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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 224 out of 4,799

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VAERS ID: 1405980 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Unknown  
Location: California  
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 EW0178 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Headache, Nausea, Pain
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: USPFIZER INC2021673044

Write-up: Mild headache; Ache; Joint pain; Nausea; Little bit of dizziness; This is a spontaneous report from a contactable consumer (patient) reported for self. A 25-years-old patient of an unspecified gender received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number: EW0178, Expiration date: unknown) via an unspecified route of administration, administered at an unspecified anatomical location on 07Jun2021 at around 15:00 to 16:00 pm (age at vaccination was 25 years) as 2nd dose, single dose for COVID-19 immunization. The patient did not have any medical history. Concomitant medications were not reported. The patient previously took first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number: EW0185, Expiration date: unknown) via an unspecified route of administration, administered at an unspecified anatomical location on an unknown date (age at vaccination was unknown) as 1st dose, single dose for COVID-19 immunization. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On an unspecified date in Jun2021, the patient had mild headache, some aches and some joint pains and nausea and little bit of dizziness as well. The patient just took the Pfizer vaccine yesterday the second dose and the patient was experiencing a couple of side effects and wondered if it was okay for the patient to take Ibuprofen. The patient was informed about Pfizer Medical Information Department. The patient stated that the patient did actually take Ibuprofen yesterday but found out today that the patient might not, shouldn''t have taken it that''s why the patient was a bit concerned the patient wanted to know if that was okay for the patient to do. The outcome of events was unknown. Information on Lot/Batch number has been requested.


VAERS ID: 1405987 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-03
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: Diarrhoea, Dysphonia, Feeding disorder, Headache, Insomnia, Nausea, Sinusitis, Taste disorder
SMQs:, Acute pancreatitis (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Vomiting
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021673342

Write-up: After the first dose I had nausea and headaches. Both worsened after 2nd dose; I can''t eat a whole lot or sleep; I can''t eat a whole lot or sleep; Everything has a funny taste to it/taste like pennies/it has a metallic taste/It''s like when orange juice mixes with toothpaste/a nasty taste; My sinus is swollen too; After the first dose I had nausea and headaches. Both worsened after 2nd dose; My voice is raspy; had some diarrhea; This is a spontaneous report from a contactable consumer (Patient). A 34-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), Solution for injection, via an unspecified route of administration on 03Jun2021 as 2nd dose, single dose for covid-19 immunisation. Medical history included, vomiting from. The patient''s concomitant medications were not reported. Patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) received on 13-MAY-2021 and experienced nausea and headache. On an unspecified date in Jun2021, the patient experienced bad nausea, can''t eat a whole lot or sleep, everything had a funny taste to it/taste like pennies/it had a metallic taste/it was like when orange juice mixes with toothpaste/a nasty taste, sinus was swollen too, headaches, voice was raspy and had some diarrhea. Patient had side effects that was not on the pamphlet she received. She received first dose on 13MAY and 2nd dose 3Jun2021. She had bad nausea, to top it off she could not eat a whole lot or sleep. Everything had a funny taste to it. taste like pennies. It did not matter what it was (it had a metallic taste; drink/liquids too). It was like when orange juice mixes with toothpaste. a nasty taste. she did have headaches when she got it initially. After the first dose she had nausea and headaches. Both worsened after 2nd dose (more with the nausea headaches was not too too bad). The nausea was unbearable. She had nausea after first shot; worsen with the 2nd one. Her voice was raspy. Her sinus was swollen too. She had vomiting before the covid vaccine when she gave blood. It had been over 3 weeks of being nauseous. She wanted to know if she should get a covid test done? She told that, she got a front and back information sheet. Not everyone was getting the same information; that needed to be corrected. Her cousin asked her about different things. Her paper was about wearing masks only have information on side effects: fever, diarrhea. She had no fever; had nausea (which wasn''t mentioned on her information sheet). Even when she asked the nurse about it, she told her fever but not nausea. We all don''t have the same reactions as others. She had some diarrhea. This nausea was annoying. The pamphlet they gave were different depending on clinic/site. She didn''t get the same information sheet. The outcome of events was unknown. Information about lot/batch number is requested.


VAERS ID: 1406000 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-02
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 EW0182 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cold sweat, Illness, Lethargy, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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:
CDC Split Type: USPFIZER INC2021675107

Write-up: He kind of got sick; He felt lethargic; He felt feverish, he had a fever; He felt feverish, he had a fever; He felt clammy; He felt nauseated; This is a spontaneous report from a Pfizer sponsored program reported by consumer (patient mother). A 16-year-old male patient (reporter son) received bnt162b2(BNT162B2 PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Batch/Lot number: EW0182), via an unspecified route of administration on 02Jun2021 (at the age of 16-years-old) at 1ST DOSE SINGLE DOSE as single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The reporter reported that the patient experienced he kind of got sick, he felt lethargic, for he felt feverish, he had a fever, for he felt clammy and for he felt nauseated on an unspecified date in Jun2021. The reporter stated that it took him 3 days to get better and she is not sure what to do and she does not if she, if her son should get the second dose even after experiencing these symptoms. The outcome of all the events was reported as resolving. Information on lot/batch number was available. Additional information has been requested.


VAERS ID: 1406008 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-08
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 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Decreased appetite, Feeling abnormal, Head discomfort, Hypoaesthesia, Insomnia, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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? 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: USPFIZER INC2021676836

Write-up: This is a spontaneous report from a contactable consumer or other non healthcare professional (patient). A 34-years-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID VACCINE, solution for injection, Batch/Lot Number: EW0180), via an unspecified route of administration on 08Jun2021 as 1st dose single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On unspecified date Jun 2021, the patient stated that she feels numb, like she is not hungry, cannot sleep, didn''t sleep last night, feels like she has insomnia severely. Caller stated, "I started experiencing, I was fine then sleep went away. I noticed more energy yesterday, I thought, I have a lot of energy, but by 11PM wasn''t tired at all and just got worse over night. It''s constant, I don''t feel manic, but I do feel awake, feel awake with more energy than usual, my head feels pressured, my whole body feels like I''m being squeezed. It''s like an emotional numbness, insomnia, not feeling hungry or anything". The patient had nausea as well. Side effects that patient experienced throughout the rest of her body (systemic side effects) included fever and chills, were observed with the first 1 to 2 days after vaccination and resolved shortly thereafter. The outcome of all other events was unknown. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1406031 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Colorado  
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 - / 1 - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Lethargy, Off label use, Sluggishness
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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 INC2021678063

Write-up: Xeljanz (tofacitinib citrate) was given for Alopecia; First Dose: felt a little sluggish and lethargic; First Dose: felt a little sluggish and lethargic; This is a spontaneous report from a contactable consumer (patient''s father) via a Pfizer sponsored program. A 16-years-old female patient received bnt162b2 (BNT162B2, Formulation: Solution for injection, Batch/Lot number: not reported), dose 1 via an unspecified route of administration on 01Jun2021 (at the age of 16-years-old) as SINGLE DOSE for covid-19 immunisation; tofacitinib citrate (XELJANZ), via an unspecified route of administration from an unspecified date (Batch/Lot number was not reported) and ongoing, at unspecified dose for alopecia. The patient medical history was not reported. The patient concomitant medications were none. It was reported that tofacitinib citrate was given for alopecia. She had no reaction except she felt ''sluggish'' and lethargic. Caller did not want to file a report. She was currently on tofacitinib citrate and she was scheduled to receive her second dose of the Pfizer BioNTech COVID-19 vaccine in 1 to 2 weeks. Since tofacitinib citrate was an immunosuppressant and people who are taking immunosuppressants may have a lower response to the vaccine and therefore not produce enough antibodies, should her daughter get an antibody test done and how long after the second dose should she get it done. The caller''s daughter was taking tofacitinib citrate for Alopecia and he wanted to know the reaction between tofacitinib citrate and the Pfizer COVID Vaccine. Caller stated his daughter has been taking tofacitinib citrate for a couple of years now and he was reading how the medication would interact with the COVID vaccine. Caller stated some reports stated that after the second vaccine, it might be wise to get an antibody test to make sure the body was producing antibodies. Caller stated the patient took the first dose, but she hasn''t taken the second one. Caller stated there were no adverse events, other than she felt a little sluggish and lethargic for a day or two. The outcome of all event were unknown. Information on Lot/Batch number has been requested.


VAERS ID: 1406033 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
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: Arthralgia, Joint swelling
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 INC2021678195

Write-up: joint pain in her elbow, knees, and ankles; ankles are also now swollen; This is a spontaneous report from a contactable consumer(patient). A 46-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number/batch number: unknown), via an unspecified route of administration on 04Jun2021 as a 2ND DOSE, single dose for COVID-19 immunisation. The patient had received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number/batch number: unknown), via an unspecified route of administration on an unspecified date as a single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. On an unspecified date Jun2021, patient experienced joint pain in her elbow, knees, and ankles and stated her ankles are also now swollen. Patient stated that she spoke to someone who took a report including the lot number of the vaccine and then she was told to call Medical Information for more information regarding her side effects. The outcome of the events was reported as unknown. Information about batch/ lot number has been requested.


VAERS ID: 1406038 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
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 - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021679035

Write-up: sore arm; fatigue; nausea; headache; This is a spontaneous report from a contactable pharmacist (patient) received via a sales representative. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on an unspecified date in Jun2021 as single dose for COVID-19 immunisation. The patient medical history and concomitant medication were not reported. The patient experienced sore arm, fatigue, nausea, and headache on an unspecified date in Jun2021. Adverse events resolved within 24-48 hours. This adverse event was reported within the 24 hour time frame. Reporter reported as, "I found out about it late afternoon on 08Jun2021 and reported very early morning on 09Jun2021". Outcome of all the events were recovered on an unspecified date in Jun2021. Information about batch/Lot number has been requested.


VAERS ID: 1406058 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-05-01
Onset:2021-06-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Circumstance or information capable of leading to medication error, Lymphadenopathy
SMQs:, Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021681756

Write-up: This is a spontaneous report from a contactable consumer. A 86-years-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EW0164 and Expiration Date not reported) via an unspecified route of administration, administered in Arm Left on May 2021 as 1ST DOSE, SINGLE DOSE for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient had no family medical history relevant to Adverse event. The patient had no history of all previous immunization with the vaccine considered as suspect. The patient did not receive any other vaccinations within four weeks prior to the first administration date of the suspect vaccine. The patient reported that, he took one shot. The patient took the first shot about 2 weeks ago. The patient reported that in the last day or so he noticed a little lymph node swelling in the left chest area and stated that, it was not bad, it was not something that the patient cannot live with. The patient stated that the swelling came up about 3 days ago and it was just tender when he pressed on it. The patient was due to get his second shot next week. The patient was wondering if he should take it as scheduled or wait a few days for shot. The patient mentioned later should he take it in the right arm this time instead of the left arm. The patient denied medications, medical conditions, labs, testing, or treatments relevant to event. The patient did not visit emergency room and physician office. The outcome of little lymph node swelling in left chest area was not resolved and the outcome of event asking about postponing second dose of the vaccine was unknown. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1406061 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: New York  
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 EW0182 / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Diaphragmalgia, Dyspnoea, Illness, Pleurisy
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Diarrhea (having bouts of diarrhea prior to receiving the covid vaccine.)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021682182

Write-up: Patient now has gotten pleurisy. Reporter describes pleurisy as meaning patient is now having a tough time breathing deeply, and patient has pain in her diaphragm area; Patient now has gotten pleurisy. Reporter describes pleurisy as meaning patient is now having a tough time breathing deeply, and patient has pain in her diaphragm area; Patient now has gotten pleurisy. Reporter describes pleurisy as meaning patient is now having a tough time breathing deeply, and patient has pain in her diaphragm area; Patient had the covid vaccine on Sunday afternoon. Patient has been feeling very ill since; Reported as worsened; This is a spontaneous report from a contactable consumer (patient''s father) (primary care physician). A 25-year-old female patient (reporter''s daughter) received first dose of BNT162B2 (Solution for injection) via an unspecified route of administration, administered to her right arm on 06Jun2021 14:30 (Lot number: EW0182, NDC number/Expiry date: Unknown) as single dose for COVID-19 immunization. The patient was taking Pfizer Covid vaccine as required to take it for college. The patient''s medical history included ongoing bouts of diarrhea (had bouts of diarrhea prior to receiving the Covid vaccine). Patient had been having bouts of diarrhea. Reporter stated that patient has been having bouts of diarrhea prior to receiving the Covid vaccine. Age at the time of vaccination: 25-year-old. Concomitant medications were not reported. On 09Jun2021, patient now had gotten pleurisy. Reporter described pleurisy as meaning patient was having a tough time breathing deeply, and patient had pain in her diaphragm area. It was reported as worsened. Reporter was calling about the first dose of the Pfizer Covid vaccine. Reporter''s daughter was the patient. Patient had the Covid vaccine on Sunday afternoon. Patient had been feeling very ill since. Patient had gotten pleurisy. Reporter provided spelling for pleurisy. Reporter describes pleurisy as meaning patient was having a tough time breathing deeply, and patient has pain in her diaphragm area. Began yesterday morning, Wednesday, 09Jun2021. Reporter was asking had Pfizer seen pleurisy as a side effect after the Covid vaccine. Reporter already took patient to the emergency room once before. The emergency room gave patient Maalox. Reporter had been trying to take patient to see her doctor, but reporter was having a hard time getting an appointment for patient. Outcome of the event reported as worsened was unknown, whereas other events was not recovered. Follow up attempts are needed. Further information has been requested.


VAERS ID: 1406066 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Ohio  
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 EW0185 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Cough, Ear pain, Oropharyngeal pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: ASPIRIN [ACETYLSALICYLIC ACID]; LEVOTHYROXINE SODIUM; PANTOPRAZOLE; SOLIFENACIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Congestive heart failure; Type I diabetes mellitus
Allergies:
Diagnostic Lab Data: Test Name: Fever; Result Unstructured Data: Test Result:Unknown results
CDC Split Type: USPFIZER INC2021682448

Write-up: I got my second shot 01Jun2021 my cough has gotten worser; sore throat; my right ears hurts bad; Fevers; This is a spontaneous report from a contactable consumer. A 49-years-old female patient bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number: EW0185 and Expiration date was not reported), dose 2 via an unspecified route of administration, administered in Arm Left on 01Jun2021 (Age at age of 49 years) as second dose single dose for covid-19 immunization. Medical history included type 1 diabetes mellitus and cardiac failure congestive. Concomitant medication included levothyroxine sodium; pantoprazole; solifenacin taken for an unspecified indication from an unspecified start date and ongoing. The patient previously took vasotec (enalapril maleate) and experienced hypersensitivity, thera flu 24 and experienced hypersensitivity. No covid prior vaccination. No covid tested post vaccination. Patient was not pregnant at the time of vaccination. The patient had a bad cough ever since the first covid shot on 11May2021, they said it will go away in a few days it did not, she got her second dose on 01Jun2021 and her cough has gotten worse they keep telling in a few a day it will go away it was not going away. She has a sore throat, her right ears hurt bad, and she was running fevers. The patient underwent lab tests and procedures which included body temperature: unknown results. The outcome of events was unknown whereas the outcome of event cough worsened was not recovered.


VAERS ID: 1406092 (history)  
Form: Version 2.0  
Age:   
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 - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021685635

Write-up: He is experiencing swelling in the left arm; first dose 18May2021 and second dose 01Jun2021; This is a spontaneous report from a Pfizer sponsored program via contactable consumer (patient himself). A male patient of an unspecified age received bnt162b2 (BNT162B2, Pfizer COVID-19 Vaccine, Formulation: Solution for injection) via an unspecified route of administration on 01Jun2021 (Lot number and Expiry date was not reported) as 2nd dose, single dose for COVID-19 immunisation and first dose on 18May2021 (Lot number and Expiry date was not reported) as single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. On 01Jun2021, the patient had 1st shot was given 18May2021 and 2nd dose was given 01Jun2021, on an unspecified date, the patient experienced swelling in the left arm. The patient wanted to check how many days he can get the pneumococcal vaccine after getting the 2nd dose of the COVID-19 vaccine. The outcome of the event swelling in the left arm was not recovered and had 1st shot was given 18May2021 and 2nd dose was given 01Jun2021 was unknown. Information about lot/batch number has been requested.


VAERS ID: 1406097 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Texas  
Vaccinated:2021-06-09
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 EW0178 / 2 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021689211

Write-up: he feel sick; This is a spontaneous report from a contactable consumer (patient''s Mother). A male patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection; lot number EW0178 and expiration date: not reported), via an unspecified route of administration, on Right arm, on 09Jun2021 18:37 as 2ND DOSE, SINGLE DOSE for covid-19 immunization. The patient medical history was not reported. The patient''s concomitant medications were not reported. Historical vaccine included bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection; lot number EW0175 and expiration date: not reported) via unspecified route of administration, on 19May2021 as 1ST DOSE, SINGLE DOSE for covid-19 immunization. The patient didn''t receive any other vaccines within 4 weeks prior to the COVID -19 vaccine. The patient felt sick on Jun2021. The reporter would like to know whether any medication can be given to the patient for sick. No treatment was received for the adverse event. The outcome of event is unknown.


VAERS ID: 1406139 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-06-10
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 EW0187 / 2 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Chills, Fatigue, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic 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:
Current Illness: Asthma (20 something years ago); Blood pressure high (20 something years ago); COPD (20 something years ago); Diabetes (20 something years ago); Heart disease, unspecified (20 something years ago); Sleep apnea (20 something years ago)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202106; Test Name: temperature; Result Unstructured Data: Test Result:100.7
CDC Split Type: USPFIZER INC2021694682

Write-up: This is a spontaneous report from a contactable consumer (patient). A 49-year-old female patient received second dose of BNT162B2 (Solution for injection) via an unspecified route of administration, administered in right arm on 10Jun2021 15:09 (Batch/Lot number: EW0187) (age at time of vaccination) as single dose for COVID-19 immunization. The patient took the Pfizer COVID-19 Shot as she did not want to get COVID-19 and too many people were dying. Vaccination Facility Type: Other, please specify: Clarified as the racetrack. The patient''s medical history included ongoing asthma (20 something years ago), ongoing sleep apnea (20 something years ago), ongoing diabetes (20 something years ago), ongoing chronic obstructive pulmonary disease (COPD) (20 something years ago), ongoing blood pressure high (20 something years ago) and ongoing heart condition (20 something years ago). Concomitant medications were not reported. The patient previously took first dose of BNT162B2 (at the age of 49-year-old) administered in right arm on 27 May 2021 (Lot number: EN6199, NDC number: Not provided, Expiry date: Unknown) as single dose (exact dose unknown) for COVID-19 immunization. On an unspecified date in June 2021, the patient experienced body aches, throwing up, tired, fever and chills. Yesterday, 10Jun2021 she got her last COVID-19 shot. She mentioned she was fine yesterday after getting the shot, but at some point while sleeping sometime between 10Jun2021 and 11Jun2021 she had body aches, throwing up, was tired, had a fever with a temperature of 100.7, and chills. She mentioned that events could have happened after midnight. All she knows was when she woke up in the morning, she had the events. It hurt her to sit. She was rocking back and forth not wanting to throw up again. She confirmed they all started around same time. She questioned if it was part of the side effects from the vaccine. She commented she would rather have this than go have COVID-19. Outcome of events: She confirmed as unknown. She cannot tell at this time. She mentioned if it gets worse she will call back and go to the Emergency Room. She hoped it gets better, but she could not tell if it was better, worse, or same at this point. Outcome of the events was unknown. Follow-up attempts completed. No further information expected.


VAERS ID: 1406186 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-11
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 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021702565

Write-up: Developed a reaction of spider/mosquito like bites; Swelling on the left arm, which is the same arm where he received the injection; Red "patchy areas" and itchiness on his leg; Red "patchy areas" and itchiness on his leg; Red "patchy areas" and itchiness on his leg; This is a spontaneous report from a contactable consumer (patient mother) or other non hcp. A 22-years-old male patient (reporters son) received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot number was not reported and expiry date: unknown), via an unspecified route of administration, administered in Arm Left on 11Jun2021 as UNKNOWN, SINGLE DOSE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. On an unknown date in June2021, the patient developed a reaction of spider/mosquito like bites and swelling on the left arm, which is the same arm where he received the injection. He also has red patchy areas and itchiness on his leg. According to the caller, its all on his left side. Caller would like to know if these symptoms have been reported with the Pfizer BioNTech COVID-19 vaccine. The Outcome of events was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1406657 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-02
Onset:2021-06-01
   Days after vaccination:60
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 6362737 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Deep vein thrombosis, Gait disturbance, Hypoaesthesia, Limb discomfort, Mobility decreased, Muscle spasms, Paraesthesia, Peripheral coldness, Poor peripheral circulation
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Dystonia (broad), Parkinson-like events (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atenolol, amlodipine, clopidogrel
Current Illness: NONE other than cramping in calf of right leg. Then it locked up & toes went numb from NO circulation & almost lost my right foot due to a 2ft long Blood clot in my leg which had been growing for several months. I had NO problems before I got the J&J shot.
Preexisting Conditions: NO
Allergies: Penicillian, propanolol, cipro, morphime, zetia, atorvastin, simvastatin, codeine.
Diagnostic Lab Data: CT scan, blood work, etc all night long. All in records. I almost lost my foot due to no circulation from 2ft long blood clot in right leg which had been coming on for several months after shot. No problems before that.
CDC Split Type:

Write-up: Cramping began in right leg off & on over 6wk period. Not thinking much of it just older I guessed. Then on June 6th my calf locked up & could barely walk. Later in evening my toes & foot went numb & cold & no feeling. Called Ambulance to take me to Hospital. 6 days of treatment. Many injections & needles.


VAERS ID: 1406746 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: New Jersey  
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 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose, Cold sweat, Dizziness, Electrocardiogram, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Admitted to Emergency Room on 6/1/2021 at approximately 6:15 PM, EKG as well as blood glucose test performed.
CDC Split Type:

Write-up: Patient (myself) experienced lightheadedness, blurred/starry vision, clammy palms, intense cold sweat and almost fainted approximately 10-15 minutes after receiving Janssen COVID19 vaccine injection. I was provided a small bag of cookies and a bottle of water while sitting in a chair. These symptoms manifested a second time approximately 10 minutes after the first on-set and I was laid on the floor with feet elevated.


VAERS ID: 1406859 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-01
Onset:2021-06-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Paracarditis


VAERS ID: 1407062 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Arizona  
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 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose normal, Blood pressure decreased, Dizziness, Heart rate decreased, Pallor, Yellow skin
SMQs:, Cholestasis and jaundice of hepatic origin (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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:

Write-up: (M|D)-Vitals: O2 98 Temp 97.5 Patient recieved COVID-19 vaccine and as soon as he got it he started feeling dizzy, turned pale and yellow and went to sit down and loss of color per (P-EMT). Right after receiving COVID-19 Vaccine given at 10:25AM. 1027 89/48 HR48 1035 110/50 HR86 1045 123/99 HR79 1048 131/82 HR73 Glucose 114 finger prick. Upon recovering at 1048 patient exam was within normal range.


VAERS ID: 1407083 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-18
Onset:2021-06-01
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hallucination, auditory, Laboratory test normal
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lithium carb er 300mg, methylphnider 36mg,
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: labwork-came back fine
CDC Split Type:

Write-up: hearing voices and reacting to them, hearing and responding to voices in head


VAERS ID: 1407198 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-01-27
Onset:2021-06-01
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 2 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Balance disorder, Coordination abnormal, Deafness neurosensory, Labyrinthitis, Nystagmus, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (narrow), Ocular motility disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: famotidine
Current Illness: none
Preexisting Conditions: celiac disease
Allergies: pencillin corn gluten containing products
Diagnostic Lab Data: head MRI scheduled
CDC Split Type:

Write-up: sudden onset sensorineural hearing loss and labrynthitis left ear onset tuesday 6/1/21 complete hearing loss occurring over 6 hour period followed by vertigo with vomiting. loss of balance and coordination, nystagmus. undergoing series of 3x intratympanic steroid injections, 1 week apart.


VAERS ID: 1407581 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-06
Onset:2021-06-01
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Mobility decreased, Motor dysfunction, Pain
SMQs:, Peripheral neuropathy (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, 325 asa
Current Illness: None
Preexisting Conditions: Htn, hypercholesterolemia, pre diabetes: RX taken
Allergies: Pcn
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Joint pain in thumbs, with limited bending and pain when bending thumb to grasp or even shake hands. Taking Ibuprofen and Asa po prn


VAERS ID: 1407664 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Tennessee  
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 EW0191 / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood iron, Blood thyroid stimulating hormone, Electrocardiogram, Full blood count, Metabolic function test, Palpitations, Serum ferritin
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG, blood testing to include iron, ferritin, CBC, CMP, TSH
CDC Split Type:

Write-up: Palpitations-ongoing since first injection


VAERS ID: 1407730 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-05-20
Onset:2021-06-01
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Back pain, Computerised tomogram thorax abnormal, Fibrin D dimer increased, Myalgia, Pain in extremity, Pulmonary thrombosis, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage laboratory terms (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: D-dimer, ultra sound of all veins in legs, ct scan of chest. Results were a clot in lower right leg, upper left leg above knee, and two bottom of the lungs.
CDC Split Type:

Write-up: Received the J&J vaccine in May 20. Started experiencing leg muscle and back pain June 1, 2021. Progressively got worse over the following weeks. On June 15 I woke up with a new pain in my leg. Went to urgent care and had a D-Dimer test that came out very high. I was sent to ER where they discovered one clot in each leg and two in my lungs via ultra sound and ct scan. I was immediately hooked up to herapin blood thinner through an IV. I was released the following afternoon with Eliquis blood thinner tablets.


VAERS ID: 1407877 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-10
Onset:2021-06-01
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Erythema, Muscle atrophy, Skin wound
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Citalopram 20mg
Current Illness: None
Preexisting Conditions: High Blood Pressure
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Red mark/bruise on arm since vaccine, quarter size in diameter muscle deterioration/hole under skin,1/4-1/2" deep


VAERS ID: 1407941 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-28
Onset:2021-06-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac disorder, 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? 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: After second dose patient has been experiencing dizziness, heart palpitations, cardiac irregularities, and patient has been to ER twice since.


VAERS ID: 1408424 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-22
Onset:2021-06-01
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Other       Purchased by: ?
Symptoms: Contusion
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)

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

Write-up: bruising to abdomen , thighs


VAERS ID: 1409000 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-27
Onset:2021-06-01
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: MMR at age 60, vaccination date 10/12/2019 in left arm. Caused severe joint pain that traveled between feet, knees and wrists,
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Similar to rash that appeared after 1st dose, except 2nd occurrence was smaller area, lighter in color and lasted a shorter time. Following 2nd dose, rash appeared on abdomen approx 2 1/2 inch dia above navel, consisting of raised red dots with bright pink backgrounds. Very little to no itching. No significant fever (less than 1 deg above normal range), and no other reactions. Rash cleared to about 95% gone by evening of 6/6/21.


VAERS ID: 1409460 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Colorado  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210619300

Write-up: ADMINISTRATION OF EXPIRED VACCINE TO ONE PATIENT; LEFT LONGER THAN 2 HOURS OUTSIDE THE FRIDGE; This spontaneous report received from a pharmacist 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 01-JUN-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 01-JUN-2021, the subject experienced administration of expired vaccine to one subject. On 01-JUN-2021, the subject experienced left longer than 2 hours outside the fridge. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the administration of expired vaccine to one patient and left longer than 2 hours outside the fridge was not reported. This report was non-serious.


VAERS ID: 1409473 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chest discomfort, Decreased appetite, Dizziness
SMQs:, Anaphylactic reaction (broad), 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:
Current Illness: Graves'' disease; Heart disorder
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210627127

Write-up: This spontaneous report received from a patient concerned a patient of unspecified age and sex.The patient''s height, and weight were not reported. The patient''s concurrent conditions included graves disease, and issue with heart. 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 09-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 loss of appetite. On JUN-2021, the subject experienced dizzy. On JUN-2021, the subject experienced weak. On 11-JUN-2021, the subject experienced chest feels tight. The action taken with COVID-19 vaccine ad26.cov2.s was not applicable. The outcome of the loss of appetite, dizzy, weak and chest feels tight was not reported. This report was non-serious.


VAERS ID: 1409488 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Injection site erythema, Pain in extremity, Skin haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Allergic to cats; Depression; Hypertension; Non-smoker
Preexisting Conditions: Comments: Patient had no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210629376

Write-up: This spontaneous report received from a patient concerned a 77 year old female. The patient''s weight was 160 pounds, and height was 62 inches. The patient''s concurrent conditions included hypertension, depression, allergy to cat dander ( sneezing, watering eyes), no alcohol use, and non-smoker, and other pre-existing medical conditions included patient had no drug abuse or illicit drug usage. The patient experienced dryness of mouth (drug allergy) when treated with codeine. The patient received COVID-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 042A21A, expiry: UNKNOWN) dose was not reported, administered on 07-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On JUN-2021, the subject experienced right and left arm soreness two to three days after the shot. On JUN-2021, the subject experienced headache. On JUN-2021, the subject experienced redness at injection site. On 10-JUN-2021, the subject experienced bleeding spots under the skin on right arm. The action taken with COVID-19 vaccine ad26.cov2.s was not applicable. The outcome of the bleeding spots under the skin on right arm, headache, right and left arm soreness two to three days after the shot and redness at injection site was not reported. This report was non-serious.


VAERS ID: 1409495 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NOVOLOG; VICTOZA; TRESIBA; METFORMIN
Current Illness: Type II diabetes mellitus
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210630317

Write-up: BLOOD GLUCOSE STABILIZATION/UNEXPECTED THERAPEUTIC BENEFIT; This spontaneous report received from a consumer concerned a 75 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included type 2 diabetic. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609 expiry: UNKNOWN) dose was not reported, administered on 09-JUN-2021 for prophylactic vaccination. Concomitant medications included insulin aspart for type 2 diabetes, insulin degludec for type 2 diabetes, liraglutide for type 2 diabetes, and metformin for type 2 diabetes. On JUN-2021, the subject experienced blood glucose stabilization/unexpected therapeutic benefit. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of blood glucose stabilization/unexpected therapeutic benefit was not reported. This report was non-serious.


VAERS ID: 1409520 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-03-17
Onset:2021-06-01
   Days after vaccination:76
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Prostatomegaly, Urinary retention
SMQs:, Anticholinergic 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: LIOTHYRONINE; LEVOTHYROXINE
Current Illness: Thyroid disorder
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Prostate swelling; Unable to urinate/Zero flow/ haven''t urinated since May 31st; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of URINARY RETENTION (Unable to urinate/Zero flow/ haven''t urinated since May 31st) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Thyroid disorder. Concomitant products included LIOTHYRONINE and LEVOTHYROXINE for Thyroid disorder. On 17-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 01-Jun-2021, the patient experienced URINARY RETENTION (Unable to urinate/Zero flow/ haven''t urinated since May 31st) (seriousness criterion medically significant). On an unknown date, the patient experienced PROSTATOMEGALY (Prostate swelling). The patient was treated with TAMSULOSIN HYDROCHLORIDE (FLOMAX [TAMSULOSIN HYDROCHLORIDE]) for Adverse event, at an unspecified dose and frequency. At the time of the report, URINARY RETENTION (Unable to urinate/Zero flow/ haven''t urinated since May 31st) and PROSTATOMEGALY (Prostate swelling) had not resolved. Treatment included pain medications. The patient went to the hospital and got a catheter inserted. Most recent FOLLOW-UP information incorporated above includes: On 08-Jun-2021: Follow up received added a new event.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Further information has been requested


VAERS ID: 1409665 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Oregon  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Aura, Blood glucose normal, Condition aggravated, Cough, Drug ineffective, Dysphonia, Eye swelling, Feeling abnormal, Headache, Hypertension, Pain in extremity, Panic attack, Pharyngeal swelling, Rhinorrhoea, Seizure, Swelling of eyelid, Thinking abnormal
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Periorbital and eyelid disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (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: Neurontin; LAMICTAL; CLONAZEPAM; SYNTHROID; ZYRTEC [CETIRIZINE HYDROCHLORIDE]
Current Illness: Anxiety (Verbatim: anxiety); Thyroid disorder (thyroid being gone)
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy (Allergic to blue dye); Allergy to antibiotic (allergic to a lot of antibiotics, allergic to a lot of medicine); Blood pressure decreased (blood pressure was high, it''s usually low, really low); Brain tumor (Discovered when she was 21 years old, now she''s 54); Grass allergy; Seizures (Verbatim: seizures); Surgery (on the left side. her surgery was done when she was 27 years old, she had been pregnant)
Allergies:
Diagnostic Lab Data: Test Date: 20210601; Test Name: blood sugar; Result Unstructured Data: Test Result:92; Test Name: blood pressure; Result Unstructured Data: Test Result:92/56; Comments: blood pressure was high, it''s usually low, really low; Test Date: 20210601; Test Name: blood pressure; Result Unstructured Data: Test Result:138/72; Comments: High
CDC Split Type: USPFIZER INC2021646458

Write-up: eyes were so swollen, they were almost swollen shut; voice is really rough and raspy; throat swollen; headache; blood pressure was high; had a panic attack/anxiety; Low blood sugar; It was like it made her seizure medicines stop working like it halted the seizure medicines; non-stop seizures; It was like it made her seizure medicines stop working like it halted the seizure medicines; Allergic to the vaccination; made her nose run; made her cough like she was in the middle of a grass field; couldn''t think straight; not in her right mind before she had her seizures, it affected her brain; has sore calves; This is a spontaneous report from a contactable consumer (patient). A 54-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in arm left on 01Jun2021 (Lot Number: EN0178) at the age of 54-year-old as single dose for covid-19 immunisation(reported as wanted to be able to hold her grandbaby). Time of the vaccination was given at 20:15 - 20:30. Co-suspect drugs included clonazepam, orally taken for seizure at 2.5 mg a day, takes it 5 times a day, they break it up, anxiety from an unspecified start date and ongoing; lamotrigine (LAMICTAL) taken for seizure from an unspecified start date and ongoing at 600 mg a day, 6 pills a day; gabapentin (NEURONTIN) taken for seizure from an unspecified start date and ongoing at 600 mg a day per day. There were no vaccines administered on same date with the Pfizer vaccine considered as suspect. Prior vaccinations within four weeks prior to the first administration date of the suspect vaccine reported as none. Medical history included seizures, ongoing anxiety, brain tumor (discovered when she was 21 years old), brain surgery in 1994 (brain surgery was on the left side, her surgery was done when she was 27 years old, she had been pregnant), blood pressure usually low, really low, allergic to blue dye, allergic to a lot of antibiotics, ongoing thyroid being gone, allergic to grass. Concomitant medications included levothyroxine sodium (SYNTHROID) taken for thyroid being gone from an unspecified start date and ongoing; cetirizine hydrochloride (ZYRTEC) taken for allergy from an unspecified start date and ongoing. The patient previously took lorazepam for seizure. The patient experienced non-stop seizures on 01Jun2021 with outcome of recovered on 01Jun2021, headache on 01Jun2021 20:45 with outcome of recovered on 02Jun2021, blood pressure was high on 01Jun2021 with outcome of unknown, eyes were so swollen, they were almost swollen shut on 02Jun2021 with outcome of not recovered, voice is really rough and raspy on 02Jun2021 with outcome of recovering, throat swollen on 02Jun2021 with outcome of not recovered, made her nose run on Jun2021 with outcome of unknown, made her cough like she was in the middle of a grass field on Jun2021 with outcome of unknown, couldn''t think straight on Jun2021 with outcome of unknown, not in her right mind before she had her seizures, it affected her brain on Jun2021 with outcome of unknown, has sore calves on Jun2021 with outcome of unknown, had a panic attack on 01Jun2021 with outcome of recovering, allergic to the vaccination on Jun2021 with outcome of unknown, low blood sugar on 01Jun2021 with outcome of unknown, "It was like it made her seizure medicines stop working like it halted the seizure medicines" on 01Jun2021 with outcome of recovered on 01Jun2021. The patient was calling to report this vaccination, which had caused her a lot of trouble. She had an ambulance come within the hour after receiving it. The police department, ambulance and the EMT they charged for that and then she had non-stop seizures they wouldn''t stop and she took medication and they finally did stop. She did have seizures, they found out she had low blood sugar, but that''s from a brain tumour and brain surgery she had. She had to be careful of her sugar content, she''s not diabetic, she''s opposite of diabetic. Her blood sugar was 92. Her blood pressure was high, it''s usually low, really low. It was 138/72 or something and it''s usually 92/56. She''s not heavy, she''s light, about 110 pounds. She''s healthy, well in a healthy condition. She didn''t have a thyroid, but she took medication. She guessed she''s not the healthiest person. She finally made it to bed last night and she was up this morning and her eyes were so swollen they were almost swollen closed. She was putting tea bags under eyes. They were so swollen one of them was almost swollen shut and now she could hear her voice was really rough and raspy. She was pretty positive she''s allergic to the vaccination. She didn''t know what to do. She could not hold her grandbaby unless she had the vaccination that''s the only reason she got one and now she''s stuck and her eyes look terrible. She thought people with seizures with epilepsy she thought there should be a warning that it could cause seizures and to double up on medication. She was allergic to blue dye, that would do the same to her she didn''t know if it had blue dye in it but she''s allergic to that. She''s also allergic to a lot of antibiotics. She got the vaccination late at (facility name withheld) about 20:15 last night on 01Jun2021 and within half an hour these symptoms started 20:45-21:00. Her throat was swollen. She didn''t normally sound raspy, she sounded normal and had a little nicer voice usually. She still had the headache with seizures. The seizure ended because of the medication, she still wouldn''t have ended her seizures if she hadn''t take the medication, they would have ended later. The seizures were gone because she''s on her medicine. Now it was her eye and her voice. The headache started within a half hour its a precursor an aura to the seizure. It started at 20:45. It was like it made her seizure medicines stop working like it halted the seizure medicines. She couldn''t think straight she called people and talked to people. She was not in her right mind before she had the seizures it was weird. It affected her brain. She also had sore claves. Her calves were very strong and muscled she worked out a lot. She had anxiety but its better since her divorce and one of the pills for the seizures was an anxiety pill too it did both they figured out. What happened after she got the shot was she got anxiety, she thought what the heck. She had a panic attack, she thought that was so weird that was on the road. When she got home she was okay. Her voice was feeling better this was her talking normally, it''s getting better. Also this shot made her nose run and made her cough like she was in the middle of a grass field, which she''s allergic to grass. She just felt like that was weird. She''s just allergic to that blue dye and allergic to a lot of medicine. Events did not resulted in emergency room or physician office visit. Patient declined to go to emergency room when asked by ambulance. The ambulance offered to take her she said no thank you. Treatment received included lorazepam: she took something called lorazepam to stop the seizures. That''s the drug they gave her at the hospital and she had some for non-stop seizures which she''s had in the past she''s had these pills just in case because she lived alone. She put it by her bed just in case she had to take it again. The Lorazepam was 0.5 mg tablets she took one. She only took it if it''s a non-stop seizure. She''s taken it 3 times maybe in the last 3.5 years. The action taken in response to the events for clonazepam, lamotrigine and gabapentin was unknown.


VAERS ID: 1409670 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-30
Onset:2021-06-01
   Days after vaccination:63
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstrual disorder, Menstruation delayed
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Migraine
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021648702

Write-up: This is a spontaneous report from a non-contactable consumer (patient). This 36-year-old female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in right arm on 30Mar2021 10:00 (Batch/Lot number was not reported) as single dose at age of 35 years old for COVID-19 immunization. There was no concomitant medication. The patient did not receive other vaccine in four weeks, no other medications in two weeks. Medical history included asthma and migraine, from an unknown date and unknown if ongoing. The patient had known allergies but unspecified. The patient''s concomitant medications were not reported. The patient experienced irregular menstrual cycle (12 days late), extremely heavy flow and blood clots on 01Jun2021. No treatment received for the events. The outcome of the events was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1409673 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Diabetic (The patient''s dad was diabetic, but the reporter did not know for sure)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021648894

Write-up: Received third dose of Covid 19 vaccine; the patient had an appointment for the hepatitis B vaccine. By mistake, the pharmacist had administered the Pfizer COVID-19 vaccine to the patient; also get the Hepatitis B vaccine afterward(administered on Same Date of the Pfizer Suspect); body aches, pains; tiredness; This is a spontaneous report from a contactable consumer. This consumer reported for a 23-year-old female patient (Reporter''s Niece). A 23-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 3 via an unspecified route of administration on 01Jun2021 (Batch/Lot number was not reported) at the age of 23-year-old as single dose at arm for covid-19 immunisation; hepatitis b vaccine via an unspecified route of administration on 01Jun2021 (Batch/Lot number was not reported), at single dose for immunization. The patient''s other medical history reported as none. The patient''s dad was diabetic, but the reporter did not know for sure. Concomitant medications were not reported. The patient previously received first dose of bnt162b2 at the age of 23-year-old(Maybe 3 weeks before second dose) for covid-19 immunisation. Prior vaccinations (within 4 weeks) also reported as no. The patient previously received second dose of bnt162b2 on May2021 (22May2021 or 23May2021) at the age of 23-year-old for covid-19 immunisation and experienced body aches, pains, tiredness. The patient had the second dose of the Pfizer COVID-19 vaccine 10 days before. The day before yesterday, the patient had an appointment for the hepatitis B vaccine. By mistake, the pharmacist had administered the Pfizer COVID-19 vaccine to the patient and at the time of the report, from Jun2021, the patient was experiencing minor adverse events that were similar to the adverse events she had experienced during her Pfizer COVID-19 vaccine second dose. She did also get the Hepatitis B vaccine afterward(administered on Same Date of the Pfizer Suspect). She felt nervous because she had both. Report reported as non-serious. Events did not resulted in emergency room and physician office. Treatment reported as none. Relevant tests was none. The outcome of the events body aches, pains, tiredness was recovering. Information on the lot/batch number has been requested.


VAERS ID: 1409712 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-17
Onset:2021-06-01
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, SARS-CoV-2 test
SMQs:, Hearing impairment (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Bell''s palsy (I used to have Bell''s Palsy); Shellfish allergy (Known allergies: I have shellfish allergy)
Allergies:
Diagnostic Lab Data: Test Date: 20210603; Test Name: Nasal Swab; Test Result: Negative ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC2021665674

Write-up: I got Bell''s palsy; This is a spontaneous report from a contactable consumer (patient). A 16-years-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Formulation: Solution for injection, Lot number: EW0177 and Expiration date: unknown), via an unknown route of administration, in left arm on 17May2021 at 15:45 (at the age of 16-years-old) as 1ST DOSE, SINGLE DOSE for COVID-19 immunization. Medical history included I used to have Bell''s Palsy and shellfish allergy. The patient''s concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. About 2 weeks later (may be on 02Jun2021 or 03Jun2021), the patient got bell''s palsy. On 03Jun2021, the patient underwent nasal swab sars-cov-2 test and tested negative. Therapeutic measures were taken as a result of bell''s palsy and patient received 21 Prednisone 20 mg and 10 Valacyclovir HCL 500 mg. The clinical outcome of event was recovering. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1409747 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Colitis ulcerative
SMQs:, Gastrointestinal ulceration (narrow), Ischaemic colitis (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HUMIRA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021690575

Write-up: huge flare with her Ulcerative Colitis; This is a spontaneous report from a contactable pharmacist via medical information team. A female patient of an unspecified age received first dose of BNT16B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Batch/Lot number and Expiration date: UN-KNOWN), via an unspecified route of administration on an unspecified date as single dose for covid-19 immunisation. The patient medical history was not reported. Concomitant medication included adalimumab (HUMIRA), 160 mg (Then in 2 weeks will go down to 80 mg dose) taken for an unspecified indication from year 2021 and ongoing. On an unspecified date of Jun2021, the patient experienced huge flare with her ulcerative colitis. Re-porter was concerned about the immune response the patient will receive and her immunity to Covid-19 after her second dose while on the immunosuppressant therapy, or should the patient wait to receive her second dose until she was at her maintenance dose in 4 weeks time. Therapeutic measures were taken as a result of the event with steroids. The outcome of the event was unknown. Information about batch/lot number has been requested.; Sender''s Comments: Based on known drug safety profile, there is reasonable possibility of causal association between the event ulcerative colitis (relapse) and the suspect drug. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.,Linked Report(s) : US-PFIZER INC-2021707940 Same reporter,patient/ different event, dose


VAERS ID: 1409766 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-10
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Maternal exposure during pregnancy, Pruritus
SMQs:, Anaphylactic reaction (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021701765

Write-up: I''m pregnant; Itching; This is a spontaneous report from a contactable consumer(patient) via Medical Information Team. A female patient of an unspecified age received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection) via an unspecified route of administration on 10Jun2021 as single dose for Covid-19 immunization. The patient''s medical history and concomitant medications were not reported. Caller received her first dose on 10Jun2021 and had itching, that started several hours after the dose. She took Benadryl. She was pregnant. She wanted to know whether she can get the second dose. Serious was reported as no. Outcome of the events was unknown. Information on lot/batch has been requested.


VAERS ID: 1409775 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-08
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Body temperature increased, Chills, Dizziness, Heart rate increased, Hypersensitivity, Myalgia, Pallor, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (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 INC2021702340

Write-up: She read in the Fact sheet that this could be a severe allergic reaction; shivering; temp was up; pale; dizzy; elevated heart rate; weakness; muscle ache pains; Woke up in the middle of the night; This is a spontaneous report from a contactable consumer. This 20-year-old female consumer (patient). A 20-years-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot Number and Expiration date was not reported), dose 1 via an unspecified route of administration on 08Jun2021 (at the age of 20-yearsr-old) as 1st dose, single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. On an unspecified date on Jun2021, the patient experienced woke up in the middle of the night with shivering, temp was up, was pale, dizzy, elevated heart rate, weakness, muscle ache pains trying to calm down, but trying to get to relax from shaking/shivering. She read in the Fact sheet that this could be a sever allergic reaction and was wondering if she should received the second dose of the vaccine. As noted in the Fact Sheet for Recipients, should not get the Pfizer-BioNTech COVID-19 Vaccine if the patient had a severe allergic reaction after a previous dose of the vaccine or if had a severe allergic reaction to any ingredient of the vaccine. The decision to receive the second dose for any other reason cannot be made by Pfizer. We refer you to speak to your healthcare provider about the risks of the vaccine compared to the risks of potentially not being fully protected against COVID-19 infection. Your healthcare provider knows your health situation and has access to information that can better help inform this decision. The outcome of the events were unknown. Information regarding Lot/Batch number has been requested


VAERS ID: 1409779 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-23
Onset:2021-06-01
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram, Atrial fibrillation, Cardiogenic shock, Cardioversion, Condition aggravated, Dyspnoea, Echocardiogram, Fatigue, Gait inability, Loss of consciousness, Nausea, Right ventricular dysfunction, Ventricular arrhythmia, Ventricular tachycardia, Vomiting
SMQs:, Torsade de pointes/QT prolongation (narrow), Cardiac failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LASIX [FUROSEMIDE]
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210610; Test Name: Angiogram; Result Unstructured Data: Test Result:ventricle pumping inadequately; Comments: An angiogram (10Jun) which did not show any blockages or valve problems but showed the right ventricle pumping inadequately; Test Date: 20210609; Test Name: Cardioversion; Result Unstructured Data: Test Result:ventricle pumping inadequately; Comments: a cardioversion on (9Jun) & an angiogram (10Jun) which did not show any blockages or valve problems but showed the right ventricle pumping inadequately; Test Date: 202106; Test Name: Echocardiogram; Test Result: 25 %; Comments: Ejection fraction=25%; Test Date: 202106; Test Name: Espophageal echo; Result Unstructured Data: Test Result:ventricle pumping inadequately; Comments: Espophageal echo to r/o any clots in heart or lungs. did not show any blockages or valve problems but showed the right ventricle pumping inadequately.
CDC Split Type: USPFIZER INC2021702740

Write-up: Talking caused SOB & nauseous/vomiting; Talking caused SOB & nauseous/vomiting; Fatigue after vaccination; fatigue increases.; Passed out at end of trip (confirmed ventricular tachycardia); Passed out at end of trip (confirmed ventricular tachycardia); Unable to walk $g 10 ft/During trip, difficultly walking uphill; By midMay tolerates walking but gets SOB on staris/talking caused SOB & nauseous/vomiting/By midMay tolerates walking but gets SOB on stairs; Admitted to hospital (6/4) in 100% A fib & significant ventricular arrhythmias.; Admitted to hospital (6/4) in 100% A fib & significant ventricular arrhythmias; Continued to worsen; Right ventricle pumping inadequately; Cardiogenic shock; This is a spontaneous report from a contactable consumer. A 60-year-old male patient received bnt162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Formulation: solution for injection, Lot number: Unknown) via an unspecified route of administration, on 23May2021 (at the age of 60-years-old), as unknown dose, single dose for COVID-19 immunization and varicella zoster vaccine RGE (CHO) (SHINGRIX) on 27May2021 for immunization. Medical history was not reported. Concomitant medications included Furosemide (LASIX). Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, it was unknown if the patient had been tested for COVID-19. It was unknown if the patient received any other vaccines within 4 weeks prior to the COVID vaccine. On 04Jun2021 after vaccination, the patient experienced fatigue and it was increased. By mid of the May the patient tolerates walking but got shortness of breath (SOB) on stairs. On 20May2021, the physician doubled Furosemide (LASIX) dose for unspecified trip. During the trip, the patient had difficulty walking uphill. It was reported that patient passed out at end of trip, it was confirmed with ventricular tachycardia. On an unknown date, the patient underwent echocardiogram, and the ejection fraction was 25%. On 04Jun2021, the patient admitted to hospital in 100% atrial fibrillation & significant ventricular arrhythmias. The patient was treated with Intravenous heparin and he was kept for 2 nights in the hospital. It continued to worsen. On 08Jun21, the patient was unable to walk more than 10 feet, while talking caused shortness of breath and nauseous/vomiting. The patient was admitted to another hospital. On an unknown date, in hospital the patient had an esophageal echo to rule out (R/o) any clots in heart or lungs. On 09Jun2021, a cardioversion and on 10Jun2021, an angiogram was performed, it did not show any blockage or valve problems but showed the right ventricle pumping inadequately. The patient was advised new medications which included amiodorone. The patient was currently diagnosed with cardiogenic shock and expected to remain in CCU (cardiac care unit) until end of week. It was also reported the patient was hospitalized for Life threatening illness (immediate risk of death from the event). Seriousness criteria was reported as life threatening and prolonged hospitalization. The outcome of all the events was unknown. Information on Lot/Batch number has been requested.


VAERS ID: 1409781 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-11
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Headache, Pyrexia, Sleep terror, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular 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: Medical History/Concurrent Conditions: ADHD
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021703299

Write-up: Fever; Dizziness; Headache; Night terrors; Slept all day; This is a spontaneous report received from a contactable consumer (Patient''s mother). A 13-year-old male patient (reporter son) received BNT162B2 (PFIZER-BONTECH COVID-19 VACCINE, Solution for injection, Lot Number: EW0182) dose 2 via an unspecified route of administration on 11Jun2021 16:30 (at the age of 13-year-old) as single dose for covid-19 immunisation. Medical history included ADHD (attention deficit hyperactivity disorder). The patient''s concomitant medications were not reported. No prior vaccines (4 weeks), no other medical conditions. Reporter Stated, he did not have any other medical conditions besides ADHD. Patient historic vaccine included first dose of BNT162B2 (PFIZER-BONTECH COVID-19 VACCINE, Lot number: EW0182) received on 21May2021 at 2:00 PM, administered in left arm via IM (intramuscular) route, and experienced night terrors and fever. On an unspecified date in Jun2021, the patient experienced fever, dizziness, headache, night terrors and slept all day. The patient, on Friday afternoon at 16:30 received his second Pfizer vaccination and he had the most he had common obviously he had the fever the next day, the dizziness, the headache, slept all day, he had the fever all day, around 6:30, he had a really bad night terror and he also had that with the first injection too. Reporter stated, she thought that he just had it with the first injection and that was gonna be it but she didn''t think that he was gonna have the same results with the second injection cause he had it with the first one but he had it a really bad night terrors with the second one as well so he''s pediatrician wanted her to report it again with the second one because his pediatrician hadn''t been seeing that with any other children. She did not know if any other parents had been reporting these. When Probed if the patient was still experiencing these problems, reporter stated that, the symptoms were improved he did not have them since. Reporter Stated, she gave him paracetamol (TYLENOL) for the fever and the headache. It was 200 mg. The outcome of events was reported as recovering. Follow-up attempts are needed. Further information is expected.


VAERS ID: 1409783 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-09
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Blood test, Impaired work ability, Loss of consciousness, Memory impairment, Somnolence
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202106; Test Name: Blood Test; Result Unstructured Data: Test Result:Inconclusive
CDC Split Type: USPFIZER INC2021703461

Write-up: Can''t stay awake and she is falling asleep; keeps forgetting things; She literally can''t work, can''t stay awake and she is falling asleep.; Passed out; Memory loss; This is a spontaneous report from a contactable consumer (patient). A 31-year-old female patient received BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number- unknown) via an unspecified route of administration in right arm on 09Jun2021at 15:00 (age at vaccination was 31 years) as 2nd dose, single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Historical vaccine included BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number- unknown) via an unspecified route of administration as 1st dose, single dose for COVID-19 immunization and no reaction on previous exposure to first vaccine. It was reported that patient was calling about the covid vaccine. She talked to someone earlier and is trying to figure out the next steps. She was having side effects. On 10Jun2021 at 10:00am, patient was literally could not work, could not stay awake and she was falling asleep then on an unspecified date in Jun2021 the patient experienced memory loss and was passed out in her car and visited the ER and she choose to go home, later she could not stay awake and on 10Jun2021 at 10:00am, she kept forgetting things and scheduled to visit a neurologist. Patient stated that she has never had this before, until last Thursday. Patient had blood test she clarified that it was inconclusive. Patient was taking covid vaccine because of her job she works with kids. Patient stated reason for no lot number of covid vaccine was other. Patient initially stated she has her vaccination card but not with her and then stated she does not know where she put them. The outcome of the events passed out, memory loss was unknown and outcome of the other events was not recovered. Information about batch/lot number has been requested.


VAERS ID: 1409784 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-02
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Head discomfort, Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021703547

Write-up: Head ringing; Faint ringing in both his ears; This is a spontaneous report from a contactable consumer (patient, reported himself). A male patient of an unspecified age received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection; Batch/Lot number was not reported) via an unspecified route of administration on 02Jun2021 as a single dose for covid-19 immunization. The patient''s medical history and concomitant medications, investigation assessment and other products were not reported. Patient previously took chemo treatment 2 years ago which caused head ringing, but it did not last longer. The patient stated that he looked at all the sheets and he did not have any of the side effects listed on the sheets. On an unknown date in Jun2021, he had a bit of head ringing and might be a day or two later he started to hear little bit of faint ringing in both of his ears, especially if things were quiet. He did not know if this was due to bit damp weather but the only thing, he had different in the last few weeks was getting his first vaccine. The patient stated that it was just weird, and he feels the chemo was all out of his system by now a year and a half later. The outcome of both the events was unknown. Information about batch/lot number has been requested.


VAERS ID: 1409797 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:2021-06-13
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Fatigue, Hypersensitivity, Malaise, Nausea, Pharyngeal swelling, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VALTREX
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy (can''t drink artificial sweetener & reaction not severe but her tongue & throat feel its closingup); Fibromyalgia; Food allergy (These things can sometimes give the caller a migraine too so she stays away from them); Herpes zoster; Hormone therapy; Irritable bowel syndrome
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021709625

Write-up: stomach cramps and diarrhea that lasted for a day and a half; stomach cramps and diarrhea that lasted for a day and a half; tiredness; nausea; feeling sick to my stomach that is still waking me up at 3 AM every morning/not achy feeling but feeling unwell; a slightly swollen tongue and throat for about an hour; a slightly swollen tongue and throat for about an hour; allergic to poly glycol which is in the first dose of the vaccine, and she had a reaction to; This is a spontaneous report from a contactable consumer (patient) via Pfizer sponsored program COVAX US support. A 70-year-old female patient BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number and expiry date: was not reported) via an unspecified route of administration, on 13Jun2021 (past Sunday) as 1st dose, single dose for COVID-19 immunization. Medical history included irritable bowel syndrome, fibromyalgia, food allergy, hypersensitivity, hormone therapy, herpes zoster all from an unknown date and unknown if ongoing. Concomitant medication(s) included valaciclovir hydrochloride (VALTREX) taken for herpes zoster, start and stop date were not reported. Patient received first dose of the Pfizer COVID-19 vaccine this past Sunday 13Jun2021 and she reports experiencing the following side effects: stomach cramps and diarrhea that lasted for a day and a half, tiredness that was starting to go away today, and nausea/feeling sick to my stomach that was still waking me up at 3 AM every morning. Patient reports that she has a pre existing history of irritable bowel syndrome and fibromyalgia. Patient also stated that she did experience a slightly swollen tongue and throat for about an hour. She states that the same thing happens if she drinks any sort of diet drinks because of the artificial sweeteners that contain poly-glycol. Patient states that she has heard from many people that they did not experience side effects with the first dose but they did with the second dose. Since she experienced side effects with the first dose she was concerned that she will experience more side effects with the second dose if the second dose stronger. Patient would like to know if the second dose is a different strength or if the two doses are the same and Do most side effects go away within a few days. Patient states that she also takes hormone therapy and that her pharmacist said that there should be no interactions with the Pfizer COVID-19 vaccine but would like to know if there was any additional information available. she takes Valtrex as needed for herpes zoster outbreaks on her legs and ribs. She does not currently has an outbreak but would like to know if this would cause an interaction with the Pfizer COVID-19 vaccine if she did have to take Valtrex. She has spoken with her pharmacist about it but wanted to check with Pfizer as well. Patient asks why there is poly-glycol in the Pfizer COVID-19 vaccine. Patient was concerned she may have worse side effects after the second dose of the Pfizer COVID-19 vaccine especially since most of the people she has spoken with have told her they did not have any side effects after their first dose. She would like to know if her side effects could be worse after the second dose. Patient wants to know if the second dose was the same or a stronger dose. Everyone the caller knows they have had no reactions to the first dose but have had bad reactions with the second dose. The caller cannot drink artificial sweeteners and the reaction was not severe but her tongue and throat feels like its closing up. Patient also has to stay away from foods with preservatives, like hot dogs and cold cuts. These things can sometimes give the caller a migraine too so she stays away from them. She saw that poly glycol was on the ingredient list of the vaccine but she decided to get the vaccine. After the vaccine, the caller had cramping, diarrhea, tiredness, she has been in bed since Sunday, and not achy feeling but feeling unwell. The second dose, from what the she hears, that people react to the second dose instead off the first. Asking the second dose going to be stronger because then the she may feel twice as bad. She was contemplating on getting the second dose. Asking it the same shot or a different dose. The outcome of the tiredness, nausea, feeling sick to my stomach that is still waking me up at 3 am every morning/ not achy feeling but feeling unwell, a slightly swollen tongue and throat for about an hour and allergic to poly glycol which is in the first dose of the vaccine, and she had a reaction to was unknown and stomach cramps and diarrhea that lasted for a day and a half was recovered on Jun2021. Information on the lot/batch number has been requested.


VAERS ID: 1409798 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-14
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Dizziness, Fatigue, Insomnia, Malaise, Oropharyngeal pain, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? 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 INC2021709656

Write-up: is hurting really bad again; Couldn''t sleep last night; Didn''t feel well at all when receiving the second dose; Got a sore throat; Started to feel dizzy; Went to sleep right away; Had like a fever; woke up and had a very upset stomach; Throwing up; This is a spontaneous report from a contactable consumer. A 14-years-old male patient received Bsecond dose of NT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection. Batch/Lot number was not reported), dose 2 via an unspecified route of administration on 14Jun2021 as 2nd single dose for COVID-19 immunization. Medical history and concomitant medication were not reported. Patient''s medical and concomitant medication history were not reported. Historical vaccine included 1st dose of BNT162B2 as a single dose for COVID-19 immunization. No reaction on previous exposure to drug. It was reported that, "patient reporting for received the second dose of the Pfizer Covid Vaccine yesterday, On 14Jun2021. Patient didn''t feel well at all when receiving the second dose Pfizer Covid Vaccine. Patient had a sore throat and started to feel dizzy. Patient ate a burrito, a fatty food and patient went to sleep right away, had like a fever. When the patient woke up he had a very upset stomach. The patient couldn''t really sleep last night. The patient woke up and took medicine. Woke up and had a very upset stomach and stomach was really hurting at 05:00 and patient threw up and right after throwing up felt better for like a minute. Hurting really bad again, patient was hurting more than yesterday. Patient ask what should do and if these symptoms are normal. The patient states, does not know what to do, but the patient fees really bad right now. Patient wanted to call his physician now. The caller states he can document his experience with Pfizer at a later time, right now the caller wants to get this done. The outcome of the event was unknown. No further information provided. Follow up is excepted. Further information is requested.


VAERS ID: 1409805 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-14
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021711465

Write-up: has numbness in both hands, but mainly her right hand, after the second vaccine; This is a spontaneous report from a contactable consumer (patient). A 49-years-old female patient received second dose of BNT162B2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot number, Expiration date and NDC number was not reported), via an unspecified route of administration on 14Jun2021 as a single dose (at the age of 49-years-old) for covid-19 immunisation at hospital. The patient medical history and concomitant medications were not reported. Patient received first dose of BNT162B2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot number and Expiration date was not reported), via an unspecified route of administration on an unspecified date as a single dose for covid-19 immunisation. On Jun2021, patient had numbness in both hands, but mainly her right hand, after the second vaccine. Patient stated that for a half hour to 45 minutes, she had numbness in her right hand and stated that hand feels like if you hold a body part in the same position, for a long time, and it feels numb. Patient clarified that she feels the numbness in both of her hands, mainly her right hand. Patient asked if it was normal to have this effect or she should worry and asked if this effect was alright to had, or should she go to a doctor. The outcome of the event was unknown. Information on batch/Lot number was not received. Further information has been requested.


VAERS ID: 1410240 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-02-18
Onset:2021-06-01
   Days after vaccination:103
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Peripheral artery thrombosis, Stent placement, Surgery
SMQs:, Embolic and thrombotic events, arterial (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? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Simvastatin, Duloxathene, Centrum Silver for men
Current Illness:
Preexisting Conditions:
Allergies: Codiene
Diagnostic Lab Data: THREE SURGERIES PLUS INSERTION OF A STINT TO LESSON THE AMOUNT OF THE BEND AT THE CLOT SITE
CDC Split Type:

Write-up: lARGE BLOOD CLOT IN ARTERY FEEDING RIGHT LEG - OCCURRED AT A BEND IN THAT ARTERY


VAERS ID: 1410413 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-05
Onset:2021-06-01
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Aspiration joint, Injection site pain, Joint effusion, Joint swelling, Muscular weakness, Pain in extremity, Sleep disorder, Synovial fluid analysis, Weight bearing difficulty, X-ray limb abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad), 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? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levothyroxine every day, occasionally multi vitamin, calcium a few times a month
Current Illness: None
Preexisting Conditions: Thyroid cancer, I had my thyroid removed and as a result of that I have a Hypothyroid
Allergies: None
Diagnostic Lab Data: X-ray- no fracture but there was just knee joint effusion
CDC Split Type: vsafe

Write-up: For a few days after the 2nd dose I had the normal arm ache, after one day of no symptoms my whole left arm from my shoulder to my elbow, it really hurt, it was like a very deep ache. Then it went away and about 3 weeks later my left knee started feeling kind of weak, I could not put any weight on it and it got progressively worse. It started getting swollen like 3 times bigger than my other knee, it was very painful. It was limited to my left knee but a few times at night my whole tight had that same kind of ache as in my arm, like a very deep ache and it was so painful it would wake me up at night. I had a hard time going back to sleep. That lasted about 2 or 3 nights. That thigh ache went away so now I just have the swollen knee. Around 06/06/2021 I went to get an x-ray so I must have called my doctor about 2 days before that. After that I was told to go to the ER and they just gave me crutches and prescribed some anti-inflammatory medicine, then a few days after I went to the ER again and they kept me overnight and they removed fluid and they tested it and they are still doing testing, they gave me a different anti-inflammatory medicine and told me to stop taking the first one.


VAERS ID: 1410457 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-01-30
Onset:2021-06-01
   Days after vaccination:122
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038K20A / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Vaccinated with Moderna on 1/30/21 and 2/27/21. Symptom onset 6/1/21 with cough, runny nose, shortness of breath, nasal congestion and pain/pressure in the chest. Patient does have a history of lung and sinus infections. Sample sent for genomic sequencing.


VAERS ID: 1410463 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-02-27
Onset:2021-06-01
   Days after vaccination:94
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031M20A / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Vaccinated on 1/30/21 and 2/27/21 with Moderna. Symptom onset 6/1/21 with cough, runny nose, shortness of breath, nasal congestion, and pain/pressure in the chest. Patient has history of lung and sinus infections. Sample sent for genomic sequencing.


VAERS ID: 1410668 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-01
Onset:2021-06-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, 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: Prescription eye drops Latanaprost and Timolol
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vertigo / headaches


VAERS ID: 1410773 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-06-18
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 RA / SYR

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

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

Write-up: I was given the vaccine and when the pharmacists removed the needle I felt a cool feeling running down my arm to my elbow and I told her that and when I looked at my arm I seen a droplet almost to my elbow and I wiped it and asked her what it was and she said I do not know. I was concerned that I did not get the full 3 millimeters of the vaccine and I asked her if that was possible and she said that maybe the muscle wasn''t strong enough and pushed some back out and she asked me if I wanted another shot and I asked if we should or is it ok to do that. she replied I don''t know then she came back and gave me another shot but the second shot was only 1 millimeter. My question is how do we know how much of the vaccine did I actually receive and what I am I supposed to do because she didn''t really seem like she knew.


VAERS ID: 1411038 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-07
Onset:2021-06-01
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cerebral haemorrhage, Cerebral venous sinus thrombosis, Headache, Intensive care, Migraine, Nausea, Pain, Unresponsive to stimuli, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vienva, Levonorgestrel and Ethinyl Estradiol Tablets, USP 0.01 mg, 0.02 mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: There were many tests run during her stay at the hospital 6/3 - 6/11/21
CDC Split Type:

Write-up: 6/1 She woke up with a severe headache and vomiting. She went to the urgent care and was treated for migraine headache and nausea. She was giving medication for pain and vomiting. Slept until the next day. Felt somewhat better the next day and continued meds. She went to work on 6/3 and towards the end of her shift she told her boss about the severe headache and sat in her car outside and then became unresponsive. The paramedics were called and she was transferred to the hospital and diagnosed with a brain blood clot and brain bleeding. She was flow by air car to another hospital and admitted to ICU. She was in Neurology ICU until 6/6, and then transferred to a normal neurology bed and released on 6/11. Diagnosis of left venous sinus thrombosis and hemorrhage in the left temporal lobe.


VAERS ID: 1411040 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-10
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: None
CDC Split Type:

Write-up: Patient received 2nd dose of Moderna vaccine from a vial that had more than 30 days. Patient has not experienced symptoms and is stable. No health concerns at this time.


VAERS ID: 1411058 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-06
Onset:2021-06-01
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 1 LA / IM

Administered by: Other       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: None reported
Current Illness: None reported
Preexisting Conditions: None reported
Allergies: None reported
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient received 1st dose 18 days before he turned 18 years old. Patient and mom reported that he was 18 years old since in their country he is considered 18 years of age in the birthday month. Patient and mom gave consent for the vaccine. Patient does not have symptoms or health concerns at this time.


VAERS ID: 1411744 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Nodule, Skin warm, Vaccination site pain
SMQs:

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

Write-up: AREA OF VACCINATION STARTED TO HURT THAT SAME DAY AND CONTINUED TO WORSEN FOR TWO WEEKS. NODULE THAT IS WARM TO TOUCH DEVELOPED FURTHER DOWN ON FOREARM AT SOME POINT. REPORTED TO PHARMACY 6/14 BUT COULD NOT SEE DOCTOR UNTIL 6/18. TRIED ICY HOT, ASPERCREME, BENADRYL, TYLENOL, ICE WITH NO RELIEF. DURING CALL PHARMACIST SUGGESTED SWITCHING FROM TYLENOL TO IBUPROFEN. IBUPROFEN WAS REPORTED TO BRING SOME BUT NOT COMPLETE PAIN RELIEF. DOCTOR STOPPED IBUPROFEN 6/18 AND PRESCRIBED ORAL PREDNISONE AND HEAT THERAPY.


VAERS ID: 1412048 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-03-01
Onset:2021-06-01
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Erythema, Pain, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: covid arm starting about 5 plus weeks after 2nd shot that is lasting... red and very painful staying localized but not going away. Pain is bad enough to regularly take Tylenol for it and I usually don''t take meds for paii


VAERS ID: 1412249 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Nausea, Oropharyngeal pain, Pain, Somatotropin stimulation test
SMQs:, Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MYCAPSSA; FLEXERIL [CYCLOBENZAPRINE HYDROCHLORIDE]; FENOFIBRATE; IBUPROFEN; MIRALAX; TRAMADOL
Current Illness: Acromegaly
Preexisting Conditions: Medical History/Concurrent Conditions: Chest pain (The patient took aspirin for chest pain.); Faeces discolored; Faeces soft; Frequent bowel movements; Insomnia; Itchy legs; Mood change; Sleep disorder; Sweating; Upper back pain
Allergies:
Diagnostic Lab Data: Test Name: Growth hormone stimulation test; Result Unstructured Data: Unknown
CDC Split Type: USJNJFOC20210631912

Write-up: BODY ACHES; SORE THROAT; NAUSEA; This spontaneous report received from a patient concerned a 66 year old female. The patient''s weight was 161 pounds, and height was not reported. The patient''s past medical history included mood change, not sleeping, chest pain, frequent bowel movement, faeces discoloured more orange in color, pain between shoulder blades, faeces soft or sluggish, itching on front leg, unspecified sleep issues, and sweating, and concurrent conditions included acromegaly. The patient was previously treated with acetylsalicylic acid for chest pain; and experienced vulvovaginal swelling when treated with octreotide for acromegaly. 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 01-JUN-2021 for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included octreotide acetate for acromegaly, cyclobenzaprine hydrochloride, fenofibrate, ibuprofen, macrogol 3350, and tramadol. On JUN-2021, the subject experienced generalised aching. On JUN-2021, the subject experienced sore throat. On JUN-2021, the subject experienced nausea. Laboratory data (dates unspecified) included: Growth hormone stimulation test (NR: not provided) Unknown. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from generalised aching, nausea, and sore throat. This report was non-serious.


VAERS ID: 1412277 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       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? 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: USJNJFOC20210634359

Write-up: HOT AND ITCHY ALLERGY LIKE BUMPS IN RANDOM AREAS OF THE BODY; RASH; ITCHY EARS; This spontaneous report received from a patient concerned a 47 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: 205A21A, expiry: UNKNOWN) dose was not reported, administered on 02-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On JUN-2021, the subject experienced itchy ears. On 02-JUN-2021, the subject experienced hot and itchy allergy like bumps in random areas of the body. On 02-JUN-2021, the subject experienced rash. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from hot and itchy allergy like bumps in random areas of the body, and rash, and the outcome of itchy ears was not reported. This report was non-serious.


VAERS ID: 1412289 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Body temperature, Chills, Cough, Headache, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Shoulder blade pain
Allergies:
Diagnostic Lab Data: Test Date: 20210616; Test Name: Body temperature; Result Unstructured Data: 101
CDC Split Type: USJNJFOC20210637759

Write-up: FEVER OF 101; HEADACHE AROUND EYES; SEVERE BODY ACHES; COUGHING; HORRIBLE CHILLS; HURTING OF SHOULDER BLADES BEHIND LUNGS; 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. The patient''s past medical history included shoulder blade pain. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 15-JUN-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow up will be requested for this case. No concomitant medications were reported. On JUN-2021, the subject experienced severe body aches. On JUN-2021, the subject experienced coughing. On JUN-2021, the subject experienced horrible chills. On JUN-2021, the subject experienced hurting of shoulder blades behind lungs. On JUN-2021, the subject experienced headache around eyes. On 16-JUN-2021, the subject experienced fever of 101. Laboratory data included: Body temperature (NR: not provided) 101 (units unspecified). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fever of 101, horrible chills, severe body aches, hurting of shoulder blades behind lungs, headache around eyes and coughing was not reported. This report was non-serious.


VAERS ID: 1412432 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-21
Onset:2021-06-01
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Biopsy, Blood test, Postmenopausal haemorrhage, Ultrasound scan
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Menopause (5 years ago); Penicillin allergy; Premature ovarian failure
Allergies:
Diagnostic Lab Data: Test Name: Biopsy; Result Unstructured Data: Test Result:Unknown results; Test Name: blood work; Result Unstructured Data: Test Result:Unknown results; Test Name: ultrasound; Result Unstructured Data: Test Result:Unknown results
CDC Split Type: USPFIZER INC2021655113

Write-up: 5 years post menopause, 10 days after injection got period/menstruated. Have to get endometriotic biopsy; This is a spontaneous report from a contactable consumer (patient). A 41-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration and administered in left arm at age of 41-years, on 21May2021 08:30 (Lot number was not reported) as single dose for covid-19 immunisation. Medical history included Premature ovarian failure and Menopause 5 years ago in 2016, and penicillin allergy. Patient was not pregnant. Concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. There was no any other medications the patient received within 2 weeks of vaccination. The patient previously took amoxicillin and experienced allergy. The patient post menopause 5 years ago. 10 days after injection, she got period/menstruated on 01Jun2021 20:30. She had to get endometriotic biopsy. The adverse event result in "Doctor or other healthcare professional office/clinic visit". Therapeutic measures were taken for it. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient was not tested for COVID-19. The patient underwent lab tests and procedures which included biopsy, blood work and ultrasound on an unknown date, all were awaiting results. Event outcome was not recovered. Information on the lot/batch number has been requested.


VAERS ID: 1412438 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-06-02
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Chest discomfort, Chest pain, Choking, Dyspnoea, Headache, Illness, Lymphadenopathy, Pain, Pain in extremity, Throat irritation, Throat tightness, Vomiting, Wheezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Bronchial asthma (When she was a child, she had bronchial asthma, and she is now 60 years old. Has not had any problems in years. Prior Vaccinations (within 4 weeks): No, has been years. Has not even had the flu shot in 3 years.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021655803

Write-up: Within 1 hour had tightness in her chest, wheezing and her throat started to tighten up; Within 1 hour had tightness in her chest, wheezing and her throat started to tighten up; Pain in the right side of her leg and in her stomach; Caller stated she has been vomiting mainly from the draining that is choking her.; Throat tightened up and glands swell; Barely able to breath, shortness of breath; Pain in right side, below her breast; Within 1 hour had tightness in her chest, wheezing and her throat started to tighten up; She was so sick; Caller stated she has been vomiting mainly from the draining that is choking her.; Headaches; Pain in the right side of her leg and in her stomach; Burning in her chest and throat/ pain was in the right side of the chest; Burning in her chest and throat/ throat has been like its on fire; This is a spontaneous report from a contactable consumer (patient). A 60-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Right on 02Jun2021 (Batch/Lot Number: EW0177) as 1ST DOSE, SINGLE for covid-19 immunisation. Time the Vaccination Was Given: Between 12:00 and 1:00pm. Medical history included when she was a child, she had bronchial asthma. Has not had any problems in years. Prior Vaccinations (within 4 weeks): No, has been years. Has not even had the flu shot in 3 years. The patient''s concomitant medications were not reported. Caller stated she had the first dose of the Pfizer covid 19 vaccine and stated she is having a reaction. Caller stated it feels like she has covid. Caller stated she got the vaccine 3 days ago and within 1 hour had tightness in her chest, wheezing and her throat started to tighten up. All she could do was wheeze. Her throat started tightening up and her glands started swelling. Caller stated she then had draining down the back of her throat. Caller reported burning in her chest and throat. Caller reported pain in the right side of her leg on 02Jun2021 and in her stomach. Caller stated she has been vomiting on 02Jun2021 mainly from the draining that is choking her. Caller stated she is still draining but not vomiting. Caller reported she is having headaches. Caller was concerned about what she should do, go to her doctor or go to the ER. Caller wanted to know how long the symptoms should last. Caller stated she is 52 hours out from the vaccine, Throat tightened up and glands swell, Barely able to breath, shortness of breath, pain on 02Jun2021. She was so sick. She was barely able to breathe within an hour and has been in pain. It is now a struggle, with shortness of breath. Her throat has been like its on fire, and lungs filled with a huge amount of drainage in the back of her throat. Is having right leg pain and pain in her stomach. It is not severe pain, but there is some pain there, is having a lot of burning sensation with the drainage. It now feels like she has Covid now. She read in the paperwork that this could not cause Covid. She was perfectly fine when she had the vaccine. She has no allergies. Does not know what to do. It has been 48 hours. She was perfectly fine until an hour later. She contacted the pharmacy and they didn''t do anything. She then contacted this number to report this. Her biggest concern was the severe drainage. There were globs of drainage down the back of her throat. Her chest tightened prior to that and she was wheezing. She has not had bronchial asthma since she was a child. Has had no flus, or nothing. Had the pain after the burning in her chest, the pain was in the right side of the chest. Pain in right side of leg: Hasn''t stopped completely. Still has pain in the right leg and in the chest. It is barely any better. It is probably because it is in one spot in the calf on her right leg. The pain in the right side, below her breast. The pain seems to be in the right side. Pain in stomach: Seems to be both sides. Has gotten better some, in the stomach. Vomiting: Was vomiting from all the drainage, it was choking her. It started within 2 hours. She is still experiencing the drainage, but not the vomiting. Has also been experiencing headaches. Shortness of breath: Was the same time as the tightness in the chest. It was within an hour after she left. They kept her there 15 minutes and she was fine when she left. Within the hour, she could barely breathe. She didn''t know if she should go to the emergency room or if it would get better in a few days. The shortness of breath and wheezing is not worse, but is constant and really hard. Her breathing is really labored. She is not having pain, other than the tightness and wheezing, which she can hear. It is like she had asthma for years, or pneumonia. Outcome of events Wheezing, Chest burning, Throat burning sensation, headache, and Shortness of breath, pain of was not recovered, of Pain in leg, Stomach pain was recovering, of Vomiting was recovered in Jun2021, of others was unknown.


VAERS ID: 1412478 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO183 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Cold sweat, Dizziness, Electrocardiogram, Loss of consciousness, Muscle spasms, Muscle strain, Nausea, Pain, Pyrexia, Urine analysis
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), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: FLUOXETINE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210603; Test Name: blood test; Result Unstructured Data: Test Result:normal levels; Test Date: 20210603; Test Name: EKG; Result Unstructured Data: Test Result:normal levels; Test Date: 20210603; Test Name: urine test; Result Unstructured Data: Test Result:normal levels
CDC Split Type: USPFIZER INC2021659745

Write-up: I passed out in the bathroom; pulled the muscles in her back; This lead to uncontrollable muscle spasms in my back; dizziness; nausea/felt like I was going to throw up; I broke out into an all over clammy sweat and felt like I was going to throw up; body aches head to toe; low grade fever; This is a spontaneous report from a contactable other hcp (patient). A 57-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration, administered in arm left on 01Jun2021 10:00 (Lot Number: EWO183) at the age of 57-year-old as single dose for covid-19 immunisation. The patient was not pregnant. Known allergies included erythromyicine. Concomitant medication included fluoxetine (reported as floxitine) taken for an unspecified indication, start and stop date were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient previously received first dose of bnt162b2(lot number: EWD176) on 10May2021 05:00 PM at the age of 57-year-old, at arm left for covid-19 immunisation. On 01Jun2021, the patient experienced body aches head to toe, low grade fever. On 02Jun2021 08:00 AM, dizziness which lead to nausea which lead to a need to sit down immediately to avoid falling to the ground. Upon sitting, the patient broke out into an all over clammy sweat and felt like she was going to throw up. On the third time of getting up(03Jun2021), about 20 minutes after the first dizzy episode, she had to use the restroom. She passed out in the bathroom, woke up wedged between the toilet and the wall. The patient had no idea how long she was passed out. When she moved out of that position to stand up, she pulled the muscles in her back. This led to uncontrollable muscle spasms in her back. That morning (03Jun2021) Advice nurse directed her to the Urgent care due to passing out. She compromised with her doctor for lab work: blood and Urine, and EKG and muscle relaxer medication. 3 hours later, arriving home at 3:30 she took the medications and went to sleep. The muscle relaxer significantly reduced her pain. The adverse events resulted in Emergency room/department or urgent care. Treatment received for the adverse events included pain medications and lab results all showed normal levels. The patient had no covid prior vaccination. No covid tested post vaccination. The outcome of the events was recovering.; Sender''s Comments: Based on temporal association, a contributory role of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE) to the event pass out cannot be excluded completely. The case will be reassessed once more information become available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.


VAERS ID: 1412486 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-02
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Colitis ulcerative, Diarrhoea, Eating disorder, Illness, Inappropriate schedule of product administration
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal ulceration (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow), Medication errors (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: GEODON [ZIPRASIDONE HYDROCHLORIDE]; TRAMADOL; HYDROXYZINE; CLONAZEPAM
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Acid reflux (esophageal); Anxiety; Blood pressure high; Broken leg (Verbatim: recovering from broken leg); Depression; Dissociative identity disorder; Nerve pain; Pain; Ulcerative colitis (treated with medication)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021660503

Write-up: This is a spontaneous report from a contactable consumer (patient). A 70-year-old female patient received BNT162B2 (BNT162B2), dose 2 via an unspecified route of administration, administered in arm right on 02Jun2021 around 2:00 to 3:00 pm (Batch/Lot number was not reported) as single dose at the age of 70-year-old for COVID-19 immunization. Medical history included lot of medical conditions, recovering from broken leg, blood pressure high treated before with Lisinopril and then with a new drug just prescribed, dissociative identity disorder, depression, anxiety, acid reflux, pain, neuralgia, had ulcerative colitis in the past (treated with medication). Family medical history included her mother had diarrhea very badly. Concomitant medication(s) included ziprasidone hydrochloride (GEODON, capsule) orally, twice a day, taken for dissociative identity disorder, start and stop date were not reported; tramadol (manufacturer unknown, tab) 50 mg, twice a day, orally, taken for pain relief, start and stop date were not reported; hydroxyzine (manufacturer unknown) 25mg taken for nerve pain, start and stop date were not reported; clonazepam (manufacturer unknown, tablet) 1 mg, orally, taken for neuralgia, start and stop date were not reported. The patient previously received, lisinopril for hypertension. Vaccine history included BNT162B2 on 23Feb2021 for covid-19 immunization. No other vaccine administered together with BNT162B2. In Jun2021 the patient experienced this is much worse than ulcerative colitis (medically significant) with outcome of unknown, diarrhoea (non-serious) with outcome of not recovered, she cannot eat anything without getting sick (non-serious) with outcome of unknown, she was very sick with diarrhea (non-serious) with outcome of unknown, she received BNT162B2 2st dose on 23Feb2021 and 2nd dose on 02Jun2021 (non-serious) with outcome of unknown. The course of events was as follows: She got the COVID019 vaccine on 02Jun2021 afternoon and she had diarrhea repetitive diarrhea ever since its uncontrolled diarrhea she had to wear diaper and on 04Jun2021 she had to wash her clothes several times and she lied on bed for a while she had to wash that cloth as well she was very sick with diarrhea and she was reading diarrhea can be result of the vaccine she cannot eat anything without getting sick and she did not know what to do. Treatment received in response to event diarrhoea: Pepto-Bismol during the day time, 2 Pepto-Bismol every 30 minutes; 262 mgs. Information on the lot/batch number has been requested.


VAERS ID: 1412488 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: USPFIZER INC2021660602

Write-up: he was showing reaction, chest pain and severe chest pain; This is a spontaneous report from a contactable consumer reporting on behalf of the son. A 21 years old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 03Jun2021, as second single dose, for COVID-19 immunization. The first dose of BNT162B2 was given on an unknown date. Medical history and concomitant medications were not reported. The patient took the second vaccine dose and he was showing reaction, chest pain and severe chest pain since an unspecified date in Jun2021. The reporter took him to ER because he was showing severe chest pain and he was 21 years old. Reporter seriousness for the event was unspecified. Event outcome was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1412522 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Headache, Influenza like illness, Oral herpes, Pain, Pain in extremity
SMQs:, Oropharyngeal infections (narrow), Tendinopathies and ligament disorders (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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Fibromyalgia (Fibromyalgia Additional Information for Other Conditions: Diagnosed over 20 years ago); Osteoarthritis (Osteoarthritis Additional Information for Other Conditions: Diagnosed over 20 years ago.); Osteoporosis (Osteoporosis Additional Information for Other Conditions: Diagnosed over 20 years ago.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021683315

Write-up: Flu like symptoms; Headache; Aches and pains; Sore arm; lower lip broke out with cold sores; This is a spontaneous report from a contactable nurse (patient). A 78-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: EW0186, Expiration date and NDC number are unknown, time the vaccination was given: Noon), via an unspecified route of administration, administered in Left arm on 03Jun2021 at the age of 78-years-old as 2nd dose, single dose for covid-19 immunisation. The patient s medical history including any illness at time of vaccination were osteopenia, osteoarthritis and fibromyalgia, diagnosed over 20 years ago in 2001. The patient s concomitant medications were not reported. The patient previously took first dose of historical vaccine, bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: EW0186, Expiration date and NDC number are unknown), via an unspecified route of administration, administered in Left arm on 13May2021 at the age of 78-years-old for covid-19 immunisation. Prior vaccinations (within 4 weeks) if applicable, list any other vaccinations within four weeks prior to the first administration date of the suspect vaccine were none. Adverse events following prior vaccinations were none. Family medical history relevant to adverse events were none. Relevant tests were none. History of all previous immunization with the pfizer vaccine considered as suspect (or patient age at first and subsequent immunizations if dates of birth or immunizations are not available) were none. Additional vaccines administered on same date of the pfizer suspect were none. It was reported that event happened after the second dose of the vaccine. About a week after receiving the second dose, her lower lip broke out with cold sores on an unspecified date in Jun2021 and she has been fighting this more than a week now. She tried Zovirax (NDC and lot unknown, expiration date 31Mar2021) which usually helps with this but it did not this time. It has been years since this has happened. Yes, this has happened to some other people. It has been two weeks now. The Zovirax tamped it down a little but did not get rid of it like it normally does. She thinks her immune system is working and her immune system is causing the issue. It was reported that she had the normal flu like symptoms and headache on 04Jun2021 and it went away in under three days, she thought it was normal. The caller also had a sore arm on 03Jun2021 and aches and pains on 04Jun2021. By the fourth day the caller was fine. The caller wanted to make Pfizer aware that someone else had the herpes complex problem. The adverse events did not require a visit to Emergency Room or Physician Office. It was reported that age at time of onset of reaction/event was 78. Time of onset of adverse events was unknown. There was no investigation assessment. It was reported that she is tired of lock down and she does not want to wear a mask the rest of your life. She googled to see if anyone else had this come up and it seems to be a minor amount of people that have experienced it. She didnt expect for this to happen to her. The reporter assessed events as non-serious. The reporter assessed events relatedness to Pfizer covid vaccine as Related. The outcome of event, lower lip broke out with cold sores was not recovered while for other events was recovered on an unspecified date in Jun2021. Additional information is requested.


VAERS ID: 1412536 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Kansas  
Vaccinated:2021-06-07
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ENO179 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021690789

Write-up: This is a spontaneous report from a contactable consumer or other non-healthcare professional (patient) via medical information team. This is report 2 of 3. A female patient of an unspecified age received first dose of BNT162B2 (Pfizer-BioNTech COVID-19 Vaccine, Solution for injection, Lot Number: ENO179) via an unspecified route of administration, administered in left arm on 07Jun2021 as 1st single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On 08Jun2021, the patient experienced sore left arm and headache. On an unspecified date in June 2021, the patient experienced nausea but it only lasted 24 hours. The patient informed that she experienced a really bad headache, soreness in her arm & nausea for a short period and she was fine already. The patient took Advil as treatment on 08Jun2021 for arms were sore. The outcome of the events was resolved on an unspecified date in June 2021. No follow-up attempts needed. No further information is expected.


VAERS ID: 1412570 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-06-11
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Swelling, Vaccination site pain
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VITAMIN D NOS
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure abnormal (Verbatim: Blood pressure)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021702176

Write-up: I am having swelling under the arm; It is in my left arm where I got the shot, it is kind of sore; Where I had the shot in my left arm, there is swelling underneath my arm; It is underneath my armpit; I am having swelling under the arm; It is in my left arm where I got the shot, it is kind of sore; Where I had the shot in my left arm, there is swelling underneath my arm; It is underneath my armpit; This is a spontaneous report from a contactable consumer (patient). A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: EW0177, NDC number, UPC number and Expiration date are unknown), via an unspecified route of administration, administered in Left arm on 11Jun2021 as unknown, single dose for covid-19 immunisation. Medical history included Blood pressure from unspecified date. Concomitant medications included Vitamin D (VITAMIN D NOS) taken for an unspecified indication on an unspecified date and unspecified blood pressure medicine, on an unspecified date. It was reported that patient was calling regarding a side effect that is not written on the paper. The patient had several of them and had shot on Friday and just noticed having swelling under the arm, it is in left arm where patient got the shot, it is kind of sore and where patient had the shot in left arm, there was swelling underneath arm on an unspecified date in Jun2021. The patient wanted to report it and also wanted to know if it was normal, the swelling and the " Consumer stated, "Not my hand, my arm where the shot was and also underneath my arm." It was reported that the patient did not take any medication for adverse events. Reporter seriousness for adverse events was unspecified. The outcome of events was unknown.


VAERS ID: 1412579 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-13
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO186 / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Loss of personal independence in daily activities, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021708685

Write-up: Fever; It has not worsened but he cannot go to work; This is a spontaneous report from a Pfizer sponsored program (CEP ID: 159558). A contactable 53-year-old male consumer (patient) reported that: A 53-years-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Batch/Lot number: EWO186), via an unspecified route of administration, administered in Deltoid Left (reported as left shoulder) on 13Jun2021 (at the age of 53-years-old) as a single dose for COVID-19 immunisation (reported as because everybody should take it). The patient''s medical history and family medical history relevant to adverse event was reported as none. There were no concomitant medications. No prior vaccinations within 4 weeks. The patient previously received flu shot (unspecified manufacturer) on an unspecified date and experienced itches and fever (anytime when he has the flu shot he had a fever). On 14Jun2021, midnight around 01:00, the patient experienced fever and was suffering. It has not worsened but he cannot go to work. He can''t make it to work. It was persisting and staying the same. The patient did not receive treatment and stated he was calling to get treatment for fever. The outcome of event fever was not recovered and the outcome of other event was unknown. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1412587 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-13
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Headache, Limb discomfort, Neck pain, Pain, Pain in extremity, Paraesthesia, Vaccination site pain
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BUPROPION; PHYTOESTROGEN; GABAPENTIN; NORTRIPTYLINE; QUETIAPINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anxiety; Chronic fatigue syndrome; Depression; Diverticulitis; Fibromyalgia; Gastroparesis; Headache; Irritable bowel syndrome; Migraine
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021710365

Write-up: This is a spontaneous report from a contactable consumer (patient). A 67-years-old male patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EW0217), via an unspecified route on 13Jun2021 (at the age of 67-years) as 1st dose, single dose in the left arm for COVID-19 immunization. The patient medical history included fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, gastroparesis, diverticulitis, depression, anxiety, migraine, headache. Concomitant medications included Bupropion, Gabapentin, Nortriptyline, Quetiapine, angelica sinensis root, cimicifuga racemosa root, dioscorea spp., glycine max (PHYTOESTROGEN). The patient previously took flu shot last year. In Jun2021, the patient experienced soreness in the arm. He got vaccine in left arm and having pain in his right arm and his right toes, then his right foot the big toe was giving him some weird sensations, the small toes. It was just a weird sensation like tingling and also having a headache in the back on my head and neck. He had fibromyalgia, he knows how that pain feels like, but this was a different kind of pain. He had pain like headache on the back of my head and my neck and like just some soreness that could be considered medicinal like he had fibromyalgia and chronic fatigue, so he know the difference in what he fell from the fibromyalgia and when it is something different and then on my right arm, he got the shot in my left arm the pharmacist said it was better to get it on the non-dominant arm in case you have a problem and he understand that he could get the fatigue but he had just kind of concern about other stuff, neck pain and headache and having symptoms that are just different from my regular fibromyalgia and also that right foot. He took Tylenol for pain, but that was years ago. The events were still persisting that means still going on. The outcome of the events was not recovered.


VAERS ID: 1412598 (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: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Feeling abnormal, Headache, Myalgia, Periorbital swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Eosinophilic pneumonia (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Fibromyalgia; Rheumatoid arthritis
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021711353

Write-up: muscle pain; joint pain; puffy eyes; feels bad; bad headache; chills; This is a spontaneous report from a contactable consumer (patient) via medical information team. A 55-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection, Lot Number: Unknown), via an unspecified route of administration on an unspecified date in Jun2021 as 2nd dose, single dose for COVID-19 immunisation. Medical history included rheumatoid arthritis, fibromyalgia. The patient''s concomitant medications were not reported. The patient previously took methotrexate for rheumatoid arthritis and experienced shingles. Patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection, Lot Number: Unknown), via an unspecified route of administration on an unknown date as 1st dose, single dose for COVID-19 immunisation and experienced pain, was nauseated, and ended up vomiting. The patient reported that she has been a mess and had Rheumatoid Arthritis and Fibromyalgia. She ended up getting Shingles 3 months ago and stopped Methotrexate prior to getting vaccine. She has not started it back, so she was pretty inflamed with Rheumatoid. The patient stated prior to the first dose of the vaccine she had gotten shingles and stopped her methotrexate for rheumatoid arthritis and fibromyalgia. On an unspecified date in Jun2021, the patient had muscle pain, joint pain, and stuff and it took a day to hit her after second vaccination. The pxatient stated the symptoms were not that bad a day before (yesterday) and she was able to work. Sunday it was the same thing. Day before she still had muscle pain and joint pain, but it was not that bad, and she ended up working. "Last night" all of a sudden "bam" the pain intensified. "Today" (15Jun2021) patient woke up with puffy eyes, feels bad, and has a bad headache. Patient would like to know did Pfizer heard of it going in sections like that, where symptoms developed on the 5th or 6th day. In between she had chills. She would have a chill and then a couple of hours later another chill. The patient stated she was used to the muscle pain and joint pain due to her fibromyalgia and rheumatoid arthritis, but she was not expecting the symptoms to hit her like a ton of bricks. She just wanted to make sure it was normal for the side effects to appear after so long since she had received the vaccine. Patient informed she does not feel good at this time. The outcome of event feels bad was not resolved and rest all events was unknown. Information about batch/lot number has been requested


VAERS ID: 1412704 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-21
Onset:2021-06-01
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye irritation, Injection site rash, Injection site urticaria, Pruritus, Sleep disorder, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Corneal 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: History of heart surgeries, chronic vertigo, colon cancer survivor
Allergies:
Diagnostic Lab Data: No medical tests have been issued as of this time; the primary care provider prescribed prednisone on 6/10/2021
CDC Split Type:

Write-up: Hives/rash first appeared near injection sight on 6/1/2021, becoming more severe through 6/9/2021. Medical intervention was sought from primary healthcare provider on 6/9/2021, whereas the hives became severe and facial swelling on the right side of the face appeared and lasted from 6/10/2021 through 6/14/2021. It was during this time that eye irritation appeared. As of this reporting the hives are still persisting, coming in ''waves'' of almost unbearable itchiness, varying between a few minutes to 3 hours, with the duration varying between a few minutes to 3 hours as well. Disrupted sleep cycles have been a peripheral side affect, caused by the hives


VAERS ID: 1412735 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-28
Onset:2021-06-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Chest pain, Dyspnoea, Fatigue, Headache, Injection site bruising, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Lethargy, Pain, Tachycardia
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Body Aches Generalized-Severe, Systemic: Chest Tightness / Heaviness / Pain-Medium, Systemic: Exhaustion / Lethargy-Severe, Systemic: Headache-Medium, Systemic: Joint Pain-Severe, Systemic: Tachycardia-Severe


VAERS ID: 1412879 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-09
Onset:2021-06-01
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anti-thyroid antibody, Anti-thyroid antibody positive, Fatigue, Ultrasound thyroid
SMQs:, Hypothyroidism (broad), Hyperthyroidism (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: The influenza vaccines leave me exhausted for a month or so.
Other Medications: Low Dose Naltrexone, NP Thyroid, Liothronine, SAMe, quercetin/bromelain, NAC, L-glutamine, citrus bioflavonoids, coQ10, fish oil, dietary fiber supplement, vitamins B1, B2, B6, B12, K2, E, D, boron, calcium/magnesium, melatonin. I''ve been
Current Illness: None
Preexisting Conditions: Chronic fatigue syndrome, fibromyalgia, endometriosis, chronic pain syndrome, hypothyroidism (without Hashimoto''s)
Allergies: Penicillin, sulfa antibiotics, fluoroquinolone antibiotics (adverse reaction), anise seed
Diagnostic Lab Data: June 1,2021: Thyroglobulin Antibodies 145 IU/mL < or = 1 IU/mL H Thyroglobulin 0.5 ng/mL ng/mL L Reference Range: Intact Thyroid 2.8-40.9 Athyrotic <0.1 Thyroid Peroxidase TPO Ab 1 IU/mL <9 IU/mL
CDC Split Type:

Write-up: I had a lot of fatigue after my vaccine which is common for me after an influenza vaccine (which is why I no longer get them) and common for others with chronic fatigue syndrome for the fatigue to last longer than for other people. I have hypothyroidism and my antithyroglobulin and anti TPO antibodies have been tested two or three times over the past 3 years or so. They''ve always been either in range or very close to the bottom of the range. In February of 2019 TgAb was 6.4 IU/mL and TPO was 12 IU/mL . When I was recently (I used this for the vaccine reaction date) tested TgAb had jumped to 145 IU/mL and TPO was down to 1.0 IU/mL. I have no idea why one would jump and one would go down, but I mentioned it to a person following up with me from the CDC about my vaccine and they felt that I should report it to VAERS in case others had a similar experience or to help better understand how it might affect autoimmunity. I had a thyroid ultrasound yesterday to rule out any issues with a hot nodule although no nodules are palpable.


VAERS ID: 1412952 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-02-16
Onset:2021-06-01
   Days after vaccination:105
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac murmur, Chest X-ray, Chest discomfort, Chest pain, Cough, Dyspnoea, Electrocardiogram, Palpitations
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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: shellfish
Diagnostic Lab Data: Chest Xray, EKG
CDC Split Type:

Write-up: persistent cough, chest pain, shortness of breath, palpitation, heart murmur, chest heaviness


VAERS ID: 1413036 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-22
Onset:2021-06-01
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Cough, Dizziness, Dyspnoea, Electrocardiogram normal, Gastrooesophageal reflux disease, Laboratory test, Palpitations, Paraesthesia, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (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: Metformin, Zoloft, Trazodone, Wellbutrin, Allegra, Magnesium, Vit C, Vit D, Vit B complex
Current Illness: no
Preexisting Conditions: PCOS
Allergies: Gluten intolerance, seasonal allergies
Diagnostic Lab Data: 6/16/21 EKG (normal) at Urgent Care, then sent to ED... another EKG (Sinus Rhythm with probable left atrial enlargement), Labs (normal), Covid Test (negative)
CDC Split Type:

Write-up: Tightness in chest, chest pain, feels like being stepped on, squeezed, unable to get an entire breath, dizzy, coughing, shortness of breath, tingling sensations.... intermittent from 6/1/21 til today 6/19/21 (still having symptoms). I had "episodes" of these chest pain attacks, some palpitations. After the Urgent Care I was sent to the ED 6/16/21, where I was diagnosed with "GERD" given meds and sent home. DIDN''T help. The next day, chest pain worse, went to another urgent care on 6/17/21, treated with Symbicort, Singular, Tusslin Pearles... symptoms improved a lot, but still lingering chest pain. TO BE CONTINUED.


VAERS ID: 1413087 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-01
Onset:2021-06-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Fatigue, Immune system disorder, Menstruation delayed, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Fertility 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: Effexor xr
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 10 days late on period (regular entire life). Persistent cough, fatigued, muscle aches, immune system seems off


VAERS ID: 1413129 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-28
Onset:2021-06-01
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymph node pain
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Humalog insulin, multivitamin, vitamin D, 50+ supplement for eye health
Current Illness: None
Preexisting Conditions: Type I diabetes
Allergies: Sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Starting in early June I developed pain in the lymph nodes of my neck. It is now the 19th of June, and the pain has not abated. No other signs of illness are present.


VAERS ID: 1413163 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-10
Onset:2021-06-01
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills
SMQs:

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

Write-up: I have suddenly started experiencing chills. No fever but consistent chills. Not sure why. It could be unrelated to vaccine but I have no way to know.


VAERS ID: 1413346 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-26
Onset:2021-06-01
   Days after vaccination:67
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Photopsia, Vision blurred, Vitreous detachment, Vitreous floaters
SMQs:, Anticholinergic syndrome (broad), Accidents and injuries (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse - 50mg Lamictal - 150 mg, 2x per day
Current Illness: None
Preexisting Conditions: None
Allergies: Codeine
Diagnostic Lab Data: Optometrist and retinal specialist with exam and various tests - diagnosis of vitreous detachment
CDC Split Type:

Write-up: Eye floaters, blurry vision, black spots, flashing lights - left eye for nearly a month now


VAERS ID: 1413461 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-26
Onset:2021-06-01
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Herpes zoster, Skin discomfort
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: Dietary supplements: B-Complex, D3, Ester-C, Zinc picolinate, Vitamin K, Quercetin, NAC
Current Illness: none
Preexisting Conditions: none
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Shingles presented on the morning of June 1. Skin lesion eruptions occurred on my right underarm and in a circular ring around my right chest. I have never had shingles before in my entire life. It''s now June 20 and the lesions are starting to recede, however I am experiencing extreme "jabbing" and "searing" discomfort under the skin around my right rib cage and right underarm consistent with the locations of the shingles lesions.


VAERS ID: 1413481 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site mass, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: The patient received the vaccine on 06/1/21 and claimed that a bump formed later which remained for 4 days at which point he claims that it had moved from his injection site to the left side of his neck under the surface of the skin where it still remains. He said that it wasn''t painful at all, there was no visible redness or swelling upon visual inspection but he claimed that he could feel it. He was instructed to go get the lump checked at the local hospital on 6/20/21, the day the event was reported to the pharmacy. The patient has no primary provider that he sees.


VAERS ID: 1413527 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chlamydia test, Culture wound, Decreased appetite, Dizziness, Fatigue, Gait disturbance, HIV test, Hepatitis B surface antigen, Hepatitis B virus test, Herpes virus test, Polymerase chain reaction, Smear cervix, Treponema test, Vomiting, Vulval disorder, Vulvovaginal pain
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: June 4 & 10 - hepb survace syphilis, hiv-1/2 , hsv type 1, 2, hsv pcr, wound culture, bhep b, surface, core surface antigen, hpe chlamydia Trachomatis Genital culter, smearP N Chla
CDC Split Type:

Write-up: Threw up shortly after second dose Extremely tired Unable to eat for days Lightheaded Lesions on vulva Pain, unable to walk Pain, unable to use bathroom Unable to leave bed


VAERS ID: 1413565 (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: 2021-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest pain, Dyspnoea, Electrocardiogram, Feeding disorder, Insomnia, Myocarditis, Troponin I increased, X-ray
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-vitamins, fiber gummies, miralax
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: June 18, Triponon I level were extremely high. Rushed her to ER. Diagnosis was myocarditis likely cause by the vaccine shot. She was sent home and ordered to do more bloodwork on June 21 and follow up with a cardiologist in 1 week.
CDC Split Type:

Write-up: Shortness of breath on the day of the shot. Then symptoms went away. About a week after she had chest pains for 1 day. On Sunday, June 13, she had chest pains and she couldn''t eat or sleep. Symptoms continued for 2 days. Took her to the doctor who ordered blood tests, EKG and x-rays.


VAERS ID: 1413726 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain upper, Arthralgia, Diarrhoea, Fatigue, Headache, Hyperhidrosis, Impaired work ability, Lethargy, Lymphadenopathy, Nausea, Neuropathy peripheral, Pain, Pain in extremity, Vision blurred, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SYNTHROID; HYDROCHLOROTHIAZIDE; CLARITIN-D
Current Illness: Abstains from alcohol; Anemia; Autoimmune disorder; Blood pressure abnormal; Celiac disease; Gluten free diet; Hashimoto''s disease; Leukocytosis; Loss of smell (since past 6 months); Loss of taste (since past 6 months); Non-smoker; Thyroid disorder
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Contracted Covid-19 in December 2020)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210629819

Write-up: CALL OFF WORK; JOINT PAIN; NAUSEA; HEADACHE; FATIGUE/ TIREDNESS; ARM ACHE; NEUROPATHY; DIARRHEA; BODYACHE AND LITTLE SHARP PAINS EVERYWHERE; SWOLLEN LYMPH NODES; BLURRY VISION; LETHARGIC; STOMACH CRAMPS; SWEATS; VOMITING; STOMACH DISCOMFORT; This spontaneous report received from a patient concerned a 48 year old female of unspecified ethnic origin. The patient''s weight was 195 pounds and height was 70 inches. The patient''s past medical history included Covid-19 (DEC-2020) and concurrent conditions included Hashimoto''s disease, thyroid disease, blood pressure, leukocytosis, celiac disease, anemia, and auto immune disease. She had loss of smell, loss of taste since last 6 months. Patient was non alcohol user and non smoker. She was on a gluten free diet. The patient experienced drug allergy when treated with Dilaudid and Neomycin. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204A21A and expiry: 23-JUN-2021) dose was not reported, 1 total dose administered on 10-JUN-2021 at 15:15 to right arm for prophylactic vaccination. Concomitant medications included Synthroid (levothyroxine sodium), hydrochlorothiazide and Claritin D (Loratadine/pseudoephedrine sulfate). On 12-JUN-2021, the patient experienced neuropathy, diarrhea, body ache, little sharp pains everywhere, swollen lymph nodes, blurry vision, lethargy/ tiredness, stomach cramps, sweats, vomiting, arm ache, nausea and headache. On 13-JUN-2021, the patient experienced joint pain. On JUN-2021, the patient experienced stomach discomfort and fatigue. On 14-JUN-2021 patient reported that she had to call off work and she did not have fever. She had not seen her doctor yet but would call the doctor. Treatment medications (dates unspecified) included: Aspirin (acetylsalicylic acid), Tylenol (paracetamol) and Ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from neuropathy on JUN-2021, was recovering from nausea, and vomiting, had not recovered from diarrhea, bodyache and little sharp pains everywhere, arm ache, headache, swollen lymph nodes, blurry vision, lethargic, stomach cramps, sweats, joint pain, stomach discomfort, and fatigue/ tiredness, and the outcome of call off work was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210629819- JANSSEN COVID-19 VACCINE Ad26.COV2.S- Neuropathy. This event is considered unassessable. The event 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.


VAERS ID: 1413738 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Colorado  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210633324

Write-up: GIVEN VACCINES OUTSIDE OF TEMPERATURE EXCURSION; INCORRECT PRODUCT STORAGE; This spontaneous report received from a pharmacist 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 (suspension for injection, route of admin not reported, batch number: 203A21A, and expiry: UNKNOWN) dose was not reported, administered on 01-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-JUN-2021, the subject experienced given vaccines outside of temperature excursion. On 01-JUN-2021, the subject experienced incorrect product storage. The action taken with covid-19 vaccine was not applicable. The outcome of the given vaccines outside of temperature excursion and incorrect product storage was not reported. This report was non-serious. This case, from the same reporter is linked to 20210633241.


VAERS ID: 1413938 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-05-24
Onset:2021-06-01
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Deep vein thrombosis, Pain in extremity, Peripheral swelling, 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 (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: MELOXICAM, METFORMIN, SEMGLEE, TAMSULOSIN
Current Illness: NONE
Preexisting Conditions: DIABETES
Allergies: NONE
Diagnostic Lab Data: DIAGNOSED WITH DVT AFTER ULTRASOUND.
CDC Split Type:

Write-up: 06/01/2021 PATIENT EXPERIENCED LEG PAIN AND SWELLING, ON 06/05/2021 PATEINT WENT TO THE ER WITH SEVERE LEG PAIN AND WAS ADMITTED TO THE HOSPITAL WITH A DVT. ON 06/07/2021 PATIENT WAS RELEASED FROM THE HOSPITAL AFTER A VASCULAR DOCTOR REMOVED A SUBSTANTIAL CLOT. PATIENT IS CURRENTLY TAKING XARELTO.


VAERS ID: 1414380 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Loss of consciousness, Syncope, 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), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? 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: Nausea; Vomiting; Lightheadedness; Collapsing or losing consciousness. Positive LOC. vomiting x1. EMS was called at 1207 and refused further care. patient waited until a ride came and picked him up.


VAERS ID: 1414404 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Hypertension, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypertension (narrow)

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

Write-up: Left arm numbness hypertension, rescue called patient refused transport.


VAERS ID: 1414462 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Hyperhidrosis, Pain, Pain in extremity, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: The patient was in extreme pain in her legs. this spread to her whole body. She had chills, shaking, sweating and stomach cramps. This event lasted almost 6 hours. We called the pediatricians on-call nurse and were told to start ibuprofen. The symptoms began residing about 5 hours after on-set and then by hour 6 the majority of the symptoms were gone. Patient still had body aches and chills for 12 hours more.


VAERS ID: 1414546 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-27
Onset:2021-06-01
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / UNK LA / -

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

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

Write-up: After couple day of vaccine, my body itching so much, special my arm, feet and 2 ear.


VAERS ID: 1414647 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-30
Onset:2021-06-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Glossodynia, Mononucleosis heterophile test negative, Pharyngeal swelling, SARS-CoV-2 test negative, Streptococcus test negative, Swollen tongue, Thyroid function test normal, Tongue geographic, Ultrasound scan normal
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: birth control
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: sulfa, penicillin
Diagnostic Lab Data: Covid test negative, strep and mono test were negative. Thyroid blood work and ultrasounds were normal.
CDC Split Type:

Write-up: Starting having tongue pain and swelling 2 days after second vaccine shot, felt like my throat was swelling up as well. Have been diagnosed with geographic tongue, which there is no cure for. Its been 3 weeks and my symptoms have not improved.


VAERS ID: 1414697 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-01
Onset:2021-06-01
   Days after vaccination:61
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, C-reactive protein increased, Chest pain, Diarrhoea
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow)

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

Write-up: Chest pain; acute respiratory failure, diarrhea; elevated CRP


VAERS ID: 1414702 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-01
Onset:2021-06-01
   Days after vaccination:61
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Chest pain, Cough
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow)

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

Write-up: Acute respiratory failure, chest pain coughing


VAERS ID: 1414979 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1415025 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-11
Onset:2021-06-01
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EW0168 / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Discomfort
SMQs:, Guillain-Barre syndrome (broad)

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

Write-up: No energy for 8-9 days, right side of brain has pressure for 10 seconds at a time, 4-5 times a day.


VAERS ID: 1415126 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1415136 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1415158 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1415222 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amyloidosis, Condition aggravated, Cough, Dysphonia, Herpes zoster, Hypertension, Pyrexia, Respiratory tract congestion, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Hypertension (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: losartan, synthroid, amlodipine, turmeric,
Current Illness: Patient has MENS2 and an amyloid disorder.
Preexisting Conditions: Hypertension, MENS2
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: After the 1st dose on 5/11/21, patient experienced a fever (99.6 to 102), rash at the injection site which then started itching, sinus pressure, chest/lungs were hurting. After 2nd dose on 6/1/21, patient experienced a low grade fever (not as bad as the first dose), sneezing, coughing, congestion like she had COVID virus (she had covid twice previously), and raspy voice and throat. Shingles like symptoms started two weeks after her vaccine. Patient started having higher blood pressure readings (i.e. 161/102). The vaccine side effects are still going on for the patient after 15 days. Patient stated her cardiologist increased her blood pressure medications. Patient stated that she also felt like her amyloid level was increasing and she did get that confirmed with her optometrist.


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