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From the 10/15/2021 release of VAERS data:

Found 800,916 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 221 out of 8,010

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VAERS ID: 1729265 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-05
Onset:2021-09-10
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / UNK - / -

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

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

Write-up: Patient presents to ED with COIVD symptoms and positive test. Treated with Regeneron antibodies. Fully vaccinated April 2021.


VAERS ID: 1729295 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-15
Onset:2021-09-10
   Days after vaccination:57
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816027 / 1 UN / UN

Administered by: Senior Living       Purchased by: ?
Symptoms: COVID-19, Encephalopathy, SARS-CoV-2 test positive
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Chronic kidney disease (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted for acute encephalopathy and COIVD positive. Vaccinated July 2021.


VAERS ID: 1729489 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin, Diclofenac Sodium external cream, Escitlopram Oxalate, Finasteride, Gabapentin, Propanolol, Reacrit
Current Illness:
Preexisting Conditions: Aortic Stenosis, Cirrhosis, CKD, Colon Polyps,DM2, Esopahgeal Varices, HTN, Hep C, Liver Neoplasm Malignant Adenocarcenoma, Opiod dependence, Osteorthritis,
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine 4 days past beyond use date 9/4/21 No adverse outcomes or symptoms reported by patient


VAERS ID: 1729497 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 - / IM

Administered by: Other       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: not current medications
Current Illness: no active problems
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine beyond use date of 9/4/21


VAERS ID: 1729500 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Other       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: Depoprovera, ibuprofen
Current Illness: none
Preexisting Conditions: none
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine beyond use date of 09/04/2021


VAERS ID: 1729501 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Other       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: not currently taking any medications
Current Illness: none reported
Preexisting Conditions: none reported
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine beyond use date of 09/04/2021


VAERS ID: 1729502 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Other       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: Amitriptyline HCL
Current Illness: Depression, Heache Syndrome, Secondary Insomnia
Preexisting Conditions: no chronic illnesses reported
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine beyond use date of 09/04/2021


VAERS ID: 1729505 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Other       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 active medications
Current Illness: none
Preexisting Conditions: no chronic illness reported
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine beyond use date of 09/04/2021


VAERS ID: 1730172 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821287 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, COVID-19, Paranasal sinus discomfort, SARS-CoV-2 test, Sinus congestion, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known allergies. The patient had no daily medications or medical conditions. The patient was not pregnant at the time of report.
Allergies:
Diagnostic Lab Data: Test Date: 20210911; Test Name: Body temperature; Result Unstructured Data: over 100.4 degrees Fahrenheit; Test Date: 20210911; Test Name: SARS-CoV-2 PCR test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210940995

Write-up: SINUS CONGESTION; CONFIRMED CLINICAL VACCINATION FAILURE; CONFIRMED COVID-19 INFECTION; SINUS PRESSURE; This spontaneous report received from a patient concerned a 52 year old white female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: The patient had no known allergies. The patient had no daily medications or medical conditions. The patient was not pregnant at the time of report. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration not reported, batch number: 1821287, and expiry: unknown) dose was not reported, 1 total administered on 21-JUN-2021 on left arm for prophylactic vaccination. No concomitant medications were reported. On 10-SEP-2021, patient developed some symptoms, in the evening patient experienced scratchy throat and sinus pressure (Confirmed covid-19 infection). On 11-SEP-2021, the patient tested positive for Covid-19 (Confirmed clinical vaccination failure), Laboratory data included:COVID-19 PCR test (NR: not provided) positive. On same day, she experienced fever, Laboratory data included: Body temperature (NR: not provided) over 100.4 degrees Fahrenheit and recovered on (Tuesday) 14-SEP-2021. On unspecified date, the patient experienced a little bit of a cough, a bad headache, loss of taste and smell. The patient stated that her overall condition was improving and was feeling okay, but other than feeling tired and a little bit of sinus congestion, also the smell hasn''t came back and the taste came back slowly. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from sinus pressure, had not recovered from confirmed covid-19 infection, and sinus congestion, and the outcome of confirmed clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000194180.; Sender''s Comments: V0: 20210940995-Covid-19 vaccine ad26.cov2.s-Confirmed clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1730238 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Kansas  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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

Write-up: her Mother-In-Law became symptomatic; She exposed to Daughter-In-Law on Friday 10SEP2021; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (her Mother-In-Law became symptomatic), EXPOSURE TO SARS-COV-2 (She exposed to Daughter-In-Law on Friday 10SEP2021) and PRODUCT DOSE OMISSION ISSUE (trying to decide if she should receive the second dose today 13SEP2021) in a 33-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006D21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced EXPOSURE TO SARS-COV-2 (She exposed to Daughter-In-Law on Friday 10SEP2021). On 13-Sep-2021, the patient experienced COVID-19 (her Mother-In-Law became symptomatic). On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (trying to decide if she should receive the second dose today 13SEP2021). At the time of the report, COVID-19 (her Mother-In-Law became symptomatic), EXPOSURE TO SARS-COV-2 (She exposed to Daughter-In-Law on Friday 10SEP2021) and PRODUCT DOSE OMISSION ISSUE (trying to decide if she should receive the second dose today 13SEP2021) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications was not provided by the reporter Treatment information was not provided


VAERS ID: 1730251 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 RA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Device connection issue, Incorrect 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: AZITHROMYCIN; VENTOLINE [SALBUTAMOL]; IBUPROFEN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: received an unknown amount due to lure lock syringe becoming detached during injection; needles were not screwed tightly enough . Some of the vaccine leaked on onto the patient during administration.; This spontaneous case was reported by a pharmacist and describes the occurrence of DEVICE CONNECTION ISSUE (received an unknown amount due to lure lock syringe becoming detached during injection) and INCORRECT DOSE ADMINISTERED (needles were not screwed tightly enough . Some of the vaccine leaked on onto the patient during administration.) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) for COVID-19 vaccination. Concomitant products included AZITHROMYCIN from 26-Jun-2021 to an unknown date, SALBUTAMOL (VENTOLINE [SALBUTAMOL]) from 26-Jun-2021 to an unknown date and IBUPROFEN from 10-Mar-2021 to an unknown date for an unknown indication. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, the patient experienced DEVICE CONNECTION ISSUE (received an unknown amount due to lure lock syringe becoming detached during injection) and INCORRECT DOSE ADMINISTERED (needles were not screwed tightly enough . Some of the vaccine leaked on onto the patient during administration.). On 10-Sep-2021, DEVICE CONNECTION ISSUE (received an unknown amount due to lure lock syringe becoming detached during injection) and INCORRECT DOSE ADMINISTERED (needles were not screwed tightly enough . Some of the vaccine leaked on onto the patient during administration.) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter considered DEVICE CONNECTION ISSUE (received an unknown amount due to lure lock syringe becoming detached during injection) and INCORRECT DOSE ADMINISTERED (needles were not screwed tightly enough . Some of the vaccine leaked on onto the patient during administration.) to be not related. No concomitant medications were reported, No treatment medications were reported. Apparently a bag of syringes with needles was received and the needles were not screwed tightly enough . Some of the vaccine leaked on onto the patient during administration. Patient was unharmed. An email has received to administer on opposite arm. Most recent FOLLOW-UP information incorporated above includes: On 17-Sep-2021: Significant follow up Appended - New reporter (Physician) added and concomitant drugs added, vaccine facility information added and Incomplete dose administered added.


VAERS ID: 1730268 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 1 LA / OT

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

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

Write-up: 15-year old patient received Moderna vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (15-year old patient received Moderna vaccine) in a 15-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014F21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (15-year old patient received Moderna vaccine). At the time of the report, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (15-year old patient received Moderna vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No Concomitant medication information was reported. No Treatment medications were provided. Most recent FOLLOW-UP information incorporated above includes: On 22-Sep-2021: Patient demographics-ethnicity updated, race information updated , pregnancy information updated


VAERS ID: 1730288 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-13
Onset:2021-09-10
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Private       Purchased by: ?
Symptoms: Breast pain, Nipple pain, Pain in extremity, Peripheral swelling, Skin irritation
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Lipodystrophy (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SYNTHROID; PROZAC; VITAMIN C PLUS [ASCORBIC ACID]; VITAMIN D [COLECALCIFEROL]; IRON; MAGNESIUM; B12-VITAMIIN
Current Illness: Acid reflux (esophageal)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Sore breast; Sore nipples; Severe irritated sore nipples; Swelling in the arm; Patient had sore arm; This spontaneous case was reported by a consumer and describes the occurrence of BREAST PAIN (Sore breast), NIPPLE PAIN (Sore nipples), SKIN IRRITATION (Severe irritated sore nipples), PERIPHERAL SWELLING (Swelling in the arm) and PAIN IN EXTREMITY (Patient had sore arm) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032B21A) for COVID-19 vaccination. Concurrent medical conditions included Acid reflux (esophageal). Concomitant products included LEVOTHYROXINE SODIUM (SYNTHROID), FLUOXETINE HYDROCHLORIDE (PROZAC), ASCORBIC ACID (VITAMIN C PLUS [ASCORBIC ACID]), COLECALCIFEROL (VITAMIN D [COLECALCIFEROL]), IRON, MAGNESIUM and CYANOCOBALAMIN (B12-VITAMIIN) for an unknown indication. On 13-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, the patient experienced PERIPHERAL SWELLING (Swelling in the arm) and PAIN IN EXTREMITY (Patient had sore arm). On 14-Sep-2021, the patient experienced BREAST PAIN (Sore breast), NIPPLE PAIN (Sore nipples) and SKIN IRRITATION (Severe irritated sore nipples). On 12-Sep-2021, PERIPHERAL SWELLING (Swelling in the arm) and PAIN IN EXTREMITY (Patient had sore arm) had resolved. At the time of the report, BREAST PAIN (Sore breast), NIPPLE PAIN (Sore nipples) and SKIN IRRITATION (Severe irritated sore nipples) outcome was unknown. Concomitant medication included acid reflux pill which the patient used to take when she had acid reflux. Treatment medications were not administered by the patient and no further treatment information was provided. This case was linked to MOD-2021-320224 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 15-Sep-2021: Follow up document received and patient''s date of birth was updated.


VAERS ID: 1730431 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-09-04
Onset:2021-09-10
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abortion spontaneous, Pregnancy test
SMQs:, Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (If covid prior vaccination: Yes); Pregnancy (I have had two healthy pregnancies and no issues)
Allergies:
Diagnostic Lab Data: Test Name: pregnancy test; Test Result: Positive ; Comments: I have taken five tests, all positive.; Test Date: 20210910; Test Name: pregnancy test; Result Unstructured Data: Test Result:do not show a strong pregnancy line
CDC Split Type: USPFIZER INC202101190065

Write-up: miscarriage; This is a spontaneous report from a contactable consumer. This 33-year old female consumer (patient) reported for herself that she received 1st dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot Ew0185) on 04Sep2021 07:30 AM at right arm for COVID-19 immunization. Age at vaccination: 33 years old. Medical history included Covid-19 and two healthy pregnancies with no issues. Concomitant drugs were not provided. The patient received the shot on 04Sep2021 and found out she was pregnant on 06Sep2021. She had five tests, all positive. On 10Sep2021 07:30 AM, she woke up bleeding and did not show a strong pregnancy line on the tests. The patient had miscarriage. The event resulted in doctor or other healthcare professional office/clinic visit. No treatment was received. The patient needed to call doctor and see what to do next. Outcome of the event was unknown. Second Pfizer Covid-19 vaccine was scheduled for 25Sep2021.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101190080 mother/baby case


VAERS ID: 1730457 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-09-08
Onset:2021-09-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Blood cholesterol, Blood pressure measurement, Lip swelling, Pruritus, Rash, Thyroid function test
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood cholesterol abnormal; Hypertension; Penicillin allergy; Thyroid disorder
Allergies:
Diagnostic Lab Data: Test Name: cholesterol; Result Unstructured Data: Test Result:unknown results; Test Name: blood pressure; Result Unstructured Data: Test Result:high; Test Name: THYROID; Result Unstructured Data: Test Result:low
CDC Split Type: USPFIZER INC202101192485

Write-up: Swelling of upper lip; slight skin rash; itchiness; This is a spontaneous report from a contactable consumer (patient). A 72-year-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: 301308A), via an unspecified route of administration, administered in left arm on 08Sep2021 09:30 (at 72-year-old, non-pregnant at time of vaccination) as dose number unknown, single for covid-19 immunisation. Vaccine was received in hospital. Medical history included low thyroid, high blood pressure, cholesterol. Known allergies: Penicillin. No COVID prior vaccination. The patient''s concomitant medications included other medications in two weeks. No other vaccine in four weeks. The patient experienced swelling of upper lip and slight skin rash, itchiness on 10Sep2021 at 12:00 AM. The events resulted in emergency room/department or urgent care. No COVID tested post vaccination. Therapeutic measures were taken as a result of the events included steroid shot along with antihistamine shot. The outcome of the events was recovered on an unspecified date.


VAERS ID: 1730485 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Blood test, Crying, Fibrin D dimer, Inappropriate schedule of product administration, Insomnia, Neuropathy peripheral, Physical examination, SARS-CoV-2 test
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad), Medication errors (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (diagnosed with Covid-19 on 26Dec2020 and her symptom included an ear ache); Ear ache (her symptom included an ear ache)
Allergies:
Diagnostic Lab Data: Test Date: 20210913; Test Name: she had blood work done; Test Result: Negative ; Comments: was negative, clot was ruled out; Test Date: 20210913; Test Name: d dimer test; Result Unstructured Data: Test Result:resulted -39, negative; Comments: was negative, clot was ruled out; Test Date: 20210913; Test Name: physical exam; Test Result: Negative ; Comments: The tests came back negative the same day; Test Date: 20210128; Test Name: Covid-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC202101216666

Write-up: has not been able to sleep and she started crying last night; has not been able to sleep and she started crying last night; Caller received the first dose Pfizer Covid Vaccine on 30Jan2021/received the second dose on 10Sep2021; developed a focal neuropathy behind left knee; throbbing, stabbing pain under her left knee; This is a spontaneous report from a contactable pharmacist (patient herself) from a Pfizer sponsored program Covax US support. A 40-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, formulation: solution for injection, lot number: not reported, expiration date: not reported), via an unspecified route of administration, administered in Arm Right on 10Sep2021 14:00 (at the age of 40-years-old) as dose 2, single for COVID-19 immunization. Medical history included diagnosed with Covid-19 on 26Dec2020 and her symptom included an ear ache. On 04Jan2021 her husband was diagnosed with COVID-19 as well. There were no concomitant medications. Caller was not taking anything when received Pfizer Covid Vaccines. The patient had not received any additional vaccines on same date of the Pfizer Suspect considered as suspect. The patient did not receive any prior vaccinations (within 4 weeks) prior to the first administration date of the suspect vaccine(s). Historical vaccine included first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE) received via an unspecified route of administration, administered in Arm Right on 30Jan2021 at 8:00 AM (at the age of 39 years old) for COVID-19 immunization and had lymph node swelling in right lower quadrant. The patient received the second dose of the Pfizer Covid-19 vaccine on 10Sep2021 and 12 hours later she started having complaints of a throbbing, stabbing pain under her left knee and spoke with her HCP who told her to take ASA 81mg PO (per oral). On Monday 13Sep2021, she went to her HCP where she had blood work done, d-dimer was negative, clot was ruled out, and there was no need for a doppler per HCP. HCP states that she was able to exercise and was fine during the day but when she lays down there was a constant throbbing in the middle back of her left knee area. HCP also stated that she had not been able to sleep and she started crying last night 14Sep2021 because of her complaints. HCP states that her HCP prescribed her Tegretol but she refused the medication but did start Gabapentin which makes her have complaints of constipation and drowsiness. It was reported that within 12 hours of receiving second dose, developed a focal neuropathy behind left knee: Caller states this was disabling and the caller could not sleep. Caller has never experienced anything like this. Caller had to seek out medical attention to rule out any cause, a d dimer test was done and resulted -39. Caller took 81mg Aspirin. Caller received the second dose on 10Sep2021. Caller was told not to get second dose, expected around July. Caller''s son was in hospital and caller went on a vacation. Caller received second dose Pfizer Covid Vaccine on 10Sep2021. Caller clarifies the focal neuropathy behind left knee was like bells palsy. Caller started Aspirin 81mg immediately on Saturday, 11Sep2021 and on Monday 13Sep2021 caller had a physical exam and blood taken to get a d dimer test to see if caller needed more attention such as an ultra sound or doppler. The tests came back negative the same day, 13Sep2021. Caller is currently prescribed Gabapentin for this particular pain. The patient was calling for information on how to treat the adverse event. Caller is asking if there is any literature or if Pfizer can say the percentage of patients who have experienced a similar even to the patient. HCP enquired if there is information regarding complaints of focal neuropathy localized in one area after the administration of the Pfizer Covid-19 vaccine. HCP is asking how many cases have been reported of localized focal neuropathy after the administration of the Pfizer Covid-19 vaccine. The reporter assessed the event focal neuropathy behind left knee as disabling. Outcome of the events was unknown. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.; Sender''s Comments: Based on available information, a possible contributory role of BNT162B2 vaccine cannot be excluded for the reported event "Neuropathy" due to temporal relationship. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate


VAERS ID: 1730511 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-06
Onset:2021-09-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blister, Oral discomfort, Oral disorder, Oropharyngeal pain, Stomatitis, Swollen tongue, Taste disorder
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Taste and smell disorders (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101240638

Write-up: Oral lesions; Blisters; Altered taste; Mouth burning; Raw mouth; Sore throat; Swollen tongue; This is a spontaneous report from a contactable nurse, the patient. A 37-year-old non-pregnant female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3183) via an unspecified route of administration on 06Sep2021 at 08:30 (at the age of 37-years-old) as a single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. Prior to the vaccination, the patient was not diagnosed with COVID-19. On 10Sep2021, the patient experienced oral lesions, blisters, altered taste, mouth burning, raw mouth, sore throat and swollen tongue. The events resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measures were taken as a result of the events which included treatment with unspecified medications. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events oral lesions, blisters, altered taste, mouth burning, raw mouth, sore throat and swollen tongue was not resolved at the time of the report.


VAERS ID: 1730912 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-09-10
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Breast pain, Chest pain, Pain, Pain in extremity, Paraesthesia, Sleep disorder
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Lipodystrophy (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: Ibuprofen Methocarbamol Meclizine Medrol Fluticasone Nasal Spray
Current Illness: Severe Vertigo
Preexisting Conditions: None
Allergies: None to my knowledge
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pinching pains on the left side of chest and the lower half of my calf had pins and needles feeling but wasn?t a numbing sensation. Now on the 24th of September the left side of my chest constantly hurts with sharp pain at rest when or during my sleep deep under my left breast muscle


VAERS ID: 1730922 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 1 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZOLOFT; ATORVASTATIN; LOSARTAN POTASSIUM; ASPIRIN 81; MULTIVITAMIN 6.
Current Illness: Depression; High cholesterol; Hypertension; Stent placement.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Itchy rash; rashes up and down and right her arm; This spontaneous case was reported by a consumer and describes the occurrence of RASH PRURITIC (Itchy rash) and VACCINATION SITE RASH (rashes up and down and right her arm) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004F21A) for COVID-19 vaccination. Concurrent medical conditions included Hypertension since 2015, Stent placement since 01-Jul-2016, High cholesterol since 2016 and Depression since 1997. Concomitant products included LOSARTAN POTASSIUM for Blood pressure high, SERTRALINE HYDROCHLORIDE (ZOLOFT) for Depression, ATORVASTATIN from 01-Jul-2016 to an unknown date for High cholesterol, ACETYLSALICYLIC ACID (ASPIRIN 81) from 01-Sep-2016 to an unknown date for Stent placement, ASCORBIC ACID, ERGOCALCIFEROL, NICOTINAMIDE, RETINOL PALMITATE, RIBOFLAVIN, THIAMINE MONONITRATE (MULTIVITAMIN 6) for unknown. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced RASH PRURITIC (Itchy rash) and VACCINATION SITE RASH (rashes up and down and right her arm). On 15-Sep-2021, RASH PRURITIC (Itchy rash) had resolved. At the time of the report, VACCINATION SITE RASH (rashes up and down and right her arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Treatment details was not reported by the reporter. Most recent FOLLOW-UP information incorporated above includes: On 16-Sep-2021: Significant: HCP reporter added, Vaccine start date added, Demographic details added, Medical history added, concomitant drugs added


VAERS ID: 1731148 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Mobility decreased, Nausea, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: A few hours after my first shot I became very nauseous, then my body hurt really bad, and I had a very bad headache. These symptoms last for about 2 days. I took Tylenol and vitamin C gummies to try and help with the side effects after getting the first dose. My arm was very sore and I could not really move it for the entire time I had the side effects.


VAERS ID: 1731153 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-09-04
Onset:2021-09-10
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea exertional, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, multivitamin, magnesium, DHEA
Current Illness: None
Preexisting Conditions: None
Allergies: Cephalosporins
Diagnostic Lab Data: None at this time. Will schedule follow up with his physician in the next few days.
CDC Split Type:

Write-up: About two weeks following vaccination, my son started to complain of dyspnea on exertion, palpitations, and chest pain. It seems the complaints have gotten more frequent in the last 10 days.


VAERS ID: 1731208 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Dysstasia, Feeling abnormal, Injection site pain, Injection site swelling, Injection site warmth, Migraine, Musculoskeletal stiffness, Varicella
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Arthritis (broad), Opportunistic infections (broad)

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

Write-up: Chicken pox on right arm, abdomen, and bottom of left foot Severe muscle stiffness in thoracic spine and neck Lightheadedness, brain fog, weakness, and difficulty standing due to weakness Warmth, pain, and swelling to injection site 8 days after injection Migraine headache


VAERS ID: 1731269 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-08-30
Onset:2021-09-10
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Eczema, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: n/a
Preexisting Conditions: Eczema
Allergies: none
Diagnostic Lab Data: no test were performed.
CDC Split Type:

Write-up: According to the recipient, there were rash developed on both side of his body, happened in one ad half weeks after the vaccination. He was not sure either it''s the side effect from the vaccine or they are from his Eczema flare up. The rash was getting better in the 3rd week. The recipient reported the rash on the appointment day of the 2nd dose.


VAERS ID: 1731282 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 1 LA / -

Administered by: Work       Purchased by: ?
Symptoms: Diarrhoea, Neck pain, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow)

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

Write-up: Vomiting, Diarrhea, Pain in right side of neck


VAERS ID: 1731348 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-23
Onset:2021-09-10
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 2 - / -

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

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

Write-up: Hospitalization for COVID. Treated with dexamethasone 6 mg IV daily and Remdesivir


VAERS ID: 1731608 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-08
Onset:2021-09-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Cough, Dyspnoea, Fatigue, Feeling abnormal, Headache, Pain, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Wheat, corn, soy
Diagnostic Lab Data: No labs done
CDC Split Type:

Write-up: Difficulty breathing, pain with inspiration, tight chest, heart palpitations, cough, headache, body aches, fatigue, brain fog. Symptoms ongoing to this day.


VAERS ID: 1731723 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Mass, Tenderness
SMQs:

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

Write-up: I noticed a lump the size of a big marble on my collar bone on my right side. I noticed this the day 9/10 after receiving my 2nd dose of Covid Vacccine the day after my vaccine. I only noticed it because it hurt when I touched it. It felt like when you touch a bruise. When touching it the ball(lump) moved and hurt. The next day the ball 9/11 became smaller like the size of a bean and did not hurt anymore. Present day 9/24 two weeks and I still feel it but now it is the size of a pinto bean and does not hurt.


VAERS ID: 1731775 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-02-04
Onset:2021-09-10
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram, Hypoaesthesia, Magnetic resonance imaging, Ultrasound scan
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hearing impairment (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI on 9/14/2021, Carotid ultrasound 10/8/2021, CT calcium score 10/8/2021
CDC Split Type:

Write-up: Bells Palsy, numbness in left arm and left leg


VAERS ID: 1731965 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Work       Purchased by: ?
Symptoms: Menstrual disorder, Pregnancy test negative
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine Prenatal vitamin Cetirizine
Current Illness:
Preexisting Conditions: Hypothroidism
Allergies:
Diagnostic Lab Data: 3 negative pregnancy tests 9/15 9/18 9/20
CDC Split Type:

Write-up: Menstrual cycle 2 weeks late after vaccine.


VAERS ID: 1732130 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-09-07
Onset:2021-09-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH SC8181 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Joint swelling, Limb discomfort, Pain in extremity
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3; dolostone
Current Illness:
Preexisting Conditions: Multi-sclerosis; chronic back pain; bronchitis
Allergies: Wheat
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: When I wake up, my feet, ankles, and my knees where in pain. I felt like I am walking like I was walking on bare bones. By Saturday my left knee was swollen. I try taking medicine and I iced it. It feels like my knee is twisted one way and my leg twisted another way. I went to my doctor. This is joint pain in my legs and foot. He put in a referral for a physical therapy and pain medicine. I as feel very fatigue.


VAERS ID: 1732208 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Heart rate increased, Heart rate irregular
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiac arrhythmia terms, nonspecific (narrow), Dehydration (broad)

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

Write-up: Patient experienced irregular (fast) heartbeats around 6 months ago. Seemed to resolve, then started again 1 week after 1st COVID vaccination.


VAERS ID: 1732216 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Immediate post-injection reaction, Migraine, Nausea, Tinnitus, Vertigo, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamictal Lunesta Vit C Vit D Magnesium Tylenol
Current Illness: None
Preexisting Conditions: Depression Insomnia
Allergies: Levaquin
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Immediate nausea, vertigo, tinnitus, severe fatigue, migraine, blurred vision. These have persisted since vaccination administration. Vertigo and blurred vision persists, tinnitus daily but not continuous, severe fatigue, and daily migraine.


VAERS ID: 1732243 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-09-07
Onset:2021-09-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Catheterisation cardiac normal, Chest pain, Computerised tomogram thorax normal, Dyspnoea, Echocardiogram normal, Fibrin D dimer, Myocardial necrosis marker increased, Myocarditis, Troponin
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Colchicine 0.6 mg albuterol inhaler budesonide 0.5mg/2ml dexamethasone 6 mg EpiPen xopenex nebulizer solution Zofran 8 mg Compazine 10 mg Allopurinol 300 mg nystatin 100,000 unit/gm cream Norco 5/325 mg Humira 40 mg/0.4 ml Adderall 30 mg As
Current Illness: Ankylosing spondylitis Follicular lymphoma ADHD asthma
Preexisting Conditions: Ankylosing spondylitis Follicular lymphoma ADHD asthma
Allergies: NKDA
Diagnostic Lab Data: Troponin 09/10/21 D-dimer 09/10/21 Echocardiogram 09/10/21 cardiac catheterization 09/10/21 CT Chest PE protocol 09/10/21
CDC Split Type:

Write-up: COVID-19 vaccination induced myocarditis He received 2nd COVID vaccine (Pfizer) on 9-7-21. Unfortunately, a few days later he was admitted with severe chest pain and shortness of breath. He had profoundly elevated cardiac markers. CTPE protocol negative, cardiac cath clear, echo unremarkable. Ultimately he was felt to have vaccine-induced myocarditis.


VAERS ID: 1732420 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Chest discomfort, Chills, Cough, Dizziness, Dyspnoea, Feeling abnormal, Feeling of body temperature change, Haematemesis, Heart rate irregular, Muscle fatigue, Myalgia, Oxygen saturation decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Tachyarrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 15 Sep 2021 ER visit. No issues found at the time but referred to Cardiology (7 October 2021)
CDC Split Type:

Write-up: Hypoxia like symptoms (internal chills under skin, and brain fog) within 5 minutes of getting the vacccine. Pressure around heart, fluttering/ irregular heart beat feeling. Headaches, muscle aches that lead to muscle fatigue/failure. Hot/ cold spells, dizziness. O2 levels (measured with pulse ox) dropped to 86 and remained between 86 and 89 for approximately 10 minutes. Vomiting with bright red blood. Tightness in chest with couching spells and labored breathing. Visited ER on 15 Sep with nothing noted and follow up with cardio.


VAERS ID: 1732624 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: did not discuss
Current Illness: did not mention
Preexisting Conditions: none
Allergies: did not discuss
Diagnostic Lab Data: None noted; pt waiting for referral into cardiologist for tests.
CDC Split Type:

Write-up: Pt described having heart palpitations, starting about 4 hours after vaccine the same evening of administration. Pt complained that even had palpitations continuing for 4 days after, also complained of shortness of breath when laying down and feeling winded quickly. Pt said he spoke with his primary care provider; PCP is referring pt to see a cardiologist. Pt said that no longer having palpitations but still having shortness of breath and easily winded; pt inquired if pharmacy could give him a faster referral to get him in for cardiology referral; told him pharmacy does not have that kind of authorization and to continue to follow up with his PCP if still have additional symptoms. Advised pt to hold on getting a 2nd Pfizer vaccine until have approval from either his PCP or the cardiologist.


VAERS ID: 1733253 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Cough, Dizziness, Dyspnoea, Electrocardiogram normal, Fatigue, Fibrin D dimer, Headache, Heart rate increased, Palpitations
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (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? No
Hospitalized? No
Previous Vaccinations: Short of breath, hospital stay high blood sugars vomiting flu vaccine 16/17 years ago. Never had another
Other Medications: Insulin-pump therapy, vitamin D, zinc with quercetin, lisinopril, atorvastatin, vitamin B12, folic acid, omega 3, vitamin C, restasis, Ozempic, acyclovere, cyclobenzaprine as needed
Current Illness: Type 1 diabetic
Preexisting Conditions: Diabetes, some neuropathy
Allergies: Sulfa: bactrim
Diagnostic Lab Data: D dimer- negative EKG-? Stress/echo- to be done October 13
CDC Split Type:

Write-up: Short of breath. Chest pain and tightness, fatigued heart beating fast and hard, headache, dizzy and lightheaded , developed cough, major shortness of breath, with any simple activity


VAERS ID: 1733902 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-02
Onset:2021-09-10
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Bronchitis, Cerebral calcification, Chest X-ray, Chest discomfort, Chronic obstructive pulmonary disease, Computerised tomogram, Dyspnoea, Facial paralysis, Head discomfort, Hemiparesis, Hypersomnia, Hypoaesthesia, Malaise, Migraine, Myalgia, Nasopharyngitis, Oropharyngeal pain, Pyrexia, Red blood cell count, Respiratory syncytial virus test, Respiratory tract congestion, Retention cyst, SARS-CoV-2 antibody test, Upper respiratory tract infection
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Depression (excl suicide and self injury) (broad), Hearing impairment (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19.
Allergies:
Diagnostic Lab Data: Test Date: 20210912; Test Name: Chest X ray; Result Unstructured Data: The lung fields are clear without evidence of pneumonia.; Test Date: 20210912; Test Name: CT Scan; Result Unstructured Data: found a mucous retention polyp or cyst of the left maxillary sinus & an 8mm calcification on the inner table of the calvarium in the left frontal region.; Test Date: 20210912; Test Name: Red blood cell count; Result Unstructured Data: Low; Test Date: 20210913; Test Name: RSV; Test Result: Positive; Result Unstructured Data: POSITIVE; Test Date: 20210913; Test Name: Covid test; Test Result: Negative; Result Unstructured Data: Negative.
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: even taking a shower wears her out; sore throat; chest congestion; fever; Diagnosed with a viral URI with cough; Diagnosed with left facial numbness, numbness of the left side of her face & mouth; CT scan found a mucous retention polyp or cyst of the left maxillary sinus; CT scan found an 8mm calcification on the inner table of the calvarium in the left frontal region; Numbness where she couldn''t feel their fingers but could feel the pressure when they checked her left arm; Subtle droopiness of the left side of her face & mouth, the left side of her mouth doesn''t smile; Felt that the left side of her face had numbness and weakness, weakness of the left side of her face & mouth; Feeling sick; Chest tightness; Feeling like she couldn''t breathe, shortness of breath; It felt like she had a cold; It felt like her head was clogged up; She had migraine since friday,diagnosed with a complicated migraine; She was diagnosed with bronchitis; Diagnosed with a touch of COPD with exasperation; slept since Friday; Had body aches since friday; This spontaneous case was reported by a nurse and describes the occurrence of HEMIPARESIS (Felt that the left side of her face had numbness and weakness, weakness of the left side of her face & mouth) and FACIAL PARALYSIS (Subtle droopiness of the left side of her face & mouth, the left side of her mouth doesn''t smile) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 039B21A and 052E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 in December 2020. On 02-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, the patient experienced MALAISE (Feeling sick), CHEST DISCOMFORT (Chest tightness), DYSPNOEA (Feeling like she couldn''t breathe, shortness of breath), NASOPHARYNGITIS (It felt like she had a cold), HEAD DISCOMFORT (It felt like her head was clogged up), MIGRAINE (She had migraine since friday,diagnosed with a complicated migraine), BRONCHITIS (She was diagnosed with bronchitis), CHRONIC OBSTRUCTIVE PULMONARY DISEASE (Diagnosed with a touch of COPD with exasperation), HYPERSOMNIA (slept since Friday) and MYALGIA (Had body aches since friday). On 11-Sep-2021, the patient experienced HEMIPARESIS (Felt that the left side of her face had numbness and weakness, weakness of the left side of her face & mouth) (seriousness criterion medically significant). On 12-Sep-2021, the patient experienced FACIAL PARALYSIS (Subtle droopiness of the left side of her face & mouth, the left side of her mouth doesn''t smile) (seriousness criterion medically significant), UPPER RESPIRATORY TRACT INFECTION (Diagnosed with a viral URI with cough), HYPOAESTHESIA (Diagnosed with left facial numbness, numbness of the left side of her face & mouth), RETENTION CYST (CT scan found a mucous retention polyp or cyst of the left maxillary sinus), CEREBRAL CALCIFICATION (CT scan found an 8mm calcification on the inner table of the calvarium in the left frontal region) and HYPOAESTHESIA (Numbness where she couldn''t feel their fingers but could feel the pressure when they checked her left arm). On an unknown date, the patient experienced ASTHENIA (even taking a shower wears her out), OROPHARYNGEAL PAIN (sore throat), RESPIRATORY TRACT CONGESTION (chest congestion) and PYREXIA (fever). At the time of the report, HEMIPARESIS (Felt that the left side of her face had numbness and weakness, weakness of the left side of her face & mouth), FACIAL PARALYSIS (Subtle droopiness of the left side of her face & mouth, the left side of her mouth doesn''t smile), MALAISE (Feeling sick), CHEST DISCOMFORT (Chest tightness), DYSPNOEA (Feeling like she couldn''t breathe, shortness of breath), NASOPHARYNGITIS (It felt like she had a cold), HEAD DISCOMFORT (It felt like her head was clogged up), MIGRAINE (She had migraine since friday,diagnosed with a complicated migraine), BRONCHITIS (She was diagnosed with bronchitis), CHRONIC OBSTRUCTIVE PULMONARY DISEASE (Diagnosed with a touch of COPD with exasperation), UPPER RESPIRATORY TRACT INFECTION (Diagnosed with a viral URI with cough), HYPOAESTHESIA (Diagnosed with left facial numbness, numbness of the left side of her face & mouth), RETENTION CYST (CT scan found a mucous retention polyp or cyst of the left maxillary sinus), CEREBRAL CALCIFICATION (CT scan found an 8mm calcification on the inner table of the calvarium in the left frontal region), HYPOAESTHESIA (Numbness where she couldn''t feel their fingers but could feel the pressure when they checked her left arm) and MYALGIA (Had body aches since friday) had not resolved and HYPERSOMNIA (slept since Friday), ASTHENIA (even taking a shower wears her out), OROPHARYNGEAL PAIN (sore throat), RESPIRATORY TRACT CONGESTION (chest congestion) and PYREXIA (fever) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 12-Sep-2021, Chest X-ray: normal (normal) The lung fields are clear without evidence of pneumonia.. On 12-Sep-2021, Computerised tomogram: abnormal (abnormal) found a mucous retention polyp or cyst of the left maxillary sinus & an 8mm calcification on the inner table of the calvarium in the left frontal region.. On 12-Sep-2021, Red blood cell count: low (Low) Low. On 13-Sep-2021, Respiratory syncytial virus test: positive (Positive) POSITIVE. On 13-Sep-2021, SARS-CoV-2 antibody test: negative (Negative) Negative. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was given. No treatment medication was given. Company comment: This case concerns a 51-year-old, female subject, who experienced the expected event OF FACIAL PARALYSIS and the unexpected event of HEMIPARESIS. The event hemiparesis occurred twelve days after the second dose of mRNA-1273 and the event facial paralysis occurred thirteen days after the second dose of mRNA-1273. The rechallenge was unknown as there''s no information available about the first dose.The benefit-risk relationship of mRNA-1273 IS not affected by this report. Events were automatically upgraded as a Serious events as per RA list and kept as serious as per medical judgement, despite it was reported as non-serious.; Sender''s Comments: This case concerns a 51-year-old, female subject, who experienced the expected event OF FACIAL PARALYSIS and the unexpected event of HEMIPARESIS. The event hemiparesis occurred twelve days after the second dose of mRNA-1273 and the event facial paralysis occurred thirteen days after the second dose of mRNA-1273. The rechallenge was unknown as there''s no information available about the first dose.The benefit-risk relationship of mRNA-1273 IS not affected by this report. Events were automatically upgraded as a Serious events as per RA list and kept as serious as per medical judgement, despite it was reported as non-serious.


VAERS ID: 1733959 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Washington  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046A201 / 2 - / OT

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

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

Write-up: Past the 30 day beyond use date; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a physician and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Past the 30 day beyond use date) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 046A201) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Past the 30 day beyond use date). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Past the 30 day beyond use date) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant and no treatment medication were given .


VAERS ID: 1734149 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood pressure increased, Blood pressure measurement, Body temperature, Headache, Heart rate, Heart rate increased, Oxygen saturation decreased, PO2, Pain, Pyrexia, Vaccination site pain, Vaccination site swelling, Weight bearing difficulty
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Hypertension (narrow), Arthritis (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Keppra [Levetiracetam]; Xanax; PRN 1371; Torsemide
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy; Seizure
Allergies:
Diagnostic Lab Data: Test Name: BP; Result Unstructured Data: Test Result: 154/97; Test Name: Fever; Result Unstructured Data: Test Result: 102.5 Fahrenheit; Test Name: pulse; Result Unstructured Data: Test Result: 136; Test Name: PO2; Result Unstructured Data: Test Result: lowest 87%.
CDC Split Type: USPFIZER INC202101192679

Write-up: BP 154/97; PO2 lowest 87%; body aches & joint pain up to 7/10 (couldn''t bear weight on left side due to hip pain, had to use crutch); Fever up to 102.5 F; pulse up to 136; body aches & joint pain up to 7/10 (couldn''t bear weight on left side due to hip pain, had to use crutch); body aches & joint pain up to 7/10 (couldn''t bear weight on left side due to hip pain, had to use crutch); headache; pain and mild swelling at injection site; pain and mild swelling at injection site; This is a spontaneous report from a contactable nurse (patient). A 44-year-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3183) Dose 1 via an unspecified route of administration, administered in the right arm on 09Sep2021 at 13:15 (at the age of 44-years-old) as a single dose for COVID-19 immunisation. Medical history included seizure disorder from an unknown date and unknown if ongoing, drug hypersensitivity from an unknown date and unknown if ongoing (penicillin). Concomitant medications included levetiracetam (KEPPRA) for an unspecified indication, start and stop date were not reported; alprazolam (XANAX) taken for an unspecified indication, start and stop date were not reported; prn 1371 (PRN 1371) taken for an unspecified indication, start and stop date were not reported; torsemide for an unspecified indication, start and stop date were not reported. The patient did not receive any other vaccines within four weeks prior to the vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. On 10Sep2021 at 03:00, the patient experienced fever up to 102.5 F, pulse up to 136, BP 154/97, PO2 lowest 87, body aches & joint pain up to 7/10 (couldn''t bear weight on left side due to hip pain, had to use crutch), headache, and pain and mild swelling at injection site. The patient was recovering from the events.; Sender''s Comments: Based on available information and the close drug event temporal association, a possible contributory role of suspect product BNT162B2 to the development of events blood pressure increased, oxygen saturation decreased and weight bearing difficulty cannot be totally excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1734177 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 1 LA / OT

Administered by: Private       Purchased by: ?
Symptoms: Poor quality product administered, Wrong technique in product usage process
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: USPFIZER INC202101200713

Write-up: vaccine administered that was not reconstituted; vaccine administered that was not reconstituted; This is a spontaneous report from a contactable Nurse. This Nurse reported for 57-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: FD0809; Expiration Date: 25Sep2021), dose 1 intramuscular, administered in Deltoid Left on 10Sep2021 15:30 (at the age of 57 years old) as dose 1, 0.3 ml single for covid-19 immunization. The Patient No medical history was reported. There were no concomitant medications. The patient had no known allergies. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 10Sep2021, the patient experienced vaccine administered that was not reconstituted. Incident report was filled out and it was reported to everyone at their office, including the nurse manager and provider. No follow-up attempts are needed. No further information is expected.; Sender''s Comments: As per the information in the case provided, the causal association between the events Wrong technique in product usage process and Poor quality vaccine administered and the suspect drug cannot be excluded.


VAERS ID: 1734222 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Condition aggravated, Hypersensitivity, Pruritus, Rash, SARS-CoV-2 test, Skin burning sensation
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; C-section; Iodine allergy; Pre-eclampsia; Shellfish allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210916; Test Name: RTPCR; Test Result: Negative ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101243361

Write-up: allergic reactions; rashes all over the body; itching; burning sensation starting in the hands and gradually spread to neck,upper chest, upper extremity, scalp,abdomen, and the rest of all over the body; burning sensation starting in the hands and gradually spread to neck,upper chest, upper extremity, scalp,abdomen, and the rest of all over the body; condition worsened; This is a spontaneous report from a contactable Nurse (patient). A 27-years-old female patient received bnt162b2 (BNT162B2), dose 1, administered in Arm Left on 10Sep2021 14:45 (Batch/Lot number was not reported) at age of 27-year-old as DOSE 1, SINGLE for covid-19 immunisation. Facility where the most recent COVID-19 vaccine was administered was Pharmacy or Drug Store. Medical history included known allergies: Shell fish and Iodine, asthma, caesarean section, preeclampsia. The patient''s concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Since receiving the vaccine just before 3 PM, on 10Sep2021 19:15 she have experienced allergic reactions in the form of rashes all over the body that has been itching, and burning sensation starting in the hands and gradually spread to neck, upper chest, upper extremity, scalp, abdomen, and the rest of all over the body. Went to ER, was sent home with steroids, but the condition worsened. Had to go back to ER and got admitted in the hospital in a very severe condition. AE resulted in [Doctor or other healthcare professional office/clinic visit, Emergency room/department or urgent care, Hospitalization, Lifethreatening illness (immediate risk of death from the event)]. Events were assessed serious as Life threatening and Caused/prolonged hospitalization (days hospitalization: 3). The patient received Ampicillin, Solumedrol, Benadryl, Methotrexate as treatment. The outcome was not recovered. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has been tested for COVID-19. Covid test type post vaccination was Nasal Swab, name RTPCR on 16Sep2021 with result of Negative. The outcome was not recovered. The lot number for [BNT162B2], was not provided and will be requested during follow up.; Sender''s Comments: Based on the description given in the narrative, there is reasonable possibility of causal association between the life threatening events and the suspect BNT162B2 cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer drug is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.


VAERS ID: 1734391 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-03
Onset:2021-09-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / IM

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

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

Write-up: Systemic: numbness of toes and fingers-Medium


VAERS ID: 1734692 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-09-10
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trintellix, loratadine, trazodone, Lyrica, Celebrex, flax seed oil, green tea extract, turmeric, ashwaganda, turkey tail mushroom extract, reishi mushroom extract, glucosamine, vitamin D
Current Illness: none
Preexisting Conditions: seasonal allergies, depression & anxiety, OA, fibromyalgia, treated for breast cancer in 2020
Allergies: morphine, adhesives
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Fat necrosis at injection site.


VAERS ID: 1734703 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 9921 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amtryptline, cetrizine
Current Illness: fibromyalgia, chronic fatigue, intermittent tachycardia
Preexisting Conditions: fibromyalgia, chronic fatigue, intermittent tachycardia, chronic migraine
Allergies: tree, grass, dust allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: fever 100.3, body aches, tiredness, dizziness lasting 3 days. Swollen lymph node under left arm pit for 8 days.


VAERS ID: 1735078 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-08
Onset:2021-09-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Chills, Diarrhoea, Endotracheal intubation, Headache, Infection, Nausea, Pain in extremity, Pyrexia, Surgery, Swelling, X-ray limb
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 22 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Pantoprazole SOD Dr 40 mg, Atorvastatin Calcium Tablets, USP, 40mg, Hydrochlorothiazide 25mg Tab, Metformin HCL 500mg Tab, Lisinopril 40mg Tab.
Current Illness:
Preexisting Conditions: Diabetic
Allergies: NA
Diagnostic Lab Data: X-rays to chest and arm.
CDC Split Type:

Write-up: Adverse event: Fever, headache, naucious , diarrhea, chest pain, chills, swelling and pain in chest and left arm., infection. Patient was intubated Treatment: Steroids, Antibiotics and surgery. Outcome: still pending and under treatment in hospital.


VAERS ID: 1735095 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-16
Onset:2021-09-10
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Positive COVID-19 Test Results
CDC Split Type:

Write-up: The employee tested positive for COVID-19


VAERS ID: 1735185 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 AR / IM

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

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

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


VAERS ID: 1735723 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-24
Onset:2021-09-10
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Hypotension, Localised infection, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: CAD STATUS POST CABG, COPD, ICD PACEMAKER, DM TYPE 2
Allergies: BRILINTA
Diagnostic Lab Data: 9/10/21 COVID -19 PCR = DETECTED
CDC Split Type:

Write-up: 9/10/21 SEEN IN THE ER HYPOTENSIVE, COUGH, SOB AND VOMITING. PATIENT ADMISSION TO HOSPITAL. 9/12/21 LEAVES 9/14/21 RETURNS TO ER AT . ADMITTED TO HOSPITAL WITH FOOT INFECTION. REPORTS BREATHING HAS IMPROVED . PATIENT DISCHARGED ON 9/22/21 TO HOME


VAERS ID: 1736158 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-08
Onset:2021-09-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Electrocardiogram, Electrocardiogram ambulatory, Fatigue, Gastrointestinal disorder, Insomnia, Nausea, Palpitations, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: hydroxychloroquine, Cymbalta, Multi-Vitamin, NAC, B Complex, Curcumin/Tumeric, Probiotics
Current Illness: Autoimmune - Sjogrens Syndrome, MCTD, Raynauds, Lupus
Preexisting Conditions: Autoimmune Disorders - Sjogrens Syndrome, MCTD, Raynauds, Lupus
Allergies: Penicillin
Diagnostic Lab Data: Two EKG''s, Holter monitor testing, Rapid Covid Test Negtive,
CDC Split Type:

Write-up: Heart Racing, Fatigue, Insomnia, Nausea, Headaches, Severe GI issues, Shortness of breath


VAERS ID: 1736253 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-12
Onset:2021-09-10
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 2 LA / OT
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / OT

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

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

Write-up: Nurse inadvertently injected a Moderna Covid-19 vaccine to a patient as a second dose who had received the Pfizer Vaccine as their first dose; This spontaneous case was reported by a nurse and describes the occurrence of INTERCHANGE OF VACCINE PRODUCTS (Nurse inadvertently injected a Moderna Covid-19 vaccine to a patient as a second dose who had received the Pfizer Vaccine as their first dose) in a 23-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016C21A) for COVID-19 vaccination. Co-suspect product included non-company product TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) for COVID-19 vaccination. No Medical History information was reported. On 12-Aug-2021, the patient received first dose of TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) (unknown route) 1 dosage form. On 10-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On 10-Sep-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced INTERCHANGE OF VACCINE PRODUCTS (Nurse inadvertently injected a Moderna Covid-19 vaccine to a patient as a second dose who had received the Pfizer Vaccine as their first dose). On 10-Sep-2021, INTERCHANGE OF VACCINE PRODUCTS (Nurse inadvertently injected a Moderna Covid-19 vaccine to a patient as a second dose who had received the Pfizer Vaccine as their first dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment details were reported. Patient did not report any adverse events with both Pfizer and Moderna vaccine. Most recent FOLLOW-UP information incorporated above includes: On 15-Sep-2021: Follow up added- Pfizer start date was added.; Sender''s Comments: This case concerns a 23 year-old male patient with no reported medical history, who experienced the unexpected event of Interchange of vaccine products. The event occurred on the same day as the first dose of Moderna COVID-19 vaccine, which followed a previous dose of Pfizer COVID-19 vaccine. The benefit-risk relationship of mRNA-1273 vaccine is not affected by this report.


VAERS ID: 1736257 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: This spontaneous case reported by a consumer, describes the occurrence of pyrexia (fever) and dyspnea (difficulty breathing) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 vaccine) for COVID-19 immunization. Concomitant products included Eliquis (apixaban). On Sep 9, 2021, patient received the first dose of mRNA-1273 (Moderna COVID-19 vaccine), unknown route; 1 dosage form. On Sep 10, 2021, patient experienced pyrexia (fever). On Sep 15, 2021, patient experienced dyspnea (difficulty breathing). On Sep 11, 2021, pyrexia (fever) resolved. At the time of the report, dyspnea (difficulty breathing) outcome: unknown. The action taken with mRNA-1273 (Moderna COVID-19 vaccine): unknown. No treatment medication reported.


VAERS ID: 1736488 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chest pain, Dyspnoea, Feeling abnormal, Headache, Hyperhidrosis, Inflammation, Pain in extremity, Painful respiration, Pyrexia, Weight decreased
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Aripiprazole, Bupropion, Lamotrigine, Pravastatin, Omeprazole
Current Illness: None
Preexisting Conditions: Depression
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: This was the 2nd shot of the 2-shot MODERNA regimen. I received the expected headache and sore arm within a few hours after the injection, they were expected. What began happening about 24 hours after the injection was this: I could literally feel the vaccine move through my kidneys, then my lungs, then down my spine over the course of about 8 hours with inflammation and a fever. What happened next was frightening, it felt as if 10,000 knives were being thrust in to my chest and back. Breathing was difficult and painful. This went on for a few hours. I was unable to find my phone to call anyone or emergency help. Over the course of 48 hours during all this I lost 8 pounds from sweating. It was after about 48 hours that the fever broke and all pain subsided.


VAERS ID: 1736671 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Asthenia, Balance disorder, Blood pressure abnormal, Chest pain, Dizziness, Dyspnoea, Fatigue, Feeling abnormal, Headache, Heart rate irregular, Hyperventilation, Immediate post-injection reaction, Impaired work ability, Nausea, Retching
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Topamax, multivitamin, probiotic
Current Illness: TBI/post concussion syndrome, tinnitus
Preexisting Conditions: TBI/post concussion syndrome, tinnitus, asthma
Allergies: severe dust; pet dander, egg sensitivity, pollen/environmental
Diagnostic Lab Data: Monitored my vitals and used an alcohol wipe to wake me up, made sure I ate something before releasing me and walked me out of the hospital vaccine site. The did not want to send me to the ER but they did call a rapid code initially.
CDC Split Type:

Write-up: Immediately I started to feel lightheaded, dizzy, nauseated. I started dry heaving, hyperventilating, had a hard time breathing, felt like I couldn''t catch my breath, they tried to have me move to a different chair and when I stood up I almost collapsed. They needed to use an alcohol wipe under my nose to keep my from going unconscious. There were no vitals available, and they had to monitor me for an hour. Felt very fatigued the rest of the day, to the point where I was made to lay down at work and then sent home, and had severe headaches, slept for over 3 hours as soon as I got home. Shot was administered around 7:45 am, was monitored for an hour, was home by 12 pm from my shift, home by 12:30 and was asleep until almost 4-5 pm. Had chest pains the following few days vaccine. Have felt very weak and not myself ever since, constantly fatigued irregular hr and bp.


VAERS ID: 1736730 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-15
Onset:2021-09-10
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 1 UN / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Guillain-Barre syndrome, Incomplete course of vaccination
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Medication errors (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted for Guillain-Barre syndrome. Only 1 Moderna dose recorded per registry.


VAERS ID: 1736743 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

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

Write-up: Patient felt very weak as if she was going to faint. Gave patient an ice pack and called EMS to check patient out. Patient refused to be seen at the hospital and left on her own feeling better.


VAERS ID: 1736930 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-06-16
Onset:2021-09-10
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19 pneumonia, Vaccine breakthrough infection
SMQs:, Infective pneumonia (narrow), 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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine 5mg; atenolol 25mg; depo-testosterone 100mg; ergocalciferol 50,000 units; levothyroxine 75mcg
Current Illness: Hypothyroidism; hypertension
Preexisting Conditions: Leukemia with bone marrow transplant in the past
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Breakthrough COVID case admitted for hospitalization for SARS-CoV-2 pneumonia


VAERS ID: 1736985 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 3 LA / SYR

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

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

Write-up: SO YOU HAD FEVER, CHILLS AND BODY ACHES AND FATIGUE FOR A COUPLE OF DAYS


VAERS ID: 1737139 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-01
Onset:2021-09-10
   Days after vaccination:101
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Dyspnoea, Fatigue, Headache, Laboratory test abnormal, Myalgia, Nausea, Oropharyngeal pain, Pyrexia, Rhinorrhoea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: Rapid test collected on 9-12-2021, resulted positive
CDC Split Type:

Write-up: fever, feverish, chills, muscle aches, runny nose, sore throat, cough, SOB, N/V, headache, fatigue


VAERS ID: 1737174 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-07
Onset:2021-09-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Heavy menstrual bleeding, Intermenstrual bleeding, Menstrual disorder
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Headaches, cycle started and it should not have, cycle was heavy and abnormal, continues to spot


VAERS ID: 1737183 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-27
Onset:2021-09-10
   Days after vaccination:106
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 027A21A / UNK - / -

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

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

Write-up: Covid positive concert


VAERS ID: 1737343 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Paraesthesia
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 so far, thought it would be gone by now. My primary care is not available this week.
CDC Split Type:

Write-up: symptoms. pins and needles sensation on face and arms ongoing since 9/10/21( Shot on 9/9/21)


VAERS ID: 1737347 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-05
Onset:2021-09-10
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes, ESRD on Hemodialysis
Allergies:
Diagnostic Lab Data: Cycle threshold 29.6 on admission.
CDC Split Type:

Write-up: Patient admitted to the hospital for COVID 19. Reporting per Moderna COVID vaccine EUA.


VAERS ID: 1737348 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Hypoaesthesia, Laboratory test, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: synthroid, prilosec,
Current Illness: strep throat
Preexisting Conditions: rheumatoid arthritis
Allergies:
Diagnostic Lab Data: Many but not revealing about the cause or recovery
CDC Split Type:

Write-up: severe numbness of right hand, pain in right arm, tingling in both feet


VAERS ID: 1737422 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 3 LA / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer BioNTech COVID-19 Vaccine EUA: Moderna COVID-19 Vaccine EUA Patient received Moderna Vaccines on 1/8/2021 and 2/2/2021 at Allergy & Asthma. Patient presented to Vaccination Clinic - on 9/10/2021, and received a Pfizer vaccine.


VAERS ID: 1737461 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-11
Onset:2021-09-10
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Asthenia, Blood creatinine normal, Blood culture, Blood potassium decreased, Blood sodium decreased, Blood thyroid stimulating hormone normal, Body temperature increased, C-reactive protein increased, COVID-19, Chest X-ray abnormal, Confusional state, Cough, Culture urine, Fatigue, Hyponatraemia, Lung opacity, Mental status changes, Oxygen saturation decreased, Procalcitonin, SARS-CoV-2 test positive, Thyroxine free, Ultrasound scan normal
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Hypokalaemia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine, aspirin, tylenol PM ES, hydrochlorothiazinde, ibuprofen PRN, lisinopril, metoprolol tartrate, multivitamin, saw palmetto
Current Illness:
Preexisting Conditions: History of diffuse follicular non-Hodgkin lymphoma low-grade, hyperuricemia, hypertension, diet-controlled hyperlipidemia, chronic low back pain, hypothyroid not on any medications, GERD, mitral regurg, tricuspid regurg, history of subacute bacterial endocarditis in the past, history of mild coronary artery disease with the last cardiac cath done in January 2016, fully immunized against COVID-19, history of chronic prostatitis, left renal artery stenosis, BPH, hard of hearing, history of MI in the past, Meniere disease, osteoarthritis, remote tonsillectomy, remote vasectomy.
Allergies: Simvastatin
Diagnostic Lab Data: 9/10/21 COVID19: Positive 9/14/21 chest xray: Patchy airspace disease most consistent with COVID-19 pneumonia. 9/20/21 chest xray: No acute cardiopulmonary disease 9/23/21 US: Neg for DVT 9/23/21 CTA chest: Multifocal atypical pneumonia described above. Consider COVID-19.
CDC Split Type:

Write-up: diagnosed with COVID-19 on last Friday on September 10. His wife also has it. Was sent from home because of increasing tiredness, generalized weakness and confusion. Apparently, he was saturating only 89% on room air at home but here he is saturating in the upper 90s. The patient is quite hard of hearing and appears to be a poor historian. He denied any headache, dizziness, chest pain. Says occasionally cough but does not bring up any sputum. Denies any shortness of breath. No nausea, vomiting, or diarrhea. His lab work however shows a sodium of 112 with a baseline being around 132. His potassium was 3.2. Creatinine is normal at 1.1. The patient also history of hypothyroidism, but for some reason I do not see any Synthroid on his medication list and his TSH is slightly high at 4.77 and a free T4 is a pending as we speak. Chest x-ray shows some patchy right-sided opacity, possible COVID-19 related pneumonia and the patient was started on Rocephin and Zithromax and then the hospitalist service was called for admission. A nephrology consult was also obtained; and because the patient has a change in mental status with a sodium of 112 he has been started on 3% normal saline to be given 25 mL/h x10 hours only which is 250 mL, and we will do BMP and sodium q.4 hours. The etiology of his sudden and acute hyponatremia is unclear. Patient denies drinking large amounts of water and is on not on any new medications. I have stopped his hydrochlorothiazide for now also because he is hyponatremic. Will put him on seizure and fall precautions. On 9/24/24: Temp 102 - improving Most likely secondary to chronic prostatitis Procalcitonin 0.12, CRP 105 Flomax Keep Foley at discharge, Urology outpatient follow-up Blood Culture pending Urine culture no growth (was on antibiotic) Chest x-ray no new findings Was on ceftriaxone and azithromycin Antibiotic changed Zosyn and Levaquin Currently continuing Levaquin Occasional spikes can be secondary to chronic prostatitis needs long-term antibiotics. Discharged on 9/25/21


VAERS ID: 1737623 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-24
Onset:2021-09-10
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 RA / SC
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / UNK RA / SC

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Nasopharyngitis, Pneumonia, SARS-CoV-2 test positive, X-ray abnormal
SMQs:, Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flecanide Atorvastatin
Current Illness: None
Preexisting Conditions: No
Allergies: None
Diagnostic Lab Data: Positive PCR, X-rays,positive for pneumonia 9 /11 hospital 9/18
CDC Split Type:

Write-up: Break through COVID . Pcr test given prior to angioplasty. Positive test. Cold like symptoms and pneumonia


VAERS ID: 1737643 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091021A / 1 LA / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Musculoskeletal chest pain, Nausea, Thinking abnormal, Tinnitus
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad)

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

Write-up: Headache since vaccine. Cloudy thinking. Ringing in the ears. Chest wall pain. Dizziness nausea


VAERS ID: 1738252 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 LA / IM

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

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

Write-up: Patient received vaccination early at 14 days instead of the 28 day interval.


VAERS ID: 1738254 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-27
Onset:2021-09-10
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Injection site swelling, Lymph node pain, Lymphadenopathy, Mammogram abnormal, Rash, Submaxillary gland enlargement, Ultrasound scan abnormal
SMQs:, Anaphylactic reaction (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lithium--450 mg 1xday seroquel--250mg 1/day levothyroxine--100mg 1/day fish oil 1500 mg Vitamin B complex Vitamin C Vitamin D
Current Illness: None
Preexisting Conditions: Stage 0 Breast cancer
Allergies: sulfa penicillin
Diagnostic Lab Data: I had an ultrasound at Radiology the next day. The results of the ultrasound showed it was not blood clots. It showed lymph node swelling and pain. This was on a Friday, The next Monday, September 13 I returned to Dr. because I had swellings in my axillary, armpit, area and they were very sore. I went to imaging center on September 20 for an already scheduled ultrasound and mammogram. It was alarming because in September 2020 I was diagnosed with breast cancer, stage 0. The results of the mammogram and ultrasound showed all of the grape sized swellings were lymph nodes. It is now September 27, and the swellings are still painful and pea sized.
CDC Split Type:

Write-up: About 2 weeks after my Moderna injection, I had unusually large swelling around the site. Also, I had grape size swollen bumps in my arm between my shoulder and elbow. I went to Dr.. He was not sure if it was 3 blood clots, vein inflammation or lymph nodes. He wrote orders for an ultrasound on this sore area.


VAERS ID: 1738261 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Face oedema, Periorbital oedema, Tinnitus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hearing impairment (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: athorvastatine, metformin
Current Illness: sore throat
Preexisting Conditions: high cholesterol
Allergies: chronic urticaria of unknown etiology
Diagnostic Lab Data: none
CDC Split Type:

Write-up: significant worsening of tinnitus, facial and periocular edema.


VAERS ID: 1738514 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Hypoaesthesia, Hypoaesthesia oral, Injection site pain, Injection site pruritus, Injection site rash, Injection site urticaria, Limb mass, Paraesthesia, Paraesthesia oral, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Sexual dysfunction (broad)

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

Write-up: Lips/face tingly and numb within a hour. Extreme fatigue for 2 days. Baseball size lump in arm for 1 week. Reduced to half, hive/rash/pain/itch on injection arm nearly 3 weeks later, despite otc allergy medicine. Day 4 included throat squeezing sensation.


VAERS ID: 1740611 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Feeling abnormal, Feeling hot, Myalgia, Peripheral swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: THYROID; PROLIA.
Current Illness:
Preexisting Conditions: Comments: No medical history were provided by reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Swollen arm; Red; Hot; Not unbearable, but uncomfortable; Sore; This spontaneous case was reported by a consumer and describes the occurrence of PERIPHERAL SWELLING (Swollen arm), ERYTHEMA (Red), FEELING HOT (Hot), FEELING ABNORMAL (Not unbearable, but uncomfortable) and MYALGIA (Sore) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history were provided by reporter. Concomitant products included THYROID and DENOSUMAB (PROLIA) for an unknown indication. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced PERIPHERAL SWELLING (Swollen arm), ERYTHEMA (Red), FEELING HOT (Hot), FEELING ABNORMAL (Not unbearable, but uncomfortable) and MYALGIA (Sore). On 14-Sep-2021, PERIPHERAL SWELLING (Swollen arm), ERYTHEMA (Red), FEELING HOT (Hot), FEELING ABNORMAL (Not unbearable, but uncomfortable) and MYALGIA (Sore) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication also include also for blood pressure. (unspecified drug name). Patient stated that no treatment for the adverse events.


VAERS ID: 1740806 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Computerised tomogram, Electrocardiogram, Laboratory test, Pericarditis, Ultrasound scan
SMQs:, Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Flovent 2 puffs BID, albuterol inhaler prn, Effexor daily
Current Illness: depression, asthma
Preexisting Conditions: depression, asthma
Allergies: no known allergies
Diagnostic Lab Data: chest xray, EKG, lab work, CT scan, ultrasound
CDC Split Type:

Write-up: hospitalized with diagnosis of pericarditis after receiving vaccine


VAERS ID: 1740902 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW1075 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthma, Hypersensitivity, Incorrect dose administered, Product preparation issue
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient administered Pfizer COVID-19 vaccine. After administration, nursing staff realized 0.8mL instead of 1.8mL of diluent was added to the Pfizer vial when trying to draw up another dose. Patient administered a higher than recommended dose of the Pfizer COVID-19 vaccine. Physician was notified and family was contacted that evening. Mom reported on 9/10/2021 and 9/11/2021 that patient was not experiencing any symptoms. Follow up on 9/28/2021 mom reported he started having some asthma and allergy difficulty the week following vaccine, but she is unsure if this was due to the vaccine or his underlying diagnoses. He is now recovered without any symptoms.


VAERS ID: 1741028 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 - / IM

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

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

Write-up: Patient received vaccine and stated she was itching really bad and noted scratches on stomach. No visible rash noted. Notified MD. Patient''s shift was about to end. MD encouraged patient to go to store to get benegryl. No reports of swelling. Vital signs stable. HR 80, RR 24, BP 154/90. Stated that she was told she had HTN, but never followed up with it.


VAERS ID: 1741161 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: PFIZER 08/20/2021 27 Y/O
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT STATED PRIOR TO RECIEVING VACCINE THAT SHE HAD BROKE OUT IN A RASH WITH THE FIRST DOSE. ALSO HAD BEEN ON MENTRAL CYCLE SINCE LAST FIRST DOSE. NOTIFIED MD. STATED TO HAVE HER WAIT 30 MINUTES TO GIVE VACCINE. ALSO WANTED PATIENT TO FOLLOW UP WITH GYNOCOLOGIST, THAT THE MENSTRAL CYCLE WAS NOT A SIDE EFFECT OF VACCINE. GAVE VACCINE. PATIENT BROKE OUT IN HIVES AND WAS ITCHING. NOTIFIED MD AGAIN. SATED TO TAKE BENEGRYL AFTER LEAVING WORK, WHICH HER SHIFT WAS ABOUT TO END. AND IF SWELLING DEVELOPED AROUND NECK MOUTH AREA TO GO TO THE ER. VS: HR89, RR 20, BP 128/78.


VAERS ID: 1741208 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-06-10
Onset:2021-09-10
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Allergy to vaccine, Computerised tomogram, Dyspnoea, Electrocardiogram, Heart rate increased, Hyperhidrosis, Hypertension, Wheezing, X-ray
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: robostatin, testerone shot, celexa, lorsartan, synthyroid, metformin
Current Illness: np
Preexisting Conditions: cancer 2001 but in remission
Allergies: no
Diagnostic Lab Data: yes EKG, 4 x-rays and a ct scan
CDC Split Type:

Write-up: Later that night he started whizzing, sweating, shortness of breathe and a rapid heartbeat. Blood pressure came high and his wife took him to ER which he was in there for 7hr. They informed him that he was allergic to the vaccine. He also another episode on Sept 9th where he was taken back to the ER and became hospitalize


VAERS ID: 1741353 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Wyoming  
Vaccinated:2021-09-07
Onset:2021-09-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Therapeutic response unexpected
SMQs:

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

Write-up: I had celiac disease for 11 years, and after receiving my first dose I am now able to eat gluten with no issue.


VAERS ID: 1741355 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Diarrhoea, Dyspnoea, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: Peanuts, soy, fish, all trees, dust mites
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Hives all over body. Shortness of breath. Chest pain. Gut pain. Diarrhea.


VAERS ID: 1741493 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-07
Onset:2021-09-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), 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: synthroid, vit D, multi vitamin, allegra, vit B12
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness and brain fog. Brain fog lasted for about 7-8 days. Dizziness lasted about 13 days.


VAERS ID: 1741822 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: OMEPRAZOLE, SERTRALINE, CARISOPRODOL, FAMOTIDINE, PREMARIN
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: INJECTION SITE REACTION, LARGE RED/SWOLLEN AREA BIGGER THAN THE SIZE OF A QUARTER, TREATED WITH PREDNISONE AND RESOLVED QUICKLY


VAERS ID: 1741824 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / 2 LA / IM

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

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

Write-up: 2nd dose was given 1 week before it was due.


VAERS ID: 1742178 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Back pain, Blood test, Bone pain, Breast pain, Ear pain, Fatigue, Groin pain, Lymphadenopathy, Muscle spasms, Musculoskeletal chest pain, Musculoskeletal pain, Neck pain, Oropharyngeal pain, Pain in extremity, Tinnitus
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hearing impairment (narrow), Lipodystrophy (broad), Osteonecrosis (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu vaccine- event reported to VAERS (approximately 2009). Neurological reaction to old Tetanus vaccine.
Other Medications: Vitamins
Current Illness: none
Preexisting Conditions: none
Allergies: Flu vaccine, sulfa, various beauty products, other meds.
Diagnostic Lab Data: Contacted PCP at week 1 and 2 of symptoms. Appointment on 9/28/21. Blood work collected. Appointment scheduled for 10/7/21 to follow up after 2nd dose.
CDC Split Type:

Write-up: Bilateral lymph node swelling and pain starting in armpit on 9/10/21 on vaccine side that continued to spread over the course of the week to breast; ribs; collar bone; neck; back/shoulder blades; ears; hips; groin; and extremities with calf pain/cramps; tinnitus in right ear; sore throat; and extreme fatigue. Above symptoms remained steady throughout the next week. At time of report- day 19- pain and/or swelling concentrated to opposite side groin; ears; throat; neck; and vaccine side arm, breast, armpit region. Fatigue continues. Palliative care at home: tylenol, ibuprofen, Epsom salt baths, topical pain relief ointments, and compresses. Communication with PCP. Appointment scheduled at 2 weeks without relief.


VAERS ID: 1742356 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Decreased appetite, Fatigue, Plasmapheresis
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Patient reports severe fatigue/ exhaustion and lack of appetite for one week after first dose. Symptoms resolved on their own. Patient had plasma for COVID on 3/27/2021. Her PCP recommended to hold off on receiving 2nd dose for now.


VAERS ID: 1742366 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bone pain, Fatigue, Joint stiffness, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pneumovax 2nd in series, unknown brand, severe joint issue.
Other Medications: lisinopril 3x10mg, Triumeq, atorvastatin 20mg
Current Illness: h.pylori, completed treatment 2 weeks prior
Preexisting Conditions: HIV 25+ years, asthma, hypertension, anxiety, GERD, reynauds, periphreal neropathy
Allergies: tadalafil, kiwi, pneumonia vaccine. (swelling, and severe bone/joint, pain)
Diagnostic Lab Data: none
CDC Split Type:

Write-up: stiff arm immediate. whole shoulder upper arm to mid forearm for about 30 hours. Stiff knee joints. unusual tibula pain, deep in bone. nearly caused falls, but only for a few hours. all symptoms gone in 30 hours. no other symtoms, mild fatigue. generally less reaction than 2nd vaccine.


VAERS ID: 1742545 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

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

Write-up: Patient starting having heart palpitations approximately 3 days after her 2nd dose of Pfizer vaccine. Having about 3 per day, worsened with alcohol intake. No hx of palpitations. She was referred to cardiology to get checked out to make sure everything is okay.


VAERS ID: 1743621 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 1 LA / OT

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

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

Write-up: Dose administered to 1 patient after temperature excursion; This spontaneous case was reported by an other health care professional and describes the occurrence of POOR QUALITY PRODUCT ADMINISTERED (Dose administered to 1 patient after temperature excursion) in a 22-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 062E21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 milliliter. On 10-Sep-2021, the patient experienced POOR QUALITY PRODUCT ADMINISTERED (Dose administered to 1 patient after temperature excursion). On 10-Sep-2021, POOR QUALITY PRODUCT ADMINISTERED (Dose administered to 1 patient after temperature excursion) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medication information was not provided by the reporter. Treatment information was not provided by the reporter. On 10 Sep 2021, 1st temperature excursion (vaccine went out of range) occurred. Consisted of 3 vials from which 1 vial was opened and administered to 1 patient. Once that dose was administered, the vial was wasted. There were still 2 unopened vials still in the refrigerator that had not been opened or administered to anyone.


VAERS ID: 1743688 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Fatigue, Headache, Malaise, Ocular hyperaemia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Glaucoma (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEXAPRO
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101205159

Write-up: Swollen, red, splotchy left eye; Swollen, red, splotchy left eye; Moderate to severe headache every day; malaise; Fatigue; This is a spontaneous report from a contactable consumer (patient). A 37-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: 30135BA), via an unspecified route of administration, administered in left arm on 10Sep2021 14:00 (at the age of 37 years old) as dose 1, single for COVID-19 immunisation. The patient has no medical history and no known allergies. The patient has not had COVID prior to vaccination. The patient is not pregnant at the time of vaccination. Concomitant medication included escitalopram oxalate (LEXAPRO). On 10Sep2021, the patient experienced Moderate to severe headache every day since day 1, fatigue and malaise. The patient also experienced Swollen, red, splotchy left eye on day 4, on 14Sep2021. No treatment was given in response to the events. The patient was not COVID tested post vaccination. The outcome of the events was not recovered.


VAERS ID: 1743725 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: School       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Headache, Hypoaesthesia, Paraesthesia, Pharyngeal swelling, Renal pain, Testicular pain
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101212014

Write-up: Kidney low back pain; Right testicular pain with tinglingness in right testicle; Dizzy spell/Dizziness/He felt like he was going to pass out; Headache; Shortness of breath; Throat swelling; Numbness and tingling to left side of face; Numbness and tingling to left side of face; This is a spontaneous report from a contactable consumer (patient) from a Pfizer sponsored program via medical information team. A 36-year-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, lot number: unknown) (age at the time of vaccination was 36 years) via an unspecified route of administration administered in arm right, on 10Sep2021 at 16:05 as dose 1, single for COVID-19 immunisation. The patient medical history was reported as none. Concomitant medication was not reported. The consumer clarified as, the first thing was, he stayed there observation after getting the vaccine for 15 minutes (10Sep2021). He was not having much happening then. However, by the time he got home he had throat swelling, numbness, and tingling to the left side of the face. His wife had to give him Benadryl and he took that because he was short of breath as well, but he was able to get through it. He initially stated this lasted an hour or so, but then stated it was also severe the day after the vaccine. He did not know how much Benadryl he took. He also added, the day he got the vaccine had dizziness. The dizziness started by the time he got home and he lives about 5 minutes from where he got the vaccine. He confirmed at this time the dizziness has gone away, but he had another episode of dizziness the day after the vaccine as well. The dizziness was not consistently. The last day he a dizzy spell it was a light spell. He had the spells up until three days. The second day he felt like he was going to pass out. He has not had the dizziness since about three days after the vaccine. The following day he had other symptoms (11Sep2021). The day after the vaccine he started to have kidney low back pain, right testicular pain with tinglingness in right testicle. This feeling had not subsided. However, it was not severe right now. He also had a headache the day he got the vaccine. The headache continued into the day after, and he had a headache all day on 11Sep2021. The most dizziness happened on this day, 11Sep2021, with one episode of him feeling like he will pass out. Therapeutic measures were taken as a result of shortness of breath, throat swelling, numbness and tingling to left side of face, numbness and tingling to left side of face. No Emergency or physician visits due to the events and he had a doctors appointment scheduled. The outcome of the event shortness of breath and dizzy spell/dizziness was recovered on unspecified date of Sep2021. The outcome of event kidney low back pain and right testicular pain with tinglingness in right testicle was recovering. The outcome of the event throat swelling, numbness, tingling to left side of face and headache were unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1744317 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Head injury, Immunisation, Nausea, Pain, Pyrexia, Syncope, Tremor, Vertigo
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oral Contraceptive (Birth control) Magnesium oxide
Current Illness: None
Preexisting Conditions: IgA deficiency
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: After 12 hours, high fever above 103, tremors After 24 hours, dizziness and nausea, body aches After 48 hours, vertigo, fainted and hit head on the floor After I fainted I felt totally back to normal


VAERS ID: 1744345 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-16
Onset:2021-09-10
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Headache, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: no
Allergies:
Diagnostic Lab Data: PCR collected 9-12-2021 and resulted positive on 9-13-2021
CDC Split Type:

Write-up: Fever, feverish, body aches, runny nose, sore throat, cough, headache, fatigue, congestion


VAERS ID: 1744382 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-01-27
Onset:2021-09-10
   Days after vaccination:226
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20-2A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Headache, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Rapid test done on 9-13-2021, positive
CDC Split Type:

Write-up: Headache, loss of taste and smell


VAERS ID: 1744383 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-06-28
Onset:2021-09-10
   Days after vaccination:74
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Hypertension, cardiovascular disease, former smoker, dementia, COPD
Allergies: unknown
Diagnostic Lab Data: COVID PCR test
CDC Split Type:

Write-up: After receiving 2 doses of Pfizer COVID vaccination on 6-28-21 & 7-19-21, patient became infected with COVID in September 2021 and was hospitalized due to this breakthrough infection.


VAERS ID: 1744558 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-01-23
Onset:2021-09-10
   Days after vaccination:230
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Cough, Fatigue, Headache, Myalgia, Polymerase chain reaction positive, Respiratory tract congestion, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Taste and smell disorders (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (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:
Current Illness:
Preexisting Conditions: tachycardia, anxiety, depression
Allergies:
Diagnostic Lab Data: PCR collected on 9-14-2021, resulted positive on 9-15-2021
CDC Split Type:

Write-up: muscle aches, runny nose, cough, headache, fatigue, loss of taste and smell, congestion


VAERS ID: 1744694 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN D123UIT / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Neck pain, Pain in extremity, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Tendinopathies and ligament 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness:
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain in arm (traveled up to neck and head area); vomiting; fainting.


VAERS ID: 1745010 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-08-27
Onset:2021-09-10
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Musculoskeletal stiffness, Sinusitis
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Olmesartan, Propranolol, Singular, phentermine,
Current Illness: none
Preexisting Conditions: Hypertension, Anxiety disorder, obesity
Allergies: Kiwi - local swelling of the mouth
Diagnostic Lab Data: none
CDC Split Type:

Write-up: C/O muscle stiffness in the neck and upper back and shoulders for the past 4 weeks or so. Has been seen by PCP and put on antibiotic and steroid shot because they dx him with sinus infection but the medication did not help at all. Has not changed his daily routine. He states that "this is a different type of pain than I have ever had" "it won''t go away and medications does not help"


VAERS ID: 1745012 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan, Xanax, contrave, metoprolol, atorvastatin, Aspirin
Current Illness: None
Preexisting Conditions: Diabetes type two; Rheumatoid arthritis
Allergies: Codeine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Approximately 12 hours after injection, developed raised red rash in both axillae. Required medication intervention to resolve


VAERS ID: 1745046 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-26
Onset:2021-09-10
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Cerebrovascular accident
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D Vitamin Synthroid Pepcid Effexor Singulair
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Strokes approximately 5 months after vaccine


VAERS ID: 1745120 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-03-28
Onset:2021-09-10
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Condition aggravated, Diarrhoea, Headache, Injection site pain, Pain, Pyrexia, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: 3/4/2021 COVID 19 Dose 1 - My arm was swollen from the shoulder to the elbow and the lymph nodes under the arm was inflamed. I h
Other Medications: Losartan; Hydrochlorothiazide; Methotrexate; Plaquenil; Estradiol; Pravastatin; Hydroxychloroquine; Folic Acid; OTC Centrum; OTC calcium
Current Illness: No
Preexisting Conditions: RA
Allergies: Latex - a bit sensitive to it
Diagnostic Lab Data: ER and Hospital Sept 11 COVID test negative result
CDC Split Type: vsafe

Write-up: I had diarrhea to start and then it started with fever up to 101.7. And then I started having chills and pain in all the joints - general body pain and headache. ER visit they did a COVID test. The result was negative. They just told me take OTC Advil and Tylenol. I had my symptoms for three days. And then they all resolved. Right after the 2nd vaccine: I had chills, fever, and injection site was very sore and I had body pain (all the joints). Those lasted 2 days, I think. No treatment.


VAERS ID: 1745126 (history)  
Form: Version 2.0  
Age: 0.33  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Headache, Heart rate increased, Heavy menstrual bleeding, Hypersensitivity, Hypoaesthesia, Laboratory test, Menstrual disorder, Muscle spasms, Night sweats, Pyrexia
SMQs:, Angioedema (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Sexual dysfunction (broad)

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

Write-up: Accelerated heart beat. Numbness in left foot. Severe headaches, fever, night sweats, problems with menstrual cycle, cramps, blood clot in menstruation. Headaches lasting 5 consecutive days. Increased seasonal allergies.


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