, pleurisy, acute congestive right ventricular heart failure, possible myocarditis vs. severe pulmonary vascular edema, and scant pericardial effusion. Patient was transferred to hospital for higher level of care. Unknown if cardiac effects are related to vaccination or acute disease process.


VAERS ID: 1392135 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: The vaccine was mixed with a multi-dose vial of diluent. The diluent vial was punctured twice and used to mix 2 vials of vaccine. The dose was administered IM and a 5/8 inch needle may have been used.


VAERS ID: 1392402 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

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

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

Write-up: The vaccine was mixed using a multi-dose vial of diluent. The diluent vial was punctured twice and used to mix two vials of vaccine. The injection was given IM but a 5/8 inch needle may have been used.


VAERS ID: 1392435 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect product formulation administered, Product use issue, Wrong device used
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: The vaccine was mixed using a multi-dose vial of diluent. The diluent vial was punctured twice and used to mix two vials of vaccine. The dose was given IM and a 5/8 inch needle may have been used.


VAERS ID: 1392467 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect product formulation 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: The vaccine was mixed using a multi-dose vial of diluent. The diluent was punctured twice and used to mix two vials of vaccine. The dose was given IM and a 5/8inch needle may have been used.


VAERS ID: 1392490 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeding disorder, Incorrect product formulation administered, Wrong device used
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: The vaccine was mixed using a multi-dose vial of diluent. The diluent was punctured twice and used to mix two vials of vaccine. The vaccine was given IM and may have been given with a 5/8inch needle.


VAERS ID: 1392522 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-16
Onset:2021-06-03
   Days after vaccination:138
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Headache, Pain, Pyrexia, Respiratory tract congestion, 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I was not taking Lexapro at the time of vaccination but I now take 5mg daily. I have Kyleena IUD.
Current Illness: No
Preexisting Conditions: HPV
Allergies: No
Diagnostic Lab Data: I got two covid tests .
CDC Split Type:

Write-up: I contracted COVID-19 and started having symptoms on June 3rd. I have a fever, no smell and taste, congestion, headache, body aches.


VAERS ID: 1392601 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-05
Onset:2021-06-03
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARS-COV-2 RAPID 03-jun-21
CDC Split Type:

Write-up: PETIENT TESTED POSITIVE FOR COVID 19 AFTER BEING FULLY VACCINATED


VAERS ID: 1392828 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Extra dose 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Third Pfizer vaccination was given in error.


VAERS ID: 1392834 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Erythema, Peripheral swelling, Rash, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ambilify, prozac, lisinopril, protonix, zofran, topamax, primadone
Current Illness:
Preexisting Conditions:
Allergies: sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: arm swollen, red, vomiting, diarrhea, rash


VAERS ID: 1393230 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-01
Onset:2021-06-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / IM

Administered by: Pharmacy       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: Vitamin d, vitamin c
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shingles


VAERS ID: 1393231 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-28
Onset:2021-06-03
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial flutter, Blood test, Cardiac ablation, Chills, Electrocardiogram, Heart rate increased, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Baclofen, Testosterone, rosuvastatin, multivitamin, turmeric
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Cardiac ablation performed May 24, 2021 to address atrial flutter EKGs blood work rapid heart rate (166 beats per minute) vs. normal rate of 55 beats per minute
CDC Split Type:

Write-up: Severe immune system response. High fever, chills, aches. Set off atrial flutter and was admitted to emergency room/hospital for cardiac ablation


VAERS ID: 1394022 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-06-03
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210612064

Write-up: VACCINE ADMINISTERED 6 HOURS POST PUNCTURING; This spontaneous report received from a pharmacist concerned multiple patients. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1820095, and expiry: 04-JUL-2021) dose was not reported, administered on 03-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-JUN-2021, the subject experienced vaccine administered 6 hours post puncturing. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of vaccine administered 6 hours post puncturing was not reported. This report was non-serious.


VAERS ID: 1394348 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-17
Onset:2021-06-03
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone normal, C-reactive protein increased, Cardiomegaly, Chest discomfort, Chest pain, Computerised tomogram thorax abnormal, Echocardiogram abnormal, Ejection fraction normal, Electrocardiogram abnormal, Fibrin D dimer, Full blood count, Haematocrit normal, Haemoglobin normal, Neck pain, Painful respiration, Pericardial effusion, Platelet count normal, Red blood cell sedimentation rate increased, Sinus tachycardia, Thyroxine normal, Troponin normal, White blood cell count increased
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma
Allergies: Sulfa, Amoxicillin
Diagnostic Lab Data: Medical Tests: 6/9/2021 Troponin ? normal; ESR ? 43(H); CRP 63.6 (H); d-dimer 930 (H); CBC ? WBC 12.2, Hgb 14.2, Hct 42.6, Plts 352; TSH and T4 normal 6/9/2021 EKG - sinus tachycardia 6/9/2021 Chest CT ? Impression: 1. No evidence of pulmonary embolus. 2. No acute infiltrate. 3. Minimal cardiomegaly with small pericardial effusion 6/10/2021 Cardiac Echo ? Impression: Normal global left ventricular size, wall thickness, systolic function with no obvious regional wall motion abnormalities. Left ventricular ejection fraction is estimated at 60 %. Normal diastolic function. No significant valvular abnormalities Small circumferential pericardial effusion.
CDC Split Type:

Write-up: Woke up with chest pains when breathing, overall tightness with sharp pain in the right pectoral as well as neck pain. Waited a week and then went to an urgent care for symptoms and they sent me to ED. After evaluation I was admitted for more testing and started on treatment. Discharged on 6/10 taking ibuprofen and colchicine with outpatient follow-up on 6/17/2021.


VAERS ID: 1394405 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

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

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


VAERS ID: 1394413 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

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

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


VAERS ID: 1394415 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

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

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


VAERS ID: 1394427 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

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

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


VAERS ID: 1394563 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-26
Onset:2021-06-03
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001A21A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Rheumatoid arthritis
SMQs:, Arthritis (narrow), Immune-mediated/autoimmune 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: Enbrel
Current Illness: Rheumatoid arthritis
Preexisting Conditions: Rheumatoid arthritis
Allergies: Bee sting
Diagnostic Lab Data:
CDC Split Type:

Write-up: A week after the 1st and about 10 days after the 2nd I had a terrible flare up of my rheumatoid arthritis i felt fine, other than pain in all my joints. Down on couch pain with pain pills I rarely take. Just thought to let you know. I am fine now. Thanks for doing what you do.


VAERS ID: 1394607 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: First Pfizer dose 05/05/2021
Other Medications:
Current Illness: Rash from first vaccine dose
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had a rash All over my body, minus the palms of my hands, bottoms of feet and face, from the first dose that I reported. It seemed like it was going away. I got my second shot and it resurfaced all over but worse on my back and bottom half of my legs.


VAERS ID: 1394683 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-01
Onset:2021-06-03
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

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

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

Write-up: Severe itching behind right and left knee and left arm. Swelling of the left ankle and left arm. Skin erythema left arm and left and right calves Time for 7 days


VAERS ID: 1394692 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-01
Onset:2021-06-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Neuropathy peripheral
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Peripheral neuropathy on right Indra finger and right elbow


VAERS ID: 1394790 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Extrasystoles, Initial insomnia, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Depression (excl suicide and self injury) (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? No
Previous Vaccinations:
Other Medications: Atenolol 100mh, Lisinopril 40mg, Amlodipine 10mg, Bupropion HCL XL 150mg, Potassium Citrate 99mg
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: None
Diagnostic Lab Data: I did not seek medical attention as this occurred over a holiday weekend and would have been prohibitively expensive for me. Under normal circumstances I would have visited my PCP. I have nearly recovered, although the jarring sensation of missed heartbeats still causes me difficulty in getting to sleep.
CDC Split Type:

Write-up: For four days I had frighteningly strong heart palpitations, racing/pounding heart, shortness of breath while doing normal activities, and a sensation of missed heartbeats/difficulty breathing while falling asleep. This was not a psychological response; I had only a minimal reaction to the first shot, and no fear nor concerns with taking the second shot.


VAERS ID: 1394863 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-05-22
Onset:2021-06-03
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Electrocardiogram, Magnetic resonance imaging, Nausea, Vertigo positional, 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Singulair
Current Illness: None
Preexisting Conditions: None
Allergies: Raw carrots, raw celery, seasonal allergies
Diagnostic Lab Data: Blood test, EKG, MRI.
CDC Split Type:

Write-up: Benign paroxysmal vertigo. Nausea with vomiting.


VAERS ID: 1394950 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-08
Onset:2021-06-03
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood test, Cerebral venous thrombosis, Computerised tomogram head abnormal, Headache, Intensive care, Nausea, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: norethindrone-ethinyl estradiol 1-20 MG-MCG per tablet
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: CT scan on June 9 and June 9 Numerous blood tests June 8, 9, 10, and 11
CDC Split Type:

Write-up: On Tuesday, June 8 I was diagnosed through a CT scan with Cerebral Venous Thrombosis. I was sent to the ICU where I stayed for 3 days and luckily never had a stroke. I am now on blood thinners and seem to be recovering fully. i was initially thinking this was oral contraceptive related, but having been on the pill for 6 years with no adverse results, wonder if the Moderna vaccine or a combination of the vaccine and the oral contraceptive, caused it. I would like my info to help outcomes for others as this was one of the most frightening weeks of my life. I had headaches, 1 incident of vomiting , nausea and vertigo before heading to urgent care, where I was diagnosed.


VAERS ID: 1395054 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-12
Onset:2021-06-03
   Days after vaccination:83
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Biopsy, Intermenstrual bleeding, Menopause, Ultrasound abdomen, Ultrasound scan
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Valacyclovir, Gabapentin, Progestrone, Metformin, Black Cohosh, Turmeric, Magnesium, Folic Acid, D3, K2, Lutein & Zeaxanthin
Current Illness: None
Preexisting Conditions: I have been in menopause for over two years and on June 3rd I started to spot bleed & have been spotting ever since. I have had an ultrasound and a biopsy to make sure there wasn''t an underlining issue.
Allergies: None
Diagnostic Lab Data: I had an ultrasound on June 4th and a biopsy on June 9th
CDC Split Type:

Write-up: In menopause for over two years and I started spotting June 3rd and have been spotting ever since.


VAERS ID: 1395070 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-28
Onset:2021-06-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2135 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood immunoglobulin G increased, Blood immunoglobulin M increased, Burning sensation, Discomfort, Dry eye, Dry mouth, Eyelid margin crusting, Glossitis, Sjogren's syndrome, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Corneal disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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: Xeljenz, 111 mg time release
Current Illness:
Preexisting Conditions: Rheumatoid Arthritis
Allergies:
Diagnostic Lab Data: SALIVARY PROTEIN 1 (SP 1) IGG ANTIBODIES* 30.7 High SALIVARY PROTEIN 1 (SP 1) IGM ANTIBODIES* 61.5 High
CDC Split Type:

Write-up: Reaction after Dose 2: Extreme dryness did not star until about 5 day after the 2nd shot. My tongues swelled to level of extreme discomfort. Over the next week the dryness, burins continues to get worse and worse. Reaction After Dose 1: Extreme dry mouth, eye, crusty eyes, burning sensation in my mouth, swollen and inflamed tongue. An extreme Sojren''s flare that was confirmed by positive antibodies result for m"Early Sojren''s antibodies. I had never had those symptoms before the vaccine. The dry mouth happened with an hour of receiving the first shot. One week later it exploded.


VAERS ID: 1395091 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-15
Onset:2021-06-03
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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:
Current Illness:
Preexisting Conditions:
Allergies: Ibuprofen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt reported experiencing tingling on left side of face, arm, fingers leg and toes. Tingling progressed to numbness on the fingers.


VAERS ID: 1395223 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Migraine, Pyrexia, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Covid test 6/3/2021 - negative. Mandatory for work.
CDC Split Type:

Write-up: On June 2, 2021 i received my second dose of Pfizer. The next day experienced a migraine. It went away with Tylenol. After that I kept experiencing migraines. On 6/13/2021 I began experiencing chills, fever of 102, and the migraine. Is this normal? It?s about to be two weeks.


VAERS ID: 1395247 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Dizziness, Erythema, Hypoaesthesia, Hypoglycaemia, Immediate post-injection reaction, Intermenstrual bleeding, Skin exfoliation, Urticaria
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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:
Other Medications:
Current Illness: Long-Covid
Preexisting Conditions: Long-covid
Allergies: Avelox
Diagnostic Lab Data:
CDC Split Type:

Write-up: 06/02/2021- Immediately (under 5 minutes) - Mottled skin on both legs, upper and lower (last 45 minutes), Extremely dizzy and lightheaded. Face went dumb 4 hours after vaccine, both legs turned bright pink like sunburn 10 hours after vaccine. 06/03/2021 - Broke out in hives on inside of arms. Lasted 3 days and no longer there 06/08/2021 - Metrorrhagia (my period was not due for 10 more days, I am always exactly regular for my whole life) 06/08/2021 - Hypoglycemia (Multiple episodes since vaccination, Bloodwork showed one episode of 56 mg/dL) No history of diabetes. Hypoglycemic episodes still happening as of 06/13/2021 when blood sugar was 72.


VAERS ID: 1395261 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Anxiety, Blood pressure decreased, Dizziness, Fear, Hyperhidrosis, Malaise, Pain in extremity, Paraesthesia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Attenolol, Atorvastatin, Amlodipine
Current Illness:
Preexisting Conditions: high blood pressure
Allergies: Codeine
Diagnostic Lab Data: Once I got to the hospital I was starting to feel better. The paramedic retook my blood pressure and it was normal. I then decided to go home and left the hospital before being admitted. I recently lost my job and I didn''t have any medical insurance and I am really hoping I don''t get billed for the ambulance ride. I am afraid to get the second shot because I am afraid what happened to me might happen again. I had terrible anxiety for days after the shot and my arm was in alot of pain.
CDC Split Type:

Write-up: I received the shot and 5 minutes later I wasn''t feeling well - lightheaded, tingly hands almost immediately and after that I broke out in a sweat. 10 minutes after that my stomach started to hurt and I threw up a few times. 20 or so minutes after the shot my blood pressure dropped to 65/40 and the people administering the shot made the decision to call an ambulance and I was taken to the hospital.


VAERS ID: 1395316 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Chills, Fatigue, Hot flush, Injection site rash, Pain, Pyrexia, Seizure, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (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), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bupropion, Spironolactone, Sprintec, Omeperzole, women''s multivitamin loo
Current Illness: Migraines
Preexisting Conditions: PCOS, Functional Neurological Disorder, Depression
Allergies: Midol, Pamprin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hot Flashes, chills, increase in non-epileptic Seizures, fever 103.7, body aches, rash around injection site, extreme exhaustion, vomiting, chest pain. Symptoms lasted 3 days with exception of rash, fever and chills which lasted 8days.


VAERS ID: 1395587 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-15
Onset:2021-06-03
   Days after vaccination:49
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003B21A / 1 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 2 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen, Oxybutynin, Hydrochlorothiazide, rosuvastatin, Losartan, Meloxicam, Cyclobenzaprine, Metronidazole, Bactroban nasal spray, Vitamin D, Vitamin C, Fish oil, Aspirin,
Current Illness: none
Preexisting Conditions: Muscle spasm, overactive bladder, obesity, Osteoarthiritis, migraine, hypertension, hyperlipidemia, foot neuroma, recu
Allergies: Lipitor(myalgias),Erythromycin(vomiting),Penicillin(anaphyltc)
Diagnostic Lab Data: none
CDC Split Type:

Write-up: First Moderna dose given 3/188/2021 and second dose given 4/15/2021 Positive COVID test on 6/3/2021. symptoms began on 5/28/2021 of cough, body aches, headaches and sore throat. Had known exposure. Was treated with monoclonal Aby therapy.


VAERS ID: 1395591 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-11
Onset:2021-06-03
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN N/A / N/A AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Dehydration, Dyspnoea, Glomerular filtration rate normal, Hyperhidrosis, Laboratory test, Supraventricular tachycardia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Supraventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (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: Prescriptions: Atorvastatin [Lipitor], Celecoxib [Celebrex], Cyclobenzaprine [Flexeril], Duloxetine HCl [Cymbalta], & Gabapentin [Neurontin]; Over-the Counter: Cetirizine HCl [Zyrtec], Diphenhydramine HCl [Benadryl], Fish Oil, Fluticasone
Current Illness: None
Preexisting Conditions: High cholesterol, high blood pressure, bone spurs & arthritis in cervical spine, multilevel degenerative disk disease in lumbar spine.
Allergies: Occasional mild itching when taking opioids.
Diagnostic Lab Data: All tests on 6/3/2021. Hemolysis Index 34, EGFR 50.8.
CDC Split Type:

Write-up: Heart rate 186, shortness of breath, profuse sweating. Successfully treated with IV adenosine [ADENOCARD]. Diagnosed as SVT (supra ventricular tachycardia), AKI (acute kidney injury), and dehydration.


VAERS ID: 1395792 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-30
Onset:2021-06-03
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Angiogram, Computerised tomogram, Computerised tomogram abdomen, Computerised tomogram pelvis, Deep vein thrombosis, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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: Anastrazole 1mg po Daily (2019) Ascorbic Acid 100mg po Daily ASA 81mg Calcium 500mg Celecoxib 200mg po BID Cholecalciferol 5,000units po Daily Cyanocobalamin 1000mcg po daily Magnesium 400mg po Daily Oxycodone-acetaminophen 5-325 Q6HPRN Ve
Current Illness:
Preexisting Conditions: Chronic Venous Insufficiency Hx Breast Cancer Hx DVT while on hormones
Allergies: No Known Drug Allergies
Diagnostic Lab Data: 06/03 Ultrasound duplex Venous right leg = acute DT of distal vein of RLE 06/09 CTA Pulm arteries and CT abdomen/pelvis with contrast - Negative for aortic aneurysm, aortic dissection or acute pulmonary embolus.
CDC Split Type:

Write-up: New/Acute DVT in right calf


VAERS ID: 1395988 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-01
Onset:2021-06-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Discomfort, Headache, Hypersomnia, Myocarditis
SMQs:, Anaphylactic reaction (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), 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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Peanuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: He had the second shot, had very mild headache, and then woke up approx 48 hours after 2nd dose, complaining that his " chest hurt", I asked him to explain the " hurt", he said his chest felt tight, heavy pressure, like weight on his chest, uncomfortable. He said it went away after a few days... I didn''t realize the inflammation of the heart was a side affect, until I recently heard that was coming up, so I put 2 and 2 together, and thought I had better report.


VAERS ID: 1396373 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-11
Onset:2021-06-03
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Audiogram, Deafness bilateral
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? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: bumex, coreg, Aldactone, vitamin d
Current Illness: no
Preexisting Conditions: HTN, pacemaker, urinary implant device for incontinence
Allergies: flecainaide
Diagnostic Lab Data: Audiogram 6/10/2021
CDC Split Type:

Write-up: woke up on June 3rd and could not hear. lost complete hearing in one ear. the other ear is profound hearing lost.


VAERS ID: 1396387 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046A21A / 1 RA / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cetirizine 10mg Fluticasone Hydrocortisone topical cream
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient was given Moderna vaccine #1 that has not yet been approved for patients age 16. No treatment necessary. No adverse effects noted at this time.


VAERS ID: 1396445 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-24
Onset:2021-06-03
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, Cough, Headache, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: iron supplement, sertraline, zertec, vitamin d
Current Illness:
Preexisting Conditions:
Allergies: kiwi, squash, sweet potato, grass, oak, ragweed, mold
Diagnostic Lab Data: covid test (june 8th) -negative
CDC Split Type:

Write-up: headache, sore throat, cough, loss of taste and smell, congestion


VAERS ID: 1396452 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Feeling abnormal, Oedema, Rash, Tachycardia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: PATIENT REPORTED WITHIN 24 HOURS POST VACCINE HE EXPERIENCED FULL BODY RASH, EDEMA, TACHYCARDIA, AND SHORTNESS OF BREATH. HE SAUGHT EVALUATION FROM THE ED AND WAS THEN DISCHARGED WITH RX FOR TYLENOL. PATIENT STATED STILL FEELING OFF ON 6/14/21 AND I ADVISED HIM TO GO BACK TO THE DOCTOR.


VAERS ID: 1396590 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-05
Onset:2021-06-03
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARS-COV-2 RAPID 03-JUN-21
CDC Split Type:

Write-up: PT TESTED POSITIVE FOR COVI-19 AFTER BIENG FULLY VACCINATED.


VAERS ID: 1396716 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (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: None.
CDC Split Type:

Write-up: Patient received vaccine dose #1. 15 minutes later she fainted. She passed out for no more than 2-4 minutes with no injuries. When she awoke, it took her about 1-2 minutes to become fully coherent. There were no other adverse reactions or side effects. EMT was called and upon arriving asked her some basic questions. Turns out she had not eaten all day so they determined the fainting was for this reason and had nothing to do with the vaccine.


VAERS ID: 1396782 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Axillary pain, Chills, Fatigue, Headache, Injection site pain, Lymphadenopathy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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: first dose of Covid vaccine
Other Medications: Same as when I received the first dose
Current Illness: N/A
Preexisting Conditions: HTN
Allergies: PPD
Diagnostic Lab Data:
CDC Split Type:

Write-up: arm pain on the injection site and arm pit. enlarge lymph node, headache, fatigue, low grade fever, chill. These took about 10 days I took Tylenol and sleep a lot


VAERS ID: 1397488 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-05
Onset:2021-06-03
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Herpes zoster, Joint swelling, Limb discomfort, Muscle spasms, Pain in extremity, Peripheral swelling, Pyrexia, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: influenza skin rash and or hives--brand and date unknown
Other Medications: zyrtec 5 mg daily lipitor 20 mg daily norvasc 10 mg daily lisinopril 20 mg calcium carbonate-D3--1500 mg/400 unit
Current Illness: none
Preexisting Conditions: severe obesity BMI 42
Allergies: PCN--rash and or hives influenza vaccination--rash and or hives bee venom
Diagnostic Lab Data: none.
CDC Split Type:

Write-up: Patient reports high fever to 101, left arm hurt and swelled and had a "giant hive size of hand print" and muscle cramps and biceps turned hard, wrist swelled to where fit bit had to be removed. Then prodrome of shingles started 6/10 and she broke out in the vesicular shingles rash 6/11. right superior anterior chest.


VAERS ID: 1397917 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-05-03
Onset:2021-06-03
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Ultrasound Doppler abnormal
SMQs:, 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? No
Previous Vaccinations:
Other Medications: losartan, latanoprost, citalopram
Current Illness: Stage 3 Chronic Kidney Disease, Depression, Hypertension, Dyslipidemia, Impaired Glucose Tolerance, Glaucoma
Preexisting Conditions: As above
Allergies: NKDA
Diagnostic Lab Data: Venous Doppler, left leg
CDC Split Type:

Write-up: Deep Vein Thrombosis, left leg


VAERS ID: 1398503 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-01-01
Onset:2021-06-03
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Pneumonia
SMQs:, 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Pneumonia (7 months after receiving Moderna vaccine)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Diagnosed with Pneumonia after receiving both the doses of Moderna vaccine 3 months ago; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of PNEUMONIA (Diagnosed with Pneumonia after receiving both the doses of Moderna vaccine 3 months ago) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Pneumonia (7 months after receiving Moderna vaccine). In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In February 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 03-Jun-2021, the patient experienced PNEUMONIA (Diagnosed with Pneumonia after receiving both the doses of Moderna vaccine 3 months ago) (seriousness criterion medically significant). At the time of the report, PNEUMONIA (Diagnosed with Pneumonia after receiving both the doses of Moderna vaccine 3 months ago) outcome was unknown. No concomitant products were reported. No treatment information was provided. Very limited information regarding the events has been provided at this time. Case without patient identifiers and contact information.; Sender''s Comments: Very limited information regarding the events has been provided at this time. Case without patient identifiers and contact information.


VAERS ID: 1398585 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure increased, Blood pressure measurement, Body temperature, Chills, Cold sweat, Flushing, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (had severe case); Hypertension; Migraine; Tubal ligation
Allergies:
Diagnostic Lab Data: Test Name: BP; Result Unstructured Data: Test Result:205/125; Test Date: 20210603; Test Name: Body temperature; Result Unstructured Data: Test Result:101 Fahrenheit
CDC Split Type: USPFIZER INC2021684273

Write-up: spike on her blood pressure for the past 2 days reaching a maximum of 205/125; fever later on the evening and the whole next day reaching 100.1F; body aches; chills; wakes up in the evening with a cold sweat; face was flushing bright red and goes away after a while; This is a spontaneous report from a contactable consumer (patient). A 45-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for Injection, Lot number: EW0182, Expiration date: Unknown), via an unspecified route on 02Jun2021 as a single dose for covid-19 immunization. Medical history included hypertension for which she has taken intracranial hypertension medication Diamox, 250mg, twice a day for over a year now to lower her blood pressure, tubal ligation in 2015 and since then she is on a low dose birth control because she was suffering from migraines in the past and was getting shots and then was taken off of that and put on hormonal continuous treatment. She now has no periods and doesn''t suffer from migraines. Also, she has COVID back in Mar2021 and had a severe case. The patient concomitant medications were not reported. On 02Jun2021, patient experienced a fever later on the evening and the whole next day reaching 100.1F (03Jun2021), she complained about body aches and for the next 2 days up until today she experienced chills and wakes up in the evening with a cold sweat ("clothing are wet because of the sweat") and the chills are also experienced during daytime (ongoing), her face was flushing bright red and goes away after a while. She knows for a fact that this is not hormonal because she is on a low dose birth control pill since she had a tubal ligation in 2015. So, she knows it is not pre- menstrual. She has had a spike in her blood pressure within the last 2 days with the highest reached being 205/125 (ongoing). She said her main concern was with the hypertension and she figured that all of her other side effects were normal, but it made her nervous with her hypertension and how her blood pressure shot up so high because her medication keep her blood pressure normal and it has never gone above normal on this medication other than two days ago when she had the spike and it has been high since then. She has been trying to keep it down and her diastolic keeps going above 90 and her doctor wants her below that. She has been trying to get in touch with the neurologist who prescribed her that medication and he is usually very busy. She has been on her medication for intracranial hypertension for over a year now and confirmed that she wasn''t started on it due to the side effects from the COVID vaccine. The patient underwent lab test and procedure which included body temperature reading of 100.1F on 03Jun2021 and blood pressure measurement of 205/125. Patient wanted to know if the adverse events that she experienced are included in the most commonly reported AEs after getting the Pfizer BioNTech Covid-19 Vaccine shot, how long the adverse events usually last after getting the first dose and if the side effects that she experienced after getting the first shot would be a contraindication in getting the 2nd dose of the vaccine. The clinical outcome of the event her blood pressure keeps going up down to today, she does not have a fever anymore, but she is still getting chills and she feels like she gets flushing in her cheeks throughout the nighttime but she is still going on with no fever. One night she may wake up with sweats and another night she wont, and outcome of body ache was unknown. Follow-up (10Jun2021): New information received from a same contactable 45-year-old female consumer (patient) included: events information updated, date for had ran a fever of 101 degrees updated, lot number updated, treatment taken as a result of events updated, medical history added, and clinical outcome of the events updated. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1398654 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-04-08
Onset:2021-06-03
   Days after vaccination:56
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Surgery
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: USMODERNATX, INC.MOD20212

Write-up: had an operation; got the first dose on 08Apr2021 and then got the second dose on 03Jun2021; This spontaneous case was reported by a consumer and describes the occurrence of SURGERY (had an operation) in a 40-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 040A21A and 048B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 08-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Jun-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (got the first dose on 08Apr2021 and then got the second dose on 03Jun2021). On an unknown date, the patient experienced SURGERY (had an operation) (seriousness criterion medically significant). At the time of the report, SURGERY (had an operation) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (got the first dose on 08Apr2021 and then got the second dose on 03Jun2021) outcome was unknown. No concomitant medication information provided. Patient got the first dose on 08Apr2021. Patient missed the appointment for second dose due to an operation he had and he got it on 3jun2021. Limited information regarding the events has been provided at this time and is insufficient for causality assessment. Further information has been requested.; Sender''s Comments: Limited information regarding the events has been provided at this time and is insufficient for causality assessment. Further information has been requested.


VAERS ID: 1398759 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Insomnia, Lethargy, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Body Aches Generalized-Mild, Systemic: Exhaustion / Lethargy-Mild, Systemic: Tingling (specify: facial area, extemities)-Medium, Systemic: Unable to Sleep-Mild


VAERS ID: 1398804 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002621A / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site rash, Pain in extremity, Pharyngeal swelling, Pruritus, Rash macular
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: zoloft 150mg hydrocodine 10 3 25 mg ropinirole 1mg
Current Illness:
Preexisting Conditions: asthma
Allergies: cherries naproxen ibprofen welbutrin chantix penicillin bactrum
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1 hour after vax pain in left arm started along with inching and "dots" broke out around injection site all the way to the elbow, hand feels like its asleep all the time, throat feels swollen


VAERS ID: 1399206 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-29
Onset:2021-06-03
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Joint stiffness
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: Taking vitamin D daily and had received a cortisone shot within one week of vaccination.
Current Illness: Wrist injury
Preexisting Conditions: N/A
Allergies: Penicillin
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Joint stiffness in fingers in both hands, particularly in the morning. Periodically applying Voltaren, which helps alleviate stiffness during the day.


VAERS ID: 1399414 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Given too soon, 21 days after the first dose.


VAERS ID: 1399432 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-30
Onset:2021-06-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH #EW0216 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Balance disorder, Disturbance in attention, Dizziness, Ear discomfort, Feeling abnormal, Hospitalisation, Hypoaesthesia, Impaired work ability, Loss of personal independence in daily activities, Paraesthesia, Vital signs measurement
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: hospital. cheched vitals, for blood clots was sent home
CDC Split Type:

Write-up: Extreme diziness, left arm numb and tingly, bad brain fog, dizziness has not stopped since 4 days after vaccine, every day. Cannot complete simple tasks at work as fast, hard to concentrate, pressure in ears, balance feels off. Hard to manage day to day routine with my kids, dizzy all the time, This is affecting my work, my lifestyle and every day concentration


VAERS ID: 1399466 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Blood test abnormal, Chills, Diarrhoea, Fibrin D dimer increased, Nausea, Pyrexia, Tinnitus, Vision blurred
SMQs:, Acute pancreatitis (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: prozac, lamictal, prozac, remeron, estrogen, progesterone
Current Illness: Rabies vaccination, c diff
Preexisting Conditions: c diff
Allergies: compozene, codeine
Diagnostic Lab Data: dimer-d plavix
CDC Split Type:

Write-up: fever, chills, nausea, severe diarrhea, blood work high dimer-d, vision blurs/lines, hearing ringing, loss of taste


VAERS ID: 1399851 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-16
Onset:2021-06-03
   Days after vaccination:48
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Facial paralysis, Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 10mg Zyrtec as needed
Current Illness: Positive ANA testing (antinuclear antibody test)
Preexisting Conditions: allergic urticaria/pruritus, anxiety
Allergies: penicillins
Diagnostic Lab Data: No testing post- diagnosis. Will have rechecks with doctors and may start testing if no improvment in next couple of weeks.
CDC Split Type:

Write-up: Bell''s Palsy; acute left sided facial nerve paralysis diagnosed officially on 6/6/21. Clinical signs started 6/3/21 with progressive facial paralysis and facial twitching. Started steroids and antiviral on 6/6/21. Disease is currently present with no resolution yet, no improvement yet (6/1521 at the time of submitting this report). First moderna vaccine, left arm 3/19/21. Second moderna vaccine, left arm 4/16/21.


VAERS ID: 1399860 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Axillary mass, Axillary pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (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: Candesartan, Spironolactone, Rosuvastatin, Hydrochlorothiazide, vitamin C, Vitamin D, Garlic
Current Illness: None
Preexisting Conditions: Congestive heart failure, high blood pressure
Allergies: Allegies to gluten, certain trees
Diagnostic Lab Data: To date I haven''t received any tests. I''m scheduling a mammogram to make sure everything is okay.
CDC Split Type:

Write-up: My underarm area and area near my breast became very sore (It hurt to put my arm down) and it appeared swollen and felt lumpy. The lumps seem to have disappeared and it''s no longer sore or swollen.


VAERS ID: 1400000 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 2 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019B21A / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Dizziness, Fatigue, Headache, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Havent went for treatment yet. Syptoms just started coming along after 2nd shot. Was otherwise pretty healthy till then.
CDC Split Type:

Write-up: Massive headaches, sore muscles, fatigue, nausea, Occasionally dizzy spells.


VAERS ID: 1400019 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-06-01
Onset:2021-06-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Asthenia, Back pain, Fatigue, Headache, Illness, Injection site pain, Injection site warmth, Musculoskeletal stiffness, Nausea, Oropharyngeal pain, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), 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)

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: Mult-vitamin, B6, B12, potassium, Ocuvite, VisiClear, Zytrec
Current Illness: Allegeries were quite bad
Preexisting Conditions: overweight
Allergies: slightly citric acid, sulfur drugs
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Day 1- 3 tired, slight pain at injection site, fever at injection site, pain & fever at some location as injection on right arm, some body ache on second as though slept in a too small bed or hunched in a chair, slight fever end of second day - lots of water 96 ozs or more, rest, food Day 4 still tired, legs and feet were stiff slight pain in back, fever a little worse, headache, slight sore throat, food went through we as soon as consumed - 2 Tyenol , 128 ozs or more of water Day 5 - 7 a little tired legs below knee a still stiff 2 Tylenols 128 oz of water Day 8 felt better Day 9 very sick in the morning around 9 am fever, weakness, nausea, headache, tired , food, Pedialyte, rested Tylenol Day 10 - 11 very tired slightly fever headache Pedialyte lots of water


VAERS ID: 1400178 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Differential white blood cell count, Dysphagia, Dyspnoea, Full blood count, Metabolic function test, Prothrombin time, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: ACCU-CHEK AVIVA PLUS strip TEST BLOOD SUGAR TWICE DAILY OR AS DIRECTED BY PROVIDER aspirin 81 MG tablet 1 QD atenolol (TENORMIN) 50 MG tablet Take 1 tablet by mouth daily. atorvastatin (LIPITOR) 40 MG tablet Take 1 tablet by mouth daily.
Current Illness: Diabetes Mellitus type 2
Preexisting Conditions: DM2
Allergies: Septra Sulfa
Diagnostic Lab Data: TELEMON BY PHILIPS Routine 06/03/2021 2:00 PM XR CHEST 1V PORTABLE ASAP 06/03/2021 1:30 PM CBC WITH AUTO DIFFERENTIAL, LAB GENERATED ORDER STAT 06/03/2021 1:17 PM PROTHROMBIN TIME Routine 06/03/2021 1:17 PM COMPREHENSIVE METABOLIC PANEL STAT 06/03/2021 1:17 PM SARS-COV-2 PCR (SIMPLEXA) Routine 06/03/2021 1:09 PM COVID-19 PCR
CDC Split Type:

Write-up: Patient was observed for 30 minutes post vaccination. It was determined he was at baseline and no reaction was occuring. The following day the patient contacted our on-call nurse advice service stating shortness of breath and difficulty swallowing. He was advised to go to the ED. Patient was treated in the ED. He remained under observation for 8 hours before they determined patient was back to baseline and okay to discharge home.


VAERS ID: 1400249 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 RA / IM

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

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

Write-up: Patient was given his 2nd Pfizer COVID-19 vaccine dose one day early.


VAERS ID: 1400874 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Intensive care, Ruptured cerebral aneurysm, Surgery
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: olmsrtn-amlepn hctz 40 -5-25 mg clonieine hcl 0.1 mg
Current Illness:
Preexisting Conditions: High blood pressure
Allergies:
Diagnostic Lab Data: Surgery and in ICU for 12 days
CDC Split Type:

Write-up: 1 Ruptured brain aneurysm


VAERS ID: 1401660 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-03
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205AZ1A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test
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: Test Date: 20210608; Test Name: COVID-19 virus test; Result Unstructured Data: positive
CDC Split Type: USJNJFOC20210617233

Write-up: CONFIRMED COVID-19 INFECTION; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205AZ1A, expiry: UNKNOWN) .5 ml, administered on 14-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-JUN-2021, the subject experienced confirmed covid-19 infection. On 08-JUN-2021, Laboratory data included: COVID-19 virus test (NR: not provided) positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from confirmed covid-19 infection. This report was non-serious. This report was associated with product quality complaint: 90000182110. The suspected product quality complaint has been confirmed to be the suspected product quality complaint has been confirmed to be voided (did not meet pqc criteria) based on the pqc evaluation/investigation performed. based on the PQC evaluation/investigation performed.


VAERS ID: 1402036 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-27
Onset:2021-06-03
   Days after vaccination:68
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bronchitis, Cough, Nasal congestion, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol sulfate (PROAIR RESPICLICK) 90 mcg/actuation aerosol powdr breath activated allopurinoL (ZYLOPRIM) 100 mg tablet aspirin (ASPIRIN LOW DOSE) 81 mg tablet esomeprazole (NexIUM) 40 mg capsule(Expired) famotidine (PEPCID) 20 mg tablet
Current Illness: None
Preexisting Conditions: Nervous Cervical radiculopathy, chronic Neuropathy Exertional chest pain Respiratory Asthma, intermittent Chronic cough Pulmonary nodule Digestive Irritable bowel syndrome Musculoskeletal Generalized osteoarthritis of multiple sites DDD (degenerative disc disease), cervical Endocrine/Metabolic Gout Other Cervical stenosis of spine Pre-procedural cardiovascular examination
Allergies: No Known Allergies
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: Acute bronchitis cough Nasal Congestion - predniSONE (DELTASONE) 20 mg tablet; Take 2 tablets (40 mg total) by mouth daily for 5 days - azithromycin (ZITHROMAX) 250 mg tablet; Take 2 tabs (500 mg) by mouth today, than 1 daily for 4 days. - amoxicillin-pot clavulanate (AUGMENTIN) 875-125 mg per tablet; Take 1 tablet by mouth 2 (two) times a day for 10 days


VAERS ID: 1402424 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-06
Onset:2021-06-03
   Days after vaccination:58
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure increased, Brain stem stroke, Cerebrovascular accident, Computerised tomogram head abnormal, Dysphagia, Feeding disorder, Gastrostomy, Headache, Hemiparesis, Illness, Intensive care, Magnetic resonance imaging head abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)

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, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hbp medicine Hbp been under control maintained Multi vitamin Type 2 diabetic Blood sugar was under control maintained
Current Illness: None
Preexisting Conditions: Hbp
Allergies: Penicillin
Diagnostic Lab Data: All test done in hospital . MRI CT scan etc
CDC Split Type:

Write-up: Patient had a stroke on June 4. Developed unusual headache evening of June 3. Went to see doctor on June 4 . Bp remained elevated even after taking bp medicine . Doctors office sent him to ER. First it was said he had a aneurysm in heart which was ruled out . Then it was advised to us he had a brain stem stroke . Patient still in icu. Still in hospital as of today .06/16/2021. Patient will be going to pt therapy snd of therapy . Has dysphagia unable to eat and left side weakness . Peg tube inserted . Want to establish if Johnson and Johnson vaccination was linked to him having stroke . Patient current illness was maintained and under control until this event happened suddenly .


VAERS ID: 1402611 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lisinopril 10mg ,rosuvastacin 20mg, ferroun sulfate 325mg, vitamin c 1000mg vit D 50 Turmeic
Current Illness:
Preexisting Conditions: hypertriton ,high clolestoral, GI bleeding
Allergies: ferrletic
Diagnostic Lab Data: no
CDC Split Type:

Write-up: Sharp in left shoulder following injection . Pain is on and off . some muscle pain,. some clavicle pain.


VAERS ID: 1402647 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / IM

Administered by: Other       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 Pfizer instead of Moderna for 2nd dose. Pt''s 1st dose of Moderna was administered through health department on 4/29/21 and 1st dose did not show in the patient''s chart. The error was discovered right after administration while completing documentation.


VAERS ID: 1402803 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Developed left lower leg pain the follow day after receiving his second COVID vaccine. Still persistent to date.


VAERS ID: 1402886 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Already received a dose of Janssen, should not have received a dose of Pfizer.


VAERS ID: 1403535 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-10
Onset:2021-06-03
   Days after vaccination:113
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004M20A / 2 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Anticoagulant therapy, COVID-19, Dyspnoea, Influenza A virus test, Influenza B virus test, Myocardial ischaemia, SARS-CoV-2 test positive, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Advair, melatonin, Protonix, Coumadin, Lipitor, Plavix, Lanoxin, Lasix, levothyroxine, lisinopril, metformin, Lopressor, Remeron, Nolvadex
Current Illness:
Preexisting Conditions: Anemia, A fib, COPD, CHF, dementia, diabetes mellitus, heart disease, hypertension, malignant neoplasm, oxygen dependent, thyroid disease
Allergies:
Diagnostic Lab Data: SARS-CoV-2 (COVID-19) and Influenza AB Antigens, POC: SARS CoV2 Positive (6/3/2021)
CDC Split Type:

Write-up: The patient is a 74-year-old female who presented to hospital with COVID-19 and exhibited shortness of breath. The patient has acute respiratory failure also and was treated with IV steroids. The patient improved throughout stay. She did have elevated troponins and was started on heparin drip, but this was deemed to be demand ischemia.


VAERS ID: 1403546 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-17
Onset:2021-06-03
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162/EW0169 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site pain, Mobility decreased
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: effexor xr 150 mg pantoprazole 40 mg diclofenac sodium 1% gel
Current Illness: broken wrist same arm just got cast off
Preexisting Conditions: n/a
Allergies: prednisone
Diagnostic Lab Data: chiropractor 6/14 chiropractor 6/16
CDC Split Type:

Write-up: center of left upper arm needle pain (shock feeling), numbness shooting down arm to fingers. loss of squeeze motion. these effects are intermittent. went to chiropractor for adjustment before i found out others were having similar problems.


VAERS ID: 1405292 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-03
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cold sweat, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Had to lie down possible faint; Cold sweat; This spontaneous case was reported by a consumer and describes the occurrence of SYNCOPE (Had to lie down possible faint) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-Jun-2021, the patient experienced SYNCOPE (Had to lie down possible faint) (seriousness criterion medically significant) and COLD SWEAT (Cold sweat). At the time of the report, SYNCOPE (Had to lie down possible faint) and COLD SWEAT (Cold sweat) outcome was unknown. Action taken with mRNA-1273 in response to the events was not applicable. Concomitant and treatment information were not provided. Company comment:Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Further information has been requested.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Further information has been requested.


VAERS ID: 1405330 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-28
Onset:2021-06-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Muscle twitching, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad)

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

Write-up: Tingling sensation around right knee, then it was developed to muscle twitching around the same area. It happened randomly. No treatment for this condition.


VAERS ID: 1405880 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-01
Onset:2021-06-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 RA / OT

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Bedridden, Bone pain, Chills, Decreased appetite, Dizziness, Dysstasia, Fatigue, Frequent bowel movements, Gait disturbance, Headache, Malaise, Myalgia, Nasal congestion, Nausea, Pollakiuria, Pyrexia, Restlessness, Swelling, Urine analysis, Vaccination site pain, Weight decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Akathisia (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), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Osteonecrosis (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LISINOPRIL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high; Gallbladder removal (Lab tests: gall stones that were in my gall bladder in 2014); Prostate examination abnormal (Verbatim: large prostate); Stone in gallbladder (gall stones that were in gall bladder in 2014)
Allergies:
Diagnostic Lab Data: Test Date: 20210601; Test Name: urine test; Result Unstructured Data: Test Result:Unknown
CDC Split Type: USPFIZER INC2021664399

Write-up: difficulty walking; headache; chills; aching of bones; tiredness and weakness; tiredness and weakness; loss of weight; loss of appetite; my joints got pain; it''s the pain at the injection site; Muscle pain; Fever; Nausea; Feeling unwell; Restless; congestion; dizzy; swollen; constantly using the bathroom, having bowel movements; peeing a lot; can''t stand up; I can''t get out of the bed; my legs are so weak; I can''t even stand now; This is a spontaneous report from a contactable consumer (patient). A 47-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot Number: EW0191), via intramuscular route of administration in right arm on 01Jun2021 at 01:00PM as single dose for covid-19 immunisation. The patients medical history included large prostate, gold stones in 2014, high blood pressure, operation on Gall Bladder (gall stones that were in gall bladder in 2014). Concomitant medication included lisinopril (20 mg, 1xday) for blood pressure measurement. Patient had the Pfizer covid vaccine on 01Jun2021. Patient went to get the Moderna but he got the Pfizer. Nurse told him that everybody was different, and it work in different kind of ways and she said that once he got the vaccination to fight the COVID, it just maintains that. On 03jan2021, Patient did not get out of the bed, he became dizzy, weak, his legs were so weak, lost massive weight (dropped to 145kg/2 pound) and the pain at the injection site, feeling tired, had a headache, got muscle pain, had the chills, joints got pain, bone aches. He had a fever, nausea, congestion, feeling unwell, swollen, was restless and pain to walk. He did not stand up. Took tylenol (spoonful, once a day, orally) for the headache and the fever. Had also been using the bathroom a lot. his most recent weight was 135 after he took the shot at 1:00pm on 01Jun2021. On 22Jun2021 to patient has get the second one but did not feel like taking it. Patient did not had any prior vaccinations within 4 weeks. The outcome of the event cannot stand was unknown and other event was not recovered. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1405898 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Headache, 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: PRADAXA
Current Illness: Dietary control
Preexisting Conditions: Medical History/Concurrent Conditions: Anesthesia; Anxiety; Arthritis (arthritis in both of her knees which is kind of hereditary); Arthritis; Cataract (right); Cataract operation; Death of sister; Fall; Family history of diabetes (diabetes runs in her family, several cousins, uncles, and aunts); Gastrointestinal disorder; Glaucoma; Illness; Physical therapy; Postoperative infection; Rheumatoid arthritis (dad had rheumatoid arthritis)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021665216

Write-up: headache; some soreness in her arm and it kind of went up to her shoulder; little bit of soreness in her arm; This is a spontaneous report from a contactable consumer (patient). A 79-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot Number: EW0153) via an unspecified route of administration, administered in left arm on 03Jun2021 13:00 (at the age of 79-years-old) as 1ST DOSE, SINGLE DOSE for covid-19 immunization. Medical history included her first cataract surgery on her right eye, and they found out she had glaucoma. She got a slight infection which is unusual after cataract surgery. She weighs around 188. She is trying to be healthier in general. She had so much going on in 2020, like everybody else. Her sister was really ill and she passed away She and her daughter were planning to fly in August and wanted to be fully vaccinated before they fly. She had been through this before as a child when she had the polio vaccine and there are people she knows got polio who are still affect by it as adults. She is also on blood thinners. She got good reports from her eye doctor. She had no eye pressure. A couple days later she saw her primary doctor and everything was good there. She sees her cardiologist on 17Jun2021. The main thing is she had been on blood thinners since Apr2017. She hopes she doesn''t have to be on them for the rest of her life, but it''s a possibility. She has to take that twice a day. She also takes a high blood pressure medicine and thyroid medication. She was told to tell the nurse to use a smaller needle. She has arthritis in both of her knees which is kind of hereditary. She had a fall after the campfire. They evacuated, and when they came back and fell in a store. She is getting physical therapy. The Pradaxa is quite expensive. She takes it twice a day. She keeps a log. This medication can''t have air reach it, so she can''t use a pill box with that. She keeps a journal and logs her medicines. She takes eye drops for her glaucoma. She takes a drop in both eyes before bedtime. It gives it a chance to rest and for the drops to absorb. She stated that diabetes runs in her family. On 20Mar2021 she had her first cataract surgery, so they gave her anesthesia for that. Glaucoma, cataract, arthritis, fall. Concomitant medication(s) included dabigatran etexilate mesilate (PRADAXA) taken for anticoagulant therapy from Apr2017 and ongoing, unspecified high blood pressure medication, thyroid medication and eye drops for glaucoma in both eyes before bedtime which would give a chance to rest and for the drops to absorb. Historical vaccination included polio vaccine. On 03Jun2021, It started that day she had the vaccine. Her vaccine was at 13:00. It was 104 that day so she stayed hydrated and drank a lot of water. She came home and had a little soreness. She was surprised she didn''t have any big noticeable difference. With her arm soreness she was surprised it hurt in her shoulder. If she touches the site she can feel that, but she was okay and was well. On 04Jun2021 she had a headache the next day, and she did take Tylenol. She tried to prolong taking the Tylenol because she heard not to take Tylenol before the vaccine or too soon afterwards to give the vaccine a chance to do its thing. She went ahead and took Tylenol and it worked. It kicked in, and her headache went away the same day. She heard from other people that is was a classic symptom. Her symptoms weren''t something she had to stay in bed for. She had a little anxiety before she had the vaccine. She read up as much as she could and decided on Pfizer because she had spoken with other people who had Pfizer. She will continue to wear a mask, she is really good at that. Outcome of the event headache was recovered on 04Jun2021. Outcome of other events it was recovering. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1405901 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-18
Onset:2021-06-03
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Infertility female, Menstruation delayed
SMQs:, Fertility 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021665683

Write-up: my period was due to start the same day, it is now June 3rd and I still have not started my period; vaccine has now cause a fertility problem; This is a spontaneous report from a contactable physician (patient). A non-pregnant female patient of an unspecified age received BNT162B2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot number and Expiration date was not reported), via an unspecified route of administration on 18May2021 as 1st dose, single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient received the covid 1st dose vaccine on 18May2021, her period was due to start the same day, it is now 03Jun2021 and still had not started her period. Nor she was pregnant. This vaccine had now caused a fertility problem. Her OB has advised against the second dose. The patient stated that for the company to say it does not cause infertility problems is a lie because there are hundreds of women going through this same exact issue. It does not involve a report of exposure during pregnancy. The outcome of the events was not recovered. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1406028 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-06-01
Onset:2021-06-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Nasopharyngitis, 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: Medical History/Concurrent Conditions: Allergy; Tonsillectomy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021677862

Write-up: He began to feel tired; Cold/acting like he had a cold; He started running a fever; This is a spontaneous report from a contactable consumer. A 12-years-old male patient received bnt162b2 ((PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EW0167, Expiration date was not reported), dose 1 via an unspecified route of administration, administered in Arm Right on 01Jun2021 13:00(Age at vaccination 12 years) as 1st dose, single dose for covid-19 immunisation. Medical history included tonsillectomy from 29Apr2021 to an unknown date, hypersensitivity. Patient family history included she and her husband had it (tonsillectomy, hypersensitivity) and it didn''t bother them other relatives had the Johnson and it didn''t bother them. The patient''s concomitant medications were not reported. The patient experienced he started running a fever that has subsequently lasted every night since on 03Jun2021(2 days later), he began to feel tired on 08Jun2021, cold/acting like he had a cold on 07Jun2021. Patient stated Patient Age at time of onset of reaction was 12 years. Patient took vaccine dose as time for kids to get it for protection from COVID-19, when he comes back in from playing, he is tired. He started to drink a lot of water and lie down on the floor. That day he was at school and they have not called so he is better. reporter is asking is this normal for him a run a fever for this long, He is due for the other shot the 23Jun2021 and should he get the shot if he is still running a fever she wanted confirm. Every night when he went to bed, he would run a temperature. Therapeutic measures were taken as a result of he started running a fever Tylenol was given to break his fever, reporter sometimes gives it twice, but it did work. The outcome of events was running a fever, cold/acting like he had a cold was not recovered and feel tired was recovering. Follow-up(09Jun2021): This is a follow-up spontaneous report from a contactable consumer. This consumer (patient''s mother) reported for a 12-year-old male patient (reporter''s son) included: Outcome of events updated, relevant medical and family history added. Dose number confirmation to 1st dose captured, Age at vaccination added.


VAERS ID: 1406120 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-22
Onset:2021-06-03
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac disorder, Dyspnoea, Fatigue, Feeling abnormal
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cholesterol high
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021691582

Write-up: Constant heart ach/discomfort for 5 days, fatigue, shortness of breath at night.; Constant heart ach/discomfort for 5 days, fatigue, shortness of breath at night.; Constant heart ach/discomfort for 5 days, fatigue, shortness of breath at night.; Constant heart ach/discomfort for 5 days, fatigue, shortness of breath at night; This is a spontaneous report from a contactable consumer. A 37-year-old male consumer (patient) reported for himself that a 37-years-old male patient received bnt162b2 (Pfizer-Biontech COVID-19 Vaccine, Batch/Lot Number: unspecified), (at the age of 37-years-old) via an unspecified route of administration on 22May2021 at 11 am on left arm as unknown, single dose for COVID-19 immunisation. The patient'' medical history included high cholesterol. She had no known allergies. The concomitant medications were not reported. No other vaccine and medications were received in respectively four weeks and two weeks. No vaccination prior to covid vaccination. Post vaccination covid tested not performed. The patient experienced heart ache or discomfort for 5 days, fatigue and shortness of breath at night on 03Jun2021. Events resulted in Emergency room visit. The outcome of the events was recovering. Information on the lot/batch number has been requested.


VAERS ID: 1406459 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 with a . Was not eligible for COVID vaccine since birthday later in year.


VAERS ID: 1406701 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: When assessed, patient did not notify hospital that he had previously received a dose of Pfizer COVID vaccine. Patient stated that he wanted the COVID vaccine. On June 3rd patient received a dose of Janssen COVID vaccine. No adverse reactions noted during hospital stay.


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