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

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



Case Details (Reverse Sorted by Onset Date)

This is page 223 out of 4,799

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VAERS ID: 1392485 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient was a new customer at pharmacy so medications are unknown
Current Illness: medical history unknown
Preexisting Conditions: not known
Allergies: no known allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: No adverse events were reported


VAERS ID: 1392544 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-04-12
Onset:2021-06-01
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Vertigo
SMQs:, Vestibular disorders (narrow)

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

Write-up: Beginning June 1st I have had vertigo every morning, it is going on 2 weeks now. I have no other symptoms that would lead to believe I have an infection of any kind.


VAERS ID: 1392587 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-24
Onset:2021-06-01
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram, Blood test, Chest pain, Dyspnoea, Electrocardiogram, Pain, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Esomeprosol, Lisinopril, Atorvastatin, Vitamins C&D, Zinc, Baby aspirin
Current Illness:
Preexisting Conditions: Cluster headaches, GERD (Barret;s syndrom)
Allergies: None
Diagnostic Lab Data: EKG, CT scan of arteries, blood work (routine and looking for clots).
CDC Split Type:

Write-up: Shortness of breath and chest pains after routine workout at the gym. Got worse thru the day. Went to ER in the evening. Tests for heart attack and blood clots were negative. Sent me home next morning feeling slightly better. Next night (6/2) woke up at 3 am with shooting pains in right leg below knee. Back to ER where they repeated heart tests and did sonogram of leg. All normal. Sent me home again. Symptoms continue to this day with slight improvement. Have follow ups scheduled with Cardio and Pulmonary.


VAERS ID: 1392683 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

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

Write-up: Rapid heartrate started 13 hours (11:00pm on 6/1/2021) after vaccine was administered (10:00am 6/1/2021) and lasted consistently for 18 hours (5:00pm on 6/2/2021), even while sleeping through the night.


VAERS ID: 1392757 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-28
Onset:2021-06-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Chest pain, Coagulation test normal, Deep vein thrombosis, Electrocardiogram abnormal, Fibrin D dimer increased, Haemoptysis, Imaging procedure abnormal, Pain in extremity, Peripheral swelling, Pleuritic pain, Pulmonary embolism, SARS-CoV-2 antibody test, Sinus tachycardia
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Was taking tylenol q4 for 3-4 days prior to today for pain Also took 1-2 doses of naproxen at home OCP use for a month prior to today
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: D Dimer 4000 Normal coags COVID IGG 184 AU/ml EKG sinus tachy
CDC Split Type:

Write-up: Patient vaccinated on 5/28. She reported having pleuritic chest pain and hemoptysis 3 days after that lasted about a week. Then after she developed right leg pain and swelling x 3 days. Seen at our ER 6/11- studies show DVT of the common femoral vein and other veins of the right lower extremity. Also had b/l pulmonary emboli. Started on lovenox treatment and pending thrombectomy by vascular surgeons in 2 days. (In addition she also had admitted to OCP use for a month prior to this event; no reported FH of clotting disorders)


VAERS ID: 1392787 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-28
Onset:2021-06-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Burning sensation, Discomfort, Lymph node pain, Lymphadenopathy, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 4 days after the vaccine I woke up with My left arm lymph nodes (under arm/armpit area) swollen and painful. This constant pain that felt like acute pressure under my arm lasted 4 days. The swelling started going down after the 4 the day making it more comfortable to sleep and stretch my arm. Prior to that even if reached my arm out to grab something, I would feel a pinch and a burning sensation on the left arm lymph node. I did not take any medication because I did not know what would make it better or worse or how long this pain would last. The control website or any other site informed me about the swelling of the lymph node or what to do to relive the pain. The only thing I did was switch to an organic deodarant and place cold compressions on my under arm.


VAERS ID: 1392795 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Fall, Loss of control of legs, Muscular weakness, Nausea, Pyrexia, Vomiting, Walking aid user
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ?Glimepiride 2 MG Tablet 1 tablet with breakfast or the first main meal of the day Orally every 12 hours ?metFORMIN HCl 500 MG Tablet 2 tablet with a meal Orally every 12 hours ?Metoclopramide HCl 10 MG Tablet 1 tablet before meals Orally T
Current Illness: n/a
Preexisting Conditions: Diabetes, hypertension
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: After he had the second Moderna vaccine 045B21A at Clinic on 06/01, he had some errands to do after getting home he took a nap for 4-5 hours and after while trying to get up and out of his bed he fell did not have control of his leg. He was able to walk with the help of his wife but he has to use a walker to ambulate as he feels his legs are weak. Weakness is worse on the left. He also experienced fever, nausea, vomiting, and diarrhea.


VAERS ID: 1392842 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Crying, Dizziness, Dyspnoea, Loss of consciousness, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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: unknown
Current Illness: No
Preexisting Conditions: No
Allergies: NKA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: After getting a vaccine, patient was advised to sit for 15 more minutes. As soon as he left the immunizing room, he fainted for couple of seconds. Then regained consciousness but had shaky hands, SOB, and in tears. He was provided with water and asked he may take off the mask if breathing is difficult. Taking the mask ease the breathing a little, but still SOB. Gave him a brown paper bag to breath into and as him to take deep breath in & out. He did that few times, then regained his normal breathing. Saw him looking down to his phone, which I told him to lift his head up to his eyelevel to decrease the dizziness. Was situated for about at least 30 minutes, then he said he was feeling better and he wants to leave as his friend is outside to pick him up and left.


VAERS ID: 1392895 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: INCORRECTLY STORED VACCINE WAS ADMINISTERED TO PATIENT; HAD TO RE-VACCINATE


VAERS ID: 1392917 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-06
Onset:2021-06-01
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 states she had rash and soreness at injection site 1 month after 1st dose of vaccine.


VAERS ID: 1393028 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-10
Onset:2021-06-01
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Generalised anxiety disorder, Hypertension, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (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: DIM supplement, Rhodiola, ashwaganda
Current Illness: None
Preexisting Conditions: Overweight
Allergies: No known allergies.
Diagnostic Lab Data: None yet.
CDC Split Type:

Write-up: Episodes of generalized, unexplained anxiety with onset about 2 1/2 weeks after vaccination. Episodes of anxiety are frequent and accompanied by tachycardia and high blood pressure.


VAERS ID: 1393211 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-11
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levonorgestrel 0.15mg daily Vit D3 1250mg once weekly
Current Illness: None
Preexisting Conditions: n/a
Allergies: NKDA
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient received #1 dose Pfizer Covid vaccine on 5/21/2021 and inadvertently received #2 dose of Moderna Covid vaccine today.


VAERS ID: 1393229 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-02-22
Onset:2021-06-01
   Days after vaccination:99
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Headache, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: xeralto, folbic, septra ds
Current Illness: none
Preexisting Conditions: blood clots, small persistent infection fm barnacle scrape
Allergies: morphine?
Diagnostic Lab Data:
CDC Split Type:

Write-up: three months after vaccination i came down with a headache, fluctuating fever (97-102) queasy stomach, loss of energy. syptoms have lasted for three days now


VAERS ID: 1394319 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-02-01
Onset:2021-06-01
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebral venous sinus thrombosis, Headache, Magnetic resonance imaging head abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (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: benazepriL (Lotensin) 20 mg tablet Take 20 mg by mouth daily. fluticasone propionate (Flonase) 50 mcg/actuation nasal spray levothyroxine (Synthroid) 100 mcg tablet pravastatin (Pravachol) 40 mg tablet tamsulosin (Flomax) 0.4 mg 24 hr c
Current Illness: no acute illness
Preexisting Conditions: htn, BPH
Allergies: NKDA
Diagnostic Lab Data: MRI brain done at hospital
CDC Split Type:

Write-up: pt with very bad headache two weeks ago. now in hospital with very large cerebral sinus thrombosis


VAERS ID: 1394325 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 second dose on 06/01/2021 of the vaccine 14 days after receiving the first dose on 05/18/2021. Patient did not report any adverse events.


VAERS ID: 1394402 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

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

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


VAERS ID: 1394559 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW01011 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster, Physical examination
SMQs:, Opportunistic infections (broad)

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

Write-up: Vaccine gives 6/4, now have shingles. Symptoms started 6/10, full blown by 6/12.


VAERS ID: 1394601 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-06-11
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: Herpes 2 outbreak


VAERS ID: 1394606 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-01
Onset:2021-06-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Cerebrovascular accident, Dysphemia
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? 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: buproprion, cymbalta, lisinopril, protonix
Current Illness: none
Preexisting Conditions: hypertension
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Stuttering began shortly afterwards and persists. Now with evidence of a stroke.


VAERS ID: 1394612 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-01
Onset:2021-06-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose, Chest X-ray, Chest pain, Dyspnoea, Electrocardiogram, Fatigue, Full blood count, Headache, Metabolic function test, Mononucleosis heterophile test, Palpitations, Urine analysis
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Nonr
Preexisting Conditions: Nonr
Allergies: Nonr
Diagnostic Lab Data: EKG, Chest X-ray, CBC, CMP, Mono test, UA w culture, blood glucose
CDC Split Type:

Write-up: Fatigue - rapid heart rate when standing up, exceeds 120bpm when walking or standing and then goes down when lying, chest pain, severe headache, shortness of breath. All tests to rule out other causes negative


VAERS ID: 1394759 (history)  
Form: Version 2.0  
Age: 102.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-02
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Incorrect product formulation 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: At 1021, patient was given 0.3 mL of Pfizer vaccine mixed with 1.4 mL NS (instead of 1.8 mL) IM on left arm. Patient is bedbound and was given the vaccine at home. Patient was observed for 30 minutes and did not have any symptoms during the observation period. Patient''s caregiver was given details of event and info about responding to adverse reactions when a healthcare professional is not present.


VAERS ID: 1394769 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-06-01
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Cough, Oropharyngeal discomfort
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: occasional throat tickle causing dry cough


VAERS ID: 1395025 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

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

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

Write-up: Patient received her 1st dose on 6/1, 9 hours later she fainted. She has no medical conditions and no history of fainting.


VAERS ID: 1395126 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: hx of fainting at md office
Other Medications: none reported
Current Illness: none reported
Preexisting Conditions: none reported
Allergies: none
Diagnostic Lab Data: None reported. Just did a follow-up with pcp per mom
CDC Split Type:

Write-up: Fainting, became alert after a few seconds


VAERS ID: 1395250 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-27
Onset:2021-06-01
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       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? 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: Can?t remember the exact dates, just now found out that you can report adverse reactions. The issue i had was what felt like my heart working hard when i laid down for bed a couple nights. One time i put a heart rate monitor one because it felt like my heart rate was very high but the monitor showed normal.


VAERS ID: 1395288 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-22
Onset:2021-06-01
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy, Ear pain
SMQs:, Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prescription: Valtrex (only when needed. not regularly) Multivitamin, Lysine Supplement, Red Marine Algae Supplement
Current Illness: Common Cold one week prior
Preexisting Conditions: Genital Herpes
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I got a mild case of Bell''s Palsy. My face did not droop but I could not lift the left side of my face at all. I could not fully smile or flare my nostrils. I also had an earache but no ear infection. I am 10 days into having Bell''s Palsy and I have seen an improvement in the movement of my face after one week of Prednisone. But there is still a long way to go before I fully recover.


VAERS ID: 1395311 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Anxiety, C-reactive protein, Confusional state, Diarrhoea, Feeling abnormal, Full blood count, Hypersomnia, Metabolic function test, Neutrophil count
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, women''s multivitamin
Current Illness: upper respiratory infection
Preexisting Conditions: Hashimoto''s hypothyroid
Allergies: n/a
Diagnostic Lab Data: CBC, CRP, Seg, kidney, liver, thyroid blood work collected on June 3
CDC Split Type:

Write-up: Developed intense brain fog, confusion, memory loss, diarrhea, sleeping 10-12 hrs per day plus 2 naps per day. Was to the point that I was reaching out to touch my family members to make sure they were really standing in front of me. As an RN myself, I was very worried. Lasted for a total of 5-6 days and then completely went away. No history of mental illness other than anxiety. Was seen by PCP on day 2 of symptoms. Scheduled for MRI of the brain and complete lab work collected. No signs of inflammation or infection. If symptoms continued then would have prescribed course of steroids but symptoms went away on June 7th. 2nd dose of vaccine was on June 1st.


VAERS ID: 1395330 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Montana  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210619418

Write-up: EXPIRED VACCINE USE; This spontaneous report received from a health care professional concerned multiple patients. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on JUN-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On JUN-2021, the subject experienced expired vaccine use. The action taken with covid-19 vaccine was not applicable. The outcome of expired vaccine use was not reported. This report was non-serious. This report was associated with product quality complaint: 90000182243. The suspected product quality complaint has been confirmed to be to be voided (no PQC was identified) based on the PQC evaluation/investigation performed.


VAERS ID: 1395534 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN XD98B / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Cerebral venous sinus thrombosis, Cerebrovascular accident, Computerised tomogram head, Magnetic resonance imaging head
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), Embolic and thrombotic events, venous (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (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, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: Brain CT 07.06.2021 Brain MRI 09.06.2021
CDC Split Type:

Write-up: Cerebral Venous Sinus Thrombosis Stroke


VAERS ID: 1395915 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-15
Onset:2021-06-01
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood test, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Dyspnoea, Fibrin D dimer, Full blood count, Laboratory test, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Simvastatin, Amaryl, Metformin, Losartan
Current Illness: None
Preexisting Conditions: Diabetes, Hypertension, Hyperlipidemia
Allergies: Lisinopril
Diagnostic Lab Data: Chest x-ray; Chest CT; Lab work, including D-Dimer, CBC, and Chemistry panel 6/3/21
CDC Split Type:

Write-up: Patient developed shortness of breath with bilateral pulmonary emboli. He was hospitalized on 6/3/21 to 6/4/21 and was discharged home on blood-thinning medication.


VAERS ID: 1395942 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-29
Onset:2021-06-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Full blood count abnormal, Ophthalmological examination abnormal, Retinal vein occlusion, Thrombocytopenia
SMQs:, Haematopoietic leukopenia (broad), Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, venous (narrow), Optic nerve disorders (broad), Corneal disorders (broad), Retinal disorders (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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: 06/01/2021 Ophthalmology examination 06/01/2021 CBC
CDC Split Type:

Write-up: Central Retinal Vein Occlusion 1 day after receiving second dose of Pfizer vaccination + Thrombocytopenia


VAERS ID: 1396046 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: C-reactive protein normal, Chest X-ray normal, Chest discomfort, Dizziness, Dyspnoea, Electrocardiogram Q waves, Electrocardiogram abnormal, Full blood count normal, Metabolic function test normal, Pain, Pyrexia, Red blood cell sedimentation rate normal
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), Cardiomyopathy (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro 10mg
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin and latex
Diagnostic Lab Data: CXR: NAD EKG: subtle ? Q wave V1-2 CBC, CMP, ESR, CRP are normal Will arrange for echocardiogram to check pump function Consider need for functional heart testing pending course Activities as tolerated pending course with symptoms reviewed ? electrocardiogram ? XR, chest, 2 view ? US, echocardiogram, transthoracic, complete, w/ color flow ? CBC with differential/platelet ? comprehensive metabolic panel ? erythrocyte sedimentation rate by westergren method ? C reactive protein, QN, serum or plasma
CDC Split Type:

Write-up: 12 hours after second Pfizer vaccine dose - Fever, body pain , chest pressure, 24 hours. Chest pressure and Dyspnea on exertion continues June 1 - present day of June 14th Severe dizziness begins on June 12th


VAERS ID: 1396051 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Autoimmune disorder, Fibromyalgia, Headache, Hypoaesthesia, Neuralgia, Paraesthesia, Rheumatoid arthritis
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Arthritis (narrow), Immune-mediated/autoimmune disorders (narrow)

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

Write-up: Fibromyalgia and rheumatoid arthritis worsens. Skin tingles and numbness continue. The nerve pain from the autoimmune disorders magnify to the point of severe pain. Headaches are unbelievable and still have them. Symptoms of fibromyalgia gets worse by the day.


VAERS ID: 1396370 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 2 - / -

Administered by: Public       Purchased by: ?
Symptoms: Device connection issue
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:

Write-up: Syringe separated from needle after vaccinator inserted into arm. No vaccine was injected, so vaccinator withdrew needle and successfully vaccinated patient with a new needle and syringe. No AE.


VAERS ID: 1396374 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-17
Onset:2021-06-01
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO171 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Lethargy, Paraesthesia, Tinnitus
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Ringing in ears, dizziness, lethargy and constant tingling in lower legs and feet.


VAERS ID: 1396394 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (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: Multivitamins for Women, Omeprazole (Rx strength)
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Soreness in arm at injection site after about 3-4 hours. Approx 12 hours later, chills, aches and extreme fatigue.


VAERS ID: 1396503 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Eye pruritus, Eye swelling, Feeling hot, Ocular discomfort, Photophobia
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Retinal disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa, Erythromycin, Azithromycin & Iodine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt received covid vaccine # 2 on 6/1/21 at 10:15 am and an hour later (11:15 am) developed itch and swelling in both eyes with sob. Pt also reported face feeling warm to touch. Eyes were sensitive to light and felt pressure around eyes. Patient was unable to keep her eyes open. No temp noted. Pt took Claritin at 2:00 pm with no relief, felt symptoms became worse. Pt reported having side effects from first vaccine on 6/1/21. She states she had lethargy, low-grade fever and body aches. Pt was advised to go to Urgent Care for evaluation. Pt went to Urgent Care and left without being seen, she has not followed up with primary care provider.


VAERS ID: 1396783 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-03
Onset:2021-06-01
   Days after vaccination:90
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest discomfort, Cough, Exposure during pregnancy, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Breakthrough covid case during pregnancy. Received dose 1 & 2 of pfizer vaccine in March of 2021 in late first trimester/early 2nd trimester of pregnancy. Came down with covid 2 months later (25 weeks pregnant) from close contact with infected covid partner. Experienced moderate covid symptoms and visited ER for chest tightness & cough. Tested positive for COVID in the hospital.


VAERS ID: 1397910 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Unknown  
Location: Colorado  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Computerised tomogram, Eye disorder, Facial spasm, Head discomfort, Hypertension, Immediate post-injection reaction, Muscle spasms, Tremor, Visual impairment
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Hypertension (narrow), Optic nerve disorders (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Klonopin lisinopril
Current Illness: Neck spasm
Preexisting Conditions: Spine fusion in neck and hypertension with anxiety
Allergies: Psycho active drugs
Diagnostic Lab Data: Ct scan
CDC Split Type:

Write-up: Severe shaking that begin immediately along with spasm and anxiety.lower face and mouth spasm.neck very strong.arms woukd not stop shaking.hypertension.vision change not eyesfront of head brain pressure


VAERS ID: 1398421 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Body temperature increased, COVID-19, Chills, Ear pain, Fatigue, Headache, Injection site pain, Nausea, Oedema, Oropharyngeal pain, Peripheral swelling, Productive cough
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? 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: ATORVASTIN; NEXIUM [ESOMEPRAZOLE MAGNESIUM]
Current Illness: Abstains from alcohol; GERD; Hypercholesterolaemia; Latex allergy; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19; Comments: The patient has no history of drug abuse or illicit drug usage. The patient was not pregnant at the time of reporting.
Allergies:
Diagnostic Lab Data: Test Date: 202102; Test Name: COVID-19; Result Unstructured Data: Positive; Test Date: 20210604; Test Name: Body temperature; Result Unstructured Data: 102.7 F
CDC Split Type: USJNJFOC20210614408

Write-up: SORE THROAT; COUGHING UP BROWN MUCUS INITIALLY WHICH IS NOW GREENISH WHITE; RIGHT SIDED EARACHE; FATIGUE; SICK TO STOMACH/NAUSEA; PAIN AT INJECTION SITE; EDEMA; CHILLS; TEMPERATURE ELEVATED; BAD HEADACHE; SWELLING UNDER THE ARM; This spontaneous report received from a patient concerned a 54 year old female. The patient''s weight was 175 pounds, and height was 68 inches. The patient''s past medical history included covid-19 infection, and concurrent conditions included high cholestrol, gerd, latex allergy, non-alcoholic, and non smoker, and other pre-existing medical conditions included the patient has no history of drug abuse or illicit drug usage. the patient was not pregnant at the time of reporting.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 207A21A, and expiry: 23-JUN-2021) dose was not reported, administered on 04-JUN-2021 for prophylactic vaccination. Concomitant medications included esomeprazole magnesium for gerd, and atorvastatin calcium for high cholestrol. On FEB-2021, Laboratory data included: COVID-19 (NR: not provided) Positive. On JUN-2021, the subject experienced swelling under the arm. On 04-JUN-2021, the subject experienced chills. On 04-JUN-2021, the subject experienced temperature elevated. On 04-JUN-2021, the subject experienced bad headache. Laboratory data included: Body temperature (NR: not provided) 102.7 F. On 05-JUN-2021, the subject experienced edema. On 05-JUN-2021, the subject experienced fatigue. On 05-JUN-2021, the subject experienced sick to stomach/nausea. On 05-JUN-2021, the subject experienced pain at injection site. On 06-JUN-2021, the subject experienced coughing up brown mucus initially which is now greenish white. On 06-JUN-2021, the subject experienced right sided earache. On 06-JUN-2021, the subject experienced sore throat. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sick to stomach/nausea on 07-JUN-2021, was recovering from bad headache, chills, edema, right sided earache, and pain at injection site, had not recovered from temperature elevated, fatigue, coughing up brown mucus initially which is now greenish white, and sore throat, and the outcome of swelling under the arm was not reported. This report was non-serious.


VAERS ID: 1398423 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: South Carolina  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Headache, Retching, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (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: USJNJFOC20210614577

Write-up: VOMIT(UNABLE TO KEEP SOLID FOODS IN); DIZZINESS; DRY HEAVING(NAUSEA); JOINT PAIN; HEADACHES; This spontaneous report received from a consumer concerned a 33 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, and batch number: 206A21A expiry: UNKNOWN) dose was not reported, administered on 28-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-JUN-2021, the subject experienced vomit (unable to keep solid foods in). On 01-JUN-2021, the subject experienced dizziness. On 01-JUN-2021, the subject experienced dry heaving (nausea). On 01-JUN-2021, the subject experienced joint pain. On 01-JUN-2021, the subject experienced headaches. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headaches, dizziness, vomit(unable to keep solid foods in), dry heaving(nausea), and joint pain. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure as the case assessed non-serious


VAERS ID: 1398439 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Alaska  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenopia, Asthma, Feeling hot, Illness, Loss of consciousness, Miosis, Pain, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ADVAIR
Current Illness: Asthma
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210619325

Write-up: ASTHMA ACTING UP; SEVERE AND EXCESSIVE VOMITING; ACHES; FEELING HOT; PUPILS LOOK LIKE NEEDLES; EYE STRAIN; REALLY SICK; FAINTING; BLACKING OUT; This spontaneous report received from a consumer concerned a male of unspecified age, race and ethnic origin. The patient''s height, and weight were not reported. The patient''s concurrent conditions included asthma. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown Expiry: Unknown) dose was not reported, with frequency 1 total administered on 08-JUN-2021 for prophylactic vaccination. The batch number is not reported and has been requested. Concomitant medications included fluticasone propionate/salmeterol xinafoate (Aadvair) for asthma. On JUN-2021, the patient experienced fainting which included episodes of blacking out along with aches, feeling hot, pupils look like needles, eye strain, really sick, severe and excessive vomiting not so much nausea but it was reported that patient was puked to the point of having nothing left in his stomach. On 08-JUN-2021, post 45 minutes of vaccination the patient experienced asthma acting up. It was also reported that patient had been administered with a nebulizer (name unspecified) which did not help hime therefore he gone through the last fourth of a rescue inhaler which he had on his hand during those last 24 hours. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the severe and excessive vomiting, fainting, blacking out, aches, feeling hot, pupils look like needles, eye strain, asthma acting up, really sick and not so much nausea was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210619325-COVID-19 VACCINE AD26.COV2.S-fainting, blacking out. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1398464 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Influenza
SMQs:, Infective pneumonia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210623078

Write-up: 2 DAYS OF THE FLU; This spontaneous report received from a consumer concerned multiple patients. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered on 02-JUN-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On JUN-2021, the subject experienced 2 days of the flu. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from 2 days of the flu on JUN-2021. This report was non-serious. This case, from the same reporter is linked to 20210622311.


VAERS ID: 1398575 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:2021-06-03
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anaesthesia, Arthralgia, Asthenia, Dizziness, Fatigue, Headache, Lethargy, Lymphadenopathy, Myalgia, Pain, Pain in extremity, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021665207

Write-up: Muscular and joint pain; Muscular and joint pain; Lethargic; Looks like she is under anesthesia; Feeling exceedingly drained/tiredness; Her entire body is in pain; Dizziness; Jabbing pains under the arms and in her head; Jabbing pains under the arms and in her head; Weakness; Experienced swollen glands/glands got swollen; Swelling in her armpits; This is a spontaneous report from a contactable consumer. This consumer reported for 19-year-old female patient (reporter''s daughter) that: A 19-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: EW0185 and expiry date: 31Aug2021), second dose via an unspecified route of administration on 03Jun2021 in her upper left arm, as single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), first dose via an unspecified route of administration on 13May2021 (Lot Number: EW0168/EJ6795 and expiry date: 31Aug2021) in her upper left arm, single dose for COVID-19 immunisation. The patient experienced swelling in her armpits in Jun2021. On 03Jun2021 (started almost on the onset of injection), experienced weakness. In Jun2021 (started probably 2 days ago on 04Jun2021 or 05Jun2021), experienced swollen glands. On 05Jun2021, jabbing pains under the arms in her gland and inside of her head (took Tylenol and it dissipated but it was worse now than in the beginning). On 06Jun2021, feeling exceedingly drained, tiredness, dizziness and entire body was in pain. Reporter stated like this was muscular and joint pain and her daughter was very lethargic. It was informed that the last night was the hardest and her daughter describes this pain feeling like she has an elephant on top of her. On 07Jun2021 (around 3am), looks like she was under anaesthesia. The patient was experiencing pain, weakness, and tiredness which made her look like she belongs in the hospital. Reporter stated her daughter has no fever or vomiting but she has made sure her daughter has stayed on tylenol products, and fully hydrated with pedialyte. The patient taking normal medications along with Tylenol with a little bit of codeine. She had consulted briefly with her pharmacist but not taken Motrin as per pharmacist instruction. She had been drinking 3 full pedialytes per day. Now she was down for the count again and it looks like she just got the shot again and now it was the 7th day and she kind of predicted it would go on for 3 to 4 days. When patient got the vaccine she was right smack in the middle of her menstrual cycle which was rough enough on her but now her cycle was over and she was still down for the count. Reporter had concerned as her daughter takes other medications. Nothing changed her daughter and had been on the same medication for other things and it has been standard and has been on them for a year. The patient had no fever, she just took it 5 minutes ago and it was normal. The outcome of the events muscular and joint pain, lethargic were unknown rest all were not recovered.


VAERS ID: 1398593 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-17
Onset:2021-06-01
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021A21C / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest pain, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin d 50,000 iu po daily
Current Illness: kidney stones; elevated blood pressure;
Preexisting Conditions: none but recent elevated triglycerides and bp but unclear how long
Allergies: NKA
Diagnostic Lab Data: none yet
CDC Split Type:

Write-up: Pt c/o chest pain starting on 01 or 02 JUN; he came in today 15JUN when he realized the chest pain was not resolving; symptoms were classic pericarditis with worse with laying down and resolved with leaning forward; ecg confirms pericarditis; he was sent directly to cardiology from primary care


VAERS ID: 1398663 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-05-26
Onset:2021-06-01
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: B Complex, D3, Melatonin, and Magnesium
Current Illness:
Preexisting Conditions: Cluster Headaches
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Broke out in hives almost a week after second injection. Have taken benadryl and a steroid taper with no change. Hives have only gotten worse.


VAERS ID: 1398779 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-02-08
Onset:2021-06-01
   Days after vaccination:113
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / UNK - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Cardiac stress test, Dizziness, Echocardiogram normal, Fatigue
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Echocardiogram and stress test on May 10, 2021
CDC Split Type:

Write-up: Dizziness, weakness and fatigue. Had an Echocardiogram and stress test and all was good.


VAERS ID: 1398805 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Unknown  
Vaccinated:2020-12-16
Onset:2021-06-01
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ0553 / 1 LA / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1688 / 2 - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Balance disorder, Chest pain, Dyspnoea, Fatigue, Pain in extremity, Paraesthesia, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Extreme tiredness, aching legs, pains across whole of chest, swollen left foot, shortness of breath , "pins and needles" in bothe hands at the same time as each other, loss of balance when walking, stomach pains only in the evening after eating a Small amount of food as I have put on weight recently even though I am eating the same amount ( less recently as above) as normal for the last 70 years.


VAERS ID: 1398897 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Electrocardiogram, Feeling abnormal, Head discomfort, Headache, Limb discomfort, Loss of personal independence in daily activities, Pain, Pyrexia, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nothing
Current Illness: None Known
Preexisting Conditions: ADHD
Allergies: None Known
Diagnostic Lab Data: EKG and Covid Test at Urgent Care Checkup and a Primary Care Doctor follow up.
CDC Split Type:

Write-up: Extremely Severe Headache, Fever, Body Ache during the first 24 hours after vaccine injection. Extreme mental fog during 24-48 hours after vaccine injection. After initial 48 hours after vaccine injection, experienced tightness in chest with a slight bias to left side. Also still experiencing very faint feeling of headache since injection. This seems to cause slight mental fog and has remained as of writing this 2 weeks after injection. At 72 hours after injection, tightness or pressure moved across entire upper chest collar area, and down left arm and up left side of head behind left ear and into the back of the head, and then finally to the top of the head. Pressure/Tightness discomfort seems to effect left hand nerves... effecting typing on keyboard with left hand fingers. Pressing on left and right collar bone pectoral areas exacerbates irritation. Adverse symptoms after initial 48 hour period have remained the mostly same for almost 2 weeks period.


VAERS ID: 1398933 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-25
Onset:2021-06-01
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO173 / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear discomfort, Head discomfort, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

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

Write-up: Persistent arm pain (ongoing as of this date), pressure in head/ears especially at nights.


VAERS ID: 1398951 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram abnormal, Diarrhoea, Hypotension, Moaning, Pulmonary embolism, Tremor, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, venous (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: 06/10/2021 Pt, per EMS report pt had his second covid vaccine shot, started having bad reaction, ems on scene, pt GCS 10, spo2 92% RA, hypotensive. at home pt having bad reaction, vomiting, defecated. Pt on gurney moaning, shaking answering questioning. Per MD, CT results show multiple Pulmonary emboli


VAERS ID: 1398953 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-11
Onset:2021-06-01
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Scheduled
CDC Split Type:

Write-up: Sharp Pain in shoulder at injection site moving down to below elbow. Almost feels like a pinched nerve or something similar.


VAERS ID: 1399015 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Dizziness, Palpitations
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Dizziness, chills, and palpitations


VAERS ID: 1399175 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-18
Onset:2021-06-01
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Anticoagulant therapy, Deep vein thrombosis, Full blood count normal, Metabolic function test normal, Pelvic venous thrombosis, Peripheral swelling, Pulmonary embolism, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vit. D3, Vit. B12, Rosuvastatin, Refresh eye drops, Nitroglycerine PRN, Lisinopril, Latanoprost eye drops, Glucosamine Chond. , fluticasone nose spray, Docusate sodium, Carvedilol, aspirin, aspercream lido patch, tums, L-Lysine, Mag., miri
Current Illness: none
Preexisting Conditions: HLD, OSA chronic pain, arthritis, glaucoma, MI, CABG, Dementia, alzheimers, lyme disease, Electronic stimulator for lumbar canal stenosis., spondyloses, mild facial pain, indigestion. Positive for covid 19 1/8/2021.
Allergies: Rhopressa, Codiene
Diagnostic Lab Data: Doppler, CBC, CMP Doppler + CBC, CMP within normal limits
CDC Split Type:

Write-up: Biliateral Pulmonary Emboli, Rt leg DVT up to iliac vein. Treated with Eliquis po. -- sent to hospital for further treatment Remains in hospital at this time Symptoms were swelling of Rt foot, normally SOB, no increase in baseline


VAERS ID: 1399178 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-07
Onset:2021-06-01
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Anosmia
SMQs:, Taste and smell disorders (narrow), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Loss of smell, occurred approximately 1 week after receiving the vaccine. Has not returned


VAERS ID: 1399250 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

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

Write-up: Chronic constant Metallic taste in mouth for 2 weeks since injection given.


VAERS ID: 1399459 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sotalol, lorazepam, losartan, Plavix, Eliquis, triamcinolone cream, Repatha, Lotemax, Pataday, minocycline, clindamycin lotion
Current Illness: None
Preexisting Conditions: Spinal stenosis, insomnia, anxiety, hyperlipidemia, breast cancer, hypertension, coronary artery disease, atrial fibrillation, GERD, sleep apnea, knee osteoarthritis
Allergies: Penicillin, statins, Arimidex, adhesive, amlodipine
Diagnostic Lab Data: none
CDC Split Type:

Write-up: paresthesia up and down body about one and a half hours after vaccine administration


VAERS ID: 1399504 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-02-11
Onset:2021-06-01
   Days after vaccination:110
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 06M20A / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Nausea, Vertigo, Vestibular disorder, Vestibular neuronitis, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)

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

Write-up: Acute Right unilateral vestibular Hypofunction (Vestibular Neuritis) Vertigo Nausea Vomiting


VAERS ID: 1399854 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 125
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: The next morning I woke up with dizziness. I experienced vertigo/dizziness over the course of a couple weeks. Frequency of vertigo/dizziness began to decline after 5 days and was gone after about 10-12 days. I''ve never had vertigo before, and was not expecting it as a side-effect either.


VAERS ID: 1399912 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-25
Onset:2021-06-01
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Rash
SMQs:, Anaphylactic reaction (broad), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl, ibuprofen, oxycodone, vitamin D3
Current Illness:
Preexisting Conditions: psoriasis
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Only the second dose: The injection site became itchy, swollen, red, and sore after about two days. After about a week, a rash developed. The rash persists as of June 15, 2021. The site remains itchy, but is no longer swollen, red, or sore.


VAERS ID: 1400072 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-01
Onset:2021-06-01
   Days after vaccination:61
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Painful respiration, Pulmonary pain
SMQs:, Retroperitoneal fibrosis (broad), Arthritis (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: gastritis
Allergies: bactrim cipro cortisine flagyl iodinated radiocontrast agents lamisil
Diagnostic Lab Data:
CDC Split Type:

Write-up: persistent R sided back pain beginning 2 weeks ago. Pt states she has had R sided "lung pain" most notable to her back. Pain is exacerbated with deep inspiration. She endorses persistent joint pain s/p receiving her second dose of COVID vaccine 2 months ago. Denies associated fever, recent travel, or hormone therapy.


VAERS ID: 1400142 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-20
Onset:2021-06-01
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Exposure during pregnancy, Ultrasound antenatal screen abnormal
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow)

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: June 7 ultrasound (9 weeks)
CDC Split Type:

Write-up: I became pregnant between my two Covid Pfizer vaccines. First shot was 4/20 and second shot was 5/11. My 9 week ultrasound showed that my baby has anencephaly. I don?t know if the vaccine played any role, but if it is possible then I want other women who might be pregnant to know the possible risks.


VAERS ID: 1400261 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-22
Onset:2021-06-01
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: calcium with D3 and elderberry, zinc, C
Current Illness: noone
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: shingles


VAERS ID: 1400271 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event, SARS-CoV-2 antibody test positive
SMQs:, Medication errors (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: NO ADVERSE EVENT OCCURRED. I was advised by the reporting system to report this due to the following. Pt received 1st dose of Moderna on 3/4/21. About 1 week later his wife developed Covid so he was advised to get antibody testing which indicated positive for antibodies. He did NOT have an adverse effect to Moderna either. Family member advised pt to not get second dose of Moderna (due to positive antibody test) and to wait about 90 days and get the Janssen vaccine instead. Pt did NOT disclose to me upon administration of Janssen vaccine that he had recieved a first dose of Moderna about 3 months prior. Realized this when entering in the reporting system. Follow up call to pt on 6/8/21-no adverse events or problems.


VAERS ID: 1400316 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-14
Onset:2021-06-01
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Oligomenorrhoea
SMQs:, Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Vitamin C, Magnesium, Zyrtec PRN, Tylenol PRN and Ibuprofen PRN
Current Illness: None
Preexisting Conditions: Sleep apnea that is being treated, rosacea
Allergies: Cats, trees and weeds (seasonal)
Diagnostic Lab Data: None
CDC Split Type:

Write-up: This isn?t really an adverse event for me, because I?m not trying to conceive, but it could be considered adverse for someone who is. It seems that both getting Covid in my last menstrual cycle AND getting the vaccines during my current menstrual cycle have caused really long cycles for me. My cycle is typically about 30 days long and quite regular. However, during my last cycle I had contracted Covid and the cycle length ended up being about 41 days. And my current cycle is on day 56 and counting. I just thought this was interesting to note, since my cycles are usually quite regular, and the only thing I can think of that has been different for me THIS cycle is that I got 2 Covid shots. I have had a tubal ligation, so it is highly unlikely that pregnancy is the reason for this unusually long menstrual cycle. Just thought this was interesting to note and important to report. Thanks!


VAERS ID: 1400320 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Washington  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Myocarditis suspected


VAERS ID: 1400332 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-05-25
Onset:2021-06-01
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0342B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Constipation, Dyspepsia, Exercise tolerance decreased, Palpitations
SMQs:, Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Thyroid medication, Low dose Naltrexone, Zolpidem, clonazepam, estriol, B vitamins, vitamin C,D, NAC, DHEA, magnesium, calcium, HCL, zinc.
Current Illness:
Preexisting Conditions: Hashimoto''s thyroiditis Chronic Inflammatory Response Syndrome
Allergies: sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: heart palpitations, abdominal pain, digestive problems, constipation, exercise intolerance. This felt like a flare up of my Hashimoto''s thyroiditis.


VAERS ID: 1400885 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphasia, Bell's palsy, Hypoaesthesia, Musculoskeletal stiffness, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), 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: Zoloft - 25mg, kyleena
Current Illness: None
Preexisting Conditions: Migraine headaches with aura - 2 to 4 per year
Allergies: None
Diagnostic Lab Data: Went to primary care doctor on Friday 6/4/2021 and was diagnosed with Bells Palsy
CDC Split Type:

Write-up: Vaccine received 6/1/2021 at 12:20pm. Tingles on right side of my face was occurring within an hour of injection. Tingles occurred for 24 hours then progressed to tingles, stiffness and somewhat "numb" like sensation all along the side of my cheek up to my right eye. I was straining to talk and noticed I had to move my mouth differently to talk Thursday 6/3/2021 afternoon + evening. Went to my primary care doctor on the morning of 6/4/2021 and was diagnosed with Bells Palsy. I then began a prescription for steroids - Prednisone (60 mg for six days with tapering down over 10 days). The Bells did not get worse but now that I have completed the steroids the the tingle, stiff, and numb sensations remain.


VAERS ID: 1401474 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-14
Onset:2021-06-01
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anosmia
SMQs:, Taste and smell disorders (narrow), Immune-mediated/autoimmune disorders (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:
Allergies: Na
Diagnostic Lab Data:
CDC Split Type:

Write-up: Loss of smell


VAERS ID: 1401673 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Burning sensation, Erythema, Lip swelling, Pruritus, Skin irritation, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210624098

Write-up: SWOLLEN LIPS; BODY BROKE OUT INTO HIVES; ITCH; ARMS BECOME EXTREMELY IRRITATED; ARMS BECOME EXTREMELY RED; SKIN FEELS LIKE IT''S IN FLAMES; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 08-JUN-2021 for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On JUN-2021, the subject experienced itch. On JUN-2021, the subject experienced arms become extremely irritated. On JUN-2021, the subject experienced arms become extremely red. On JUN-2021, the subject experienced skin feels like it''s in flames. On 09-JUN-2021, the subject experienced body broke out into hives. On 11-JUN-2021, the subject experienced swollen lips. Treatment medications (dates unspecified) included: diphenhydramine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the body broke out into hives, swollen lips, itch, arms become extremely irritated, arms become extremely red and skin feels like it''s in flames was not reported. This report was non-serious.


VAERS ID: 1401692 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chills, Fatigue, Feeling abnormal, Hunger, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202106; Test Name: Body temperature; Result Unstructured Data: High as 103.4 (Units were not reported)
CDC Split Type: USJNJFOC20210628221

Write-up: VERY HUNGRY; BODY ACHES; ORGANS FEEL LIKE THEY HAVE BEEN SITTING OUT IN THE DESERT EVEN THOUGH CONSTANTLY DRINKING WATER; CHILLS; OVERALL FATIGUE; FEVER; VERY NAUSEOUS; This spontaneous report received from a patient via a company representative concerned a 2 decade old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: not reported) dose was not reported, administered on 12-JUN-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On JUN-2021, the subject experienced very hungry. On JUN-2021, the subject experienced body aches. On JUN-2021, the subject experienced organs feel like they have been sitting out in the desert even though constantly drinking water. On JUN-2021, the subject experienced chills. On JUN-2021, the subject experienced overall fatigue. On JUN-2021, the subject experienced fever. On JUN-2021, the subject experienced very nauseous. Laboratory data included: Body temperature (NR: not provided) High as 103.4 (Units were not reported). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fever, body aches, chills, very hungry, overall fatigue, organs feel like they have been sitting out in the desert even though constantly drinking water and very nauseous was not reported. This report was non-serious.


VAERS ID: 1401694 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: 103.5 (Unit not reported)
CDC Split Type: USJNJFOC20210628262

Write-up: FEVER; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 18-MAR-2021 for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On JUN-2021, the subject experienced fever. Laboratory data (dates unspecified) included: Body temperature (NR: not provided) 103.5 (Unit not reported). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of fever was not reported. This report was non-serious.


VAERS ID: 1401710 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Severe thrombocytopenia; This spontaneous case was reported by a physician and describes the occurrence of THROMBOCYTOPENIA (Severe thrombocytopenia) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 01-Jun-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 01-Jun-2021, the patient experienced THROMBOCYTOPENIA (Severe thrombocytopenia) (seriousness criteria hospitalization, medically significant and life threatening). At the time of the report, THROMBOCYTOPENIA (Severe thrombocytopenia) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. The patient experienced the event after administration of the 2nd dose. No treatment information was provided. The patient received both scheduled doses of mRNA-1273 prior to the events therefore, action taken with the drug in response to the events was not applicable.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of this event, a causal relationship cannot be excluded.


VAERS ID: 1401900 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-01
Onset:2021-06-01
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Intermenstrual bleeding, Polymenorrhoea
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: After 7 years without menstruation due to Mirena IUD, patient experienced regular menstrual spotting and a 2 day period in the months following the second vaccination


VAERS ID: 1402161 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-05-01
Onset:2021-06-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alopecia
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: Flu vaccine 2008
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Levaquin; prescription allergy medications
Diagnostic Lab Data:
CDC Split Type:

Write-up: Significant amount of hair loss


VAERS ID: 1402538 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-30
Onset:2021-06-01
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Decreased appetite, Heart rate increased, Sinus tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control (Apri 30mg, low dose), iron pills (low dose)
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: Mother of PT states her daughter experienced as diagnosed a sinus tachycardia, her heart rate elevated at 136bpm, it took awhile to come down at resting rate. Mother of PT experienced nausea, heart palpitations. Her daughter is now taking Metoprolol medication and is also now seeing a cardiologist. Mother of PT states her daughter''s appetite is also gone since receiving the Pfizer vaccine.


VAERS ID: 1402687 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-10
Onset:2021-06-01
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Haematocrit normal, Haemoglobin normal, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Pain in extremity, Platelet count normal, Red cell distribution width normal, Rheumatoid factor, White blood cell count normal
SMQs:, 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: Daily vitamin
Current Illness: N/A
Preexisting Conditions: asthma
Allergies: N/A
Diagnostic Lab Data: Serum Rheumatoid Factor = <10 IU/ml WBC 5.1 RBC 5.12 HGB 14 HCT 43.1% MCV 84.2 MCH 27.3 MCHC 32.5 RDW, Blood 13.3% Platelets 263 X 1000/mcl
CDC Split Type:

Write-up: Joint pain limited to hands that started approximately 1 week after injection. Started in one finger and progressed to entire hand, then both hands after each vaccination.


VAERS ID: 1402799 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disturbance in attention, Impaired work ability, Mental impairment, Pyrexia, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Hearing impairment (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: None
Current Illness: None
Preexisting Conditions: Joint hypermobility
Allergies: None known
Diagnostic Lab Data: None yet, starting now that it''s apparently not going to get any better on its own.
CDC Split Type:

Write-up: Severe tinnitus, variable throughout the night, louder than the train horn 4 blocks away. Severity slowly lessened the next day, by evening June 2 it was at the steady state level it is still at now, 2 weeks later. It''s extremely distracting and reduces my ability to focus or think clearly. I have a purely thinking job and this is an extremely disruptive and productivity reducing level of sound. Related but not what is being reported: Fever of 103F from about 7pm (6 hours after injection) to early morning. Down to 101F by 8am. 400mg ibuprofen taken at 9pm. I''ve never had any negative reaction to any other vaccine before.


VAERS ID: 1402900 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-30
Onset:2021-06-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Myocarditis
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Anaphylactic allergies to eggs, shellfish, peanuts, and tree nuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: A patient with no past medical history presenting with Myocarditis following Pfizer-BioNTech COVID-19 vaccination. The patient received Colchicine 0.6 mg daily with subsequent resolution of symptoms.


VAERS ID: 1402989 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: no known allergies
Diagnostic Lab Data: immunocap panel drawn to assess to allergies - no significant environmental or food allergies noted. IgE total elevated.
CDC Split Type:

Write-up: Patient broke out with full body, pruritic rash on arms, trunk, back, and legs approximately 1 week after receiving the first dose of Moderna covid-19 vaccine. Rash continues to spread onto face, and non-responsive to anti-histamine. Short term course of PO steroid recently prescribed, which has helped alleviate itching and has stopped spread.


VAERS ID: 1403321 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-24
Onset:2021-06-01
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Oligomenorrhoea
SMQs:, Fertility disorders (broad)

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

Write-up: My daughter?s period has lasted 15 days. She usually has it for only 3 days.


VAERS ID: 1403374 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-07
Onset:2021-06-01
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac imaging procedure abnormal, Hypotension, Myocardial strain, Pulmonary embolism, Troponin increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: maxzide 75/50 potassium chloride 20meq tamoxifen 20mg
Current Illness: unknown
Preexisting Conditions: malignant neoplasm of upper outer quadrant of breast (estrogen receptor pos) GERD Hypercholestremia
Allergies: epinephrine
Diagnostic Lab Data: 6-15-21 "large left pulmonary artery embolus with right heart strain" noted on CT
CDC Split Type:

Write-up: Patient seen in clinic on 6-14 and admitted to observation in the hospital setting. Patient was transferred to Medical Center for higher level of care due to hypotension and elevated troponins on 6/15


VAERS ID: 1403435 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-28
Onset:2021-06-01
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Full blood count, Immune thrombocytopenia, Platelet count decreased, Rash
SMQs:, Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CBC showed platelets at 16
CDC Split Type:

Write-up: Idiopathic thrombocytopenia purpura, rash starting 1 week prior to presenting to the hospital on 6/15/2021


VAERS ID: 1403793 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Washington  
Vaccinated:2020-12-26
Onset:2021-06-01
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Biopsy, Impaired work ability, Influenza like illness, Lymph node pain, Lymphadenopathy, Mammogram, Pain, Pyrexia, Swelling, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: chronic Fatigue Syndrome - about 10 years
Allergies: hydrocodone; Toradol
Diagnostic Lab Data: Imaging Center - had a mammogram - it was inclusive - breasts were too dense; ultrasound - lymph nodes swollen; Breast surgeon - said they were enlarged nodes and she said to wait until July but it was way to of an irritant and I was getting anxious. Breast cancer runs in my family. I couldn''t even working or typing on keyboard was very uncomfortable. I went back to Breast surgeon and she had me do another ultrasound - radiologist said that nothing had changed - it was the same size. I then had a needle biopsy -that when it was all narrowed down to that I have very irritable, enlarged lymph nodes since having the vaccine. Inflamed but not going down - 2 lymph nodes that they biopsied.
CDC Split Type: vsafe

Write-up: I had schedule an appt with my primary care doctor on January 18th for symptoms: January 1st - swelling - huge sore lump that bulged out under my armpit (injection site arm)- became more sore over time. Any times I did any activities it became more irritant. 2nd vaccine - (I had my ultrasound - first one - the day before the 2nd vaccine) - January 23 - 28 days after - on right arm and nothing happened after that vaccine - except that I had flu-like symptoms, fever, body aches - and was out of work for a week but nothing happened on my right side lymph nodes. It''s still there with the large lymph nodes on the left side under the arm - very large and irritable (just as irritable as it every was) - they aren''t finding anything that will help. Still ongoing.


VAERS ID: 1404233 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-06-01
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

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

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

Write-up: Shingles


VAERS ID: 1404487 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-31
Onset:2021-06-01
   Days after vaccination:62
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Condition aggravated, Full blood count, Lipoma, Polycystic ovaries, Ultrasound abdomen, Ultrasound scan vagina
SMQs:, Lipodystrophy (broad), Fertility disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Qvar, vitamin d, ibuprofen, Albuterol
Current Illness:
Preexisting Conditions: Asthma, pcos
Allergies:
Diagnostic Lab Data: Ultrasound 6/10/2021-upper abdominal Ultrasound 6/15/2021-vaginal A ton of blood work on 6/15/2021 (routine though - but CBC and such)
CDC Split Type:

Write-up: Giant lipoma 10x15x5 cm developed on upper abdominal wall. Tender, sharp pains. Also 50 cysts now on ovaries as opposed to prior imaging consistently being at 9 on one side 12 on the other.


VAERS ID: 1405231 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Idaho  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Pain, Palpitations, Pyrexia, Vertigo, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: USJNJFOC20210616783

Write-up: VERTIGO; RACING HEART; BLURRED VISION; CHILLS; FEVER; BODY ACHES AND PAIN; HEADACHE; This spontaneous report received from a parent concerned a 35 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 02-JUN-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On JUN-2021, the subject experienced headache. On 02-JUN-2021, the subject experienced body aches and pain. On 02-JUN-2021, the subject experienced chills. On 02-JUN-2021, the subject experienced fever. On 03-JUN-2021, the subject experienced vertigo. On 03-JUN-2021, the subject experienced racing heart. On 03-JUN-2021, the subject experienced blurred vision. Treatment medications (dates unspecified) included: amoxicillin. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache, fever, chills, body aches and pain, vertigo, and racing heart, and the outcome of blurred vision was not reported. This report was non-serious.


VAERS ID: 1405250 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Influenza
SMQs:, Infective pneumonia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210622311

Write-up: FLU; This spontaneous report received from a patient concerned a 6 decade old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number were not reported) dose was not reported, administered on 02-JUN-2021 for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow up to request batch/lot numbers. No concomitant medications were reported. On JUN-2021, the subject experienced flu. The action taken with covid-19 vaccine was not applicable. The patient recovered from flu on JUN-2021. This report was non-serious. This case, from the same reporter is linked to 20210623078.


VAERS ID: 1405278 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Asthenia, Blood glucose abnormal, Blood pressure measurement, Chills, Concussion, Eating disorder, Fall, Feeling abnormal, Headache, Loss of consciousness, Nausea, Tinnitus, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210601; Test Name: Blood sugar; Result Unstructured Data: abnormal; Test Date: 20210601; Test Name: Blood pressure; Result Unstructured Data: abnormal
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Woke up on floor/ Past out; Anxiety; Fall; Little weak; Foggy head; Shiver; Headache; Nausea; Throw up; Concussion; Buzzing in ears; Did not eat; This spontaneous case was reported by a consumer and describes the occurrence of LOSS OF CONSCIOUSNESS (Woke up on floor/ Past out) in an 18-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 033C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 01-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Jun-2021, the patient experienced CONCUSSION (Concussion), TINNITUS (Buzzing in ears), EATING DISORDER (Did not eat), CHILLS (Shiver), HEADACHE (Headache), NAUSEA (Nausea) and VOMITING (Throw up). On 02-Jun-2021, the patient experienced ASTHENIA (Little weak) and FEELING ABNORMAL (Foggy head). On an unknown date, the patient experienced LOSS OF CONSCIOUSNESS (Woke up on floor/ Past out) (seriousness criterion medically significant), ANXIETY (Anxiety) and FALL (Fall). At the time of the report, LOSS OF CONSCIOUSNESS (Woke up on floor/ Past out), CONCUSSION (Concussion), TINNITUS (Buzzing in ears), EATING DISORDER (Did not eat), ASTHENIA (Little weak), FEELING ABNORMAL (Foggy head), ANXIETY (Anxiety), FALL (Fall), CHILLS (Shiver), HEADACHE (Headache), NAUSEA (Nausea) and VOMITING (Throw up) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 01-Jun-2021, Blood glucose abnormal: abnormal (abnormal) abnormal. On 01-Jun-2021, Blood pressure measurement: abnormal (abnormal) abnormal. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not reported . Treatment information was not provided. Company comment:Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1405282 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

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

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

Write-up: Stroke; Blood clot; This spontaneous case was reported by a consumer and describes the occurrence of CEREBROVASCULAR ACCIDENT (Stroke) and THROMBOSIS (Blood clot) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 01-Jun-2021, the patient experienced CEREBROVASCULAR ACCIDENT (Stroke) (seriousness criterion medically significant) and THROMBOSIS (Blood clot) (seriousness criterion medically significant). At the time of the report, CEREBROVASCULAR ACCIDENT (Stroke) and THROMBOSIS (Blood clot) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. The concomitant medications on use were not provided. No laboratory data was provided. No treatment information was provided. The patient did not have any family history of stroke. The patient received the vaccine 3 months prior to AEs. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Reporter did not allow further contact; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1405301 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebral haemorrhage, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Haemorrhagic central nervous system vascular conditions (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Severe brain bleed; Severe thrombocytopenia/; This spontaneous case was reported by a physician (subsequently medically confirmed) and describes the occurrence of THROMBOCYTOPENIA (Severe thrombocytopenia/) and CEREBRAL HAEMORRHAGE (Severe brain bleed) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 01-Jun-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Jun-2021, the patient experienced THROMBOCYTOPENIA (Severe thrombocytopenia/) (seriousness criteria hospitalization, medically significant and life threatening). On 09-Jun-2021, the patient experienced CEREBRAL HAEMORRHAGE (Severe brain bleed) (seriousness criteria hospitalization, medically significant and life threatening). At the time of the report, THROMBOCYTOPENIA (Severe thrombocytopenia/) and CEREBRAL HAEMORRHAGE (Severe brain bleed) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were provided. Treatment information for the events was not provided. Very limited information regarding these events has been provided at this time. Further information has been requested. Most recent FOLLOW-UP information incorporated above includes: On 09-Jun-2021: Additional event was added.; Sender''s Comments: Very limited information regarding these events has been provided at this time. Further information has been requested.


VAERS ID: 1405858 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Texas  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021651298

Write-up: woke up with migraine; Arm very sore; Headache; This is a spontaneous report from a contactable consumer reporting for herself. A 56-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration at the age of 56 years old on 01Jun2021 17:15 (Lot Number: EW0178) at upper left arm at single dose for COVID-19 immunization. Medical history and concomitant medication were reported as none. The patient immediately got a headache within an hour and a half or so on 01Jun2021. Arm was very sore. That night headache lasted all night and she went to bed Woke up in morning and still had nagging headache. Headache came and went all day. Would get worse and then go away. Last night headache started getting really bad. Went to bed early. Woke up this morning with a migraine on 03Jun2021 07:00. Patient stated her head was killing her. Asked what can she take for it. Initially heard a person was not supposed to take Ibuprofen or something. Heard a person could take one but not the other. Clarified she wanted to know if Ibuprofen or other medications are not recommended to take after the COVID-19 Vaccine. As she moved from a different state and that her insurance was maxed out. She wanted to confirm medications that were not supposed to be taken post vaccination as she reported that some patient with adverse event who took a medication (not positive if it was ibuprofen or acetaminophen) had heightened AEs that even resulted to death. For arm very sore: Confirmed in the injection arm, upper left arm. Had a little soreness on 01Jun2021. On 02Jun2021 was more sore. 03Jun2021 it''s the same. Headache and woke up with migraine: Been the same since she woke up at 07:00 this morning on 03Jun2021. The outcome of the events were not resolved. Follow-up attempts are needed; Additional information has been requested.


VAERS ID: 1405902 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Oregon  
Vaccinated:2021-06-04
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO191 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache, Hyperhidrosis, Illness, Malaise, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021665954

Write-up: Tiredness; headache; muscle pain; chill; joint pain; fever; feeling unwell definitely; diarrhea; Sweating; really knocked me for a loop/knock me out; get sick; fever; feeling unwell; This is a spontaneous report from a contactable consumer (patient). A patient of unspecified age and gender received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot Number: EWO191), via an unspecified route of administration on an 04Jun2021 as SINGLE DOSE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. Patient''s historical vaccine includes first dose of BNT162b2 on unspecified date for COVID-19 immunisation and experienced no adverse effect. On Jun2021 the patient experienced get sick, tiredness, headache, muscle pain, chill, joint pain, fever, feeling unwell, diarrhoea, sweating and really knocked me for a loop/knock me out. It was reported that, did really well after the first injection but the second one is really knock me out. Reading about the side effects vaccine I received. I have quite of few of them here. I didn''t think I would because the first injection I experience nothing. The second one really knocked me for a loop. I haven''t been sick for two years and this really shot get sick from a vaccine. I don''t think I ever been sick from a vaccine. but this one really turned me in. You have the side effects list here in and I can tell you which ones I have. You have all the side effect listed. I did not have the severe allergic reaction, of course so I needn''t be at home but some of these the other one really is turning for look and it''s been 2 days now. Tiredness, here is this one, the headache, the muscle pain, chill, joint pain, fever, feeling unwell definitely, and diarrhoea. That''s what it got listed here and I had all of those. And I have all of those I just told you about. I am trying not to pass to anybody else because I don''t want anybody else not get the second dose just because what I experience. I will stay silent, I mean, it''s been rough last 2 days, still last two days. I guess, I am still not feeling well. I was experienced that they don''t have listed as the side effect is sweat, Sweating and that could be a sign of having fever. The sweating It''s just a bit just Pfizer knows that there is can reaction Pfizer sacks to the vaccine. May be not the anaphylactic shock somebody might get but I don''t feel good. EWO191 would that be the lot number, and received it on June 4th, two days ago I am having this reaction to this. No nothing at all I just got to get better that''s all, I hope it does not take too long. The outcome of the events was reported as recovering. Information about lot/batch number has been requested.


VAERS ID: 1405906 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-06
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202106; Test Name: Body temperature; Result Unstructured Data: Test Result:100.5
CDC Split Type: USPFIZER INC2021666164

Write-up: Running a temperature of 100.5; Feels yucky; Arm is a little sore; Headache; Tiredness; This is a spontaneous report from a contactable consumer (patient''s wife) reporting for her husband. A male patient of an unspecified age received BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Lot number- UNKNOWN) via an unspecified route of administration on 06Jun2021 as unknown, single dose for COVID-19 immunization. Patient medical history and concomitant medications were not reported. During reporting for herself the patient''s wife also reported information about her husband. Her husband was the patient in this report. Her husband got Pfizer Covid Vaccination yesterday (06Jun2021) and was having minor side effects including running a temperature of 100.5, feels yucky, arm is a little sore, has headache and tiredness. She thought these are just normal symptoms. The outcome of the events was unknown. Information about lot/batch number has been requested.


VAERS ID: 1405932 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-07
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021670935

Write-up: her arm was more sore right now than in her first shot.; This is a spontaneous report from a contactable consumer (patient) reported for herself. A female patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for Injection, Batch/Lot Number: number was not reported) dose 2 on 07Jun2021 via an unspecified route of administration for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for Injection, Batch/Lot Number: number was not reported) dose 1 on unspecified date via an unspecified route of administration for covid-19 immunisation and had sore arm. The patient said on an unspecified date in Jun2021, her arm was more sore right now than in her first shot. The patient had the second shot of the Pfizer COVID-19 vaccine yesterday (07Jun2021) and she wanted to know why she was reacting differently than when she had her first shot. Outcome of the event was unknown. No follow-up attempts are possible; Information about lot/batch number cannot be obtained.


VAERS ID: 1405935 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Chills, Heart rate increased, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021671020

Write-up: discomfort chest pain; rapid heart rate; fever; chills; This is a spontaneous report from a contactable consumer (patient). This 14-year-old male patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, lot number: EW0180), via an unspecified route of administration on 04Jun2021 into left arm as a 2nd dose, single dose for covid-19 immunization. The medical history and concomitant medications were not reported. Historical vaccine includes first dose of BNT162B2 (lot number: EW0182) on 14May2021 in to left arm for covid-19 immunization and experienced discomfort chest pain on 08Jun2021. The patient reported, he had fever and chills, but those went away. He has experienced not severe chest pain, but discomfort chest pain. And for the past few days, he had a rapid heart rate. The first day he got his second dose, he took some Ibuprofen but that''s really about it. He states well he''s sitting down so he''s not having it anymore but when he stands up or is in a weird position, it kind of comes back. States it''s about the same, caller confirms its persisting. Prior to vaccination (within 4 weeks), the patient was not diagnosed with COVID-19. The outcome of the events was not recovered for discomfort chest pain, unknown for rapid heart rate and recovered for rest all the events. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1405939 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-04
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Hypersensitivity, Lymphadenopathy, Malaise, Nausea, Oropharyngeal pain, Pulmonary pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (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), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021671100

Write-up: Respiratory reaction right away; Sore throat; Swollen glands; Nauseous; Sick; lungs ached; difficulty breathing; This is a spontaneous report from a contactable consumer (patient). A 65-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), dose 2 via an unspecified route of administration on 04Jun2021 (Batch/Lot number was not reported) as single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE) for COVID-19 immunisation. The patient received her second dose of the Pfizer COVID 19 Vaccine Friday (04Jun2021) afternoon and very shortly after getting the vaccine she got sick. Friday night (04Jun2021) her lungs ached, and she had never felt like that before in her life. She stated she definitely had a respiratory reaction right away; sore throat, swollen glands, and she felt nauseous. She had difficulty breathing last night (Jun2021). The patient was still sick and its a little concerning with some of the things she had experienced over the past few days. She wanted to know if she should go to a health care professional and wanted to know what she should do. The patient was advised that she should contact her HCP. Outcome of event sick was not recovered and other events was unknown. Information about lot/batch number has been requested.


VAERS ID: 1405944 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Heart rate increased, Influenza, Insomnia, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LOSARTAN; AMLODIPINE; HYDROCHLOROTHIAZIDE
Current Illness: Blood pressure high (High Blood Pressure for over 20 years)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021671211

Write-up: feels that his "heart rate is higher than normal; the minor symptoms a person gets with the flu; pain in the arm; Typical Tiredness; nausea; difficulty sleeping and getting rested, he feels like he is trying to sleep; This is a spontaneous report from a contactable consumer. This 63-year-old male patient reported for herself that she received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: EW0180) via an unspecified route of administration on 01Jun2021 at 18:00 hours (at 63-years-old) on left arm as 2nd dose, single dose for COVID-19 immunization. Medical history of the patient included ongoing high blood pressure for over 20 years. The concomitant medications of the patient included losartan at a dose of 100 mg, 1x/day, amlodipine at a dose of 5 mg, 1x/day and hydrochlorothiazide at a dose of 12.5 mg, 1x/day, the patient had been taking these for at least 20 years for high blood pressure. Historical vaccine of the patient included first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: EW0182) via an unspecified route of administration on 11May2021 (at 63-years-old) on left arm as 1st dose, single dose for COVID-19 immunization. The caller mentioned that he does not recall getting any vaccines as an adult, but his parents had him vaccinated as a child. It was mentioned that the patient did not require visit to emergency room and physician office and prior vaccinations within 4 weeks were reported as none. On 01-Jun-2021, the same day the patient experienced typical side effects of pain in the arm, tiredness, nausea. The patient also has difficulty sleeping as well as feels that his heart rate was higher than normal. Caller was asking if similar side effects have been reported. The patient states he is calling about his Second Shot of the Pfizer BioNTech Covid Vaccine. He had it a week ago and he is still having a side effect from it, it was on Tuesday a week ago from today. Caller states the main side effects are he feels like he has a rapid heart beat and he has difficulty sleeping and getting rested, he feels like he is trying to sleep at grand central station, his body won''t rest. Caller asking if anyone else has reported symptoms similar to this. The treatment received was reported as none, the patient wanted to wait and see if they would go away. On 02Jun2021 the event of typical tiredness, nausea and the minor symptoms a person gets with the flu recovered. On 03Jun2021 the event of pain in the arm recovered. The event of difficulty sleeping and getting rested, he feels like he is trying to sleep and feels that his heart rate is higher than normal had not recovered.


VAERS ID: 1405954 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-07
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Allergy to vaccine, Dysphonia, Feeling abnormal, Urticaria, Vaccination site discomfort
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Parkinson-like events (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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy to animal; Allergy to plants; Food allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021671907

Write-up: Her voice was a little rasped which may have been allergies; Her voice was a little rasped which may have been allergies; Felt bad; Hives on her left wrist, which was the arm of the vaccine; Feel a little stressed at the vaccination site due to poor safety precautions; This is a spontaneous report from a contactable consumer (patient herself) via Medical Information Team. A 61-year-old female received BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number- UNKNOWN) via an unspecified route of administration on 07Jun2021 as 2nd dose, single dose for COVID-19 immunization. Patient medical history included allergies to trees, cats, and several foods. The concomitant medications were not reported. Historical vaccine included BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number- UNKNOWN) via an unspecified route of administration on 10May2021 as 1st dose, single dose for COVID-19 immunization. Patient received her first Pfizer Covid 19 Vaccine on 10May2021. She took the second Pfizer Covid-19 Vaccine on 07Jun2021. On an unspecified date in Jun2021, her voice was a little rasped which may have been allergies. Within one hour of receiving the vaccine she felt bad and experienced hives on her left wrist, which was the arm of the vaccine. She reports eating a hamburger prior to her appointment yesterday (07Jun2021). Voiced she was not allergic to anything on the burger. She did feel a little stressed at the vaccination site due to poor safety precautions. She was not sure if the hives came from stress or not. Patient asked if hives have been reported. The outcome of the events was unknown. Information about batch/lot number has been requested.


VAERS ID: 1405958 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-06
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Catheterisation cardiac, Chest discomfort, Diarrhoea, Dizziness, Dyspnoea, Feeling abnormal, Headache, Limb discomfort, Nausea, Taste disorder, Throat tightness, Tongue discomfort
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Kidney disorder (Verbatim: kidney disease); Shortness of breath (Verbatim: Shortness of breath); Sleep apnea (Verbatim: Sleep apnea)
Allergies:
Diagnostic Lab Data: Test Date: 202105; Test Name: right heart catheter; Result Unstructured Data: Test Result:unknown
CDC Split Type: USPFIZER INC2021671941

Write-up: Brain fog; Nausea; weakness; Weird sensation on [his] tongue 5-10 mins; Weird taste in [his] mouth soon after that/funny taste in mouth; Shortness of breath/difficulty in breathing; Dizziness/Light headedness; Weakness in his upper chest and in both arms; Weakness in his upper chest and in both arms; Diarrhoea; Headache; felt like my throat is gonna close, I won''t say I had any difficulty in swallowing, but it was not normal; This is a spontaneous report from a contactable consumer (patient). A 55-years-old male patient received BNT162B2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot number, Expiration date, NDC and UPC number was unknown), via an unspecified route of administration on 06Jun2021 at 11:30 hours as 1st dose, single dose (at the age of 55-years-old) for COVID-19 immunisation. Regarding lot number patient stated that it looks like EW, patient thought he was not sure if it was 6185 or 0185, not sure it looks like 0 but it looks like 6 too but patient think it was 0. The patient medical history included shortness of breath, sleep apnea and kidney disease (from an unknown date and unknown if ongoing). Patient sees a doctor for lot of conditions one was for shortness of breath and sleep apnea and sees a neurologist for Bph. The patient concomitant medications were not reported. Patient explained he was reluctant from getting vaccinated and nervous before the shot. On 06Jun2021, after patient took the shot, probably around 11:30 in the morning, patient was same, soon after 5 min maybe more, patient got a sensation on the left side of his tongue 5-10 mins, then kind of a weird taste came to his mouth, patient started to get a little dizzy, a little light headedness, weakness in his chest and both his arms, got shortness of breath but had been seeing a doctor for shortness of breath prior taking the Covid shot and had kind of reluctant of taking the shot but some other issues going on side, patient decided to take it, a couple of hours after the shot, patient had a headache, had the diarrhea. Patient described the weird taste like having a penny in his mouth. Patient explained he consulted a doctor on that Monday (07Jun2021), who said she encountered patients who also had the sensation on their tongues following vaccination, and that it was normal. Today (08Jun2021) patient had feeling just a little bit of nausea and patient kind a feel like a little brain fog, it was just his head doesn''t feel right, the major concern was says some things risks factors and some of them had severe reactions, patient had a reaction difficulty in breathing, dizziness and feel little bit weakness, patient kind of a felt like his throat was going to close and he won''t say he had any difficulty in swallowing, but it was not normal. Patient developed symptoms which spooked and scared him. Patient did not have his lab test but was constantly going to patient had just had right heart catheter right two weeks ago, you know last for him, patient was supposed to take another lab test to conduct at the end of the month for cholesterol, but patient saw neurologist for kidney disease. Events did not improve, patient just had this brain fog you know. Patient had to call a doctor after he got home, they did not prescribe him anything, patient mean he did bunch of appointment with doctor with the phone as soon as he got home from taken a Covid shot he was little worried. Patient stated he was concerned about getting the second dose of vaccine scheduled on 27Jun2021. Patient stated he will not be able to consult his doctor before the vaccination appointment and was not able to get further assistance from a pharmacist. Patient repeated he does not know what to do about the second dose. Patient was kind of reluctant taking the next shot, if he was going to feel the something like this again, he don''t want to, as he already had uneasy you know just had and patient did not had difficulty in breathing all of time this comes and go, from the sentence he described it says on pamphlet that there was severe reaction to the shot and don''t want to take the second shot and then end up in hospital because patient had more from it so his question was he was afraid to take the second shot. Patient don''t had answer to that he means he would like to talk to somebody who can give him information kind of help me to relax little bit if it was normal and in in response it was responded that decision to receive the second dose for any other reason cannot be made by the company. Patient was referred to speak to his healthcare provider about the risks of the vaccine compared to the risks of potentially not being fully protected against COVID-19 infection, as healthcare provider knows his health situation and had access to information that can better help inform this decision. The outcome of brain fog was not recovered and outcome for other events was unknown. Information about lot/batch number is requested.


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